ORCID Profile
0000-0001-9850-9224
Current Organisations
University of California, San Diego
,
University of Sydney
,
San Diego State University
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Publisher: American Medical Association (AMA)
Date: 06-2015
DOI: 10.1001/JAMAINTERNMED.2015.0541
Abstract: Few studies have examined how different proportions of moderate and vigorous physical activity affect health outcomes. To examine whether the proportion of total moderate to vigorous activity (MVPA) that is achieved through vigorous activity is associated with all-cause mortality independently of the total amount of MVPA. We performed a prospective cohort study with activity data linked to all-cause mortality data from February 1, 2006, through June 15, 2014, in 204,542 adults aged 45 through 75 years from the 45 and Up population-based cohort study from New South Wales, Australia (mean [SD] follow-up, 6.52 [1.23] years). Associations between different contributions of vigorous activity to total MVPA and mortality were examined using Cox proportional hazards models, adjusted for total MVPA and sociodemographic and health covariates. Different proportions of total MVPA as vigorous activity. Physical activity was measured with the Active Australia Survey. All-cause mortality during the follow-up period. During 1,444,927 person-years of follow-up, 7435 deaths were registered. Compared with those who reported no MVPA (crude death rate, 8.34%), the adjusted hazard ratios for all-cause mortality were 0.66 (95% CI, 0.61-0.71 crude death rate, 4.81%), 0.53 (95% CI, 0.48-0.57 crude death rate, 3.17%), and 0.46 (95% CI, 0.43-0.49 crude death rate, 2.64%) for reporting 10 through 149, 150 through 299, and 300 min/wk or more of activity, respectively. Among those who reported any MVPA, the proportion of vigorous activity revealed an inverse dose-response relationship with all-cause mortality: compared with those reporting no vigorous activity (crude death rate, 3.84%) the fully adjusted hazard ratio was 0.91 (95% CI, 0.84-0.98 crude death rate, 2.35%) in those who reported some vigorous activity (but <30% of total activity) and 0.87 (95% CI, 0.81-0.93 crude death rate, 2.08%) among those who reported 30% or more of activity as vigorous. These associations were consistent in men and women, across categories of body mass index and volume of MVPA, and in those with and without existing cardiovascular disease or diabetes mellitus. Among people reporting any activity, there was an inverse dose-response relationship between proportion of vigorous activity and mortality. Our findings suggest that vigorous activities should be endorsed in clinical and public health activity guidelines to maximize the population benefits of physical activity.
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.ANAI.2011.09.022
Abstract: Tobacco smoke is a widely recognized environmental pollutant and is a major public health hazard worldwide. Although environmental tobacco smoke (ETS) has a clear link with many conditions, including asthma, ear infections, and sinus cancer, evidence related to aspirin-exacerbated respiratory disease (AERD) requires further investigation. To investigate whether active smoke or ETS exposures are associated with an increased risk of developing AERD. A total of 260 patients with AERD were enrolled in a case-control study with their respective asymptomatic spouses serving as matched controls. Multiple logistic regression analysis was used to examine the association of AERD with active smoking and ETS, adjusted for age, sex, and location of childhood residence. The AERD case patients were more likely to have ever smoked actively when compared with controls (odds ratio [OR], 1.54 95% confidence interval [CI], 1.04-2.28). A significant association (OR, 3.46 95% CI, 2.22-5.39) was found between childhood ETS exposure and AERD. If a patient was exposed to ETS during both childhood and adulthood, results showed an OR of 5.09 for developing AERD (95% CI, 2.75-9.43). However, no statistically significant association between AERD and ETS only during adulthood was found (OR, 1.60 95% CI, 0.75-3.40), suggesting that the combined effect of childhood and adulthood ETS may be augmented by the prior childhood exposure. Active smoking and childhood ETS exposure are associated with increased odds of developing AERD. In particular, combined childhood and adulthood exposure had major effects. This study suggests that ETS is at least one contributor to the syndrome of AERD.
Publisher: American Medical Association (AMA)
Date: 11-2015
Publisher: Public Library of Science (PLoS)
Date: 22-01-2015
Publisher: Public Library of Science (PLoS)
Date: 20-08-2015
Publisher: Elsevier BV
Date: 03-2010
Publisher: Public Library of Science (PLoS)
Date: 08-12-2015
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.AMEPRE.2016.01.004
Abstract: Little is known about whether cardiovascular benefits vary by activity type. Dance is a multidimensional physical activity of psychosocial nature. The study aimed to examine the association between dancing and cardiovascular disease mortality. A cohort study pooled 11 independent population surveys in the United Kingdom from 1995 to 2007, analyzed in 2014. Participants were 48,390 adults aged ≥40 years who were free of cardiovascular disease at baseline and consented to be linked to the National Death Registry. Respondents reported participation in light- or moderate-intensity dancing and walking in the past 4 weeks. Physical activity amount was calculated based on frequency, duration, and intensity of participation in various types of exercise. The main outcome was cardiovascular disease mortality based on ICD-9 codes 390-459 or ICD-10 codes I01-I99. During 444,045 person-years, 1,714 deaths caused by cardiovascular disease were documented. Moderate-intensity, but not light-intensity, dancing and walking were both inversely associated with cardiovascular disease mortality. In Cox regression models, the hazard ratios for cardiovascular disease mortality, adjusted for age, sex, SES, smoking, alcohol, BMI, chronic illness, psychosocial distress, and total physical activity amount, were 0.54 (95% CI=0.34, 0.87) for moderate-intensity dancing and 0.67 (95% CI=0.52, 0.87) for moderate-intensity walking. Moderate-intensity dancing was associated with a reduced risk for cardiovascular disease mortality to a greater extent than walking. The association between dance and cardiovascular disease mortality may be explained by high-intensity bouts during dancing, lifelong adherence, or psychosocial benefits.
Publisher: Elsevier BV
Date: 06-2018
Publisher: BMJ
Date: 05-06-2023
DOI: 10.1136/BJSPORTS-2022-106653
Abstract: Although 30 min/day of moderate-intensity physical activity is suggested for preventing type 2 diabetes (T2D), the current recommendations exclusively rely on self-reports and rarely consider the genetic risk. We examined the prospective dose-response relationships between total/intensity-specific physical activity and incident T2D accounting for and stratified by different levels of genetic risk. This prospective cohort study was based on 59 325 participants in the UK Biobank (mean age=61.1 years in 2013–2015). Total/intensity-specific physical activity was collected using accelerometers and linked to national registries until 30 September 2021. We examined the shape of the dose-response association between physical activity and T2D incidence using restricted cubic splines adjusted for and stratified by a polygenic risk score (based on 424 selected single nucleotide polymorphisms) using Cox proportional hazards models. During a median follow-up of 6.8 years, there was a strong linear dose-response association between moderate-to-vigorous-intensity physical activity (MVPA) and incident T2D, even after adjusting for genetic risk. Compared with the least active participants, the HRs (95% CI) for higher levels of MVPA were: 0.63 (0.53 to 0.75) for 5.3–25.9 min/day, 0.41 (0.34 to 0.51) for 26.0–68.4 min/day and 0.26 (0.18 to 0.38) for .4 min/day. While no significant multiplicative interaction between physical activity measures and genetic risk was found, we found a significant additive interaction between MVPA and genetic risk score, suggesting larger absolute risk differences by MVPA levels among those with higher genetic risk. Participation in physical activity, particularly MVPA, should be promoted especially in those with high genetic risk of T2D. There may be no minimal or maximal threshold for the benefits. This finding can inform future guidelines development and interventions to prevent T2D.
Publisher: Oxford University Press (OUP)
Date: 17-08-2012
DOI: 10.1007/S12160-012-9394-1
Abstract: The principle of cross-level interactions of influence on behavior in ecological models is seldom studied. To examine built environment × psychosocial interactive effects on physical activity. Multi-level mixed regression analyses used data from the Neighborhood Quality of Life Study conducted in neighborhoods in two US regions (n = 2,199 adults). Outcomes were (1) objectively measured moderate-to-vigorous physical activity, (2) reported transport walking, and (3) leisure-walking. Conceptually matched built environment variables were analyzed for domain-specific outcomes. With leisure walking as the outcome, built environment × psychosocial interactions were significant in 7 of 20 models tested. Directions of interactions were consistent, indicating a stronger built environment-leisure walking association in adults with less favorable psychosocial status. Little evidence supported such interactions with objectively measured moderate-to-vigorous physical activity or transport walking as outcomes. The results imply that the built environment may exert stronger influence on adults who are not psychologically predisposed to be active.
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.YPMED.2013.12.021
Abstract: Most studies on multiple health behaviors include physical inactivity, alcohol, diet, and smoking (PADS), with few including emerging lifestyle risks such as sleep or sitting. We examined whether adding sitting and sleep to a conventional lifestyle risk index improves the prediction of cross-sectional health outcomes (self-rated health, quality of life, psychological distress, and physical function). We also explored the demographic characteristics of adults with these multiple risk behaviors. We used baseline data of an Australian cohort study (n=191,853) conducted in 2006-2008 in New South Wales. Lifestyle risk index was operationalized as 1) PADS, 2) PADS+sitting, 3) PADS+sleep, and 4) PADS+sitting+sleep. We estimated receiver operating characteristic curve for self-reported binary health outcomes and calculated the area under the curve to illustrate how well each index classified the outcome. We used multiple logistic regression to determine the demographic characteristics of adults with multiple lifestyle risks. Adding sleep duration but not sitting time to the PADS index significantly improved the classification of all health outcomes. Men, those aged 45-54years, those with 10 years of education or less, and those living in regional/remote areas had higher odds of multiple risk behaviors. Future research on multiple health behaviors might benefit from including sleep as an additional behavior. In Australia, unhealthy lifestyles tend to cluster in adults with certain demographic characteristics.
Publisher: BMJ
Date: 30-06-2020
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.JACC.2019.02.031
Abstract: It is unclear what level of moderate to vigorous intensity physical activity (MVPA) offsets the health risks of sitting. The purpose of this study was to examine the joint and stratified associations of sitting and MVPA with all-cause and cardiovascular disease (CVD) mortality, and to estimate the theoretical effect of replacing sitting time with physical activity, standing, and sleep. A longitudinal analysis of the 45 and Up Study calculated the multivariable-adjusted hazard ratios (HRs) of sitting for each sitting-MVPA combination group and within MVPA strata. Isotemporal substitution modeling estimated the per-hour HR effects of replacing sitting. A total of 8,689 deaths (1,644 due to CVD) occurred among 149,077 participants over an 8.9-year (median) follow-up. There was a statistically significant interaction between sitting and MVPA only for all-cause mortality. Sitting time was associated with both mortality outcomes in a nearly dose-response manner in the least active groups reporting 8 h/day) to the least sedentary ( 6 sitting h/day) where, for ex le, the per-hour CVD mortality HR for sitting replaced with vigorous activity was 0.36 (95% confidence interval: 0.17 to 0.74). Sitting is associated with all-cause and CVD mortality risk among the least physically active adults moderate-to-vigorous physical activity doses equivalent to meeting the current recommendations attenuate or effectively eliminate such associations.
Publisher: Oxford University Press (OUP)
Date: 04-06-2023
Abstract: Despite media and public dialog portraying loneliness as a worsening problem, little is known about how the prevalence of loneliness has changed over time. Our study aims to identify (a) temporal trends in episodic and sustained loneliness (lonely in 1 wave vs consistently lonely in 3 consecutive waves) (b) trends across sociodemographic subgroups by sex, race/ethnicity, birth cohort, education, employment status, marital status, and living alone and (c) longitudinal predictors of loneliness in middle-aged and older Americans (≥50 years). Based on Waves 3 (1996) to 14 (2018) of the Health and Retirement Study (n = 18,841–23,227), we conducted a series of lagged mixed-effects Poisson regression models to assess trends of episodic and sustained loneliness in the overall and sociodemographic subgroup s les (by sex, race/ethnicity, birth cohort, education, employment, relationship, and living alone status). To examine the predictors of episodic and sustained loneliness, we used a multivariate mixed-effects Poisson regression model with all sociodemographic variables entered into the same model. Episodic loneliness prevalence decreased from 20.1% to 15.5% and sustained loneliness from 4.6% to 3.6%. Trends were similar across most subgroups. Males, Caucasians, those born in 1928–1945, with university education, working, married artnered, and those not living alone reported lower episodic and sustained loneliness, although associations with sustained loneliness were stronger. Contrary to common perceptions, loneliness has decreased over 20 years of follow-up in middle-aged and older Americans. Several sociodemographic subgroups have been identified as having a higher risk of loneliness, prompting targeted public health attention.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.YPMED.2018.10.007
Abstract: This study aimed to examine the association between in idual and combined lifestyle risk factors and the incidence of hypertension 1) in middle-aged and older Australians, and 2) to compare findings in men and women. A s le of 32,393 adults aged ≥45 years from New South Wales completed baseline (2006-2008) and follow-up (2010) questionnaires. Self-reported incident hypertension was defined as not having physician-diagnosed hypertension nor taking antihypertensive medications at baseline and reporting a diagnosis/treatment of hypertension at follow-up. High-risk categories for six lifestyle risk factors were defined as: a BMI ≥ 25 kg/m
Publisher: Elsevier BV
Date: 08-2017
Publisher: Informa UK Limited
Date: 04-01-2011
Publisher: Springer Science and Business Media LLC
Date: 24-03-2014
Publisher: BMJ
Date: 27-09-2020
DOI: 10.1136/BJSPORTS-2019-101001
Abstract: In the past few decades, the field of physical activity has grown and evolved in scope, depth, visibility and impact around the world. Global progress has been observed in research and practice in physical activity regarding surveillance, health outcomes, correlates/determinants, interventions, translation and policy. The 2012 and 2016 Lancet series on physical activity provide some of the most comprehensive global analysis on various topics within physical activity. Based on the Lancet series and other key developments in the field, literature searches, and expert group meetings and consultation, we provide a global summary on the progress of, gaps in and future directions for physical activity research in the following areas: (1) surveillance and trends, (2) correlates and determinants, (3) health outcomes and (4) interventions, programmes and policies. Besides lessons learnt within each specific area, several recommendations are shared across areas of research, including improvement in measurement, applying a global perspective with a growing emphasis on low-income and middle-income countries, improving inclusiveness and equity in research, making translation an integral part of research for real-world impact, taking an ‘upstream’ public health approach, and working across disciplines and sectors to co-design research and co-create solutions. We have summarised lessons learnt and recommendations for future research as ‘roadmaps’ in progress to encourage moving the field of physical activity towards achieving population-level impact globally.
