This study investigated the acute effect of exercise on sleep outcomes among healthy older women by comparing days with structured exercise versus days without structured exercise during 4 months of exercise training. Participants (n = 51) in this study had wrist-worn actigraphic sleep data available following at least 3 days with structured exercise and 3 days without structured exercise at mid-intervention and at the end of intervention. The exercise intervention was treadmill walking. Multilevel models were used to examine whether structured exercise impacted sleep outcomes during the corresponding night. Overall, 1,362 nights of data were included in the analyses. In unadjusted and adjusted models, bedtimes were significantly earlier on evenings following an acute bout of structured exercise than on evenings without structured exercise. No other sleep parameters differed between exercise and nonexercise days. Understanding the effects of exercise on sleep in this understudied population may help to improve their overall sleep quality.
Charity B. Breneman, Christopher E. Kline, Delia West, Xuemei Sui, and Xuewen Wang
Andréa L. Maslow, Anna E. Price, Xuemei Sui, Duck-chul Lee, Ikka Vuori, and Steven N. Blair
This study examined the associations of body mass index (BMI), waist circumference (WC), and cardiorespiratory fitness (CRF) with incident functional limitation (IFL) in adults.
Patients (n = 2400), 30+ years [mean age, 45.2 (SD, 8.3); 12% women], completed a baseline health examination during 1979 to 1995. CRF was quantified by age-and sex-specific thirds for maximal treadmill exercise test duration. Adiposity was assessed by BMI and WC (grouped for analysis according to clinical guidelines). Incident IFL was identified from mail-back surveys during 1995, 1999, and 2004.
After adjusting for potential confounders and either BMI or WC, CRF was inversely related to IFL (P trend < .001). The association between BMI and IFL was significant after adjusting for all confounders (P trend = .002), but not after additional adjustment for CRF (P trend = .23). After controlling for all confounders and CRF, high WC was associated with greater odds of IFL in those aged 30 to 49; normal WC was associated with greater odds of IFL in those aged 50+.
CRF was a significant predictor of IFL in middle aged and older adults, independent of overall or abdominal adiposity. Clinicians should consider the importance of preserving functional capacity by recommending regular physical activity for normal-weight and overweight individuals.
Anna E. Greer, Xuemei Sui, Andréa L. Maslow, Beau Kjerulf Greer, and Steven N. Blair
To date, no longitudinal studies have examined the influence of sedentary behavior on metabolic syndrome development while accounting for cardiorespiratory fitness.
Purpose and Methods:
This prospective study examined the relationship between sedentary behavior and incident metabolic syndrome while considering the effects of physical activity and cardiorespiratory fitness on the association among 930 men enrolled in the Aerobics Center Longitudinal Study.
A total of 124 men developed metabolic syndrome during 8974 person-years of exposure. After adjusting for covariates, men with middle and high sedentary behavior had 65% and 76% higher risks of developing metabolic syndrome, respectively, than men with low sedentary behavior (linear trend P = .011). This association remained significant after additional adjustment for activity status and cardiorespiratory fitness. Cardiorespiratory fitness and physical activity were also inversely associated with metabolic syndrome, even after adjustment for sedentary behavior.
The findings highlight the importance of reducing sedentary behavior, increasing physical activity, and improving cardiorespiratory fitness for preventing metabolic syndrome.
Bruna Camilo Turi, Jamile S. Codogno, Romulo A. Fernandes, Xuemei Sui, Carl J. Lavie, Steven N. Blair, and Henrique Luiz Monteiro
Hypertension is one of the most common noncommunicable diseases worldwide, and physical inactivity is a risk factor predisposing to its occurrence and complications. However, it is still unclear the association between physical inactivity domains and hypertension, especially in public healthcare systems. Thus, this study aimed to investigate the association between physical inactivity aggregation in different domains and prevalence of hypertension among users of Brazilian public health system.
963 participants composed the sample. Subjects were divided into quartiles groups according to 3 different domains of physical activity (occupational; physical exercises; and leisure-time and transportation). Hypertension was based on physician diagnosis.
Physical inactivity in occupational domain was significantly associated with higher prevalence of hypertension (OR = 1.52 [1.05 to 2.21]). The same pattern occurred for physical inactivity in leisure-time (OR = 1.63 [1.11 to 2.39]) and aggregation of physical inactivity in 3 domains (OR = 2.46 [1.14 to 5.32]). However, the multivariate-adjusted model showed significant association between hypertension and physical inactivity in 3 domains (OR = 2.57 [1.14 to 5.79]).
