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1.
BackgroundWeight-loss-induced fat loss improves cardiometabolic health in individuals with overweight and obesity; however, weight loss can also result in bone loss and increased fracture risk. Weight-loss-induced bone loss may be attenuated with exercise. Our aim was to compare changes in bone mineral density (BMD) in adults with overweight and obesity who undertook diet-induced weight loss alone or in combination with exercise.MethodsWe included randomized controlled trials (RCTs) in adults with overweight or obesity (aged ≥18 years; body mass index ≥25 kg/m2) that prescribed diet-induced weight loss alone or in combination with supervised exercise, and measured any bone structural parameters. Risk of bias was assessed using the Cochrane Risk of Bias tool. Random-effects meta-analyses determined mean changes and net mean differences (95% confidence intervals (95%CIs)) in the percentage of areal BMD (aBMD) change between groups.ResultsWe included 9 RCTs. Diet-induced weight loss led to significant losses in femoral neck aBMD (mean change: −1.73% (95%CI: −2.39% to −1.07%), p < 0.001) and total hip aBMD (−2.19% (95%CI: −3.84% to −0.54%), p = 0.009). Femoral neck aBMD losses were significantly greater in the diet-induced weight loss group compared to the exercise plus diet-induced weight loss group (net difference: −0.88% (95%CI: −1.73% to −0.03%)); however, there were no differences in aBMD changes at any other skeletal site: total hip (−1.96% (95%CI: −4.59% to 0.68%)) and lumbar spine (−0.48% (95%CI: −1.81% to 0.86%)). aBMD changes did not differ significantly according to exercise modality (resistance exercise, aerobic exercise, or a combination of the two) during diet-induced weight loss.ConclusionDiet-induced weight loss led to greater femoral neck bone loss compared to diet-induced weight loss plus exercise. Bone loss at the total hip and lumbar spine was not attenuated by exercise during diet-induced weight loss. The lack of consistent skeletal benefits may be due to the insufficient duration and/or training intensities of most exercise interventions. Additional RCTs with appropriate, targeted exercise interventions should be conducted.  相似文献   

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Purpose:We aimed to perform a systematic review and meta-analysis of the effects of training to muscle failure or non-failure on muscular strength and hypertrophy.Methods:Meta-analyses of effect sizes(ESs)explored the effects of training to failure vs.non-failure on strength and hypertrophy.Subgroup meta-analyses explored potential moderating effects of variables such as training status(trained vs.untrained),training volume(volume equated vs.volume non-equated),body region(upper vs.lower),exercise selection(multi-vs.single-joint exercises(only for strength)),and study design(independent vs.dependent groups).Results:Fifteen studies were included in the review.All studies included young adults as participants.Meta-analysis indicated no significant difference between the training conditions for muscular strength(ES=-0.09,95%confidence interval(95%CI):-0.22 to 0.05)and for hypertrophy(ES=0.22,95%CI:-0.11 to 0.55).Subgroup analyses that stratified the studies according to body region,exercise selection,or study design showed no significant differences between training conditions.In studies that did not equate training volume between the groups,the analysis showed significant favoring of non-failure training on strength gains(ES=-0.32,95%CI:-0.57 to-0.07).In the subgroup analysis for resistance-trained individuals,the analysis showed a significant effect of training to failure for muscle hypertrophy(ES=0.15,95%CI:0.03-0.26).Conclusion:Training to muscle failure does not seem to be required for gains in strength and muscle size.However,training in this manner does not seem to have detrimental effects on these adaptations,either.More studies should be conducted among older adults and highly trained individuals to improve the generalizability of these findings.  相似文献   