Publisher: Springer Science and Business Media LLC
Date: 04-08-2011
Abstract: In 2004, the media repeatedly reported water pollution and "cancer villages" along the Huai River in China. Due to the lack of death records for more than 30 years, a retrospective survey of causes of death using verbal autopsy was carried out to investigate cancer rates in this area. An epidemiologic study was designed to compare numbers of deaths and causes of death between the study areas with water pollution and the control areas without water pollution in S County and Y District in 2005. The study areas were selected based on the distribution of the Huai River and its tributaries. Verbal autopsy was used to assist cause of death (COD) diagnoses and to verify mortality rates. The standard mortality rates (SMRs) of cancer in the study area were compared with those in the control areas. In order to verify the difference between mortality rates due to cancers in the study and the control areas, patients who reported having cancer in the survey received a second diagnosis by national and provincial oncologists with pathological and laboratory examinations. Comparisons were made to determine if differential cancer prevalence rates in the study and control areas were similar to the difference in mortality due to cancer in these study and control areas. Mortality rates of cancers in study and control areas were also compared with national statistics for the rural population of China. Over five years, 3,301 deaths were identified, including 1,158 cancer deaths. The annual average SMRs of cancer in the study areas of S County and Y District were 277.8/100,000 and 223.6/100,000, respectively, which is three to four times higher than those in the control areas. In addition, a total of 626 cases of cancer in the study and control areas were confirmed. The prevalence rates of cancer were 545/100,000 and 128.1/100,000 per year in the study and control areas in S County, respectively, and 440.9/100,000 and 200/100,000 per year in the study and control areas in Y District, respectively. The mortality and prevalence rates of digestive cancers were higher in the study areas than the control areas. In 2000, the SMR for cancer in rural areas nationwide was 120.9/100,000, and in study areas in S County and Y District, the excess rates of deaths were 184/100,000 and 138.8/100,000, respectively. The death rates of digestive cancers were much higher in the study areas of S County and Y District. The patterns for between-area differences in prevalence and mortality rates of cancer were similar. Verbal autopsy is shown to be a useful tool in retrospective mortality surveys in low-resource areas with limited access to health care.
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1186/S40798-021-00394-8
Abstract: “Sit less–move more” has been the univocal advice to adults for better health. Predominantly, this advice is based on research of physical behaviors during leisure-time. A recent study among 100,000 adults indicates a u-shaped association between leisure-time physical activity and risk for cardiovascular disease and mortality among adults in physically active occupations. This may be explained by the considerable difference in 24-h physical behaviors between adults in sedentary and physically active occupations. Thus, the advice “sit less–move more” might not be the best for health among adults in physically active occupations. To provide a scientific approach and encourage research on 24-h physical behaviors and health for those in physically active occupations, we propose the “Sweet-Spot Hypothesis.” The hypothesis postulates that the “Sweet-Spot” of 24-h physical behaviors for better health differs between adults, depending on their occupation. Specifically, the hypothesis claims that the advice “sit less–move more” does not bring adults in physically active occupations toward their “Sweet-Spot” of 24-h physical behaviors for better health. The purpose of our paper is to encourage researchers to test this proposed hypothesis by describing its origin, its theoretical underpinning, approaches to test it, and practical implications. To promote health for all, and decrease social health inequalities, we see a great need for empirically testing the “Sweet-Spot Hypothesis.” We propose the “Sweet-Spot Hypothesis” to encourage discussion, debates, and empirical research to expand our collective knowledge about the healthy “24-h physical behavior balance” for all.
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.YPMED.2014.10.004
Abstract: To determine the association between standing time and all-cause mortality. Prospective questionnaire data from 221,240 in iduals from the 45 and Up Study were linked to mortality data from the New South Wales Registry of Deaths (Australia) from February 1, 2006 to June 17, 2012. Hazard ratios for all-cause mortality according to standing time at baseline were estimated in 2013 using Cox regression modelling, adjusted for sex, age, education, urban/rural residence, physical activity, sitting time, body mass index, smoking status, self-rated health and disability. During 937,411 person years (mean follow-up=4.2 yr) 8009 deaths occurred. All-cause mortality hazard ratios were 0.90 (95% CI 0.85-0.95), 0.85 (95% CI 0.80-0.95), and 0.76 (95% CI 0.69-0.95) for standing 2-≤5h/d, 5-≤8h/d, or >8h/d respectively, compared to standing two or less hours per day. Further analyses revealed no significant interactions between standing and sex (p=0.93), the presence/absence of cardiovascular disease or diabetes (p=0.22), BMI (p=0.78), physical activity (p=0.16) and sitting time (p=0.22). This study showed a dose-response association between standing time and all-cause mortality in Australian adults aged 45 years and older. Increasing standing may hold promise for alleviating the health risks of prolonged sitting.
Publisher: Elsevier BV
Date: 10-2018
Publisher: Springer Science and Business Media LLC
Date: 20-11-2011
DOI: 10.1038/NCLIMATE1295
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.AMEPRE.2016.01.019
Abstract: Population aging is associated with a rising burden of non-communicable disease, profoundly impacting health policy and practice. Adopting and adhering to healthy lifestyles in middle or older age can protect against morbidity and mortality. Retirement brings opportunities to reconfigure habitual lifestyles and establish new routines. This study examines the longitudinal association between retirement and a range of lifestyle risk behaviors among a large population-based s le of Australian adults. Study s le included working adults aged ≥45 years at baseline (2006-2009, N=23,478-26,895). Lifestyle behaviors, including smoking, alcohol use, physical activity, diet, sedentary behavior, and sleep, were measured at both baseline and follow-up (2010). Logistic regression models estimated the odds of having each risk factor at follow-up and multiple linear regression models calculated the change in the total number of risk factors, adjusted for baseline risk and other covariates. Sociodemographic characteristics and reasons for retirement were tested as potential effect modifiers. During the 3.3-year follow-up, about 11% of respondents retired. Retirement was associated significantly with reduced odds of smoking (AOR=0.74) physical inactivity (AOR=0.73) excessive sitting (AOR=0.34) and at-risk sleep patterns (AOR=0.82). There was no significant association between retirement and alcohol use or fruit and vegetable consumption. Change in the total number of lifestyle risk factors differed significantly by reason for retirement. In a large population-based Australian cohort, retirement was associated with positive lifestyle changes. Health professionals and policymakers should consider developing special programs for retirees to capitalize on the healthy transitions through retirement.
Publisher: Springer Science and Business Media LLC
Date: 2011
Publisher: Oxford University Press (OUP)
Date: 25-09-2015
DOI: 10.1093/NTR/NTU198
Abstract: One population-level solution to smoking cessation are quitlines, telephone-based services to aid quitting. Monitoring the profile of quitline callers in a changing tobacco policy environment is important for informing future policy strategies and identifying target groups to improve the reach and impact of quitline services. De-identified data from 43,618 new callers to the New South Wales Quitline, Australia between January 2008 and October 2011 (inclusive) were extracted from the Quitline database. Regression analyses explored the effect of year of first call on the distribution of demographic and smoking-related variables. Men calling the Quitline increased proportionately (prevalence ratio [PR] = 1.05, 95% CI = 1.03-1.08), but callers from non-major city areas fell (PR = 0.90, 95% CI = 0.87-0.93) in 2011 versus 2008. The proportion of callers not working demonstrated a significant increasing linear trend (PR = 1.08, p < .001), although area-level socioeconomic status did not change. The proportions of new Quitline callers who had stopped smoking (relative to still smoking) (relative risk ratio [RRR] = 1.29, 95% CI = 1.14-1.46) and who were classified as low nicotine dependent (vs. high nicotine dependent, RRR = 1.60, 95% CI = 1.39-1.83) were higher in 2011 versus 2008. Proportionately, more callers nominated "money" as a motivation to quit in 2010 (PR = 1.58, 95% CI = 1.49-1.66) and 2011 (PR = 1.70, 95% CI = 1.62-1.79) compared with 2008. Quitline callers showed decreasing tobacco consumption and dependence 2008 to 2011, but remained more addicted than the average NSW smoker. Clear effects of tobacco policy were shown, as money as a motivator increased dramatically in conjunction with increased tobacco taxation, highlighting the importance of promoting cessation services concurrent with policy change to capitalize on increased motivation to quit.
Publisher: SAGE Publications
Date: 05-2012
DOI: 10.4278/AJHP.101015-QUAN-339
Abstract: Describe small business support for youth physical activity opportunities (YPAO) and identify factors associated with this support. Cross-sectional analysis of quantitative data relating business characteristics and support for YPAO. Eight demographically heterogeneous, urban neighborhoods in a Midwest metropolitan area. Adult small business owners (n = 90 65% response rate mean age 48.4 years 73.3% male 45.2% minority). Neighborhood demographics from the 2000 U.S. Census and self-reported business and owner characteristics. Multivariate analysis of variance was used to contrast business and owner characteristics between businesses that did and did not support YPAO. Businesses supporting YPAO had larger annual operating (F = 7.6 p = .018) and advertising budgets (F = 8.5 p = .009) and had younger owners (F = 6.1 p = .034), with sports backgrounds (χ 2 = 5.6 p = .018) and who felt businesses should support YPAO (χ 2 = 3.8 p = .048). Of the 46 businesses not supporting YPAO, 82.6% felt small businesses should support YPAO. The major reasons for nonsupport were difficulty identifying YPAO to support and not being asked for support. Business (e.g., budgets) and business owner characteristics (e.g., age), owner connectedness with YPAO, and the approach used for garnering support (active solicitation, clearly defined support mechanism) were associated with supporting YPAO. Additional business (e.g., annual revenues), owner (e.g., perceptions of YPAO), and environmental (e.g., crime rate, land use) factors should be examined as potential correlates.
Publisher: Springer Science and Business Media LLC
Date: 15-05-2021
DOI: 10.1038/S41366-021-00832-3
Abstract: This study aims to investigate the association between weight change and total knee or hip replacement (TKR or THR) for OA among middle-aged and older adults with overweight or obesity. Weight data were collected in 2006–2009 and in 2010 from the 45 and Up Study—a population-based cohort aged ≥45 years in New South Wales, Australia. Participants were included if they had a baseline body mass index (BMI) ≥ 25 kg/m 2 and no history of TKR or THR. Weight change was categorised into four groups: .5% loss –7.5% loss stable (≤5% change) and % gain. Hospital admission data were linked to identify TKR and THR for OA, and multivariable Cox regression was used to assess risk of TKR and THR. Of 23,916 participants, 2139 lost .5% weight, 1655 lost 5–7.5% weight, and 4430 gained % weight. Over 5.2 years, 1009 (4.2%) underwent TKR and 483 (2.0%) THR. Compared to weight-stable, weight loss of .5% was associated with reduced risk of TKR after adjusting for age, sex, BMI, socioeconomic and lifestyle factors (hazard ratio 0.69, 95%CI 0.54–0.87), but had no association with THR. Weight loss of 5–7.5% was not associated with altered risk of either TKR or THR. Weight gain was associated with increased risk of THR after adjusting for confounders, but not TKR. This study suggests that a weight loss target .5% is required to reduce the risk of TKR in adults with overweight or obesity. Weight gain should be avoided as it increases the risk of THR.
Publisher: Springer Science and Business Media LLC
Date: 30-09-2015
Publisher: Springer Science and Business Media LLC
Date: 15-04-2011
Publisher: Springer Science and Business Media LLC
Date: 11-04-2015
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.YPMED.2015.09.004
Abstract: The way in which lifestyle risk factors for chronic disease co-occur among people with different cultural backgrounds is largely unknown. This study investigated chronic disease risk among immigrants aged ≥45 years in Australia by combining common lifestyle risk factors into a weighted chronic disease risk index (CDRI). Among 64,194 immigrants and 199,908 Australian-born participants in the 45 and Up Study (2006-2009), Poisson regression was used to derive relative risks (RR) and 95% confidence intervals (CI) for five risk factors (smoking, alcohol use, overweight/obesity, physical activity, diet) by place of birth adjusting for socio-demographic characteristics. Multiple linear regression was used to determine adjusted mean differences (AMDs) in CDRI score by place of birth and years lived in Australia. Immigrants had higher RRs of smoking than Australian-born participants, lower RRs of excessive alcohol consumption and overweight/obesity, and no difference in RR for physical inactivity and insufficient fruit/vegetable intake. Participants born in the Middle East/North Africa (AMD 3.5, 95% CI 2.7, 4.3), Eastern/Central Europe (1.3, 0.8, 1.9), and Western Europe (0.5, 0.1, 0.8) had higher mean CDRI scores than Australian-born participants, while participants born in East Asia (-7.2, -7.8, -6.6), Southeast Asia (-6.6, -7.2, -6.1), Central/South Asia (-3.1, -4.0, -2.1), Sub-Saharan Africa (-1.9, -2.6, -1.2) and the United Kingdom/Ireland (-0.2, -0.5, 0.0) had lower scores. CDRI score among immigrants generally approximated that of Australian-born participants with greater years lived in Australia. This study reveals differences in potential risk of chronic disease among different immigrant groups in Australia.
