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Paul D. Loprinzi

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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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.

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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.

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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.

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Paul D. Loprinzi and Elizabeth Crush

Objective:

No study has comprehensively examined the independent and combined effects of sensory impairment, physical activity and balance on mortality risk, which was this study’s purpose.

Methods:

Data from the population-based 2003–2004 National Health and Nutrition Examination Survey (NHANES) was used, with follow-up through 2011. Physical activity was assessed via accelerometry. Balance was assessed via the Romberg test. Peripheral neuropathy was assessed objectively using a standard monofilament. Visual impairment was objectively assessed using an autorefractor. Hearing impairment was assessed via self-report. A 5-level index variable (higher score is worse) was calculated based on the participant’s degree of sensory impairment, dysfunctional balance and physical inactivity.

Results:

Among the 1658 participants (age 40–85 yrs), 228 died during the median follow-up period of 92 months. Hearing (Hazard Ratio [HR] = 1.18; P = .40), vision (HR = 1.17; P = .58) and peripheral neuropathy (HR = 1.06; P = .71) were not independently associated with all-cause mortality, but physical activity (HR = 0.97; P = .01) and functional balance (HR = 0.59; P = .03) were. Compared with those with an index score of 0, the HR (95% CI) for those with an index score of 1 to 3, respectively, were 1.20 (0.46–3.13), 2.63 (1.08–6.40) and 2.88 (1.36–6.06).

Conclusions:

Physical activity and functional balance are independent contributors to survival.

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Paul D. Loprinzi and Chelsea Joyner

Objective:

To examine the association of source of emotional- and financial-related social support and size of social support network on physical activity behavior among older adults.

Methods:

Data from the 1999–2006 NHANES were used (N = 5616; 60 to 85 yrs). Physical activity and emotional- and financial-related social support were assessed via self-report.

Results:

Older adults with perceived having emotional social support had a 41% increased odds of meeting physical activity guidelines (OR = 1.41; 95% CI: 1.01–1.97). The only specific sources of social support that were associated with meeting physical activity guidelines was friend emotional support (OR = 1.19; 95% CI: 1.01–1.41) and financial support (OR = 1.28; 95% CI: 1.09–1.49). With regard to size of social support network, a dose-response relationship was observed. Compared with those with 0 close friends, those with 1 to 2, 3 to 4, 5, and 6+ close friends, respectively, had a 1.70-, 2.38-, 2.57-, and 2.71-fold increased odds of meeting physical activity guidelines. There was some evidence of gender- and age-specific associations between social support and physical activity.

Conclusions:

Emotional- and financial-related social support and size of social support network are associated with higher odds of meeting physical activity guidelines among older adults.

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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.

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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.

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Paul D. Loprinzi and Manish Kohli

Objective:

Independent of previously recognized clinical factors influencing prostate-specific antigen (PSA) levels (eg, age and race-ethnicity), sedentary behavior has recently been reported to be associated with higher PSA measurements. The extent of interaction of putative clinical factors with sedentary behavior and their impact on PSA levels is unknown. We examined the interaction of previously known PSA influencing demographic patient characteristics with patient sedentary behavior on PSA levels.

Methods:

Data from the 2003–2006 National Health and Nutrition Examination Survey were used. Sedentary behavior was objectively measured using an accelerometer in 1690 participants who were included in the analytic sample. Multivariate linear regression analysis across potential clinical and biological modifiers of PSA levels were used to examine the association between sedentary behavior and PSA levels.

Results:

After controlling for covariates, a positive association between sedentary behavior and PSA was detected among distinctive patient groups, including non-Hispanic whites, overweight/obese subjects, hypertensive participants, and participants with evidence of diabetes and those reported to have benign prostate hypertrophy.

Conclusion:

These results suggest that patients with distinct clinical characteristics engaging in sedentary lifestyles are likely to have higher PSA levels.

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Paul D. Loprinzi and Jerome F. Walker

Objective:

To our knowledge, no longitudinal epidemiological study among daily smokers has examined the effects of physical activity change/trajectory on smoking cessation. The purpose of this study was to examine the longitudinal effects of changes in physical activity on smoking cessation among a national sample of young (16–24 y) daily smokers.

Methods:

Data from the 2003–2005 National Youth Smoking Cessation Survey were used (N = 1178). Using hierarchical agglomerative cluster analysis, 5 distinct self-reported physical activity trajectories over 3 time periods (baseline, 12-month, and 24-month follow-up) were observed, including stable low physical activity, decreasing physical activity, curvilinear physical activity, stable high physical activity, and increasing physical activity. Nicotine dependence (Heaviness of Smoking Index) and demographic parameters were assessed via survey.

Results:

With stable low physical activity (16.2% quit smoking) serving as the referent group, those in the stable high physical activity (24.8% quit smoking) group had 1.8 greater odds of not smoking at the 24-month follow-up period (odds ratio = 1.81; 95% confidence interval, 1.12–2.91) after adjusting for nicotine dependence, age, gender, race-ethnicity, and education.

Conclusions:

Maintenance of regular physical activity among young daily smokers may help to facilitate smoking cessation.