The results suggest an unequal prevalence of hypertension according to physical inactivity across different domains and increasing the promotion of physical activity in the healthcare system is needed.
Tiago R. de Lima, David A. González-Chica, Eleonora D’Orsi, Xuemei Sui, and Diego A.S. Silva
Background: The authors aimed to identify the effect of adherence to healthy lifestyle habits on muscle strength (MS) according to a distinct health status. Methods: Longitudinal analysis using data from 2 population-based cohorts in Brazil (EpiFloripa adult, n = 862, 38.8 [11.4] y—6 y of follow-up length; EpiFloripa Aging, n = 1197, 69.7 [7.1] y—5 y of follow-up length). MS was assessed by handgrip strength (kgf). Information assessed by questionnaire regarding adequate physical activity levels, regular consumption of fruit and vegetables, low alcohol consumption, and nonsmoking habits were analyzed in the relationship with MS according to the health status. The participants were grouped into 3 health status categories: (1) with cardiovascular disease (CVD); (2) at risk of CVD (abdominal obesity or overweight/obesity, high blood pressure, hyperglycemia, and dyslipidemia); and (3) healthy individuals (without CVD and risk of CVD). Results: Simultaneous adherence of 4 healthy lifestyle habits was directly associated with MS among healthy individuals (β = 10.0, 95% CI, 2.0–18.0, SE = 4.0), at risk of CVD (β = 5.5, 95% CI, 0.3–12.6, SE = 3.6), and those with CVD (β = 11.4, 95% CI, 5.8–16.7, SE = 2.8). Conclusions: Adopting a healthy lifestyle can contribute to increased MS in adults and older adults, regardless of health status.
Christianne F. Coelho-Ravagnani, Jeeser A. Almeida, Xuemei Sui, Fabricio C.P. Ravagnani, Russell R. Pate, and Steven N. Blair
Background: The effects of compliance with the US Physical Activity (PA) Guidelines and changes in compliance over time on cardiovascular disease (CVD) mortality are unknown. Methods: Male participants in the Aerobics Center Longitudinal Study (n = 15,411; 18–100 y) reported leisure-time PA between 1970 and 2002. The frequency of and time spent in PA were converted into metabolic equivalent minutes per week. The participants were classified into remained inactive, became active, became inactive, or remained active groups according to their achievement of the PA guidelines along the follow-up, equivalent here to at least 500 metabolic equivalent minutes of PA per week. Cox regression adjusted for different models was used for the analyses, using age, body mass index, smoking and drinking status, hypertension, diabetes, hypercholesterolemia, and parental history of CVD. Results: Over a mean follow-up of 6.2 years, 439 CVD deaths occurred. Consistently meeting the PA guidelines, compared with not meeting, was associated with a 54% (95% confidence interval, 0.32–0.67) decreased risk of CVD mortality. After controlling for all potential confounders, the risk reduction was 47% (95% confidence interval, 0.36–0.77). Conclusions: Maintaining adherence to the PA guidelines produces substantial reductions in the risk of CVD deaths in men. Furthermore, discontinuing compliance with the guidelines may offset the beneficial effects on longevity.
Bruna C. Turi, Jamile S. Codogno, Romulo A. Fernandes, Xuemei Sui, Carl J. Lavie, Steven N. Blair, and Henrique L. Monteiro
Evidence has shown that physical activity (PA) is associated with low mortality risk. However, data about reduced mortality due to PA are scarce in developing countries and the dose–response relationship between PA from different domains and all-cause mortality remains unclear. Thus, the aim of this study is to investigate the association of PA from different domains on all-cause mortality among Brazilian adults.
679 males and females composed the study sample. Participants were divided into quartile groups according to PA from different domains (occupational, sports, and leisure-time). Medical records were used to identify the cause of the death. Cox regression analysis was performed to determine the independent associations of PA from different domains and all-cause mortality.
During the follow-up period, 59 participants died. The most prevalent cause of death was circulatory system diseases (n = 20; 33.9% [21.8%–45.9%]). Higher scores of occupational (HR= 0.45 [95% CI: 0.20–0.97]), sports (HR= 0.44 [95% CI: 0.20–0.95]) and overall PA (HR= 0.40 [95% CI: 0.17–0.90]) were associated with lower mortality, even after adjustment for confounders.