Publisher: Oxford University Press (OUP)
Date: 06-05-2009
DOI: 10.1093/NTR/NTP060
Publisher: BMJ
Date: 26-04-2017
DOI: 10.1136/BJSPORTS-2016-097385
Abstract: To summarise the literature on the economic burden of physical inactivity in populations, with emphases on appraising the methodologies and providing recommendations for future studies. Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42016047705). Electronic databases for peer-reviewed and grey literature were systematically searched, followed by reference searching and consultation with experts. Studies that examined the economic consequences of physical inactivity in a population opulation-based s le, with clearly stated methodologies and at least an abstract/summary written in English. Of the 40 eligible studies, 27 focused on direct healthcare costs only, 13 also estimated indirect costs and one study additionally estimated household costs. For direct costs, 23 studies used a population attributable fraction (PAF) approach with estimated healthcare costs attributable to physical inactivity ranging from 0.3% to 4.6% of national healthcare expenditure 17 studies used an econometric approach, which tended to yield higher estimates than those using a PAF approach. For indirect costs, 10 studies used a human capital approach, two used a friction cost approach and one used a value of a statistical life approach. Overall, estimates varied substantially, even within the same country, depending on analytical approaches, time frame and other methodological considerations. Estimating the economic burden of physical inactivity is an area of increasing importance that requires further development. There is a marked lack of consistency in methodological approaches and transparency of reporting. Future studies could benefit from cross-disciplinary collaborations involving economists and physical activity experts, taking a societal perspective and following best practices in conducting and reporting analysis, including accounting for potential confounding, reverse causality and comorbidity, applying discounting and sensitivity analysis, and reporting assumptions, limitations and justifications for approaches taken. We have adapted the Consolidated Health Economic Evaluation Reporting Standards checklist as a guide for future estimates of the economic burden of physical inactivity and other risk factors.
Publisher: Human Kinetics
Date: 12-2018
Abstract: Background : To examine the associations between school-age children’s sedentary behavior, screen time, and 3 physical activity attributes: muscular strength, cardiorespiratory endurance (CRE), and fundamental movement skills. Methods : Cross-sectional survey of 2734 children in years 2 and 4 and 3671 adolescents in years 6, 8, and 10. Total sitting time, 6 screen time behaviors, and physical activity were measured by self-report. Muscular strength was assessed by standing broad jump CRE by 20-m shuttle run test and fundamental movement skills by process-oriented checklists. Associations between incremental sitting and screen time (in hours) and meeting the healthy zone of physical activity attributes were examined using logistic regression. Results : After adjusting for covariates and physical activity, children had lower odds of achieving the healthy zone for muscular strength and CRE for each hour of week (but not weekend) screen time. For adolescents, each hour of screen time per day was associated with lower odds of achieving the healthy fitness zone for CRE, locomotor skills, and overall healthy zone, and each hour of weekend screen time was associated with lower odds of achieving the healthy zone for most attributes and overall healthy zone. The associations were slightly stronger among adolescent girls than boys. The findings were similar for total sitting time. Conclusions : Screen time was associated with a lower likelihood to achieve healthy zones of physical activity attributes, and the effect was more consistent and slightly stronger among adolescents than children. This may suggest that the negative effects of screen time are incremental, emerging during adolescence.
Publisher: BMJ
Date: 31-05-2018
DOI: 10.1136/BJSPORTS-2017-098677
Abstract: Walking pace is associated with risk of premature mortality. However, whether this relationship is independent of total volume of physical activity and highest physical activity intensity remains unclear. We examined the associations between walking pace and cause-specific mortality, investigating the potential modifying effect of factors such as total physical activity volume, highest physical activity intensity, age, sex and body mass index (BMI). Prospective pooled analysis of 11 population-based baseline surveys in England and Scotland between 1994 and2008 that were linked with mortality records. Multivariate-adjusted Cox proportional hazards models examined associations between walking pace (slow, average, brisk/fast) and all-cause, cancer and cardiovascular disease (CVD) mortality. 50 225 walkers were entered in the core analyses. Among participants who did not experience an event in the first 2 years of follow-up (n=49 731), walking at an average or brisk/fast pace was associated with a reduced risk of all-cause (20% (95% CI 12% to 28%) and 24% (95% CI 13% to 33%), respectively) and CVD mortality (24% (95% CI 9% to 36%) and 21% (95% CI 1% to 38%), respectively), compared with reporting walking at a slow pace. In stratified analyses, such associations were evident among those over 50 years, those not meeting the physical activity recommendations and those who did not undertake vigorous-intensity activity. There were no interactions by sex or BMI. No associations were seen between pace and cancer mortality. Walking benefits health. Assuming causality, these analyses suggest that increasing walking pace could reduce risk for all-cause and CVD mortality. Walking pace could be emphasised in public health messages, especially in situations when increase in walking volume or frequency is less feasible.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 16-03-2021
Abstract: Cardiorespiratory fitness may moderate the association between obesity and all‐cause mortality (ie, the “fat‐but‐fit” hypothesis), but unaddressed sources of bias are a concern. Cardiorespiratory fitness was estimated as watts per kilogram from a submaximal bicycle test in 77 169 men and women from the UK Biobank cohort and combined with World Health Organization standard body mass index categories, yielding 9 unique fitness‐fatness combinations. We also formed fitness‐fatness combinations based on bioimpedance as a direct measure of body composition. All‐cause mortality was ascertained from death registries. Multivariable‐adjusted Cox regression models were used to estimate hazard ratios and 95% CIs. We examined the association between fitness‐fatness combinations and all‐cause mortality in models with progressively more conservative approaches for accounting for reverse causation, misclassification of body composition, and confounding. Over a median follow‐up of 7.7 years, 1731 participants died. In our base model, unfit men and women had higher risk of premature mortality irrespective of levels of adiposity, compared with the normal weight–fit reference. This pattern was attenuated but maintained with more conservative approaches in men, but not in women. In analysis stratified by sex and excluding in iduals with prevalent major chronic disease and short follow‐up and using direct measures of body composition, mortality risk was 1.78 (95% CI, 1.17–2.71) times higher in unfit‐obese men but not higher in obese‐fit men (0.94 [95% CI, 0.60–1.48]). In contrast, there was no increased risk in obese‐unfit women (1.09 [95% CI, 0.44–1.05]) as compared with the reference. Cardiorespiratory fitness modified the association between obesity and mortality in men, but this pattern appeared susceptible to biases in women.
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.YPMED.2016.12.044
Abstract: The vegetarian diet is thought to have health benefits including reductions in type 2 diabetes, hypertension, and obesity. Evidence to date suggests that vegetarians tend to have lower mortality rates when compared with non-vegetarians, but most studies are not population-based and other healthy lifestyle factors may have confounded apparent protective effects. The aim of this study was to evaluate the association between categories of vegetarian diet (including complete, semi and pesco-vegetarian) and all-cause mortality in a large population-based Australian cohort. The 45 and Up Study is a cohort study of 267,180 men and women aged ≥45years in New South Wales (NSW), Australia. Vegetarian diet status was assessed by baseline questionnaire and participants were categorized into complete vegetarians, semi-vegetarians (eat meat≤once/week), pesco-vegetarians and regular meat eaters. All-cause mortality was determined by linked registry data to mid-2014. Cox proportional hazards models quantified the association between vegetarian diet and all-cause mortality adjusting for a range of potential confounding factors. Among 243,096 participants (mean age: 62.3years, 46.7% men) there were 16,836 deaths over a mean 6.1years of follow-up. Following extensive adjustment for potential confounding factors there was no significant difference in all-cause mortality for vegetarians versus non-vegetarians [HR=1.16 (95% CI 0.93-1.45)]. There was also no significant difference in mortality risk between pesco-vegetarians [HR=0.79 (95% CI 0.59-1.06)] or semi-vegetarians [HR=1.12 (95% CI 0.96-1.31)] versus regular meat eaters. We found no evidence that following a vegetarian diet, semi-vegetarian diet or a pesco-vegetarian diet has an independent protective effect on all-cause mortality.
Publisher: Oxford University Press (OUP)
Date: 16-12-2012
DOI: 10.1093/NTR/NTR277
Abstract: As Rich and Xiao suggested, cigarette sharing and gifting play an important role in China's smoking epidemic. Understanding the cultural roots, history, and impacts of such practices should be emphasized in tobacco control efforts. "Tobacco as a social currency" is a consequence of the tobacco industry usurping traditional values and cultural customs to make cigarette gifting acceptable, desirable, and socially reinforcing. The cigarettes-social reinforcement link created by the tobacco industry can be broken by deglamorizing smoking and cigarette gifting and by reinforcing alternative healthful behaviors. A behavioral ecological perspective, with an emphasis of understanding and engineering cultures, should guide future health promotion efforts to reduce smoking and other risk practices in China.
Publisher: MDPI AG
Date: 09-08-2013
Publisher: Elsevier BV
Date: 05-2020
DOI: 10.1016/J.PEC.2019.11.028
Abstract: Health literacy measurement can identify healthcare consumers' needs and help inform healthcare service delivery. The objective of this review is to identify and evaluate tools to measure health literacy among Chinese speakers. A systematic literature search was undertaken in nine databases, both English and Chinese, on articles published from the databases' inception to May 2018, addressing health literacy among Chinese speakers. Ten health literacy instruments in the Chinese language were reported in 17 studies, of which ten were published in English and seven in Chinese. Of the 17 studies, six reported on a new instrument, while the remainder reported on derivative instruments. All, except for one, are self-administered. These studies applied various implicit or explicit conceptual or operational health literacy definitions. The psychometric strength varied across the instruments. A number of instruments are available for assessing health literacy among Chinese speakers. Careful selection is recommended, given the variation in components and psychometric properties assessed. This review can be used by healthcare providers and researchers to select effective health literacy tools to examine patients' ability to understand and apply health information so that services can be more appropriately tailored to Chinese speaking patients.
Publisher: Elsevier BV
Date: 02-2022
Publisher: BMJ
Date: 31-05-2018
DOI: 10.1136/BJSPORTS-2017-098833
Abstract: To synthesise the literature on the effects of neighbourhood environmental change through residential relocation on physical activity, walking and travel behaviour. Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42017077681 ). Electronic databases for peer-reviewed and grey literature were systematically searched to March 2017, followed by forward and backward citation tracking. A study was eligible for inclusion if it (1) measured changes in neighbourhood built environment attributes as a result of residential relocation (either prospectively or retrospectively) (2) included a measure of physical activity, walking, cycling or travel modal change as an outcome (3) was quantitative and (4) included an English abstract or summary. A total of 23 studies was included in the review. Among the eight retrospective longitudinal studies, there was good evidence for the relationship between relocation and walking (consistency score (CS) %). For the 15 prospective longitudinal studies, the evidence for the effects of environmental change/relocation on physical activity or walking was weak to moderate (CS mostly %), even weaker for effects on other outcomes, including physical activity, cycling, public transport use and driving. Results from risk of bias analyses support the robustness of the findings. The results are encouraging for the retrospective longitudinal relocation studies, but weaker evidence exists for the methodologically stronger prospective longitudinal relocation studies. The evidence base is currently limited, and continued longitudinal research should extend the plethora of cross-sectional studies to build higher-quality evidence.
Publisher: Human Kinetics
Date: 07-2014
Abstract: Post-communist countries have experienced rapid economic development and social changes, which have been accompanied by changes in health-related lifestyle behaviors, such as physical activity. The purpose of this study was to examine the associations of domain-specific physical activity and total sedentary time with BMI among adults in the Czech Republic. We surveyed a nationally representative s le (n = 4097) of the Czech Republic in fall 2007 using the International Physical Activity Questionnaire (long form). Multiple linear regression analyses were used to examine associations of physical activity, sedentary time and sociodemograhic characteristics with BMI. Older age, lower educational attainment, and lower levels of leisure-time physical activity were associated with higher BMI. Compared with those living in large cities, men living in small towns and women living in small villages had higher BMI. This study has identified correlates of BMI in the Czech Republic. Although more evidence from longitudinal studies is needed, findings from the current study can inform interventions to prevent the rising obesity epidemic.
Publisher: Elsevier BV
Date: 09-2016
Publisher: BMJ
Date: 02-2020
DOI: 10.1136/BMJOPEN-2019-034036
Abstract: Compared with sighted in iduals, people with visual impairment have a higher prevalence of chronic conditions and lower levels of physical activity. This review aims to systematically review physical activity interventions for those with a visual impairment and to assess their effectiveness. A systematic review of articles reporting physical activity interventions in visually impaired in iduals was conducted. Medline, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus and the Physiotherapy Evidence Database were searched in August 2018. Meta-analyses were conducted on randomised controlled trials with the same outcome measure. Most interventions were conducted in a group setting, with some including an at-home, self-directed component. Following identification of a recent systematic review of physical activity interventions in children, our review focused on adults aged 18 years and older with a visual impairment. Outcomes included measures of balance, mobility, mental well-being (eg, quality of life), number of falls, muscle strength, flexibility and gait. Eighteen papers from 17 studies met inclusion criteria. Physical activity components include falls prevention and/or balance-based activities, walking, tai chi, Alexander Technique, Yoga, dance, aerobics and core stability training. Significant results in favour of the intervention were reported most commonly in measures of functional capacity (9/17 studies) and in falls/balance-related outcomes (7/13 studies). The studies identified were generally small and erse in study design, and risk of bias was high across several categories for most studies. Meta-analyses indicated non-significant effects of the included interventions on the Timed Up and Go, Chair Sit Test and Berg Balance Scale. Physical activity interventions in in iduals with visual impairment incorporating activities such as tai chi, Yoga and dance can have positive results, particularly in physical measures such as mobility and balance. However, when performing a meta-analysis of randomised controlled trials, the evidence for effectiveness is less clear. More studies with larger s le sizes, stronger designs and longer follow-up periods are needed. CRD42018103638.
Publisher: Informa UK Limited
Date: 15-06-2020
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: Elsevier BV
Date: 11-2020
Publisher: BMJ
Date: 02-2019
DOI: 10.1136/BMJOPEN-2018-024280
Abstract: To examine (1) the effect of new dock-less bicycle-sharing programmes on change in travel mode and (2) the correlates of change in travel mode. A retrospective natural experimental study. 12 neighbourhoods in Shanghai. 1265 respondents were recruited for a retrospective study in May 2017. Prevalence of cycling before and after launch of dock-less bicycle-sharing programme. The proportion of participants cycling for transport increased from 33.3% prior to the launch of the bicycle-sharing programmes to 48.3% 1 year after the launch (p .001). Being in the age group of 30–49 years (OR 2.28 95% CI 1.30 to 4.00), living within the inner ring of the city (OR 2.27 95% CI 1.22 to 4.26), having dedicated bicycle lanes (OR 1.37, 95% CI 1.12 to 1.68) and perceiving riding shared bicycles as fashionable (OR 1.46, 95% CI 1.21 to 1.76) were positively associated with adopting cycling for transport. Access to a public transportation stop/station (OR 0.82, 95% CI 0.67 to 0.99) was inversely correlated with adopting cycling for transport. Dock-less bicycle sharing may promote bicycle use in a metropolitan setting. Findings from this study also highlight the importance of cycling-friendly built environments and cultural norms as facilitators of adopting cycling.
