Muscle strength and physical activity are associated with self-rated health in an adult Danish population

Objective

To describe associations of muscle strength, physical activity and self-rated health.

Method

Isometric muscle strength by maximal handgrip strength (HGS) or muscle strength by 30 s repeated chair stand test (30 s-CS) was combined with leisure time physical activity. Using logistic regression odds ratio was calculated for good self-rated health according to the combined associations among 16,539 participants (59.7% women), mean age 51.9 (SD: 13.8) years, from a cross-sectional study in Denmark 2007–2008.

Results

Good self-rated health was positively associated with higher levels of physical activity and greater muscle strength. Regarding HGS the highest OR for good self-rated health was in the moderate/vigorous physically active participants with high HGS (OR = 6.84, 95% CI: 4.85–9.65 and OR = 7.34, 95% CI: 5.42–9.96 for men and women, respectively). Similarly the highest OR for good self-rated health was in the moderate/vigorous physically active participants with high scores in the 30 s-CS test (6.06, 95% CI: 4.32–8.50 and 13.38, 95% CI: 9.59–18.67 for men and women, respectively). The reference groups were sedentary participants with low strength (HGS or 30 s-CS).

Conclusion

The combined score for physical activity level with either HGS or 30 s-CS was strongly positively associated with self-related health.     

A population-based randomized controlled trial of the effect of combining a pedometer with an intervention toolkit on physical activity among individuals with low levels of physical activity or fitness

Objectives

To examine if receiving a pedometer along with an intervention toolkit is associated with increased physical activity, aerobic fitness and better self-rated health among individuals with low levels of physical activity or fitness.

Methods

The intervention was nested in the Danish Health Examination Survey (DANHES) and carried out in 2008. Participants were randomly assigned to either a pedometer group (n = 326) or a control group (n = 329). Physical activity, aerobic fitness, and self-rated health were measured at baseline and at 3-month follow-up, and differences were tested by Wilcoxons signed rank tests and Chi-squared tests.

Results

At follow-up, no significant differences in physical activity, aerobic fitness and self-rated health were found between the groups. However, the oldest participants in the pedometer group reported significantly more walking time compared to the controls (controls = 368 min/week, pedometer group = 680 min/week, P = 0.05). Among participants who completed the intervention, a significant effect on total walking time was observed (median difference = 225 min/week, P = 0.04).

Conclusions

The results suggest that receiving a pedometer and along with an intervention toolkit can increase walking time in older individuals, but not in younger individuals. Thus, this type of intervention offers great potential for promoting physical activity in older individuals.Trial registration number: NCT01071811     

Primary prevention of metabolic syndrome in the community using an evidence-based exercise program

Objectives

The purpose of the present study was to examine the effectiveness of a community-based exercise program to lower metabolic syndrome (MetS) risk factors.

Methods

MetS components were retrospectively analyzed in 332 adults (190 women, 142 men) before and after a 14-week supervised community exercise program between January 2007 and May 2012 at the University of Wisconsin-Eau Claire.

Results

Except for total cholesterol, all health outcome variables, including the 5 MetS components, improved following community exercise. Individuals having MetS decreased from 22.3% before participation to 13.5% at end (p < 0.05), while prevalence of participants with no MetS components increased 56% (from 65 to 102; p < 0.05). Compared to the lowest quartile of relative energy expenditure, participants with the highest quartile were 6.4 (95% CI 1.8–23.2; p < 0.05), 7 (95% CI 2.5–20.0; p < 0.05) and 9.3 (95% CI 2.6–34.0; p < 0.05) times more likely to eliminate low-HDL cholesterol, impaired fasting glucose, and low cardiorespiratory fitness as MetS risk factors, respectively.

Conclusion

A community exercise program is an effective method to reduce cardiovascular risk in adults by substantially decreasing the prevalence of MetS and its components. Greater volumes of exercise may increase the likelihood of MetS risk factor elimination.     

Leisure-time physical activity and psychotropic medication: A prospective cohort study

Background

Physical inactivity is a major public health problem associated with an increased risk of mental health problems. The aim of this study was to examine the associations of leisure-time physical activity with subsequent psychotropic medication among middle-aged people employed at baseline.