The findings in this study showed the importance of being active in different domains to reduce mortality risk.
Leanna M. Ross, Jacob L. Barber, Alexander C. McLain, R. Glenn Weaver, Xuemei Sui, Steven N. Blair, and Mark A. Sarzynski
Background: This study examined the cross-sectional and longitudinal associations of cardiorespiratory fitness (CRF) and ideal cardiovascular health (CVH). Methods: CRF and the 7 CVH components were measured in 11,590 (8865 males; 2725 females) adults at baseline and in 2532 (2160 males; 372 females) adults with at least one follow-up examination from the Aerobics Center Longitudinal Study. Ideal CVH score was calculated as a composite of 7 measures, each scored 0 to 2. CVH groups were based on participant point score: ≤7 (poor), 8 to 11 (intermediate), and 12 to 14 (ideal). Analyses included general linear, logistic regression, and linear mixed models. Results: At baseline, participants in the high CRF category had 21% and 45% higher mean CVH scores than those in the moderate and poor CRF categories (P < .001). The adjusted odds (95% confidence interval) of being in the poor CVH group at baseline were 4.9 (4.4–5.4) and 16.9 (14.3–19.9) times greater for individuals with moderate and low CRF, respectively, compared with those with high CRF (P < .001). Longitudinal analysis found that for every 1-minute increase in treadmill time, CVH score increased by 0.23 units (P < .001) independent of age, sex, exam number, and exam year. Conclusions: Higher CRF is associated with better CVH profiles, and improving CRF over time is independently associated with greater improvements in CVH.
Jessica L. Chandler, Keith Brazendale, Clemens Drenowatz, Justin B. Moore, Xuemei Sui, Robert G. Weaver, and Michael W. Beets
Background: The primary purpose of this study was to determine which physical activity (PA) opportunity elicits the most moderate to vigorous PA (MVPA) in after-school programs. This study used a 3-group cross-over design in which participants were exposed to 3 variations of activity structures: free play, organized, or a mixture. Methods: PA was measured using ActiGraph GT3X+ accelerometers. All data were transformed into percentage of time spent sedentary or in MVPA. Repeated-measures mixed-effects models were used to examine differences in MVPA and sedentary among the 3 activity sessions. Participants included 197 unique children, aged 5–12 years, and were 53% male and 55% white. Results: Statistically significant differences were observed in the percentage of time boys spent in MVPA during free play and mixed compared with organized only sessions (35.8% and 34.8% vs 29.4%). No significant difference was observed in the percentage of time girls spent in MVPA during free play compared with organized or mixed (27.2% and 26.1% vs 26.1%). Both boys and girls experienced ∼10% less time sedentary during free play compared with the others. Conclusion: Offering free play during PA opportunities can help children attain as much if not more MVPA compared with only offering organized, adult-led games.
Robin Puett, Jane Teas, Vanesa España-Romero, Enrique Garcia Artero, Duck-chul Lee, Meghan Baruth, Xuemei Sui, Jessica Montresor-López, and Steven N. Blair
The importance of physical activity for health is well-established. Questions remain whether outdoor exercise additionally benefits overall mental and physical well-being.
Using cross-sectional data from the Aerobics Center Longitudinal Study, we examined relationships of physical activity environment (PAE) with reported tension, stress, emotional outlook, and health.
11,649 participants were included. 18% exercised indoors, 54% outdoors, and 28% in both. Participants who exercised partially or entirely outdoors exercised more. In fully adjusted models, for women combined PAE was protective for worse emotional outlook (OR: 0.72; 95% CI: 0.52–0.98). Combined PAE was also protective for reported poor health (OR for women: 0.63; 95% CI: 0.44–0.91; OR for men: 0.75; 95% CI: 0.61–0.92). Amount of physical activity modified PAE relationships with outcomes. Combined and outdoor PAE were more consistently protective for worse outcomes among high activity participants. Regardless of PAE, better outcomes were observed in active versus inactive participants.
The current study suggests addition of outdoor PAE may be linked with better stress management, outlook and health perceptions for more active populations, whereas indoor PAE may be more important for low active populations. Further research should examine the order of causation and whether type of outdoor PAE (eg, urban, natural) is important.