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Comparison between recent and long-term physical activity levels as predictors of cardiometabolic risk: a cohort study.

ABSTRACT: OBJECTIVE:To compare recent and long-term physical activity levels as predictors of cardiometabolic risk in a risk factor-free adult population. DESIGN:A 12-year prospective cohort study. SETTING:The Finnish Public Sector study with surveys conducted in four waves at 4-year intervals. PARTICIPANTS:19?230 participants (mean age 50.2 (SD 9.1) years, 84% women) with no prevalent cardiometabolic risk factors at wave 3 were included. Physical activity was assessed at waves 1, 2 and 3. The long-term physical activity level was determined as the mean of activity from wave 1 to 3 (over 8 years). OUTCOME MEASURE:4-year incidence of cardiometabolic risk factors (obesity, hypertension, dyslipidaemia and diabetes) after wave 3, measured individually and as a sum (accumulation of two or more risk factors vs none). Logistic and multinomial logistic regression analyses were used for the analysis. RESULTS:Graded associations between higher physical activity levels and lower odds of all risk factors were observed (p for trend <0.01). In comparison with the persistently vigorously active participants (?60 metabolic equivalent (MET)-hours/week), those who were persistently inactive (<7 MET-hours/week) were about four times more likely to develop obesity (OR=4.24, 95% CI=2.83 to 6.36), two times more likely to develop hypertension (OR=2.02, 95% CI=1.45 to 2.82) and dyslipidaemia (OR=1.82, 95% CI=1.03 to 3.22) and eight times more likely to develop diabetes (OR=7.84, 95%?CI=1.78 to 34.6). The corresponding OR for accumulating two or more risk factors was 5.24-fold (95% CI=2.39 to 11.47). For recently inactive versus recently vigorously active, the estimates were weaker (OR=2.36, 95% CI=1.71 to 3.25 for obesity; 1.78, 95% CI=1.35 to 2.35 for hypertension; 1.71, 95% CI=1.04 to 2.82 for dyslipidaemia; 3.56, 95% CI=1.06 to 11.96 for diabetes and 2.66, 95% CI=1.48 to 4.78 for ?2?risk factors). CONCLUSION:Cardiometabolic risk associated with physical inactivity is better captured by repeated measurements of physical activity than by a single measurement of the most recent activity level.

SUBMITTER: Leskinen T

PROVIDER: S-EPMC7045178 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Comparison between recent and long-term physical activity levels as predictors of cardiometabolic risk: a cohort study.

Leskinen Tuija T Stenholm Sari S Pulakka Anna A Pentti Jaana J Kivimäki Mika M Vahtera Jussi J

BMJ open 20200216 2

<h4>Objective</h4>To compare recent and long-term physical activity levels as predictors of cardiometabolic risk in a risk factor-free adult population.<h4>Design</h4>A 12-year prospective cohort study.<h4>Setting</h4>The Finnish Public Sector study with surveys conducted in four waves at 4-year intervals.<h4>Participants</h4>19 230 participants (mean age 50.2 (SD 9.1) years, 84% women) with no prevalent cardiometabolic risk factors at wave 3 were included. Physical activity was assessed at wave ...[more]

PMID: 32066606

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Project description:PurposesPhysical activity (PA) may mitigate late cardiometabolic toxicity of cisplatin-based chemotherapy in testicular germ cell tumor (TGCT) long-term survivors. In this cross-sectional study, we evaluated the effects of habitual PA on metabolic syndrome (MetS) prevalence, and on the markers of cardiometabolic health and chronic inflammation in a population of long-term TGCT survivors.MethodsMetS prevalence was evaluated, and habitual PA was assessed using Baecke's habitual PA questionnaire in TGCT survivors (n=195, age=41.1±8.1years, 11.7±5.2years post-therapy) and healthy male controls (n=41, age=38.2±8.8years). Participants were stratified into low- and high-PA groups based on median values. Differences were examined between low- and high-PA groups (in the entire sample, TGCT survivor sub-samples differing in disease stage, and healthy controls), and between TGCT survivors and controls. Next, TGCT survivors were stratified into age- and BMI-matched sub-groups based on post-treatment time (5-15/15/30years) and number of chemotherapy cycles (≤3/>3), allowing us to detect age- and BMI-independent effects of habitual PA on cardiometabolic health in the given TGCT survivor sub-populations. A correlation matrix of habitual PA and sport activity with cardiometabolic and pro-inflammatory markers was generated.ResultsTGCT survivors had higher MetS prevalence than controls. Patients with high habitual PA had lower waist circumference and Systemic Inflammation Index. Habitual PA scores correlated positively with HDL-cholesterol and negatively with waist circumference and atherogenic risk. Furthermore, cardiometabolic benefits of habitual PA were more pronounced in patients with disease stages 1 and 2. Effects of habitual PA on patients sub-populations stratified by chemotherapy dose and post-treatment time clearly showed that higher levels of habitual PA were associated with lower numbers of MetS components, except for patients who received more than 3 chemotherapy cycles and were examined more than15 years post-therapy.ConclusionsHigher levels of habitual PA effectively mitigated cardiometabolic toxicity in TGCT survivors. Patients with higher cumulative doses of chemotherapy may need structured exercise interventions involving higher-intensity physical activity to achieve significant improvements in cardiometabolic health.