Methods

Questionnaire survey data collected in 2000–02 among 40–60-year-old employees of the City of Helsinki (N = 8960) were linked with register data on prescribed psychotropic medication (74% gave permission to linkage). The mean follow-up time was 4.2 years. The analysis included 5961 respondents (78% women). The participants were classified into four groups according to physical activity recommendations. Cox regression analysis was used to calculate hazard ratios (HR) for the first psychotropic medication purchase.

Results

Leisure-time physical activity was associated with decreased risk of any psychotropic medication. After adjusting for prior psychotropic medication conditioning exercisers (HR = 0.65, 95% CI, 0.53–0.80), the vigorously active (HR = 0.83, 95% CI, 0.71–0.98) and the moderately active (HR = 0.85, 95% CI, 0.74–0.97) all showed a reduced risk of medication compared with the inactive. The associations were similar for the two main groups of psychotropic medication: antidepressants as well as sedatives and sleep medication.

Conclusions

Leisure-time physical activity is potentially important for preventing mental health problems among the middle-aged.     

Screen time and passive school travel as independent predictors of cardiorespiratory fitness in youth

Objective

The most prevalent sedentary behaviours in children and adolescents are engagement with small screen media (screen-time) and passive travel (by motorised vehicle). The objective of this research was to assess the independence of these behaviours from one another and from physical activity as predictors of cardiorespiratory fitness in youth.

Methods

We measured cardiorespiratory fitness in n = 6819 10-16 year olds (53% male) who self-reported their physical activity (7-day recall) school travel and screen time habits. Travel was classified as active (walking, cycling) or passive; screen time as < 2 h, 2-4 h or > 4 h.

Results

The multivariate odds of being fit were higher in active travel (Boys: OR 1.32, 95% CI: 1.09-1.59; Girls: OR 1.46, 1.15-1.84) than in passive travel groups. Boys reporting low screen time were more likely to be fit than those reporting > 4 h (OR 2.11, 95% CI: 1.68-2.63) as were girls (OR 1.66, 95% CI: 1.24-2.20). These odds remained significant after additionally controlling for physical activity.

Conclusion

Passive travel and high screen time are independently associated with poor cardiorespiratory fitness in youth, and this relationship is independent of physical activity levels. A lifestyle involving high screen time and habitual passive school travel appears incompatible with healthful levels of cardiorespiratory fitness in youth.     

Correlates of seasonal flu vaccination among U.S. home health aides

Introduction

Home health aides (HAs) receive limited training and reach many older patient populations highly susceptible to influenza virus. We sought to examine socio-demographic correlates of seasonal flu vaccination receipt among HAs.

Methods

We analyzed data from the 2007 U.S. National Home Health Aide Survey, a nationally representative sample of HAs reporting on occupational status, job and demographic characteristics and receipt of seasonal flu vaccine (n = 3377).

Results

Seasonal flu vaccine receipt was low among all types of HAs (43.9%). After adjustment for socio-demographic indicators (i.e. age, gender, race and health insurance), home health, home care, hospice and personal care attendants were significantly less likely to report receiving seasonal flu vaccine as compared to licensed nursing assistants (adjusted odds ratio, AOR = 0.42, 95% CI [0.20–0.85]; 0.41, [0.17–0.99]; 0.50, [0.26–0.97], and 0.53, [0.26–0.99], respectively).

Conclusion

Targeted effective vaccination campaigns are needed to improve vaccination rates among home health aides.     

Life-style and self-rated global health in Sweden: A prospective analysis spanning three decades

Objective

To study the relations between lifestyle factors (smoking, drinking, exercise, vegetable consumption, social relations) and global self-rated health in the adult Swedish population.

Method

The data come from the Swedish Level of Living Survey, a face-to-face panel study. The analysis follows the respondents with good health in 1991 (N = 4035) and uses multivariate logistic regression to assess the relations between lifestyle factors in 1991 and health in 2000 and 2010.

Results

Baseline (1991) exercise, social support, smoking and vegetable consumption are associated with health in 2000 and/or 2010. 2000: Weekly exercise in 1991 increases the probability of good health by 6 percentage points [95% CI: 1–10] compared to no exercise, and smoking 10 or more cigarettes a day decreases the probability of good health by 5 percentage points [95% CI 1–8]. Lacking social support decreases the probability of good health by 17 percentage points (95% CI: 9–25). 2010: Smoking 10 or more cigarettes a day decreases the probability of good health by 10 percentage points [95% CI 5–15], and eating vegetables every day increases the probability of good health by 4 percentage points [95% CI 0.2–7].

