Understanding of the objectively measured physical activity (PA) and sedentary patterns of adults with diabetes at the population level is currently limited. Therefore, the purpose of this study was to report accelerometer-determined PA and sedentary patterns among a national sample of U.S. adults with and without evidence of diabetes and to also explore differences across other comorbidity characteristics. Data from the 2003–2006 National Health and Nutrition Examination Survey were used. Four hundred seven participants had evidence of diabetes (mean age = 73.4 years), and 1,346 did not have diabetes (mean age = 74.3 years). Results showed that few older adults meet PA guidelines; the majority of their time is spent in sedentary activities; very few engage in more light-intensity PA than sedentary behavior; and older adults with multiple comorbidities engage in less PA and more sedentary behavior than their counterparts. The development and implementation of feasible, effective PA programs for older adults with multiple comorbidities are warranted.
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Accelerometer-Determined Sedentary and Physical Activity Estimates Among Older Adults With Diabetes: Considerations by Demographic and Comorbidity Characteristics
Paul D. Loprinzi
Physical Activity With Alanine Aminotransferase and Gamma-Glutamyltransferase: Implications of Liver Pathology on the Relationship Between Physical Activity and Mortality
Paul D. Loprinzi
Objective:
Examine the association between objectively-measured moderate-to-vigorous physical activity (MVPA) and engagement in self-reported muscle strengthening activities (MSA) with alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT), and in turn, how each of these parameters associate with of all-cause mortality.
Methods:
Data from the 2003–2006 NHANES were employed, with follow-up through December 31, 2011 (N = 5030; 20+ yrs). Physical activity was assessed via accelerometry; MSA was assessed via survey; and ALT and GGT were assessed via a blood sample. Linear regression and Cox proportional hazard models were used.
Results:
MVPA (βadjusted = 0.15; 95% CI: –0.45 to 0.76; P = .60) was not associated with ALT, but MSA was (β adjusted = –0.31; 95% CI: –0.56 to –0.05; P = .02). With regard to GGT, MSA was not significant (β adjusted = –0.12; 95% CI: –0.71 to 0.47; P = .67), nor was MVPA (β adjusted = –1.10; 95% CI: –2.20 to 0.06; P = .06). Higher ALT levels were associated with increased allcause mortality risk (HRadjusted = 1.05; 95% CI: 1.02 to 1.06; P < .001).
Conclusion:
Physical activity is favorably associated with markers of hepatic inflammation, and higher levels of markers of hepatic inflammation are associated with increased mortality risk. These findings suggest that physical activity may help protect against premature mortality through its influence on liver pathology.
Association of Family Functioning on Youth Physical Activity and Sedentary Behavior
Paul D. Loprinzi
Objective:
High family functioning is associated with reduced depression symptoms, better academic achievement, less disordered eating, and better metabolic control among youth. However, we know very little about the role of family functioning on physical activity and sedentary behavior among youth, which was the purpose of this study.
Methods:
Data from the 2003 and 2011–2012 cycles of the National Survey of Children’s Health were used. A total of 61,226 parents/guardians from the 2003 cycle and 40,446 parents/guardians from the 2011–2012 cycle (total n = 101,672) across all 50 states and the District of Columbia were examined. Parents answered questions related to family functioning and their child’s (age 6–17 yrs) physical activity and sedentary behavior.
Results:
Results were the same across both cycles; after adjustments, youth engaged in less physical activity if the family had worse family functioning (β = −0.06, P < .001). Similarly, youth engaged in more sedentary behavior if the family had worse family functioning (β = 0.05, P < .001).
Conclusion:
This research suggests that youth are more active and engage in less sedentary behavior if their family has greater family functioning.
Need for Increased Promotion of Physical Activity Among Adults at Risk for Alzheimer’s Disease: A Brief Report
Paul D. Loprinzi
Background:
We have a limited understanding of the physical activity (PA) and sedentary levels among individuals at risk and not at risk for developing Alzheimer’s disease (AD), which was the purpose of this study.
