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Sedentary Behavior in People Living With HIV: A Systematic Review and Meta-Analysis

Davy Vancampfort, James Mugisha, Marc De Hert, Michel Probst, and Brendon Stubbs

Background:

Sedentary behavior is independently associated with an increased risk of poor mental health, developing cardiovascular disease (CVD) and premature mortality. Despite the knowledge that CVD is one of the leading causes of non-AIDS related premature mortality in people living with HIV (PLWH), relatively little attention has been attributed to sedentary behavior in this population. The aims of this meta-analysis were to (a) establish the pooled mean time spent sedentary, (b) investigate predictors of sedentary levels, and (c) explore differences with age- and gender-matched healthy controls.

Methods:

Two independent authors searched major databases until August 2016. A random effects meta-analysis was performed.

Results:

Across 6 unique cross-sectional studies, including 9 sedentary levels, there were 523 (292 men) PLWH (age range = 37 to 58 years). PLWH spent 533 min/day (95% CI = 466 to 599) engaging in sedentary behavior. There was a trend (P = .07) for higher levels of sedentary behavior in self-report measures (551 min, 95% CI = 543 to 560, N = 4) than in objective sedentary behavior time (505 min, 95% CI = 498 to 512, N = 3). The time PLWH spend engaging in sedentary behavior is among the highest levels reported in the literature.

Conclusions:

Given that sedentary behavior is an independent predictor of CVD, future lifestyle interventions specifically targeting the prevention of sedentary behavior in PLWH are warranted.

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Correlates of Physical Activity Among Middle-Aged and Older Adults With Hazardous Drinking Habits in Six Low- and Middle-Income Countries

Davy Vancampfort, Brendon Stubbs, Mats Hallgren, Andreas Lundin, James Mugisha, and Ai Koyanagi

We investigated physical activity (PA) correlates among middle-aged and older adults (aged ≥50 years) with hazardous drinking patterns in six low- and middle-income countries. Cross-sectional data were analyzed from the World Health Organization’s Study on Global Ageing and Adult Health. Hazardous drinking was defined as consuming >7 (females) or >14 (males) standard drinks per week. Participants were dichotomized into low (i.e., not meeting 150 min of moderate PA/week) and moderate–high physically active groups. Associations between PA and a range of correlates were examined using multivariable logistic regressions. The prevalence of low PA in 1,835 hazardous drinkers (60.5 ± 13.1 years; 87.9% males) was 16.2% (95% confidence interval [13.9%, 18.9%]). Older age, living in an urban setting, being unemployed, depression, underweight, obesity, asthma, visual impairment, poor self-rated health, and higher levels of disability were identified as significant PA correlates. The current data provide important guidance for future interventions to assist older hazardous drinkers to engage in regular PA.

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Physical Activity and Mental Health: A Little Less Conversation, a Lot More Action

Brendon Stubbs, Ruimin Ma, Felipe Schuch, James Mugisha, Simon Rosenbaum, Joseph Firth, and Davy Vancampfort

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Physical Activity in People With Posttraumatic Stress Disorder: A Systematic Review of Correlates

Davy Vancampfort, Justin Richards, Brendon Stubbs, Grace Akello, Caleb Ademola Gbiri, Philip B. Ward, and Simon Rosenbaum

Background:

People with posttraumatic stress disorder (PTSD) are more likely than the general population to be physically inactive. The present review systematically evaluated correlates of physical activity across the socioecological model for people with PTSD.

Methods:

Two independent reviewers searched Embase, PubMed, PsycARTICLES, and CINAHL from inception until June 2015, combining the medical subject heading “posttraumatic stress disorder” or “PTSD,” with “physical activity” or “exercise.” Data were extracted by the same independent researchers and summarized according to the socioecological model.

Results:

Eight papers involving 1368 (994 men) participants (age range = 18–70 years) were eligible and enabled evaluation of 21 correlates. The only correlate (n ≥ 4) consistently associated with lower physical activity participation in people with PTSD was symptoms of hyperarousal. No consistent facilitators were identified.

Conclusions:

Hyperarousal symptoms are associated with lower physical activity participation among people with PTSD and should be considered in the design and delivery of individualized exercise programs targeting this population. The role of social, environmental, and policy factors on physical activity participation among people with PTSD is unknown and should be addressed by future research.