4.
BackgroundLittle is known about the association between different types of physical activity (PA) and chronic back conditions (CBCs) at the population level. We investigated the association between levels of total and type-specific PA participation and CBCs.MethodsThe sample comprised 60,134 adults aged ≥16 years who participated in the Health Survey for England and Scottish Health Survey from 1994 to 2008. Multiple logistic regression models, adjusted for potential confounders, were used to examine the association between total and type-specific PA volume (walking, domestic activity, sport/exercise, cycling, football/rugby, running/jogging, manual work, and housework) and the prevalence of CBCs.ResultsWe found an inverse association between total PA volume and prevalence of CBCs. Compared with inactive participants, the fully adjusted odds ratio (OR) for very active participants (≥15 metabolic equivalent h/week) was 0.77 (95% confidence interval (CI): 0.69–0.85). Participants reporting ≥300 min/week of moderate-intensity activity and ≥75 min/week of vigorous-intensity activity had 24% (95%CI: 6%–39%) and 21% (95%CI: 11%–30%) lower odds of CBCs, respectively. Higher odds of CBCs were observed for participation in high-level manual domestic activity (OR = 1.22; 95%CI: 1.00–1.48). Sport/exercise was associated with CBCs in a less consistent manner (e.g., OR = 1.18 (95%CI: 1.06–1.32) for low levels and OR = 0.82 (95%CI: 0.72–0.93) for high levels of sport/exercise).ConclusionPA volume is inversely associated with the prevalence of CBCs.  相似文献   

5.
PurposeThis study aimed to evaluate the effectiveness of physical activity (PA) interrupting prolonged sitting (PS) on postprandial glycemia and insulin responses among adults.MethodsPubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, PsycINFO, and the China National Knowledge Infrastructure databases were searched through September 30, 2020. Randomized controlled trials (RCTs) that examined the effect of all forms of PA interrupting PS on postprandial glycemia and/or insulin responses among adults without chronic diseases were included in this study. The risk of bias of included studies was evaluated based on the Cochrane tool. A network meta-analysis was performed to estimate the summary standardized mean differences (SMDs) with 95% confidence intervals (95%CIs) with random effects.ResultsThirty crossover RCTs were included in our review. These RCTs included 9 types of interventions that interrupted PS. When compared to PS by itself, light-intensity PA intermittent interrupting (LPA-INT) PS and moderate-intensity PA intermittent interrupting (MPA-INT) PS significantly lowered postprandial glycemia (SMD = –0.46, 95%CI: –0.70 to –0.21; SMD = –0.69, 95%CI: –1.00 to –0.37, respectively) and significantly reduced postprandial insulin response (SMD = –0.46, 95%CI: –0.66 to –0.26; SMD = –0.47, 95%CI: –0.77 to –0.17, respectively). Results of the clustered ranking plot indicated that MPA-INT was the most effective intervention in lowering postprandial glycemia and insulin responses.ConclusionReplacing PS with MPA-INT or LPA-INT has a positive effect in reducing postprandial glycemia and insulin responses, with MPA-INT being the optimal intervention strategy.  相似文献   

6.
PurposeThis study aimed to describe the national prevalence of Chinese children and adolescents who met the World Health Organization muscle-strengthening exercise (MSE) recommendations and identify correlates of meeting the MSE recommendations.MethodsCross-sectional data from the 2019 Physical Activity and Fitness in China—The Youth Study, a nationally representative sample of Chinese children and adolescents (n = 80,413; mean age = 13.7 years; 53.9% girls) and their parents, were analyzed. Children and adolescents who reported engaging ≥3 days (up to 7 days) of MSE per week were classified as meeting the MSE recommendations. MSE, demographics, lifestyle behaviors (sport participation, moderate-to-vigorous physical activity, screen time, and sleep duration), exercise intention, peer and parental support, and parental MSE participation were assessed through self-reports. Logistic regression models were used to determine the correlates of meeting the MSE recommendations. The analyses were completed in 2020.ResultsOverall, 39.3% of children and adolescents met the MSE recommendations. Girls, 10th–12th graders, minorities, those from lower income households and those from families with lower parental education were less likely to meet the MSE recommendations. Children and adolescents who were proficient in ≥2 sports were more likely to meet the MSE recommendations (adjusted odds ratio (aOR) = 1.44, 95% confidence interval (95%CI): 1.26–1.65), as were those with more moderate-to-vigorous physical activity (aOR = 1.57, 95%CI: 1.53–1.61). Additionally, children and adolescents with high exercise intention (aOR = 1.60, 95%CI: 1.51–1.69), those whose parents met the adult MSE recommendations (aOR = 1.46, 95%CI: 1.40–1.52), and those who received high peer (aOR = 1.27, 95%CI: 1.20–1.34) and parental support (aOR = 1.07, 95%CI: 1.04–1.12) were more likely to meet the MSE recommendations.ConclusionLess than two-fifths of Chinese children and adolescents met the World Health Organization MSE recommendations. The correlates identified in our study can help inform the development of school and community based strategies and policies to enhance participation in MSE and improve muscular fitness of all Chinese children and adolescents.  相似文献   