Publisher: BMJ
Date: 29-03-2019
Publisher: BMJ
Date: 10-06-2018
DOI: 10.1136/BJSPORTS-2018-099131
Abstract: Sedentary behaviour (SB) has been proposed as an ‘independent’ risk factor for chronic disease risk, attracting much research and media attention. Many countries have included generic, non-quantitative reductions in SB in their public health guidelines and calls for quantitative SB targets are increasing. The aim of this narrative review is to critically evaluate key evidence areas relating to the development of guidance on sitting for adults. We carried out a non-systematic narrative evidence synthesis across seven key areas: (1) definition of SB, (2) independence of sitting from physical activity, (3) use of television viewing as a proxy of sitting, (4) interpretation of SB evidence, (5) evidence on ‘sedentary breaks’, (6) evidence on objectively measured sedentary SB and mortality and (7) dose response of sitting and mortality/cardiovascular disease. Despite research progress, we still know little about the independent detrimental health effects of sitting, and the possibility that sitting is mostly the inverse of physical activity remains. Unresolved issues include an unclear definition, inconsistencies between mechanistic and epidemiological studies, over-reliance on surrogate outcomes, a very weak epidemiological evidence base to support the inclusion of ‘sedentary breaks’ in guidelines, reliance on self-reported sitting measures, and misinterpretation of data whereby methodologically inconsistent associations are claimed to be strong evidence. In conclusion, public health guidance requires a consistent evidence base but this is lacking for SB. The development of quantitative SB guidance, using an underdeveloped evidence base, is premature any further recommendations for sedentary behaviour require development of the evidence base and refinement of the research paradigms used in the field.
Publisher: Human Kinetics
Date: 2020
Abstract: Background : It is not always clear whether physical activity is causally related to health outcomes, or whether the associations are induced through confounding or other biases. Randomized controlled trials of physical activity are not feasible when outcomes of interest are rare or develop over many years. Thus, we need methods to improve causal inference in observational physical activity studies. Methods : We outline a range of approaches that can improve causal inference in observational physical activity research, and also discuss the impact of measurement error on results and methods to minimize this. Results : Key concepts and methods described include directed acyclic graphs, quantitative bias analysis, Mendelian randomization, and potential outcomes approaches which include propensity scores, g methods, and causal mediation. Conclusions : We provide a brief overview of some contemporary epidemiological methods that are beginning to be used in physical activity research. Adoption of these methods will help build a stronger body of evidence for the health benefits of physical activity.
Publisher: Springer Science and Business Media LLC
Date: 10-01-2017
Publisher: JMIR Publications Inc.
Date: 15-09-2017
DOI: 10.2196/JMIR.8081
Publisher: Informa UK Limited
Date: 15-05-2014
DOI: 10.3109/03014460.2014.910270
Abstract: In China, the prevalence of overweight and obesity appears to be increasing at unacceptable levels among young people living in major cities undergoing rapid economic growth. To report the prevalence of overweight and obesity among Shanghai inner city youth using the recently published International Obesity Task Force (IOTF) Asian definition. Secondary analysis of children aged 8-15 years who participated in the Shanghai Schools' Physical Fitness Examinations, a representative school-based survey. Height and weight were measured and body mass index (kg/m(2)) was calculated. The prevalence of overweight and obesity was determined using the IOTF children's BMI cut-points for Asian populations, equivalent to an adult BMI of 23 g/m(2) (overweight) and 27 kg/m(2) (obese). The prevalence of combined overweight and obesity was 49.1% for boys and 30.8% for girls aged 8-15-years. Almost one-in-five boys were obese, compared with 8.4% of girls. In boys the prevalence of overweight appeared to increase from age 10 years. The high prevalence of combined overweight and obesity among urban Chinese youth, especially among boys, requires immediate health promotion intervention.
Publisher: BMJ
Date: 11-2019
DOI: 10.1136/BMJOPEN-2019-028947
Abstract: Greenspace is one of the important factors that can promote an active lifestyle. Thus, greener surroundings may be a motivating factor for people with newly diagnosed diabetes to engage in more physical activity. Given that diagnosis of type 2 diabetes (T2D) may serve as a window opportunity for behavioural modification, we hypothesise that the association between neighbourhood greenspace and physical activity among people with newly diagnosed T2D may be greater than those not diagnosed with T2D. The aim of this study was to investigate the association between access to greenspace and changes in physical activity and sedentary behaviour, and whether these associations differed by T2D. Prospective cohort. New South Wales, Australia. We used self-reported information from the New South Wales 45 and Up Study (baseline) and a follow-up study. Information on sitting, walking and moderate to vigorous physical activity was used as outcomes. The proportion of greenspace within 500 m, 1 km and 2 km road network buffers around participant’s residential address was generated as a proxy measure for access to greenspace. The association between the access to greenspace and the outcomes were explored among the newly diagnosed T2D group and those without T2D. Among New T2D, although no significant changes were found in the amount of walking with the percentage of greenspace, increasing trends were apparent. There was no significant association between the percentage of greenspace and changes in amount of moderate to vigorous physical activity (MVPA). Among No T2D, there were no significant associations between the amount of MVPA and walking, and percentage of greenspace. For changes in sitting time, there were no significant associations with percentage of greenspace regardless of buffer size. In this study, there was no association between access to greenspace at baseline and change in walking, MVPA and sitting time, regardless of T2D status.
Publisher: Springer Science and Business Media LLC
Date: 12-03-2018
Publisher: American Diabetes Association
Date: 02-2017
DOI: 10.2337/DS15-0044
Abstract: Whether patients with type 2 diabetes change their lifestyle in response to their diagnosis and maintain behavior changes is unclear. This study aimed to 1) compare changes in lifestyle behaviors among participants who were newly diagnosed with type 2 diabetes and those never diagnosed with type 2 diabetes and 2) investigate changes in lifestyle behaviors in relation to the duration of newly diagnosed type 2 diabetes. We used self-reported information from the New South Wales 45 and Up Study and a follow-up study. Changes in body weight amount of walking, moderate to vigorous physical activity (MVPA), and sitting fruit and vegetable consumption and smoking status and number of cigarettes smoked were used as measures of health behavior change. These variables were compared between participants in a “new type 2 diabetes” group and a “no type 2 diabetes” group. The new type 2 diabetes group had a smaller decrease in vegetable consumption, lost more weight, and were more likely to quit smoking than the no type 2 diabetes group. MVPA, fruit consumption, and number of cigarettes smoked did not change significantly for either group. Although no significant changes were found in any of the health behaviors based on time since diagnosis, the magnitude of changes in weight and walking increased as duration of diagnosis increased, whereas changes in MVPA, number of cigarettes smoked, and proportion of participants who quit smoking decreased. In this population-based study, participants with incident type 2 diabetes reported only minimal changes in their lifestyle factors after receiving their diagnosis.
Publisher: Elsevier BV
Date: 09-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 19-03-2019
Abstract: Few studies have investigated the longitudinal association between breastfeeding and maternal cardiovascular disease ( CVD ) outcomes. This study examined the association between breastfeeding and CVD hospitalization and mortality in a large Australian cohort. Baseline questionnaire data (2006–2009) from a s le of 100 864 parous women aged ≥45 years from New South Wales, Australia, were linked to hospitalization and death data until June 2014 and December 2013, respectively. Analysis was restricted to women without self‐reported medically diagnosed CVD at baseline or without past CVD hospitalization 6 years before study entry. Never versus ever breastfeeding and average breastfeeding duration per child, derived from self‐reported lifetime breastfeeding duration and number of children, and categorized as never breastfed, , to 12, or months/child, were assessed. Cox proportional hazards models were used to explore the association between breastfeeding and CVD outcomes. Covariates included sociodemographic characteristics, lifestyle risk factors, and medical and reproductive history. There were 3428 (3.4%) first CVD ‐related hospital admissions and 418 (0.4%) deaths during a mean follow‐up time of 6.1 years for CVD hospitalization and 5.7 years for CVD mortality. Ever breastfeeding was associated with lower risk of CVD hospitalization (adjusted hazard ratio [95% CI]: 0.86 [0.78, 0.96] P =0.005) and CVD mortality (adjusted hazard ratio [95% CI]: 0.66 [0.49, 0.89] P =0.006) compared with never breastfeeding. Breastfeeding ≤12 months/child was significantly associated with lower risk of CVD hospitalization. Breastfeeding is associated with lower maternal risk of CVD hospitalization and mortality in middle‐aged and older Australian women. Breastfeeding may offer long‐term maternal cardiovascular health benefits.
Publisher: BMJ
Date: 13-02-2019
Publisher: Springer Science and Business Media LLC
Date: 15-10-2015
DOI: 10.1007/S40279-014-0273-8
Abstract: Over the last decade, there has been a marked increase in studies about built environments and physical activity. As the number of publications is growing rapidly, literature reviews play an important role in identifying primary studies and in synthesizing their findings. However, many of the reviews of effectiveness in this field demonstrate methodological limitations that might lead to inaccurate portrayals of the evidence. Some literature reviews a priori excluded intervention studies even though they provide the strongest level of evidence. The label 'systematic review' has mostly been used inappropriately. One of the major criteria of a systematic review that is hardly ever met is that the quality of the primary studies needs to be assessed and this should be reflected in the synthesis, presentation and interpretation of results. With few exceptions, 'systematic' reviews about environments and physical activity did not refer to or follow the QUORUM or PRISMA statements. This commentary points out the usefulness of the PRISMA statement to standardize the reporting of methodology of reviews and provides additional guidance to limit sources of bias in them. The findings and recommendations from this article can help in moving forward the synthesis of evidence of effectiveness not only in built environments and physical activity, but also more broadly in exercise science and public health.
Publisher: Springer Science and Business Media LLC
Date: 22-04-2023
Publisher: Elsevier BV
Date: 12-2011
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1093/JN/NXAB393
Publisher: SAGE Publications
Date: 06-11-2008
Abstract: The prevalence and correlates of home smoking bans in the Republic of Korea were examined using population-based data from telephone interviews with 500 Seoul adult residents in 2002. Most (97%) respondents indicated that they smoked, or that their spouse, other family member, or a regular friend smoked. Nearly all indicated that environmental tobacco smoke (ETS) is harmful. Only 19% of homes banned smoking, 65% allowed smoking anywhere, and 16% allowed smoking by special guests or in certain areas. The odds of having a full ban were significantly greater for men, married in iduals, those less than 35 years or more than 50 years of age, non-smokers, in iduals whose nonspouse family members did not smoke, and in iduals with more sources of anti-ETS messages. Home smoking bans should be promoted by media c aigns and other tobacco control activities, because knowledge of the effects of ETS was already high.
Publisher: Elsevier BV
Date: 08-2009
DOI: 10.1016/J.YPMED.2009.07.011
Abstract: To examine the psychometric properties of the Neighborhood Environment Walkability Scale-Youth (NEWS-Y) and explore its associations with context-specific and overall physical activity (PA) among youth. In 2005, parents of children ages 5-11 (n=116), parents of adolescents ages 12-18 (n=171), and adolescents ages 12-18 (n=171) from Boston, Cincinnati, and San Diego, completed NEWS-Y surveys regarding perceived land use mix- ersity, recreation facility availability, pedestrian/automobile traffic safety, crime safety, aesthetics, walking/cycling facilities, street connectivity, land use mix-access, and residential density. A standardized neighborhood environment score was derived. Self-reported activity in the street and in parks, and walking to parks, shops, school, and overall physical activity were assessed. The NEWS-Y subscales had acceptable test-retest reliability (ICC range .56-.87). Being active in a park, walking to a park, walking to shops, and walking to school were related to multiple environmental attributes in all three participant groups. Total neighborhood environment, recreation facilities, walking and cycling facilities, and land use mix-access had the most consistent relationships with specific types of activity. The NEWS-Y has acceptable reliability and subscales were significantly correlated with specific types of youth PA. The NEWS-Y can be used to examine neighborhood environment correlates of youth PA.
Publisher: Public Library of Science (PLoS)
Date: 09-06-2014
Publisher: BMJ
Date: 29-04-2021
Publisher: Springer Science and Business Media LLC
Date: 26-06-2013
Abstract: Handheld computers for data collection (HCDC) and management have become increasingly common in health research. However, current knowledge about the use of HCDC in health research in China is very limited. In this study, we administered a survey to a hard-to-reach population in China using HCDC and assessed the acceptability and adoption of HCDC in China. Handheld computers operating Windows Mobile and Questionnaire Development Studio (QDS) software (Nova Research Company) were used for this survey. Questions on tobacco use and susceptibility were drawn from the Global Adult Tobacco Survey (GATS) and other validated instruments, and these were programmed in Chinese characters by local staff. We conducted a half-day training session for survey supervisors and a three-day training session for 20 interviewers and 9 supervisors. After the training, all trainees completed a self-assessment of their skill level using HCDC. The main study was implemented in fall 2010 in 10 sites, with data managed centrally in Beijing. Study interviewers completed a post-survey evaluation questionnaire on the acceptability and utility of HCDC in survey research. Twenty-nine trainees completed post-training surveys, and 20 interviewers completed post-data collection questionnaires. After training, more than 90% felt confident about their ability to collect survey data using HCDC, to transfer study data from a handheld computer to a laptop, and to encrypt the survey data file. After data collection, 80% of the interviewers thought data collection and management were easy and 60% of staff felt confident they could solve problems they might encounter. Overall, after data collection, nearly 70% of interviewers reported that they would prefer to use handheld computers for future surveys. More than half (55%) felt the HCDC was a particularly useful data collection tool for studies conducted in China. We successfully conducted a health-related survey using HCDC. Using handheld computers for data collection was a feasible, acceptable, and preferred method by Chinese interviewers. Despite minor technical issues that occurred during data collection, HCDC is a promising methodology to be used in survey-based research in China.