Conclusions

Exercise, smoking, social support and vegetable consumption are related to self-rated health 2000 and/or 2010.     

Using an individualised consultation and activPAL™ feedback to reduce sedentary time in older Scottish adults: Results of a feasibility and pilot study

Objective

Sedentary behaviours have been linked to poor health, independent of physical activity levels. The objective of this study was to explore an individualised intervention strategy aimed at reducing sedentary behaviours in older Scottish adults.

Methods

This feasibility and pilot study was a pre-experimental (one group pretest–posttest) study design. Participants were enrolled into the study in January–March 2012 and data analysis was completed April–October 2012. The study was based in Glasgow, Scotland. Participants received an individualised consultation targeting sedentary behaviour incorporating feedback from an activPAL activity monitor. Outcome measures were objectively (activPAL) and subjectively measured (Sedentary Behaviour Questionnaire) sedentary time.

Results

Twenty four participants received the intervention. Objectively measured total time spent sitting/lying was reduced by 24 min/day (p = 0.042), a reduction of 2.2%. Total time spent in stepping activities, such as walking increased by 13 min/day (p = 0.044). Self-report data suggested participants achieved behaviour change by reducing time spent watching television and/or using motorised transport.

Conclusion

Interventions to reduce sedentary behaviours in older people are urgently needed. The results of this feasibility and pilot study suggest a consultation approach may help individuals reduce time spent in sedentary behaviours. A larger, controlled trial is warranted with a diverse sample to increase generalisability.     

Staying on track: A cluster randomized controlled trial of automated reminders aimed at increasing human papillomavirus vaccine completion

Objectives

To evaluate whether automated reminders increase on-time completion of the three-dose human papillomavirus (HPV) vaccine series.

Methods

Ten reproductive health centers enrolled 365 women aged 19–26 to receive dose one of the HPV vaccine. Health centers were matched and randomized so that participants received either routine follow-up (control) or automated reminder messages for vaccine doses two and three (intervention). Intervention participants selected their preferred method of reminders – text, e-mail, phone, private Facebook message, or standard mail. We compared vaccine completion rates between groups over a period of 32 weeks.

Results

The reminder system did not increase completion rates, which overall were low at 17.2% in the intervention group and 18.9% in the control group (p = 0.881). Exploratory analyses revealed that participants who completed the series on-time were more likely to be older (OR = 1.15, 95% CI 1.01–1.31), report having completed a four-year college degree or more (age-adjusted OR = 2.51, 95% CI 1.29–4.90), and report three or more lifetime sexual partners (age-adjusted OR = 3.45, 95% CI 1.20–9.92).

Conclusions

The study intervention did not increase HPV vaccine series completion. Despite great public health interest in HPV vaccine completion and reminder technologies, completion rates remain low.     

Association between physical activity and major depressive disorder among current or former smokers with pulmonary disease

Objective

To examine the association between physical activity and major depressive disorder (MDD) in a nationally representative sample of current or former smokers with pulmonary impairments.

Methods

The analyzed sample from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 included 536 adults who indicated that they were current or former smokers, had at least mild pulmonary impairment (FEV₁/FVC < 0.70), and provided depression and physical activity data.

Results

After controlling for asthma status, pulmonary impairment, age, poverty-to-income ratio (PIR), education, gender, marital status, body mass index (BMI), cotinine, comorbidity index, race-ethnicity, and smoking status, those who met physical activity guidelines had a 59% (odds ratio (OR) = 0.41; 95% confidence interval (CI): 0.18–0.94) lower odds of having MDD. Using multivariate linear regression with depression symptoms as the outcome variable, and after adjustments, physical activity was inversely associated with depression symptoms in a dose–response manner; lowest tertile was the referent group, middle tertile coefficient: − 1.06 (95% CI: − 1.98 to − 0.14), and highest tertile coefficient: − 1.10 (95% CI: − 1.84 to − 0.34).