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PurposeThis study aimed to examine the effects of plyometric jump training (PJT) on lower-limb stiffness.MethodsSystematic searches were conducted in PubMed, Web of Science, and Scopus. Study participants included healthy males and females who undertook a PJT programme isolated from any other training type.ResultsThere was a small effect size (ES) of PJT on lower-limb stiffness (ES = 0.33, 95% confidence interval (95%CI): 0.07–0.60, z = 2.47, p = 0.01). Untrained individuals exhibited a larger ES (ES = 0.46, 95%CI: 0.08–0.84, p = 0.02) than trained individuals (ES = 0.15, 95%CI: ‒0.23 to 0.53, p = 0.45). Interventions lasting a greater number of weeks (>7 weeks) had a larger ES (ES = 0.47, 95%CI: 0.06–0.88, p = 0.03) than those lasting fewer weeks (ES = 0.22, 95%CI: ‒0.12 to 0.55, p = 0.20). Programmes with ≤2 sessions per week exhibited a larger ES (ES = 0.39, 95%CI: 0.01–0.77, p = 0.04) than programmes that incorporated >2 sessions per week (ES = 0.20, 95%CI: –0.10 to 0.50, p = 0.18). Programmes with <250 jumps per week (ES = 0.50, 95%CI: 0.02–0.97, p = 0.04) showed a larger effect than programmes with 250–500 jumps per week (ES = 0.36, 95%CI: 0.00–0.72, p = 0.05). Programmes with >500 jumps per week had negative effects (ES = –0.22, 95%CI: –1.10 to 0.67, p = 0.63). Programmes with >7.5 jumps per set showed larger effect sizes (ES = 0.55, 95%CI: 0.02–1.08, p = 0.04) than those with <7.5 jumps per set (ES = 0.32, 95%CI: 0.01–0.62, p = 0.04).ConclusionPJT enhances lower-body stiffness, which can be optimised with lower volumes (<250 jumps per week) over a relatively long period of time (>7 weeks).  相似文献   

8.
BackgroundThe aim of this study was to compare 6 weeks short-term moderate intensity aerobic exercise and dieting on serum metabolomics and cardio-metabolic risk factors in pre-menopausal women.MethodsNinety previously inactive overweight and obese (BMI 25–35 kg/m2) women (age 41.5 ± 7.6 years) were randomized to either a 6-week Nordic walking exercise program (EX, n = 45) or dietary counseling group (DI, n = 45). Body composition, serum glucose, insulin and lipids were measured. Serum low-molecular-weight metabolites and lipid constituents were analyzed by nuclear magnetic resonance spectroscopy. Measurements were done at baseline and 7 days after the last training session.ResultsSix weeks aerobic exercise program yielded reductions in serum free fatty acids (−34.7%, 95% confidence interval (CI), −50 to −18, p < 0.001), glucose (−9.6%, 95%CI, −15 to −4, p < 0.001) and homeostasis model assessment of insulin resistance (HOMA-IR) (−28.7%, 95%CI, −48 to −10, p = 0.005) without changes in body weight or fat mass. Diet counseling resulted in loss of body weight (1.5%, 95%CI, −2.3 to −0.7, p = 0.001) but no changes in free fatty acids, fasting glucose, or HOMA-IR were found.ConclusionOur results indicate that small weight loss does not produce measurable health benefits, whereas short-term regular aerobic exercise can improve glucose and lipid metabolism even in the absence of weight loss in previously sedentary overweight and obese women.  相似文献   