Publisher: Elsevier BV
Date: 08-2009
Publisher: Springer Science and Business Media LLC
Date: 03-03-2012
Publisher: Oxford University Press (OUP)
Date: 24-10-2017
Abstract: Background Acculturation is associated with increased prevalence of cardiovascular disease (CVD) risk-factors among immigrants in Western countries. Little is known about acculturation effects on CVD risks among Chinese immigrants, one of the fastest growing populations in Western countries. In this study, we aim to examine the association between acculturation and CVD risk-factors among Chinese immigrants, Australia's third-largest foreign-born group. Methods We accessed a subs le of Chinese immigrants ( n = 3220) within the 45-and-Up Study (2006-2009). Poisson regression model with a robust error variance examined the association between acculturation and CVD risk-factors, and prevalence ratios were reported, adjusted for socio-demographic characteristics. Indicators of acculturation included age at migration, length of Australian residence and language spoken at home. The outcomes were self-reported CVD diagnosis and six risk-factors (hypertension, diabetes, high cholesterol, smoking, overweight/obesity, physical inactivity). Results Mean age of Chinese participants was 58.9-years (SD = 10.7) and 55.5% were women. Chinese migrating to Australia aged <18 years were significantly more likely to report diabetes (prevalence ratio = 1.71 p < 0.01), overweight/obesity (prevalence ratio = 1.49 p < 0.001) and ≥ 3 CVD risk-factors (prevalence ratio = 1.47 p < 0.05) compared with those who migrated after 18-years-old. Chinese immigrants who lived in Australia for ≥ 30 years were significantly more likely to have diabetes (prevalence ratio = 1.84 p < 0.01) and ≥ 3 CVD risk-factors (prevalence ratio = 1.84 p < 0.01). There were no significant differences by language spoken at home. The association between indicators of acculturation and CVD risk-factors appeared to differ by sex. Conclusion Greater acculturation was associated with adverse CVD risk-factors among Chinese immigrants in Australia.
Publisher: Elsevier BV
Date: 09-2015
Publisher: Japan Epidemiological Association
Date: 2014
Publisher: Springer Science and Business Media LLC
Date: 29-05-2013
Publisher: BMJ
Date: 08-11-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2012
Publisher: Oxford University Press (OUP)
Date: 02-02-2018
Abstract: There is limited evidence on the directionality of the associations of sitting time with physical function. This study examined the longitudinal associations of sitting time with changes in physical function, and physical function with changes in sitting time. Data from 10,027 retirees in the Social, Economic, and Environmental Factor (SEEF) population-based cohort were collected in 2006-20008 and in 2010-2011. Daily sitting time was assessed by a single-item question. Physical function was measured with the Medical Outcomes Study Physical Functioning Scale (range 0-100) with participants categorized as: no minor moderate or severe limitation. General linear regression models, adjusted for covariates, were used to assess associations of sitting time with physical function for all participants and in subgroups according to sex, and categories of body mass index, physical activity, and physical function limitations. Each hour of baseline sitting was associated with declines in physical function for women (0.20 units [95% confidence interval {CI} 0.04-0.37]) and those with severe functional limitations (0.65 units [95% CI 0.20-1.12]). Each unit of baseline physical function was associated with declines in sitting time for all participants (0.009 hours/day [95% CI 0.005-0.013]) and for all subgroups. There was limited evidence of a bidirectional association of sitting time with physical function except in women and people with severe functional limitations. Health promotion efforts are needed to address the impact of poor physical function on increases in sitting time which result in further functional declines for these subgroups of the population.
Publisher: Elsevier BV
Date: 05-2018
Publisher: Wiley
Date: 19-06-2014
DOI: 10.1002/OBY.20817
Publisher: Public Library of Science (PLoS)
Date: 04-08-2011
Publisher: Elsevier BV
Date: 03-2017
Publisher: Elsevier BV
Date: 06-2022
Publisher: Springer Science and Business Media LLC
Date: 14-08-2013
Publisher: SAGE Publications
Date: 2012
DOI: 10.4278/AJHP.100701-QUAN-224
Abstract: To (1) assess the reliability of the newly developed Fears of Stranger Danger (FSD) scale, (2) examine measurement invariance and identify demographic variation in FSD, and (3) examine associations of FSD with physical activity, screen time, and body mass index (BMI) z score. Cross-sectional survey with test-retest. Neighborhoods with various socioeconomic characteristics and walkability in San Diego, Boston, and Cincinnati. Parent-adolescent pairs (n = 171), and parents of children (n = 116). Response rate was 47% for Survey 1, and 69% were retained for Survey 2. Data analyses included test-retest reliability and internal consistency for FSD, tests of differential functioning for measurement invariance, t-test for associations between FSD and demographic variables, and partial correlation for associations of FSD with physical activity, screen time, and BMI z score. The FSD scale had moderate to substantial test-retest reliability (intraclass correlation coefficient = .65–.85) and excellent internal consistency (Cronbach á = .88–.94). Measurement invariance was established across gender, race/ethnicity, and income. FSD was higher regarding younger children, females, nonwhites, and lower-income youth. FSD was positively associated with restrictive parental rules for playing outside (partial r = .28–.33), and negatively associated with children's outdoor physical activity in the neighborhood (partial r = −.27), but not associated with other measures of physical activity, screen time, or BMI z score. The new measure of FSD had good evidence of reliability and measurement invariance, but there were inconsistent associations of FSD with youth physical activity.
Publisher: BMJ
Date: 03-2017
Publisher: Springer Science and Business Media LLC
Date: 03-2014
DOI: 10.1007/S12529-014-9393-7
Abstract: We describe the emergence of recent public health challenges in China, particularly those regarding lifestyle-related non-communicable diseases (NCDs). We also summarize some recent ex les of behavioral medicine research and practice in relation to the prevention and control of NCDs in China. Finally, we describe recent changes in the public health system in China and how behavioral medicine research and practice can be incorporated into this system to address these public health challenges. We considered research and policy literature from both China and Western countries in order to evaluate the relevance of the field of behavioral medicine for addressing the rising NCDs in China. Rapid economic development and related social and environmental changes have brought about increasing wealth and lifestyle changes in China, along with new public health challenges related to the prevention and control of NCDs. The field of behavioral medicine has much to offer China in addressing these public health challenges. Although behavioral medicine research and practice are still at an early stage in China, there are encouraging signs of its development, particularly resulting from international collaborations with researchers from Western countries. The next stage of this field's development in China will involve increased integration of behavioral medicine into public health education, training, and the health system. However, this process of integration will need to build on China's traditional approaches to public health training, research, and practice. Although the field of behavioral medicine in public health is still in its infancy in China, we argue that the practice and principles of behavioral medicine are important for successfully addressing the substantial burden of NCDs now and in the future.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.AMEPRE.2013.10.019
Abstract: The second phase of Active Living Research (ALR-2, 2007-2012) focused on advancing the Robert Wood Johnson Foundation (RWJF)'s goal of reversing the childhood obesity epidemic. The mission was to stimulate and support research to identify environmental factors and policies that influence physical activity for children and families to inform effective childhood obesity prevention strategies, with an emphasis on the lower-income and racial/ethnic communities with highest childhood obesity prevalence. The present report describes ALR activities undertaken to accomplish three goals. The first goal-to build an evidence base-was furthered by funding 230 competitive grants to identify and evaluate promising environment and policy changes. More than 300 publications have been produced so far. The second goal-to build an interdisciplinary and erse field of investigators-was supported through annual conferences and linked journal supplements, academic outreach to multiple disciplines, and grants targeting young investigators and those representing groups historically disadvantaged or underrepresented in RWJF-funded research. The third goal-to use research to inform policy and practice-was advanced through research briefs webinars research-translation grants supporting ALR grantees to design communications tailored to decision-maker audiences active engagement of policymakers and other stakeholders in ALR program meetings and annual conferences ALR presentations at policy-related meetings and broad outreach through a widely used website, e-mailed newsletters, and social media. ALR-2 findings and products have contributed to a rapid increase in the evidence base and field of active living research, as documented by an independent program evaluation.
Publisher: BMJ
Date: 21-12-2021
DOI: 10.1136/BJSPORTS-2020-102892
Abstract: To determine the effectiveness of physical activity interventions involving mobile applications (apps) or trackers with automated and continuous self-monitoring and feedback. Systematic review and meta-analysis. PubMed and seven additional databases, from 2007 to 2020. Randomised controlled trials in adults (18–65 years old) without chronic illness, testing a mobile app or an activity tracker, with any comparison, where the main outcome was a physical activity measure. Independent screening was conducted. We conducted random effects meta-analysis and all effect sizes were transformed into standardised difference in means (SDM). We conducted exploratory metaregression with continuous and discrete moderators identified as statistically significant in subgroup analyses. Physical activity: daily step counts, min/week of moderate-to-vigorous physical activity, weekly days exercised, min/week of total physical activity, metabolic equivalents. Thirty-five studies met inclusion criteria and 28 were included in the meta-analysis (n=7454 participants, 28% women). The meta-analysis showed a small-to-moderate positive effect on physical activity measures (SDM 0.350, 95% CI 0.236 to 0.465, I 2 =69%, T 2 =0.051) corresponding to 1850 steps per day (95% CI 1247 to 2457). Interventions including text-messaging and personalisation features were significantly more effective in subgroup analyses and metaregression. Interventions using apps or trackers seem to be effective in promoting physical activity. Longer studies are needed to assess the impact of different intervention components on long-term engagement and effectiveness.
Publisher: Human Kinetics
Date: 10-2022
Publisher: Informa UK Limited
Date: 03-05-2018
DOI: 10.1080/00140139.2018.1468494
Abstract: Driving may be detrimental to health, with one hypothesis suggesting that driving may elicit an acute stress response and, with repeated exposures, may become a chronic stressor. The present study examined the stress response to driving and the effectiveness of a prior exercise bout in d ening this response. Twenty healthy adults performed three tasks: control, driving and exercise plus driving. Heart rate (HR), heart rate variability (HRV), blood pressure (BP) and cortisol were measured to quantify the acute stress response to each condition. Data indicated a stress response to driving: HR was elevated and HRV was reduced during the driving task compared with control. HR was elevated and HRV was reduced comparing the exercise plus driving with the driving condition. BP and cortisol were not different among conditions. The potential of interventions, such as exercise, to counter daily stressors should be evaluated to safeguard long-term health. Practitioner Summary: this study confirms that driving induces a stress response, with the exercise intervention providing mixed results (an increase in cardiovascular measures and a decrease in cortisol measure trending significance). Given the known consequences of stress and evidence that exercise can mitigate acute stress, further evaluation of exercise interventions is recommended.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.CTIM.2017.10.009
Abstract: Yoga is promoted as an anti-stress activity, however, little is known about the mechanisms through which it acts. The present study investigated the acute effects of a hatha yoga session, displayed on a video, on the response to and recovery from an acute psychological stressor. Twenty-four healthy young adults took part in a counterbalanced, randomized-crossover trial, with a yoga and a control condition (watching TV). Participants attended the laboratory in the afternoon on two days and each session comprised a baseline, control or yoga task, stress task and recovery. Blood pressure (BP), heart rate (HR) and salivary cortisol responses were measured. State cognitive- and somatic-anxiety along with self-confidence were assessed before and after the stressor. Although no difference in the BP or HR responses to stress were found between conditions, systolic BP (p=0.047) and diastolic BP (p=0.018) recovery from stress were significantly accelerated and salivary cortisol reactivity was significantly lower (p=0.01) in the yoga condition. A yoga session also increased self-confidence (p=0.006) in preparation for the task and after completion. Moreover, self-confidence reported after the stress task was considered debilitative towards performance in the control condition, but remained facilitative in the yoga condition. Our results show that a single video-instructed session of hatha yoga was able to improve stress reactivity and recovery from an acute stress task in healthy in iduals. These positive preliminary findings encourage further investigation in at-risk populations in which the magnitude of effects may be greater, and support the use of yoga for stress reactivity and recovery.
Publisher: Wiley
Date: 11-11-2020
DOI: 10.1002/OBY.22673
Abstract: Both aerobic physical activity and muscle-strengthening exercise are recommended for obesity prevention. However, at the population level, the independent and/or combined associations of these physical activity modalities with obesity are unknown. The aim of this study was to examine the associations between aerobic physical activity and muscle-strengthening exercise with obesity among a representative s le of adults. Data were pooled from four US public health surveillance surveys from 2011 to 2017. Cross-sectional associations between adherence to the aerobic physical activity (≥ 150 min/wk) and muscle-strengthening exercise (≥ 2 times/wk) guidelines with different classes of BMI-defined obesity were examined using Poisson regression. Prevalence ratios are reported as both unadjusted and adjusted for sociodemographic and lifestyle characteristics. Data were available for 1,677,108 adults (≥ 18 years old). Compared with meeting neither guideline (reference category), meeting both guidelines was associated with the lowest adjusted prevalence ratios (APRs) for the following: Class I obesity and above (BMI ≥ 30.0 kg/m Among nearly 1.7 million US adults, meeting both aerobic and muscle-strengthening exercise guidelines was associated with a lower obesity prevalence, and associations were more pronounced for higher obesity classes.
Publisher: SAGE Publications
Date: 30-12-2015
Abstract: Background: Workplace energy expenditure devices (WEEDs), such as bicycle desks and treadmill desks, can contribute to weight gain prevention and disease risk-reduction. Little is known about the extent to which adults with erse health risk factors are interested in using WEEDs. Methods: Primary care patients aged 18 to 65 years at 2 outpatient clinics in Central Pennsylvania completed a cross-sectional survey in April, 2014 to assess interest in using “a small pedaling device under the desk” and “walking on a treadmill with a desk attached” if these options were provided at no cost. Demographic and health risk factors were also assessed. Multiple logistic regression analyses were used to examine the associations of demographic and health risk factors with interest in using WEEDs. Results: Among 240 patients, 106 (44.2%) reported interest in using WEEDs. Of these 106 patients, interest in using a bicycle desk (91.5%) was higher than interest in using a treadmill desk (65.1%), P .001. Females were more likely than males to be interested in using a bicycle desk, and patients aged 18 to 44 years were more likely than those aged 45 to 65 years to be interested in using a treadmill desk. Conclusions: Results suggest that erse patient populations may have interest in using WEEDs. Promoting use of WEEDs in primary care practices could help meet national standards for providing comprehensive, patient-centered care.