Project description:BackgroundThe evidence for the prospective relationships between specific physical activities (PA), sedentary behaviours (SB) and sleep on subsequent total PA levels is scarce. The purpose of this study was to examine prospective associations of self-reported PA, SB and sleep, and changes in these with subsequent accelerometer-measured PA.MethodsA sub-sample of 91,648 UK Biobank participants reported moderate-to-vigorous PA (MVPA), lifestyle activities, TV viewing, computer use and sleep through screen-based questionnaires at baseline (2006-2010), and provided valid accelerometry data (dominant wrist-worn for 7 days between 2013 and 2015). A further sub-sample of 7709 participants repeated the screen-based questionnaires between 2012 and 2013.ResultsIn both women (n = 51,545) and men (n = 40,103), positive associations were observed between all self-reported measures of PA at baseline (MVPA, lifestyle/job-related activities, active transporting modes) and accelerometer-measured PA levels at follow-up (median 5.7 years); an exception was 'walking/standing at work' in women. Sedentary time at work, TV viewing and computer use were inversely associated with PA at follow-up. Sleeping either more or less than 7 h/day at baseline was associated with lower PA at follow-up (except for ≤6 h/day in men). In the repeat self-report sub-sample (median 4.3 years), relatively higher physical activity at follow-up was observed in those who maintained or achieved favourable levels of MVPA, walking for pleasure, strenuous sports, other exercises, heavy DIY (in women), heavy physical work, and walking/standing at work (in women), sedentary time at work, getting about methods (in women), commuting methods (in women), TV viewing, computer use or sleep.ConclusionsInitial levels of PA, SB and sleep, and changes in these variables were generally associated with subsequent accelerometer-measured PA in the expected directions, suggesting these specific behaviours all contribute to the total volume of physical activity over time and could thus be targets for intervention.

Project description:Further research is needed to improve the evidence regarding determinants of physical activity (PA) as a crucial step to plan higher effective intervention strategies. The goal of the present study is to identify socio-demographic and clinical characteristics of primary care (PHC) insufficiently active patients that are associated with longitudinal changes in the level of physical activity.Longitudinal analysis of baseline socio-demographic and clinical predictors of physical activity change in insufficiently active PHC patients who participated in a PA-promoting multi-centre randomized clinical trial conducted from October 2003 through March 2006. The primary outcome measure was the self-reported physical activity assessed with the 7-day Physical Activity Recall (PAR), at baseline, 6, 12 and 24 months. Baseline covariates included sex, age, social class, anthropometric measures and other cardiovascular risk factors or associated diseases (Diabetes, HTA, tobacco use, etc.), and stage of readiness to change PA. Generalized linear mixed models were used to estimate longitudinal association of studied variables on PA change over the three follow-up measurements.A total of 3691 patients (85% of the 4317 recruited in the trial) with at least one follow-up measurement were included in the longitudinal analysis. At baseline, analysed patients (mean age: 50.6 years; 64.6% women) devoted 34.7 minutes and 2.36 metabolic equivalent hours per week (MET.h/week) to moderate and vigorous physical activity. Older age, male gender, higher social class, lower BMI, diagnosis of diabetes or hypertension, and measurement season were significant predictors of PA longitudinal change. The effect of baseline readiness to change on PA dose was modified by time, showing a positive gradient in favour of those with more readiness to change that increases significantly at 12 and 24 months (p-value interaction < .0001).Identified baseline characteristics such as readiness to change and risk factors can guide physicians to prioritize time and intervention efforts for maximizing their impact on insufficiently active PHC patients.

Project description:IntroductionChildren and adolescents with cerebral palsy may be trapped in a vicious circle of low physical fitness, resulting in deconditioning that causes a further decrease in physical activity (PA), a lower quality of life and an increased risk of developing non-communicable diseases. Therefore, establishing a healthy and active lifestyle during childhood is even more important for individuals with a disability. However, the factors that influence habitual PA in children and adolescents with cerebral palsy remain unknown.The present protocol outlines a prospective cohort study with the aim of investigating potential predictors of habitual PA in children and adolescents with cerebral palsy in order to provide evidence for optimising PA levels and associated overall health.Methods and analysisThis prospective cohort study will enrol participants with cerebral palsy between the ages of 8 and 15 years at Gross Motor Function Classification System levels I-III. Using a modified version of the International Classification of Functioning, Disability and Health model as a conceptual analytical framework, the analysis will be divided into six components and will provide predictors for habitual PA measured by accelerometry. The potential predictive variables are registry data on physical function (Danish Cerebral Palsy Follow-Up Programme); validated proxy-reported questionnaires on quality of life (Paediatric Quality of Life Inventory), overall health, pain and participation in daily activities (Paediatric Outcomes Data Collection Instrument) and supplementary questions regarding sleep, screen time and socioeconomic status.Ethics and disseminationThe project is approved by the Danish Data Protection Agency (19/16396) and has been declared not notifiable by the Regional Committee on Health Research Ethics, cf. Committee Act Art. 14, paragraph 1 (S-20192000-23). The study results will be published in international peer-reviewed journals, presented at international conferences, and published in a PhD dissertation.Trial registration numberNCT04614207.

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Comparison between recent and long-term physical activity levels as predictors of cardiometabolic risk: a cohort study.

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Comparison between recent and long-term physical activity levels as predictors of cardiometabolic risk: a cohort study.

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