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BackgroundDelirium is a neurocognitive disorder characterized by an abrupt decline in attention, awareness, and cognition after surgical/illness-induced stressors on the brain. There is now an increasing focus on how cardiovascular health interacts with neurocognitive disorders given their overlapping risk factors and links to subsequent dementia and mortality. One common indicator for cardiovascular health is the heart rate response/recovery (HRR) to exercise, but how this relates to future delirium is unknown.MethodsElectrocardiogram data were examined in 38,740 middle- to older-aged UK Biobank participants (mean age = 58.1 years, range: 40–72 years; 47.3% males) who completed a standardized submaximal exercise stress test (15-s baseline, 6-min exercise, and 1-min recovery) and required hospitalization during follow-up. An HRR index was derived as the product of the heart rate (HR) responses during exercise (peak/resting HRs) and recovery (peak/recovery HRs) and categorized into low/average/high groups as the bottom quartile/middle 2 quartiles/top quartile, respectively. Associations between 3 HRR groups and new-onset delirium were investigated using Cox proportional hazards models and a 2-year landmark analysis to minimize reverse causation. Sociodemographic factors, lifestyle factors/physical activity, cardiovascular risk, comorbidities, cognition, and maximal workload achieved were included as covariates.ResultsDuring a median follow-up period of 11 years, 348 participants (9/1000) newly developed delirium. Compared with the high HRR group (16/1000), the risk for delirium was almost doubled in those with low HRR (hazard ratio = 1.90, 95% confidence interval (95%CI): 1.30–2.79, p = 0.001) and average HRR (hazard ratio = 1.54, 95%CI: 1.07–2.22, p = 0.020)). Low HRR was equivalent to being 6 years older, a current smoker, or ≥3 additional cardiovascular disease risks. Results were robust in sensitivity analysis, but the risk appeared larger in those with better cognition and when only postoperative delirium was considered (n = 147; hazard ratio = 2.66, 95%CI: 1.46–4.85, p = 0.001).ConclusionHRR during submaximal exercise is associated with future risk for delirium. Given that HRR is potentially modifiable, it may prove useful for neurological risk stratification alongside traditional cardiovascular risk factors.  相似文献   

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Background:Physical activity(PA)has substantial health benefits and is important in combatting chronic diseases,which have been associated with elevated levels of advanced glycation endproducts(AGEs).AGEs play a role in the aging process,and an association between PA and AGEs has been reported.We aimed to investigate the relationship between PA and AGE accumulation in a general population and in a population with chronic diseases.Methods:This large cross-sectional population study used data from adult participants in the LifeLines project,with participant information drawn from the LifeLines database as well data from patients with diabetes mellitus or renal and/or cardiovascular diseases.Tissue AGE accumulation was assessed non-invasively by skin-autofluorescence(SAF)using an AGE reader(DiagnOptics Technologies BV,Groningen,the Netherlands).PA was assessed using the short questionnaire to assess health-enhancing physical activity(SQUASH).Multivariate linear regression analyses were adjusted for age,body mass index,sex,and smoking status.Results:Data from 63,452 participants(general population n=59,177,chronic disease n=4275)were analyzed.The general population was significantly younger(43.58±11.77 years,mean±SD)and had significantly lower SAF(1.90±0.42 arbitrary units(AU))compared to the population with chronic disease(age:55.51±12.07 years;SAF:2.27±0.51 AU).In the group with chronic disease,more hours of moderate to vigorous physical activities per week were associated with lower SAF(β=-0.002,95%confidence interval(95%CI):-0.002 to-0.001).For the general population,there was no association between hours of moderate to vigorous activity and SAF(β=3.2×10-5,95%CI:0.000-0.001,p=0.742).However,there was an association in the general population between total hours of PA per week and SAF(β=4.2×10-4,95%CI:0.000-0.001,p<0.001),but this association was not found in the chronic disease population(β=-3.2×10-4,95%CI:-0.001 to 0.000,p=0.347).Conclusion:Our study demonstrates that an inverse relationship exists between PA and AGE accumulation in the population with chronic disease.More hours of moderate to vigorous activity is associated a significantly decreased SAF.More PA is associated a lower SAF,even after for the established predictors(age,body mass index,smoking status,and sex).Our findings could help to promote health and prolong longevity.  相似文献   