Conclusions

Physical activity inversely associates with MDD in adults with pulmonary impairments, and does so in a dose–response manner. This suggests that individuals with pulmonary impairments should be encouraged to engage in enjoyable, safe forms of physical activity in a progressive manner.     

Hypertension identification via emergency responders: A randomized controlled intervention study

Objective

The objective was to test the effectiveness of a mail campaign that included blood pressure (BP) measurements from patients treated by emergency medical technicians (EMTs) to motivate them to (re)check their BP at a fire station. The mailing used a 2 × 2 research design tailoring on risk and source personalization.

Method

In this randomized controlled trial, participants were randomized into a control group or one of four experimental groups. Participants residing in one of four fire departments in a Pacific Northwest metropolitan area were eligible if they had a systolic BP ≥ 160 mm Hg and/or diastolic BP ≥ 100 mm Hg when seen by EMTs during the study period (July 2007–September 2009).

Results

Of 7106 eligible participants, 40.7% were reached for a follow-up interview. Multivariable logistic regression analysis showed that although the absolute number of fire station BP checks was low (4%), participants who received any mailed intervention had a 3 to 5-fold increase in the odds of reporting a fire station BP check over controls. Fire station visits did not differ by type of tailored mailing.

Conclusion

Partnering with Emergency Medical Services is an innovative way to identify high-risk community members for population health interventions.     

Maintaining sleep and physical activity alleviate mood instability

Objective

Building on previous work indicating that mood instability is the hallmark of neuroticism, our aim was to examine whether changes in exercise, sleep duration and leisure predicted decreases in mood instability with time.

Methods

We used data from 3374 participants of the British Health and Lifestyle Study who answered the Eysenck Personality Inventory–Neuroticism subscale (EPI-N) and the General Health Questionnaire on two occasions 7 years apart. We predicted mood instability scores derived from the EPI-N at follow-up using self-reported changes in exercise, sleep duration and leisure hours between the two time points as independent variables.

Results

We confirmed the observation that mood instability decreases with age. Maintaining one's exercise at baseline level decreased mood instability (beta = − 0.21) while sleeping less increased mood instability (beta = 0.14). Change in leisure time was not independently related to mood instability after accounting for the two other lifestyle factors.

Conclusion

Personality, at least with regard to mood instability, can be modified by lifestyle factors. Exercise and sleep support mood stability and could be important components of preventative mental health (as well as physical health) benefits.     

Steps/day and metabolic syndrome in African American adults: The Jackson Heart Study

Objective

To examine the relationship between pedometer-measured step count data and the Metabolic Syndrome (MetS) in African American adults.

Method

379 African American adults (mean age 60.1 years; 60% female) enrolled in the Jackson Heart Study (Jackson, MS) from 2000 to 2004 provided sufficient pedometer data for inclusion in this analysis. MetS was classified according to the International Diabetes Federation Task Force on Epidemiology and Prevention.

Results

Using steps/day categorized as tertiles (< 3717 (referent), 3717–6238, > 6238), participants taking 3717–6238 (Odds Ratio (OR)(95% Confidence Interval (CI)) = 0.34 (0.19, 0.61)) and > 6238 steps/day (OR(95% CI) = 0.43 (0.23, 0.78)) had lower odds of having MetS compared to participants in the lowest tertile. Using previously suggested steps/day cut-points (< 2500 (referent), 2500–4999, 5000–7499, ≥ 7500), the odds of having MetS were lower for participants taking 2500–4999 (OR(95% CI) = 0.32 (0.14, 0.72)), 5000–7499 (OR(95% CI) = 0.22 (0.09, 0.53)), and > 7500 (OR(95% CI) = 0.26 (0.11, 0.65)) steps/day compared to those taking < 2500 steps/day.

Conclusion

Compared to lower levels, higher levels of steps/day are associated with a lower prevalence of MetS in this older African American population.     

Temporal relationships between screen-time and physical activity with cardiorespiratory fitness in English schoolchildren: a 2-year longitudinal study

Objective

To determine the temporal relationships screen-time and physical activity have with cardiorespiratory fitness.

Method

Measures were made over two years (2008-2010) in 1500 participants aged 11.5 (SD 0.5) years at baseline.