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-045818
Abstract: With the growing representation of older adults in the workforce, the health and fitness of older employees are critical to support active ageing policies. This systematic review aimed to characterise and evaluate the effects on physical activity (PA) and fitness outcomes of workplace PA interventions targeting older employees. We searched Medline, PreMedline, PsycInfo, CINAHL and the Cochrane Controlled Register of Trials (CENTRAL) for articles published from inception to 17 February 2020. Eligible studies were of any experimental design, included employees aged ≥50 years, had PA as an intervention component and reported PA-related outcomes. Titles and abstracts of 8168 records were screened, and 18 unique interventions were included (3309 participants). Twelve studies were randomised controlled trials (RCTs). Seven interventions targeted multiple risk factors (n=1640), involving screening for cardiovascular disease risk factors, but had a non-specific description of the PA intervention. Four interventions targeted nutrition and PA (n=1127), and seven (n=235) focused only on PA. Interventions overwhelmingly targeted aerobic PA, compared with only four interventions targeting strength and/or balance (n=106). No studies involved screening for falls/injury risk, and only two interventions targeted employees of low socioeconomic status. Computation of effect sizes (ESs) was only possible in a maximum of three RCTs per outcome. ESs were medium for PA behaviour (ES=0.25 95% CI −0.07 to 0.56), muscle strength (ES=0.27, 95% CI −0.26 to 0.80), cardiorespiratory fitness (ES=0.28, 95% CI −22 to 0.78), flexibility (ES=0.50, 95% CI −0.04 to 1.05) and balance (ES=0.74, 95% CI −0.21 to 1.69). Grading of Recommendations Assessment, Development and Evaluation criteria-rated quality of evidence was ‘low’ due to high risk of bias, imprecision and inconsistency. The lack of high-quality effective workplace PA interventions contrasts the importance and urgency to improve the health and fitness in this population. Future interventions should incorporate strength and balance training and screening of falls/injury risk in multi risk factors approaches. CRD42018084863. ( www.crd.york.ac.uk rospero/display_record.php?RecordID=84863 ).
Publisher: Emerald Publishing Limited
Date: 16-06-2017
Publisher: Public Library of Science (PLoS)
Date: 29-11-2017
Publisher: JMIR Publications Inc.
Date: 26-06-2018
DOI: 10.2196/CARDIO.9424
Publisher: Springer Science and Business Media LLC
Date: 25-01-2016
Publisher: BMJ
Date: 09-02-2022
Abstract: To identify data availability, gaps, and patterns for population level prevalence of loneliness globally, to summarise prevalence estimates within World Health Organization regions when feasible through meta-analysis, and to examine temporal trends of loneliness in countries where data exist. Systematic review and meta-analysis. Embase, Medline, PsycINFO, and Scopus for peer reviewed literature, and Google Scholar and Open Grey for grey literature, supplemented by backward reference searching (to 1 September 2021) Observational studies based on nationally representative s les (n≥292), validated instruments, and prevalence data for 2000-19. Two researchers independently extracted data and assessed the risk of bias using the Joanna Briggs Institute checklist. Random effects meta-analysis was conducted in the subset of studies with relatively homogeneous research methods by measurement instrument, age group, and WHO region. Prevalence data were available for 113 countries or territories, according to official WHO nomenclature for regions, from 57 studies. Data were available for adolescents (12-17 years) in 77 countries or territories, young adults (18-29 years) in 30 countries, middle aged adults (30-59 years) in 32 countries, and older adults (≥60 years) in 40 countries. Data for all age groups except adolescents were lacking outside of Europe. Overall, 212 estimates for 106 countries from 24 studies were included in meta-analyses. The pooled prevalence of loneliness for adolescents ranged from 9.2% (95% confidence interval 6.8% to 12.4%) in South-East Asia to 14.4% (12.2% to 17.1%) in the Eastern Mediterranean region. For adults, meta-analysis was conducted for the European region only, and a consistent geographical pattern was shown for all adult age groups. The lowest prevalence of loneliness was consistently observed in northern European countries (2.9%, 1.8% to 4.5% for young adults 2.7%, 2.4% to 3.0% for middle aged adults and 5.2%, 4.2% to 6.5% for older adults) and the highest in eastern European countries (7.5%, 5.9% to 9.4% for young adults 9.6%, 7.7% to 12.0% for middle aged adults and 21.3%, 18.7% to 24.2% for older adults). Problematic levels of loneliness are experienced by a substantial proportion of the population in many countries. The substantial difference in data coverage between high income countries (particularly Europe) and low and middle income countries raised an important equity issue. Evidence on the temporal trends of loneliness is insufficient. The findings of this meta-analysis are limited by data scarcity and methodological heterogeneity. Loneliness should be incorporated into general health surveillance with broader geographical and age coverage, using standardised and validated measurement tools. PROSPERO CRD42019131448.
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.YPMED.2014.03.009
Abstract: Socioeconomic position (SEP) is associated with health-related behaviours but little is known about the socioeconomic gradient of sedentary behaviour. This study aims to assess the associations between SEP and multiple indicators of sedentary behaviour among Australian mid-to-older age adults. Multivariate analysis of 60,404 (>47years, 26,366 in paid employment) participants in the Social, Economic, and Environmental Factor Study, examining the associations between SEP (educational attainment, household income, and an area-level index of socioeconomic advantage) and self-reported daily time for total sitting, TV viewing, computer use, and car driving. Data was collected in 2010 in New South Wales, Australia. For participants in paid employment, we found positive associations with all SEP indicators for total sitting and computer use time, and inverse associations for TV viewing. Driving time was inversely associated with education level only. We observed similar but less pronounced patterns of associations among participants not in paid employment. Higher SEP is linked to higher total sitting and computer time, particularly among those in paid employment, and lower TV viewing time.
Publisher: Elsevier BV
Date: 11-2010
Publisher: Springer Science and Business Media LLC
Date: 13-04-2018
DOI: 10.1007/S10903-017-0584-6
Abstract: Health outcomes and impact of cardiovascular disease vary between populations, where ethnic minorities and immigrant groups are more likely to be disadvantaged. Compared with the majority residents, health outcomes, especially short-term mortality from coronary heart disease event are worse in people of Chinese ethnicity, potentially due to poor self-management and experiences with the healthcare system in host countries. A scoping review was conducted. Four overarching themes were found: (1) understanding of heart disease, risk factors and symptom recognition, (2) adherence to medication and lifestyle modification, (3) health service/information choice, and (4) family role in disease self-management and decision making. All themes were greatly influenced by English language proficiency and cultural practices. English language proficiency and cultural practices should be taken into consideration when providing healthcare services for people of Chinese ethnicity, as it plays an important role in self-management and experiences with the healthcare system.
Publisher: Springer Science and Business Media LLC
Date: 28-02-2015
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.IJCARD.2016.11.062
Abstract: Although Chinese form the largest non-English speaking group in Australia, cardiovascular disease (CVD) risk profiles among Chinese Australians have not been comprehensively examined, nor has the effect of mixed-Chinese ethnicity been adequately explored. This study is to investigate cardiovascular risk among Chinese, mixed-Chinese, and non-Chinese Australians. Using data from 266,696 Australian participants from the 45 and Up Study (2006-2009), this study investigated cardiovascular risk among Chinese (n=3454), mixed-Chinese (n=1062), and non-Chinese (n=262,180) participants. Poisson regression models with a robust error variance were used to estimate prevalence ratio (PR) and 95% confidence intervals (CI) for CVD (coronary heart disease (CHD) and stroke) and six major risk factors (hypertension, diabetes, high cholesterol, smoking, overweight/obesity, and physical inactivity) by ethnicity using non-Chinese participants as the reference group. Each outcome was adjusted for sociodemographic characteristics. Compared with non-Chinese Australians, Chinese had lower prevalence of CHD (PR=0.67 95% CI=0.59-0.75) and stroke (PR=0.67 95% CI=0.51-0.88). Of the risk factors, Chinese had higher prevalence of diabetes (PR=1.25 95% CI=1.12-1.39), smoking (PR=1.22 95% CI=1.04-1.43) and physical inactivity (PR=1.48 95% CI=1.41-1.55) but lower prevalence of hypertension (PR=0.90 95% CI=0.86-0.95), high cholesterol (PR=0.87 95% CI=0.79-0.95), and overweight/obesity (PR=0.46 95% CI=0.43-0.48). Mixed-Chinese had higher prevalence of CVD and worse CVD risk profiles compared with Chinese. There are marked differences in the prevalence of CVD and risk factors among three groups. The noticeable variations in CVD risk between Chinese and mixed-Chinese indicate that conventional classification of treating all Chinese as homogeneous could be misleading. More investigation into the health outcomes of mixed ancestry is warranted.
Publisher: Oxford University Press (OUP)
Date: 12-07-2016
Publisher: Human Kinetics
Date: 2017
Abstract: To examine the combined effects of body mass index (BMI), physical activity (PA) and sitting on incident type 2 diabetes mellitus (T2DM) among Australian adults. A s le of 29,572 adults aged ≥45 years from New South Wales, Australia, completed baseline (2006–2008) and follow-up (2010) questionnaires. Incident T2DM was defined as self-reported, physician-diagnosed diabetes at follow-up. BMI was categorized as normal/overweight/obese. PA was tertiled into low/medium/ high. Sitting was dichotomized as higher/lower sitting (≥ 8 hours/day or 8 hours/day). Odds ratios (OR) were estimated for developing T2DM using logistics regression for in idual and combined risk factors, and data stratified by BMI categories. During a mean 2.7 (SD: 0.9) years of follow-up, 611 (2.1%) participants developed T2DM. In fully adjusted models, BMI was the only independent risk factor for incident T2DM. In stratified analyses, the association between BMI and T2DM did not differ significantly across sitting or PA categories. Overweight/obese in iduals with high PA and lower sitting had higher odds of incident T2DM than normal counterparts with low PA and higher sitting. High PA/low sitting did not attenuate the risk of T2DM associated with overweight/obesity. Maintaining a healthy weight, by adopting healthy lifestyle behaviors, is critical for T2DM prevention.
Publisher: BMJ
Date: 30-08-2022
Publisher: Oxford University Press (OUP)
Date: 31-10-2017
DOI: 10.1093/AJE/KWX345
Abstract: Public health guidance includes recommendations to engage in strength-promoting exercise (SPE), but there is little evidence on its links with mortality. Using data from the Health Survey for England and the Scottish Health Survey from 1994-2008, we examined the associations between SPE (gym-based and own-body-weight strength activities) and all-cause, cancer, and cardiovascular disease mortality. Multivariable-adjusted Cox regression was used to examine the associations between SPE (any, low-/high-volume, and adherence to the SPE guideline (≥2 sessions/week)) and mortality. The core s le comprised 80,306 adults aged ≥30 years, corresponding to 5,763 any-cause deaths (736,463 person-years). Following exclusions for prevalent disease/events occurring in the first 24 months, participation in any SPE was favorably associated with all-cause (hazard ratio (HR) = 0.77, 95% confidence interval (CI): 0.69, 0.87) and cancer (HR = 0.69, 95% CI: 0.56, 0.86) mortality. Adhering only to the SPE guideline was associated with all-cause (HR = 0.79, 95% CI: 0.66, 0.94) and cancer (HR = 0.66, 95% CI: 0.48, 0.92) mortality adhering only to the aerobic activity guideline (equivalent to 150 minutes/week of moderate-intensity activity) was associated with all-cause (HR = 0.84, 95% CI: 0.78, 0.90) and cardiovascular disease (HR = 0.78, 95% CI: 0.68, 0.90) mortality. Adherence to both guidelines was associated with all-cause (HR = 0.71, 95% CI: 0.57, 0.87) and cancer (HR = 0.70, 95% CI: 0.50, 0.98) mortality. Our results support promoting adherence to the strength exercise guidelines over and above the generic physical activity targets.
Publisher: BMJ
Date: 05-05-2018
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.YPMED.2012.01.021
Abstract: To examine the associations of TV viewing time and domain-specific physical activity with weight change to determine whether domain-specific physical activity moderates the potential association of TV viewing time with weight change. We used four-year longitudinal data (baseline: 2003-2004, follow-up: 2007-2008) on 969 adults from selected neighborhoods in Adelaide, Australia (Age: 48.6 ± 10.6 years, 61% females). Mixed models examined four-year weight change as the dependent variable, with TV viewing time, habitual transport and past week domain-specific physical activity at baseline as independent variables. On average, participants gained 1.6 kg over four years. TV viewing time at baseline was positively associated with weight gain at follow-up. Each additional hour of TV viewing was associated with 0.24-0.27 kg of extra weight gain. This relationship was not moderated by recent recall of transport, leisure-time, and occupational physical activity, but was moderated by habitual transport: an additional hour of TV viewing time at baseline was significantly associated with an extra weight gain of 0.65 kg at follow-up among those who were inactive in everyday transport TV time was not significantly associated with weight change among those who were regularly active in transport. Habitual active transport may protect adults against risk of weight gain associated with prolonged TV viewing time.
Publisher: BMJ
Date: 06-04-2022
DOI: 10.1136/BJSPORTS-2021-104961
Abstract: We aimed to investigate the dose–response associations of long-term leisure-time physical activity (LTPA) obtained from repeated measures with all-cause and cardiovascular disease (CVD) mortality outcomes in Taiwanese adults. We included 210 327 participants with self-reported LTPA at least in two medical examinations (867 968 data points) for up to 20 years (median, IQR: 4.8 years, 2.3–9.0). Dose–response relationships were modelled with restricted cubic spline functions and Cox regressions HRs (95% CIs) adjusted for main covariates. During up to 23 years of follow-up (3 655 734 person-years), 10 539 participants died, of which 1919 of CVD. We observed an inverse, non-linear dose–response association between long-term LTPA and all-cause and CVD mortality. Compared with the referent (0 metabolic equivalent of task (MET) hours/week), insufficient (0.01–7.49 MET hours/week), recommended (7.50–15.00 MET hours/week) and additional ( MET hours/week) amounts of LTPA had a lower mortality risk of 0.74 (0.69–0.80), 0.64 (0.60–0.70) and 0.59 (0.54–0.64) for all-cause mortality and 0.68 (0.60–0.84), 0.56 (0.47–0.67) and 0.56 (0.47–0.68) for CVD mortality. When using only baseline measures of LTPA, the corresponding mortality risk was 0.88 (0.84–0.93), 0.83 (0.78–0.88) and 0.78 (0.73–0.83) for all-cause and 0.91 (0.81–1.02), 0.78 (0.68–0.89) and 0.80 (0.70–0.92) for CVD mortality. Long-term LTPA was associated with lower risks of all-cause and CVD mortality. The magnitude of risk reductions was larger when modelling repeated measures of LTPA compared with one measure of LTPA at baseline.