11.
BackgroundPhysical inactivity and insomnia symptoms are independently associated with increased risk of depression and anxiety; however, few studies jointly examine these risk factors. This study aimed to prospectively examine the joint association of physical activity (PA) and insomnia symptoms with onset of poor mental health in adults.MethodsParticipants from the 2013 to 2018 annual waves of the Household Income and Labour Dynamics in Australia panel study who had good mental health (Mental Health Inventory-5 >54) in 2013, and who completed at least 1 follow-up survey (2014–2018), were included (n = 10,977). Poor mental health (Mental Health Inventory-5 ≤ 54) was assessed annually. Baseline (2013) PA was classified as high/moderate/low, and insomnia symptoms (i.e., trouble sleeping) were classified as no insomnia symptoms/insomnia symptoms, with 6 mutually exclusive PA-insomnia symptom groups derived. Associations of PA–insomnia symptom groups with onset of poor mental health were examined using discrete-time proportional-hazards logit-hazard models.ResultsThere were 2322 new cases of poor mental health (21.2%). Relative to the high PA/no insomnia symptoms group, there were higher odds (odds ratio and 95% confidence interval (95%CI)) of poor mental health among the high PA/insomnia symptoms (OR = 1.87, 95%CI: 1.57–2.23), moderate PA/insomnia symptoms (OR = 1.93, 95%CI: 1.61–2.31), low PA/insomnia symptoms (OR = 2.33, 95%CI: 1.96–2.78), and low PA/no insomnia symptoms (OR = 1.14, 95%CI: 1.01–1.29) groups. Any level of PA combined with insomnia symptoms was associated with increased odds of poor mental health, with the odds increasing as PA decreased.ConclusionThese findings highlight the potential benefit of interventions targeting both PA and insomnia symptoms for promoting mental health.  相似文献   

12.
Purpose:The aim of the present study was to determine the association between adherence to the 24-h movement guidelines during middle adolescence and glucose outcomes(glycated hemoglobin and fasting glucose) and type 2 diabetes mellitus(T2DM) in adulthood,14 and 22 years later.Methods:We analyzed data from apparently healthy adolescents aged 12-18 years who participated in Waves Ⅰ and Ⅱ(1994-1996,n=14,738),Wave Ⅳ(2008-2009,n=8913),and Wave V(2016-2018,n=3457) of the National Longitudinal Study o...  相似文献   

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BackgroundCardiorespiratory fitness (CRF) is inversely associated with mortality in apparently healthy subjects and in some clinical populations, but evidence for the association between CRF and all-cause and/or cardiovascular disease (CVD) mortality in patients with established CVD is lacking. This study aimed to quantify this association.MethodsWe searched for prospective cohort studies that measured CRF with cardiopulmonary exercise testing in patients with CVD and that examined all-cause and CVD mortality with at least 6 months of follow-up. Pooled hazard ratios (HRs) were calculated using random-effect inverse-variance analyses.ResultsData were obtained from 21 studies and included 159,352 patients diagnosed with CVD (38.1% female). Pooled HRs for all-cause and CVD mortality comparing the highest vs. lowest category of CRF were 0.42 (95% confidence interval (95%CI): 0.28–0.61) and 0.27 (95%CI: 0.16–0.48), respectively. Pooled HRs per 1 metabolic equivalent (1-MET) increment were significant for all-cause mortality (HR = 0.81; 95%CI: 0.74–0.88) but not for CVD mortality (HR = 0.75; 95%CI: 0.48–1.18). Coronary artery disease patients with high CRF had a lower risk of all-cause mortality (HR = 0.32; 95%CI: 0.26–0.41) than did their unfit counterparts. Each 1-MET increase was associated with lower all-cause mortality risk among coronary artery disease patients (HR = 0.83; 95%CI: 0.76–0.91) but not lower among those with heart failure (HR = 0.69; 95%CI: 0.36–1.32).ConclusionA better CRF was associated with lower risk of all-cause mortality and CVD. This study supports the use of CRF as a powerful predictor of mortality in this population.  相似文献   

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ObjectiveThis study sought to analyze the prospective association between vigorous-intensity physical activity (VPA) and health-related outcomes in children and adolescents.MethodsStudies reporting associations between device-measured VPA and health-related factors in children and adolescents aged 3–18 years were identified through database searches (MEDLINE, EMBASE, and SPORTDiscus). Correlation coefficients were pooled if outcomes were reported by at least 3 studies, using DerSimonian-Laird random effects models.ResultsData from 23 studies including 13,674 participants were pooled using random effects models. Significant associations were found between VPA at baseline and overall adiposity (r = −0.09, 95% confidence interval (95%CI): –0.15 to –0.03; p = 0.002; I2 = 89.8%), cardiometabolic risk score (r = –0.13, 95%CI: –0.24 to –0.02, p = 0.020; I2 = 69.6%), cardiorespiratory fitness (r = 0.25, 95%CI: 0.15−0.35; p < 0.001; I2 = 57.2%), and total body bone mineral density (r = 0.16, 95%CI: 0.06 to 0.25; p = 0.001; I2 = 0%).ConclusionVPA seems to be negatively related to adiposity and cardiometabolic risk score and positively related to cardiorespiratory fitness and total body bone mineral density among children and adolescents at follow-up. Therefore, our findings support the need to strengthen physical activity recommendations regarding VPA due to its health benefits in children and adolescents.  相似文献   