Results

Tracking coefficients were low-to-moderate for all measures. At follow-up, 25% of participants moved from having low (< 2 h) to high (≥ 2 h) daily screen-time and 6% became unfit according to FITNESSGRAM standards. Baseline screen-time was the strongest univariate predictor of becoming unfit. Multivariate analysis controlling for decimal age, BMI and deprivation confirmed baseline screen-time as the strongest independent predictor of becoming unfit over the 2-year study period (OR 2.4; 95%CI:1.4-4.0). Current (OR 2.3; 95%CI:1.3-4.0) and previous (OR 1.7; 95%CI:1.0-2.9) physical activity levels also independently predicted becoming unfit.

Conclusion

There is currently no guidance for limiting screen-time in UK children. These longitudinal data add to the cross-sectional evidence of lower physical activity and fitness in children reporting ≥ 2 h daily screen-time. More importantly, these data demonstrate that high screen-time during childhood is an independent predictor of lower cardiorespiratory fitness in adolescence.     

Is park visitation associated with leisure-time and transportation physical activity?

Objective

The aim of this study was to examine whether frequency of park visitation was associated with time spent in various domains of physical activity among adults living in a disadvantaged neighbourhood of Victoria, Australia.

Methods

In 2009, participants (n = 319) self-reported park visitation and physical activity including: walking and cycling for transport, leisure-time walking, leisure-time moderate- to vigorous-intensity physical activity, and total physical activity.

Results

The mean number of park visits per week was 3.3 (SD = 3.8). Park visitation was associated with greater odds of engaging in high (as compared to low) amounts of transportation physical activity, leisure-time walking, leisure-time moderate- to vigorous-intensity physical activity (MVPA) and total physical activity. Each additional park visit per week was associated with 23% greater odds of being in the high category for transportation physical activity, 26% greater odds of engaging in high amounts of leisure-time walking, 11% greater odds of engaging in MVPA, and 40% greater odds of high total physical activity.

Conclusions

Acknowledging the cross-sectional study design, the findings suggest that park visitation may be an important predictor and/or destination for transportation and leisure-time walking and physical activity. Findings highlight the potentially important role of parks for physical activity.     

Correlates of weight gain in German children attending elementary school

Objective

To examine the association of physical fitness, sports participation, physical activity and sedentary behavior as well as dietary patterns and family background with weight gain in non-overweight elementary school children, independent of absolute body weight.

Methods

Height, weight, and physical fitness were assessed in 1249 (51% male) children in south-west Germany during the fall of 2010 and 2011 (age at baseline: 7.0 ± 0.6 years). Based on changes in body mass index percentiles children were classified into a weight loss, constant weight, or weight gain group. Health behavior and family background were assessed via parent questionnaire. Group differences were examined via analysis of variance and multinomial logistic regression.

Results

Weight gain was associated with low physical activity, lack of active transport, and lack of regular breakfast at follow-up. Children in the weight gain category also displayed lower fitness during baseline and follow-up, but differences were more pronounced during follow-up. TV time, migration background or parental education was not associated with weight gain.

Conclusion

Ensuring adequate physical activity and high fitness is an important aspect in the prevention of excessive weight gain during childhood. In addition to sports participation active transport should be emphasized in future weight management programs in children.     

Legislated changes to federal pension income in Canada will adversely affect low income seniors' health

Objective

This study uses a population health intervention modeling approach to project the impact of recent legislated increases in age eligibility for Canadian federally-funded pension benefits on low income seniors' health, using food insecurity as a health indicator.

Method

Food insecurity prevalence and income source were assessed for unattached low income (<$20,000 CAD) persons aged 60–64 years (population weighted n = 151,350) versus seniors aged 65–69 years (population weighted n = 151,485) using public use data from the Canadian Community Health Survey Cycle 4.1 (2007–2008).

Results

Seniors' benefits through federal public pension plans constituted the main source of income for the majority (79.4%) of low income seniors aged 65–69 years, in contrast to low income seniors aged 60–64 years who reported their main income from employment, employment insurance, Workers' Compensation, or welfare. The increase in income provided by federal pension benefits for low income Canadians 65 and over coincided with a pronounced (50%) decrease in food insecurity prevalence (11.6% for seniors ≥ 65 years versus 22.8% for seniors < 65 years).

Conclusion

Raising the age of eligibility for public pension seniors' benefits in Canada from 65 to 67 years will negatively impact low income seniors' health, relegating those who are food insecure to continued hardship.     