Publisher: Springer Science and Business Media LLC
Date: 13-11-2014
Publisher: Elsevier BV
Date: 05-2011
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.JNEB.2010.07.003
Abstract: To determine (1) reliability of new food environment measures (2) association between home food environment and fruit and vegetable (FV) intake and (3) association between community and home food environment. In 2005, a cross-sectional survey was conducted with readministration to assess test-retest reliability. Adolescents, parents of adolescents, and parents of children (n = 458) were surveyed in San Diego, Boston, and Cincinnati. Most subscales had acceptable reliability. Fruit and vegetable intake was positively associated with availability of healthful food (r = 0.15-0.27), FV (r = 0.22-0.34), and ratio of more-healthful/less-healthful food in the home (r = 0.23-0.31) and was negatively associated with less-healthful food in the home (r = -0.17 to -0.18). Home food environment was associated with household income but not with community food environment. A more healthful home food environment was related to youth FV intake. Higher income households had more healthful food in the home. The potential influence of neighborhood food outlets warrants further study.
Publisher: BMJ
Date: 06-2023
DOI: 10.1136/BMJSEM-2023-001549
Abstract: The current study analysed the implementation costs of a community-based walking football exercise programme for patients with type 2 diabetes. The direct costs of a community-based walking football programme for middle-aged and older male patients with type 2 diabetes, designed and tested in Porto (Portugal), were calculated from the payer’s perspective. One season of this programme consists of three sessions per week (60 min per session) for nine months (October to June). Cost calculations were based on two groups of 20 patients and included the sports infrastructure and equipment, human resources, pre-exercise clinical evaluation, medical equipment, technical training and other consumable costs. An economic depreciation of 1 year using the linear method for sports and electronic materials was considered. Cost analysis dated December 2021 and is expressed in international dollars ($). This programme was estimated to have a total implementation cost of $22 923.07 $2547.01/month $573.08 atient $106.13/session $63.68 atient/month and $5.31 atient/session. A community-based walking football programme for patients with type 2 diabetes is affordable and can be scaled up by local communities to promote physical activity and manage type 2 diabetes with the involvement of multiple stakeholders such as the football clubs, municipalities and primary healthcare units.
Publisher: Springer Science and Business Media LLC
Date: 11-02-2019
Publisher: JMIR Publications Inc.
Date: 27-11-2017
Abstract: arriers to attending cardiac rehabilitation (CR), including cultural and linguistic differences, may be addressed by recent technological developments. However, the feasibility of using these approaches in culturally and linguistically erse patients is yet to be determined. his study aims to assess the use of mobile technologies and features, as well as confidence in utilization across patients speaking different languages at home (ie, English, Mandarin Chinese, and a language other than English and Mandarin [other]) and are both eligible and physically suitable for CR. In addition, the study aims to determine the sociodemographic correlates of the mobile technology/feature use, including language spoken at home in the three groups mentioned above. his is a descriptive, case matched, comparative study. Age and gender-matched patients speaking English, Mandarin and other languages (n=30/group) eligible for CR were surveyed for their mobile technology and mobile feature use. Participants had a mean age of 66.7 years (SD 13, n=90, range 46-95), with 53.3% (48/90) male. The majority (82/90, 91.1%) used at least one technology device, with 87.8% (79/90) using mobile devices, the most common being smartphones (57/90, 63.3%), tablets (28/90, 31.1%), and text/voice-only phones (24/90, 26.7%). More English-speaking participants used computers than Mandarin or “other” language speaking participants (P=.003 and .02) and were more confident in doing so compared to Mandarin-speaking participants (P=.003). More Mandarin-speaking participants used smartphones compared with “other” language speaking participants (P=.03). Most commonly used mobile features were voice calls (77/82, 93.9%), text message (54/82, 65.9%), the internet (39/82, 47.6%), email (36/82, 43.9%), and videoconferencing (Skype or FaceTime [WeChat or QQ] 35/82, 42.7%). Less Mandarin-speaking participants used emails (P=.001) and social media (P=.007) than English-speaking participants. Speaking Mandarin was independently associated with using smartphone, emails, and accessing the web-based medication information (OR 7.238, 95% CI 1.262-41.522 P=.03, OR 0.089, 95% CI 0.016-0.490 P=.006 and OR 0.191, 95% CI 0.037-0.984 P=.05). his study reveals a high usage of mobile technology among CR patients and provides further insights into differences in the technology use across CALD patients in Australia. The findings of this study may inform the design and implementation of future technology-based CR.
Publisher: Human Kinetics
Date: 04-2015
Abstract: Media reporting of published research findings can increase the profile and reach of new scientific findings. Dissemination is an important part of research, and media reporting can catalyze this process. In many areas, including health-related research, policymakers often rely on the media for information and guidance. Furthermore, media reports can influence the scientific community and clinicians. 1 · 2 However, despite the potential beneficial role as a bridge between scientists and the public, misleading information can cause controversy, confusion, and even harm. 3
Publisher: Springer Science and Business Media LLC
Date: 09-2015
Abstract: Endometriosis is a hormonal disease and also an inflammatory condition. Converging evidence indicates that inflammation and coagulation are 2 major host-defense systems that interact with each other. This study was undertaken to test the hypothesis that women with ovarian endometriomas are in a hypercoagulable state as manifested by the altered procoagulant factors and higher percentage of activated platelets in their peripheral blood. Two sets of participants were recruited. The first set consisted of 50 premenopausal women with endometriosis and 50 age-matched healthy women, and the second set consisted of 21 women with endometriosis and 17 age-comparable women without endometriosis. For the first set, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen, and other coagulation factors, along with their demographic, clinical, and anthropometric data, were measured/retrieved. For the second set, only the percentage of activated platelets in peripheral blood was evaluated. We found that women with endometriosis had a significantly shortened APTT and TT and elevated fibrinogen levels as compared with controls. They also had significantly higher percentage of circulating degranuated platelets, and the percentage was significantly reduced 1 month after surgical removal of endometriotic lesions. These findings provide evidence of a hypercoagulable state in women with endometriosis, reflecting the intimate relationship between coagulation and inflammation. They also suggest that these coagulation parameters such as APTT and fibrinogen and others could potentially be used for diagnostic or prognostic purposes. It also underpins the possibility for the use of antithrombotic therapy in the treatment of endometriosis.
Publisher: BMJ
Date: 10-07-2022
DOI: 10.1136/BJSPORTS-2021-105195
Abstract: To examine independent and interactive associations of physical activity and diet with all-cause, cardiovascular disease (CVD) and physical activity, diet and adiposity-related (PDAR) cancer mortality. This population-based prospective cohort study (n=346 627) is based on the UK Biobank data with linkage to the National Health Service death records to 30 April 2020. A left-truncated Cox proportional hazards model was fitted to examine the associations between exposures (self-reported total moderate-to-vigorous intensity physical activity (MVPA), vigorous-intensity physical activity (VPA) and a diet quality index (score ranged 0–3)) and outcomes (all-cause, CVD and PDAR cancer mortality). During a median follow-up of 11.2 years, 13 869 participants died from all causes, 2650 from CVD and 4522 from PDAR cancers. Compared with quartile 1 (Q1, 0–210 min/week), Q2–Q4 of MVPA were associated with lower risks of all-cause (HR ranged from 0.87 (95% CI: 0.83 to 0.91) to 0.91 (95% CI: 0.87 to 0.96)), CVD (HR ranged from 0.85 (95% CI: 0.76 to 0.95) to 0.90 (95% CI: 0.81 to 1.00)) and PDAR cancer mortality (HR ranged from 0.86 (95% CI: 0.79 to 0.93) to 0.94 (95% CI: 0.86 to 1.02)). Compared with no VPA, any VPA was associated with lower risk for all-cause and CVD mortality (HR ranged from 0.85 (95% CI: 0.80 to 0.89) to 0.88 (95% CI: 0.84 to 0.93) and from 0.75 (95% CI: 0.68 to 0.83) to 0.90 (95% CI: 0.80 to 1.02), respectively). Although not reaching statistical significance for all-cause and CVD mortality, being in the best dietary category (diet quality index=2–3) was associated with a reduction in PDAR cancer mortality (HR=0.86, 95% CI: 0.78 to 0.93). No additive or multiplicative interactions between physical activity categories and dietary quality was found. When comparing across physical activity and diet combinations, the lowest risk combinations consistently included the higher levels of physical activity and the highest diet quality score. Adhering to both quality diet and sufficient physical activity is important for optimally reducing the risk of mortality from all causes, CVD and PDAR cancers.
Publisher: Springer Science and Business Media LLC
Date: 21-01-2020
DOI: 10.1038/S41598-019-57070-X
Abstract: Physical inactivity is a global pandemic with no signs of improvement. Prolonged sitting time is an emerging risk factor that exacerbates the health consequences of physical inactivity. Both behaviours are influenced by various in idual and environmental factors but it remains unknown whether early-life exposures “program” these behaviours in later life. The current evidence is limited by a small number of studies which were primarily conducted in high-income countries, and a narrow range of early-life variables examined. Using data from three population-based Brazilian birth cohorts (analytical s les: n = 2740 for 1982 cohort, aged 30 years n = 3592 for 1993 cohort, aged 18 n = 2603 for 2004 cohort, aged 6), we show that being female and higher family socioeconomic status at birth are strong and consistent predictors of lower physical activity and higher sedentary time from childhood to adulthood. Meanwhile, higher birth weight and lower birth order may also predict lower physical activity and higher sedentary time. Our findings are distinct from evidence from high-income countries, suggesting the importance of broader socioeconomic context in determining in idual’s activity patterns through the life- course. Such evidence is essential for understanding the biological etiology and socioeconomic context of physical activity and sedentary behaviour at an early stage in life.
Publisher: Human Kinetics
Date: 2023
Publisher: BMJ
Date: 02-2019
DOI: 10.1136/BMJOPEN-2018-025285
Abstract: We aimed to describe the rationalisation beliefs endorsed by Chinese male smokers and to examine the association between rationalisation and the intention to quit. Questionnaires were conducted among male smokers in three cities (Shanghai, Nanning and Mudanjiang) which represent different geographical locations, economic development levels and legislative status of tobacco control in China. It was a multicentre cross-sectional survey involved a total of 3710 male smokers over 18 years. Primary outcomes were intention to quit, smoking rationalisation scores and sub scores in six dimensions. Smoking rationalisation was assessed using a newly developed Chinese rationalisation scale. Multivariable logistic regression was performed to examine the relationship between rationalisation and intention to quit. On average, smokers scored 3.3 out of 5 on the smoking rationalisation scale. With a one point increase in total rationalisation scale, the odds for intention to quit in the next 6 months decreased by 48% (OR=0.52, 95% CI: 0.44 to 0.61 p .001). Separate logistic regressions for six subscales of rationalisation shown consistent inverse associations with intention to quit (all p values .001). Believing that smoking was socially acceptable was the strongest predictor (OR=0.62, 95% CI: 0.55 to 0.71 p .001). Rationalisation beliefs could be important barriers to smoking cessation. Some beliefs have stronger association with quit intention than others. Eroding rationalisation beliefs endorsed by smokers is a potential strategy for smoking cessation intervention.
Publisher: Elsevier BV
Date: 09-2016
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.HEALTHPLACE.2011.08.021
Abstract: To evaluate the growing literature on the built environment and physical activity/obesity, we conducted a review of review papers. Through a systematic search, we identified 36 reviews that met the inclusion criteria and evaluated these reviews based on key information provided, review methodology, and specificity regarding measurement. We also analyzed research gaps and areas of improvement identified by previous reviews and propose a research agenda. Future studies should develop complex conceptual and statistical models that include moderators and mediators, improve objective and perceived measures of the built environment, and strengthen evidence of causality through better research designs.
Publisher: Human Kinetics
Date: 09-2023
Publisher: Springer Science and Business Media LLC
Date: 06-07-2019
Publisher: Oxford University Press (OUP)
Date: 06-12-2020
Abstract: Clinical exercise interventions show that combining moderate to vigorous intensity physical activity (MVPA) and muscle strengthening exercise (MSE) has more favourable cardiometabolic health benefits than engaging in only one mode of physical activity. However, few studies have examined these associations among community-based s les and none among Asian adults. This cross-sectional analysis included 9120 participants aged 20–80 years from the 2014–2015 Korea National Health and Nutritional Examination Survey. Fasting blood s les were analysed for adverse cardiometabolic biomarkers (e.g. high glucose/glycohaemoglobin/triglycerides) and MVPA and MSE were assessed using validated questionnaires. Poisson regression models examined the association between the in idual and total number of adverse biomarkers across categories of MVPA–MSE guideline adherence (met neither (reference) met MSE only met MVPA only met both) and prevalence ratios are reported adjusted for covariates (e.g. age, education, smoking, waist circumference and sitting time). The mean ± SD age was 46.2 ± 16.3 years and 50.3% of the participants were women. Compared with meeting neither guideline, meeting both guidelines had the lowest prevalence ratios for four out of eight in idual adverse cardiometabolic biomarkers. In a sex-stratified analysis of men, only meeting both guidelines had a lower prevalence ratio for ≥4 adverse biomarkers (prevalence ratio 0.67 95% confidence interval 0.53–0.85). For women, the prevalence ratio for ≥4 adverse biomarkers was lowest among those meeting both guidelines (prevalence ratio 0.46 95% confidence interval 0.31–0.66), followed by MSE only (prevalence ratio 0.65 95% confidence interval 0.42–0.96) and MVPA only (prevalence ratio 0.78 95% confidence interval 0.65–0.92). Among a large s le of Korean adults, concurrent MVPA–MSE was independently associated with favourable cardiometabolic outcomes. This study supports public health action to promote adherence to MVPA–MSE guidelines to enhance cardiovascular health among Korean adults.