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ObjectiveThis study aimed to examine (1) the independent effects of hypoxia on cognitive function and (2) the effects of exercise on cognition while under hypoxia.MethodsDesign: Systematic review with meta-analysis. Data sources: PubMed, Scopus, Web of Science, PsychInfo, and SPORTDiscus were searched. Eligibility criteria for selecting studies: randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered (Aim 2), as were studies investigating the effects of hypoxia on cognition (Aim 1).ResultsIn total, 18 studies met our inclusionary criteria for the systematic review, and 12 studies were meta-analyzed. Exposure to hypoxia impaired attentional ability (standardized mean difference (SMD) = –0.4), executive function (SMD = –0.18), and memory function (SMD = –0.26), but not information processing (SMD = 0.27). Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement (SMD = 0.3, 95% confidence interval: 0.14 – 0.45, I2 = 54%, p < 0.001). Various characteristics (e.g., age, cognitive task type, exercise type, exercise intensity, training type, and hypoxia level) moderated the effects of hypoxia and exercise on cognitive function.ConclusionExercise during exposure to hypoxia improves cognitive function. This association appears to be moderated by individual and exercise/hypoxia-related characteristics.  相似文献   

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PurposeTo evaluate the potential of a year-round school calendar (180-day school year distributed across 12 months) as an intervention compared to a traditional school calendar (180-day school year distributed across 9 months) for mitigating children's weight gain and fitness loss via a natural experiment.MethodsHeight, weight, and cardiorespiratory fitness (CRF) (i.e., Fitnessgram Progressive Aerobic Cardiovascular Endurance Run) were measured in children (5–12 years old) in 3 schools (2 traditional, 1 year-round, n = 990 students, age = 8.6 ± 2.4 years, 53.1% male, 68.9% African American) from 1 school district. Structure (represented by the presence of a school day) was the independent variable. Changes in body mass index (BMI), age- and sex-specific BMI z-scores (zBMI), BMI percentile, percent of overweight or obese children, and CRF (Progressive Aerobic Cardiovascular Endurance Run laps completed) were assessed for summer 2017 (May–August 2017), school year 2017/2018 (August 2017–May 2018), and summer 2018 (May–August 2018). Primary analyses examined the overall change in weight and CRF from summer 2017 until summer 2018 via multilevel mixed effects regression, with group (traditional vs. year-round calendar), time, and a group-by-time interaction as the independent variables. Secondary regression analyses estimated differences in change within and between groups during each time period, separately.ResultsYear-round students gained less BMI (difference in ∆ = –0.44, 95% confidence interval (CI): –0.67 to –0.03) and less CRF (difference in ∆ = –1.92, 95%CI: –3.56 to –0.28) than students attending a traditional school overall. Compared with traditional students, during both summers, year-round students gained less BMI (summer 2017 difference in ∆ = –0.15, 95%CI: –0.21 to –0.08; summer 2018 difference in ∆ = –0.16, 95%CI: –0.24 to –0.07) and zBMI (summer 2017 difference in ∆ = –0.032, 95%CI: –0.050 to –0.010; summer 2018 difference in ∆ = –0.033, 95%CI: –0.056 to –0.009), and increased CRF (summer 2017 difference in ∆ = 0.40, 95%CI: 0.02–0.85; summer 2018 difference in ∆ = 0.23, 95%CI: –0.25 to 0.74). However, the opposite was observed for the school year, with traditional students gaining less BMI and zBMI and increasing CRF compared with year-round students (difference in BMI ∆ = 0.05, 95%CI: 0.03–0.07; difference in zBMI ∆ = 0.012, 95%CI: 0.005–0.019; difference in Progressive Aerobic Cardiovascular Endurance Run laps ∆ = –0.43, 95%CI: –0.58 to –0.28).ConclusionThe year-round school calendar had a small beneficial impact on children's weight status but not CRF. It is unclear if this benefit to children's weight would be maintained because gains made in the summer were largely erased during the school year. Trajectories of weight and CRF gain/loss were consistent with the structured days hypothesis.  相似文献   