Risk factors for single and recurrent falls: A prospective study of falls in community dwelling seniors without cognitive impairment

Objective

The purpose of this study is to contribute evidence towards heterogeneity in risk factors for single and recurrent falls.

Method

This is a prospective study conducted in Taiwan. Participants were randomly selected from the examinees of the annual health examination in 2010. Participants were interviewed with a detailed questionnaire and followed up one year later. Predictor variables included socio-demographic characteristics, medical conditions, laboratory data, and risk factors for osteoporosis. The outcome was falls in the ensuing 12 months.

Results

The mean age of the 653 completers was 75.6 ± 6.4. Half (48.7%) were women. Fallers and recurrent fallers comprised 14.5% and 6.0% of the participants, respectively. Blurred vision (adjusted odds ratio (aOR): 1.93, 95% confidence interval (CI): 1.02–3.67), minimal outdoor activities (aOR: 2.28, 95% CI: 1.06–4.88), and overactive thyroid/parathyroid (aOR: 3.49, 95% CI: 1.29–9.50) were associated with single falls. Frailty (aOR: 2.81, 95% CI: 1.11–7.09), decreased body height (aOR: 3.15, 95% CI: 1.52–6.54) and taking sedatives/hypnotics (aOR: 4.23, 95% CI: 2.06–8.67) were associated with recurrent falls. Previous falls (aOR: 2.64, 95% CI: 1.44–4.84 for single falls; aOR: 5.26, 95% CI: 2.61–10.60 for recurrent falls) were associated with all falls.

Conclusion

Different intervention strategies should be developed for single and recurrent fallers.     

Physical activity-friendly neighbourhood among older adults from a medium size urban setting in Southern Europe

Objective

In this cross-sectional study, we examined the relationship between socio-environmental characteristics of neighborhood of residence and the frequency of leisure-time physical activity (LTPA) among older adults from Porto (Portugal).

Method

Data from EpiPorto – a prospective adult cohort study from Porto (Portugal) – were used. Only adults aged ≥ 65 at baseline (1999–2003) were included (n = 580). We used a Geographic Information System to objectively measure the neighborhood characteristics and Generalized Additive Models to estimate their effect on participation in LTPA (none vs. some reported) and frequency of LTPA (min/day).

Results

62% of the participants reported no LTPA. Active elderly spent on average 38 (women) and 67 (men) minutes per day exercising. Neighborhood characteristics were unrelated to whether older people exercised or not. However, among active individuals, distance to the nearest destination (β = − 0.154, p = 0.016), in women, and distance to the nearest park, in men (− 0.030, 0.050), were predictors of LTPA frequency.

Conclusion

There was almost no association between neighborhood characteristics and whether older adults engaged in LTPA or not, but among those that did engage, neighborhood characteristics were associated with increased frequency of LTPA. The promotion of well distributed destinations and parks might improve physical activity levels among the elderly.     

Factors affecting repeated influenza vaccination among older people in Taiwan

Objective

This study identifies factors that influence repeated influenza vaccination among people aged 65 years and older in Taiwan.

Methods

Data of this retrospective cohort study were drawn from the 2005 National Health Interview Survey and the 2005–2007 National Health Insurance claims data; a sample of 1384 older people was analyzed. The pattern of repeated influenza vaccination was divided into 3 groups: unvaccinated all 3 years, vaccinated 1–2 times over 3 years, and vaccinated all 3 years. Multinomial logistic regression analyses were performed.

Results

Only 20.6% of older people were vaccinated all 3 years. Those 70–74 years of age (odds ratio [OR] = 1.81), living in rural areas (OR = 2.47), having one (OR = 2.07) or more (OR = 2.41) chronic conditions, frequent outpatient visits (OR = 1.48), and undergoing preventive health examinations (OR = 2.22) were more likely to have repeated vaccinations. However, those with difficulties performing one or more activities of daily living (ADL difficulty) (OR = 0.41) and seeking care from alternative medicine (OR = 0.48) were less likely to undergo regular vaccinations.

Conclusion

The repeated influenza vaccination rates in our Taiwan sample were far from optimal. Factors identified in this analysis may help to improving influenza vaccination programs.