Publisher: Elsevier BV
Date: 07-2017
Publisher: Elsevier BV
Date: 02-2013
DOI: 10.1016/J.AMEPRE.2012.09.063
Abstract: Prolonged sitting, including time spent sitting in cars, is detrimentally associated with health outcomes. This study examined whether commuting by car was associated with adults' weight gain over 4 years. Among 822 adult residents of Adelaide, Australia, weight change was ascertained from self-reported weight at baseline (2003-2004) and at follow-up (2007-2008). Using time spent for car commuting and work status at baseline, participants were categorized as non-car commuters, occasional car commuters, and daily car commuters. Multilevel linear regression (conducted in 2012) examined associations of weight change with car-commuting category, adjusting for potential confounding variables, for the whole s le, and among those who were physically inactive or active (≥150 minutes/week) in their leisure time. For the overall s le, adjusted mean weight gain (95% CI) over 4 years was 1.26 (0.64, 1.89) kg for non-car commuters 1.53 (0.69, 2.37) kg for occasional car commuters and 2.18 (1.44, 2.92) kg for daily car commuters (p for trend=0.090). Stratified analyses found a stronger association for those with sufficient leisure-time physical activity. For non-car commuters with sufficient leisure-time physical activity, the adjusted mean weight gain was 0.46 (-0.43, 1.35) kg, which was not significantly greater than 0. Over 4 years, those who used cars daily for commuting tended to gain more weight than those who did not commute by car. This relationship was pronounced among those who were physically active during leisure time. Reducing sedentary time may prevent weight gain among physically active adults.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.DIABRES.2015.02.002
Abstract: To describe the incidence of type 2 diabetes mellitus (T2DM) among middle-aged and older Australian adults and to examine a broad range of risk factors of T2DM. A large cohort of Australian adults aged 45 and up was s led from the general population and was followed up for approximately 3 years (n=60,404). Physician-diagnosed T2DM was self-reported at baseline (2006-2008) and follow-up (2010). Incident T2DM was determined as not reporting T2DM at baseline, but reporting T2DM at follow-up. A broad range of risk factors, including socio-demographic characteristics, health status, family history, and lifestyle behaviors were examined at baseline. Multiple logistic regression was used for selecting potential predictors of incident T2DM, and age and reported family history of T2DM were tested as potential effect modifiers. Of the 54,997 without T2DM at baseline, 888 reported T2DM at follow-up (cumulative incidence 1.6% over 3.4 years, annual incidence rate 0.44%). Adjusted for other risk factors, being male, older age, higher relative socio-economic disadvantage, being born in Asia, lower educational attainment, medical history of hypertension and dyslipidemia, family history of T2DM, overweight/obese, smoking, long sleeping hours, and psychological distress were significantly associated with higher odds of developing T2DM. Particularly, hypertension, dyslipidemia, and overweight/obesity were stronger predictors of T2DM among middle-aged than older adults (≥60 years). Understanding risk factors for incident T2DM could help identify at-risk populations and develop upstream preventive strategies to combat the epidemic of diabetes.
Publisher: Elsevier BV
Date: 12-2017
Publisher: Springer Science and Business Media LLC
Date: 27-04-2016
Publisher: Elsevier BV
Date: 09-2011
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.AMEPRE.2011.06.036
Abstract: Research examining the association between environmental attributes and physical activity among youth is growing. An updated review of literature is needed to summarize the current evidence base, and to inform policies and environmental interventions to promote active lifestyles among young people. A literature search was conducted using the Active Living Research (ALR) literature database, an online database that codes study characteristics and results of published papers on built/social environment and physical activity/obesity/sedentary behavior. Papers in the ALR database were identified through PubMed, Web of Science, and SPORTDiscus using systematically developed and expert-validated search protocols. For the current review, additional inclusion criteria were used to select observational, quantitative studies among youth aged 3-18 years. Papers were categorized by design features, s le characteristics, and measurement mode. Relevant results were summarized, stratified by age (children or adolescents) and mode of measurement (objective or perceived) for environmental attributes and physical activity. Percentage of significant results was calculated. Mode of measurement greatly influenced the consistency of associations between environmental attributes and youth physical activity. For both children and adolescents, the most consistent associations involved objectively measured environmental attributes and reported physical activity. The most supported correlates for children were walkability, traffic speed/volume, access roximity to recreation facilities, land-use mix, and residential density. The most supported correlates for adolescents were land-use mix and residential density. These findings support several recommendations for policy and environmental change from such groups as the IOM and National Physical Activity Plan.
Publisher: SAGE Publications
Date: 20-07-2020
Abstract: The purpose of this study is to develop a smoking rationalization scale for Chinese male smokers. A total of 35 focus groups and 19 one-on-one interviews were conducted to collect items of the scale. Exploratory factor analyses and confirmatory factor analyses were conducted to identify the underlying structure of the scale. Results found a 26-item scale within six dimensions (smoking functional beliefs, risk generalization beliefs, social acceptability beliefs, safe smoking beliefs, self-exempting beliefs, and quitting is harmful beliefs). The scale showed acceptable validity and reliability. Results highlight that smoking rationalization is common among Chinese male smokers, and some beliefs of smoking rationalization seem to be peculiar to China.
Publisher: Springer Science and Business Media LLC
Date: 18-09-2019
DOI: 10.1186/S13104-019-4626-0
Abstract: Kuwait has one of the highest obesity rates in the world. This study examined the associations between sedentary behaviour (objectively measured and self-reported), adiposity and systolic blood pressure in a s le of adolescents residing in Kuwait. Data was obtained from the Study of Health and Activity among adolescents in Kuwait (2012–2013). The s le included a total of 435 adolescents (201 boys). Outcomes were age- and sex specific body mass index Z-scores and systolic blood pressure. Exposures were total sedentary behaviour measured by accelerometry and time spent in some sedentary behaviours (television viewing, video games, computer use and total screen-time). We used multiple linear regression analyses, adjusted for age, governorate, maternal education and physical activity, to examine associations between sedentary behaviour and adiposity and systolic blood pressure. Only 2 statistically significant associations were found between sedentary behaviour and the study outcomes: body mass in boys was directly associated with higher sedentary time [β (95% CIs) 0.003 (0.00 to 0.06)] body mass index was inversely associated with videogames in both sexes [girls: β (95% CIs) − 0.17 (− 0.48 to − 0.04) boys: − 0.24 (− 0.57 to − 0.12)]. In this s le of Kuwaiti adolescents, sedentary behaviour showed limited deleterious associations with adiposity and systolic blood pressure.
Publisher: BMJ
Date: 03-2019
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.ANAI.2010.05.020
Abstract: Intranasal ketorolac challenges can induce respiratory reactions in patients with aspirin-exacerbated respiratory disease (AERD). To determine whether intranasal ketorolac challenges might be used for aspirin desensitization. One hundred patients with suspected AERD who were referred to Scripps Clinic from May 1, 2007 to December 31, 2009 were challenged with 4 increasing doses of ketorolac intranasally at 30-minute intervals. Symptoms, objective changes in the results of their nasal examination, peak nasal inspiratory flow rates, and forced expiratory volume in 1 second (FEV(1)) values were recorded. After nasal ketorolac dosing, patients were given oral aspirin as part of the challenge and desensitization. A control group consisted of 100 patients who had previously undergone our standard oral aspirin challenges and desensitization. Both groups were consecutively enrolled and had similar clinical characteristics. Compared with the standard oral aspirin challenge and desensitization, intranasal ketorolac and modified aspirin challenge significantly attenuated the mean percentage decrease in FEV(1) values (8.5% vs 13.4% P = .01) and decreased the percentage of extrapulmonary reactions (23% vs 45% P = .002), particularly laryngospasm (7% vs19% P = .02) and gastrointestinal reactions (12% vs 33% P = .001). This new protocol was significantly shorter, lasting an average of 1.9 vs 2.6 days (P = <.001). In fact, 83% of the patients completed the new protocol in less than 48 hours compared with only 20% in the oral challenge control group (P < .001). Intranasal ketorolac challenge and desensitization followed by rapid oral aspirin challenges is effective, safe, and less time-consuming than our standard oral aspirin desensitization protocol.
Publisher: Human Kinetics
Date: 07-2014
Abstract: Some attributes of neighborhood environments are associated with physical activity among older adults. This study examined whether the associations were moderated by driving status. Older adults from neighborhoods differing in walkability and income completed written surveys and wore accelerometers ( N = 880, mean age = 75 years, 56% women). Neighborhood environments were measured by geographic information systems and validated questionnaires. Driving status was defined on the basis of a driver’s license, car ownership, and feeling comfortable to drive. Outcome variables included accelerometer-based physical activity and self-reported transport and leisure walking. Multilevel generalized linear regression was used. There was no significant Neighborhood Attribute × Driving Status interaction with objective physical activity or reported transport walking. For leisure walking, almost all environmental attributes were positive and significant among driving older adults but not among nondriving older adults (five significant interactions at p .05). The findings suggest that driving status is likely to moderate the association between neighborhood environments and older adults’ leisure walking.
Publisher: Springer Science and Business Media LLC
Date: 31-01-2015
Publisher: The Optical Society
Date: 26-02-2018
DOI: 10.1364/AO.57.001589
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.YPMED.2013.12.030
Abstract: To examine prospectively whether higher proportions of vigorous physical activity (VPA), independent of total activity volume, are associated with better outcomes in weight maintenance and physical function. We used three-year longitudinal data (2006/07-2009/10) of adults 45 and older (n=32,087 59.5±9.3years) from New South Wales, Australia. Logistic regression models examined odds of weight gain and functional decline by volume and intensity of physical activity. On average, body weight increased by 0.66kg (SD=5.83, p<0.001) a validated physical function score (MOS-PF) decreased by 4.79 (SD=12.56, p<0.001). There was a 10% reduction in the odds of weight gain for participants who reported 300min/week or more of moderate to vigorous physical activity (MVPA) compared to less than 150min of MVPA. The proportion of MVPA that was vigorous was not associated with weight change. With the physical functioning outcome, there were independent protective effects from volume and intensity of physical activity. Independent of total MVPA, each 1% increase in the proportion of total activity that was vigorous was associated with a 0.3% decrease in the odds of decline in physical function. These prospective findings indicate that VPA per se plays an important role in the prevention of functional decline.
Publisher: Oxford University Press (OUP)
Date: 17-09-2019
DOI: 10.1093/IJE/DYZ187
Abstract: Duplicate and salami publication are unethical, but are common practices with substantial consequences for science and society at large. Scientific journals are the ‘gatekeepers’ of the publication process. We investigated journal policies on duplicate and salami publication. In 2018, we performed a content analysis of policies of journals in the disciplines of ‘epidemiology and public health’ and ‘general and internal medicine’. Journal policies were searched, extracted, coded and cross-checked. The associations of disciplinary categories and journal impact factors with journal policies were examined using Poisson regression models with a robust error variance. A total of 209 journals, including 122 in epidemiology and public health and 87 in general and internal medicine, were s led and their policies investigated. Overall, 18% of journals did not have any policies on either practice, 33% only referred to a generic guideline or checklist without explicit mention about either practice, 36% included policies on duplicate publication and only 13% included policies on both duplicate and salami publication. Having explicit journal policies did not differ by journal disciplinary categories (epidemiology and public health vs general and internal medicine) or impact factors. Further analysis of journals with explicit policies found that although duplicate publication is universally discouraged, policies on salami publication are inconsistent and lack specific definitions of inappropriate isions of papers. Gaps exist in journal policies on duplicate and salami publication, characterized by an overall lack of explicit policies, inconsistency and confusion in definitions of bad practices, and lack of clearly defined consequences for non-compliance. Scientific publication and the academic reward systems must evolve to credit good research practice.
Publisher: Public Library of Science (PLoS)
Date: 16-10-2017
Publisher: Elsevier BV
Date: 02-2018
Publisher: SAGE Publications
Date: 03-07-2020
Abstract: Introduction: Health disparities among immigrants exist across socioecological domains. While Chinese immigrants face increased risk for coronary heart disease (CHD) after migration, the reasons are not well understood. Method: This descriptive qualitative study collected 18 semistructured interviews with Chinese immigrants with CHD and family carers from two Australian hospitals. Analysis was guided by the social–ecological model. Results: Poor knowledge and limited English proficiency increased CHD risk and difficulty navigating health care systems/resources. Interpersonal and family factors positively influenced health-seeking behaviors, acceptance of cardiac procedures, adoption of secondary preventive behaviors and information acquisition through social networks. A lack of culturally specific health information and programs in Chinese languages was described. Ethnic concordance between Chinese doctors and patients improved health literacy and engendered trust. Discussion: Culturally specific interventions could include health promotion materials in Chinese, inclusion of family in educational programs, and Chinese-focused public health c aigns about warning signs of heart attack.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2015
Abstract: Chinese form a large proportion of the immigrant population in Western countries. There is evidence that Chinese immigrants experience an increased risk of coronary heart disease ( CHD ) after immigration in part due to cultural habits and acculturation. This is the first systematic review and meta‐analysis that aims to examine the risk of CHD in people of Chinese ethnicity living in Western countries, in comparison with whites and another major immigrant group, South Asians. Literature on the incidence, mortality, and prognosis of CHD among Chinese living in Western countries was searched systematically in any language using 6 electronic databases up to December 2014. Based on the meta‐analysis, Chinese had lower incidence of CHD compared with whites (odds ratio 0.29 95% CI : 0.24–0.34) and South Asians (odds ratio 0.37 95% CI : 0.24–0.57) but higher short‐term mortality after first hospitalization for acute myocardial infarction compared with whites (odds ratio 1.34 95% CI , 1.04–1.73) and South Asians (odds ratio 1.82 95% 1.33–2.50). There was no significant difference between Chinese immigrants and whites in long‐term outcomes (mortality and recurrent events) after acute myocardial infarction. These findings provide an important focus for resource planning to enhance early secondary prevention of CHD to improve short‐term survival outcomes among Western‐dwelling Chinese immigrants.
Location: United States of America
No related grants have been discovered for Ding Ding.