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BackgroundBoth hypertension and grip strength (GS) are predictors of mortality and cardiovascular disease (CVD), but whether these risk factors interact to affect CVD and all-cause mortality is unknown. This study sought to investigate the associations of GS with the risk of major CVD incidence, CVD mortality, and all-cause mortality in patients with hypertension.MethodsGS was measured using a Jamar dynamometer (Sammons Preston, Bolingbrook, IL, USA) in participants aged 35–70 years from 12 provinces included in the Prospective Urban Rural Epidemiology China Study. Cox frailty proportional hazards models were used to examine the associations of GS and hypertension and the outcomes of all-cause mortality and CVD incidence/mortality.ResultsAmong 39,862 participants included in this study, 15,964 reported having hypertension, and 9095 had high GS at baseline. After a median follow-up of 8.9 years (interquartile range, 6.7–9.9 years), 1822 participants developed major CVD, and 1250 deaths occurred (388 as a result of CVD). Compared with normotensive participants with high GS, hypertensive patients with high GS had a higher risk of major CVD incidence (hazard ratio (HR) = 2.39; 95% confidence interval (95%CI): 1.86–3.06; p < 0.001) or CVD mortality (HR = 3.11; 95%CI: 1.59–6.06; p < 0.001) but did not have a significantly increased risk of all-cause mortality (HR = 1.24; 95%CI: 0.92–1.68; p = 0.159). These risks were further increased if hypertensive participants whose GS level was low (major CVD incidence, HR = 3.31, 95%CI: 2.60–4.22, p < 0.001; CVD mortality, HR = 4.99, 95%CI: 2.64–9.43, p < 0.001; and all-cause mortality, HR = 1.93, 95%CI: 1.47–2.53, p < 0.001).ConclusionThe present study demonstrates that low GS is associated with the highest risk of major CVD incidence, CVD mortality, and all-cause mortality among hypertensive patients. High levels of GS appear to mitigate long-term mortality risk among hypertensive patients.  相似文献   

18.
BackgroundWhether or not there is targeted pharmacotherapy for dementia, an active and healthy lifestyle that includes physical activity (PA) may be a better option than medication for preventing dementia. We examined the association between leisure-time sedentary behavior (SB) and the risk of dementia incidence and mortality. We further quantified the effect on dementia risk of replacing sedentary time with an equal amount of time spent on different physical activities.MethodsIn the UK Biobank, 484,169 participants (mean age = 56.5 years; 45.2% men) free of dementia were followed from baseline (2006–2010) through July 30, 2021. A standard questionnaire measured individual leisure-time SB (watching TV, computer use, and driving) and PA (walking for pleasure, light and heavy do-it-yourself activity, strenuous sports, and other exercise) frequency and duration in the 4 weeks prior to evaluation. Apolipoprotein E (APOE) genotype data were available for a subset of 397,519 (82.1%) individuals. A Cox proportional hazard model and an isotemporal substitution model were used in this study.ResultsDuring a median 12.4 years of follow-up, 6904 all-cause dementia cases and 2115 deaths from dementia were recorded. In comparison to participants with leisure-time SB <5 h/day, the hazard ratio ((HR), 95% confidence interval (95%CI)) of dementia incidence was 1.07 (1.02–1.13) for 5–8 h/day and 1.25 (1.13–1.38) for >8 h/day, and the HR of dementia mortality was 1.35 (1.12–1.61) for >8 h/day. A 1 standard deviation increment of sedentary time (2.33 h/day) was strongly associated with a higher incidence of dementia and mortality (HR = 1.06, 95%CI: 1.03–1.08 and HR = 1.07, 95%CI: 1.03–1.12, respectively). The association between sedentary time and the risk of developing dementia was more profound in subjects <60 years than in those ≥60 years (HR = 1.26, 95%CI: 1.00–1.58 vs. HR = 1.21, 95%CI: 1.08–1.35 in >8 h/day, p for interaction = 0.013). Replacing 30 min/day of leisure sedentary time with an equal time spent in total PA was associated with a 6% decreased risk and 9% decreased mortality from dementia, with exercise (e.g., swimming, cycling, aerobics, bowling) showing the strongest benefit (HR = 0.82, 95%CI: 0.78–0.86 and HR = 0.79, 95%CI: 0.72–0.86). Compared with APOE ε4 noncarriers, APOE ε4 carriers are more likely to see a decrease in Alzheimer's disease incidence and mortality when PA is substituted for SB.ConclusionLeisure-time SB was positively associated with the risk of dementia incidence and mortality. Replacing sedentary time with equal time spent doing PA may be associated with a significant reduction in dementia incidence and mortality risk.  相似文献   