Methods:
Data from the 2003–2004 NHANES were used, from which 3015 participants were evaluated with 416 indicating a family history of AD. Physical activity and sedentary behavior were assessed via accelerometry with individuals at risk for AD self-reporting a family history of AD.
Results:
For the entire sample, those at risk for AD engaged in more sedentary behavior than those not at risk (494.9 vs. 477.9 min/day, P = .03, respectively). Similarly, those at risk for AD engaged in less total MVPA than those not at risk (22.4 vs. 24.3 min/day, P = .05, respectively). Results were also significant for various subgroups at risk for AD.
Conclusion:
Despite the beneficial effects of PA in preventing AD and prolonging the survival of AD, adults at risk for AD tend to engage in more sedentary behavior and less PA than those not at risk for AD. This finding even persisted among minorities (Hispanics and non-Hispanic blacks) who are already at an increased risk of developing AD.
Comparison Between Wrist-Worn and Waist-Worn Accelerometry
Paul D. Loprinzi and Brandee Smith
Objective:
To use the most recent ActiGraph model (GT9X) to compare counts per minute (CPM) estimates between wrist-worn and waist-worn attachment sites.
Methods:
Participants completed 2 conditions (laboratory [N = 13] and free-living conditions [N = 9]), in which during both of these conditions they wore 2 ActiGraph GT9X accelerometers on their nondominant wrist (side-by-side) and 2 ActiGraph GT9X accelerometers on their right hip in line with the midaxillary line (side-by-side). During the laboratory visit, participants completed 5 treadmill-based trials all lasting 5 min: walk at 3 mph, 3.5 mph, 4 mph, and a jog at 6 mph and 6.5 mph. During the free-living setting, participants wore the monitors for 8 hours. Paired t test, Pearson correlation and Bland-Altman analyses were employed to evaluate agreement of CPM between the attachment sites.
Results:
Across all intensity levels and setting (laboratory and free-living), CPM were statistically significantly and substantively different between waist- and wrist-mounted accelerometry.
Conclusion:
Attachment site drastically influences CPM. As such, extreme caution should be exercised when comparing CPM estimates among studies employing different attachment site methodologies, particularly waist versus wrist.
The Association Between Sedentary Behavior and Cognitive Function Among Older Adults May Be Attenuated With Adequate Physical Activity
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.
Adequate Muscular Strength May Help to Reduce Risk of Residual-Specific Mortality: Findings From the National Health and Nutrition Examination Survey
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.
Physical Activity–Related Obesity Risk Classification Model and All-Cause Mortality
Paul D. Loprinzi and Ovuokerie Addoh
Background:
This study evaluated a physical activity–related obesity model on mortality.
Methods:
Data from the 1999–2006 NHANES were used (N = 16,077), with follow-up through 2011. Physical activity (PA) was subjectively assessed, with body mass index (BMI) and waist circumference (WC) objectively measured. From these, 12 mutually exclusive groups (G) were evaluated, including: G1: Normal BMI, Normal WC and Active; G2: Normal BMI, Normal WC and Inactive; G3: Normal BMI, High WC and Active; G4: Normal BMI, High WC and Inactive; G5: Overweight BMI, Normal WC and Active; G6: Overweight BMI, Normal WC and Inactive; G7: Overweight BMI, High WC and Active; G8: Overweight BMI, High WC and Inactive; G9: Obese BMI, Normal WC and Active; G10: Obese BMI, Normal WC and Inactive; G11: Obese BMI, High WC and Active; and G12: Obese BMI, High WC and Inactive.
Results:
Compared with G2, the following had a reduced mortality risk: G1, G3, G5, G6, G7, G8, G9, and G11. Compared with G12, the following had a reduced mortality risk: G1, G3, G5, G7, G9, and G11. In each respective group for BMI and WC, the active group had a reduced mortality risk.
Conclusions:
Across all BMI and WC combinations, PA improved mortality risk identification.
Examination of Accelerometer Reactivity Among a Population Sample of Children, Adolescents, and Adults
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.
Lower Extremity Muscular Strength and Leukocyte Telomere Length: Implications of Muscular Strength in Attenuating Age-Related Chronic Disease
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.