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Reliability and Convergent Validity of Self-Reported Physical Activity Questionnaires for People With Mental Disorders: A Systematic Review and Meta-Analysis

Vagner Deuel de Oliveira Tavares, Nicole Leite Galvão-Coelho, Joseph Firth, Simon Rosenbaum, Brendon Stubbs, Lee Smith, Davy Vancampfort, and Felipe Barreto Schuch

Purpose: To examine the reliability and convergent validity of self-reported questionnaires (SRQs) to measure physical activity (PA). Methods: Systematic review with meta-analysis. The validity and reliability of SRQs to assess PA in people with mental disorders (January 20, 2020). Random-effects meta-analyses were performed pooling (1) test–retest correlations or (2) the convergent validity between the SRQs and objective measures (eg, accelerometry). Associations were provided in r values with the 95% confidence interval. Methodological quality was assessed. Results: A total of 9 unique studies (N = 1344; 40.5% females) were included. The authors found a moderate correlation test–retest reliability for PA SRQs in the assessment of vigorous PA (r = .69 [.38 to .85]; P = .001), moderate to vigorous PA (r = .63 [.25 to .84]; P = .003), moderate PA (r = .63 [.39 to .79]; P = .001), and good correlation total PA (r = .75 [.37 to .92]; P = .001). The SRQs have moderate correlations with objective measures for moderate to vigorous PA (r = .25 [.18 to .32]; P = .0001) and total PA (r = .47 [.28 to .62]; P = .005), a poor correlation for moderate PA (r = .18 [.03 to .36]; P = .047), and no correlation with vigorous PA (r = .06 [−.10 to .22]; P = .440). Conclusion: Current evidence indicates that SRQs are reliable over time to assess moderate, vigorous, and total PA levels and valid when assessing moderate PA.

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Associations of the Built Environment With Physical Activity and Sedentary Time in Ugandan Outpatients With Mental Health Problems

Davy Vancampfort, Brendon Stubbs, James F. Sallis, Justine Nabanoba, David Basangwa, Adewale L. Oyeyemi, Sandra S. Kasoma, Marc De Hert, Inez Myin-Germeys, and James Mugisha

Background: This study investigated whether reported neighborhood variables explained variance in time spent walking, exercising, and being sedentary, in addition to mental health and demographic variables among Ugandan outpatients with mental illness. Methods: Ninety-nine outpatients (78 men; 31.1 [8.6] y) of the Butabika National Referral Hospital in Uganda completed the Neighborhood Environment Walkability Scale for Africa, the Simple Physical Activity Questionnaire, and the Brief Symptoms Inventory-18. Multiple regression analyses were performed. Results: Seven percent of the variance in walking time was explained by the variance in anxiety/depression and an additional 13% by the variance in perceived mixed land use and the availability of roads and walking paths. Eight percent of the variance in exercise time was explained by variance in age and an additional 6% by the variance anxiety/depression. The availability of recreational space added 8%. Six percent of variance in time spent sedentary was explained by family income, while availability of roads and walking paths added another 6%. Conclusions: This study shows the relevance of availability of roads and walking paths and recreational space for more physical activity and less sedentary behavior in people with mental illness. This is particularly relevant in low-income countries where a rapid urbanization is taking place.

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Is Active Transport and Leisure-Time Physical Activity Associated With Inflammatory Markers in US Adults? A Cross-Sectional Analyses From NHANES

Lee Smith, Brendon Stubbs, L. Hu, Nicola Veronese, Davy Vancampfort, Genevieve Williams, Domenico Vicinanza, Sarah E. Jackson, Li Ying, Guillermo F. López-Sánchez, and Lin Yang

Background: To investigate the association between levels of active transport and leisure-time physical activity (LTPA) with C-reactive protein, white blood cell count, body mass index, waist circumference, and lipids in a large representative sample of adults residing in the United States. Methods: Cross-sectional data from the National Health and Nutrition Examination Survey. Adjusted multinomial logistic regressions were carried out to quantify associations between levels of self-reported active transport (or LTPA) and quintiles of anthropometric measures and serum markers. Results: A total of 3248 adults were included. For serum inflammatory biomarkers, the authors observed a lower likelihood of being in the top quintile groups of circulating C-reactive protein (adjusted odds ratio [aOR]: 0.60; 95% confidence interval [CI], 0.40–0.90) and white blood cell count (aOR: 0.65; 95% CI, 0.44–0.95) with engaging in low to medium levels of active transport but not with high levels of active transport. Higher levels of LTPA were associated with lower likelihood of having high levels of serum inflammatory biomarkers (aOR: 0.60; 95% CI, 0.42–0.86 in the top C-reactive protein group and aOR: 0.58; 95% CI, 0.39–0.87 in top white blood cell group). Conclusions: Promoting active transport and/or LTPA may be a beneficial strategy to improving some, but not all, cardiometabolic health outcomes.