19.
ObjectiveThis cross-sectional study examined environmental correlates of sedentary behavior (SB) and physical activity (PA) in preschool children in the urban area of Tianjin, China.MethodsData were collected from the Physical Activity and Health in Tianjin Chinese Children study, involving healthy children 3–6 years old and their families. In all children (n = 980), leisure-time SB (LTSB) and leisure-time PA (LTPA) were reported in min/day by parents. In a subgroup (n = 134), overall sedentary time, light PA, and moderate-to-vigorous PA (MVPA) were objectively measured using ActiGraph accelerometry (≥3 days, ≥10 h/day). Environmental correlates were collected using a questionnaire that included home and neighborhood characteristics (e.g., traffic safety, presence of physical activity facilities) and children's behaviors. Potential correlates were identified using linear regression analysis.ResultsMultiple linear regression analysis showed that “having grandparents as primary caregivers” (βs and 95% confidence intervals (95%CIs) for overall sedentary time: 29.7 (2.1–57.2); LTSB (ln): 0.19 (0.11–0.28)) and “having a television (for LTSB (ln): 0.13 (0.00–0.25)) or computer (for LTSB (ln): 0.13 (0.03–0.23)) in the child's bedroom” were both associated with higher SB. Furthermore, “having grandparents as primary caregivers” was associated with less MVPA (β (95%CI): ?7.6 (?14.1 to ?1.2)), and “active commuting to school by walking” correlated with more MVPA (β (95%CI): 9.8 (2.2–17.4)). The path model showed that “more neighborhood PA facilities close to home” was indirectly related to higher LTPA (ln), which was partly mediated by “outdoor play” (path coefficients (95%CI): 0.005 (0.002–0.008)) and “going to these facilities more often” (path coefficients (95%CI): 0.013 (0.008–0.018)). Traffic safety was not a correlate.ConclusionFamily structure and media exposure in the home maybe important factors in shaping preschoolers’ PA patterns. Built environmental correlates could indirectly influence preschoolers’ LTPA through parental help with engaging in active behaviors.  相似文献   

20.
PurposeThis study aimed to examine the associations of accelerometer-derived steps volume and intensity with hospitalizations and all-cause mortality in older adults.MethodsThis prospective cohort study involved 768 community-dwelling Spanish older adults (78.8 ± 4.9 years, mean ± SD; 53.9% females) from the Toledo Study for Healthy Aging (2012–2017). The number of steps per day and step cadence (steps/min) were derived from a hip-mounted accelerometer worn for at least 4 days at baseline. Participants were followed-up over a mean period of 3.1 years for hospitalization and 5.7 years for all-cause mortality. Cox proportional hazards regression models were used to estimate the individual and joint associations between daily steps and stepping intensity with hospitalizations and all-cause mortality.ResultsIncluded participants walked 5835 ± 3445 steps/day with an intensity of 7.3 ± 4.1 steps/min. After adjusting for age, sex, body mass index (BMI), education, income, marital status and comorbidities, higher step count (hazard ratio (HR) = 0.95, 95% confidence interval (95%CI: 0.90–1.00, and HR = 0.87, 95%CI: 0.81–0.95 per additional 1000 steps) and higher step intensity (HR = 0.95, 95%CI: 0.91–0.99, and HR = 0.89, 95%CI: 0.84–0.95 per each additional step/min) were associated with fewer hospitalizations and all-cause mortality risk, respectively. Compared to the group having low step volume and intensity, individuals in the group having high step volume and intensity had a lower risk of hospitalization (HR = 0.72, 95%CI: 0.52–0.98) and all-cause mortality (HR = 0.60, 95%CI: 0.37–0.98).ConclusionAmong older adults, both high step volume and step intensity were significantly associated with lower hospitalization and all-cause mortality risk. Increasing step volume and intensity may benefit older people.  相似文献   

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