Physical activity as a determinant of mortality in women

BACKGROUND: There is substantial evidence that higher levels of activity reduce the risk of mortality, but several research questions remain about the protective effect of physical activity. We aimed to quantify the effect of physical activity on overall mortality in younger women and to assess the effect of past versus current activity. METHODS: During 1991-1992, we enrolled 99,099 women, age 30-49 years, from the entire country of Norway and one Swedish region, in a population-based cohort study. The women provided information on physical activity level at age 14 and 30 years and at enrollment, as well as information on other personal characteristics at enrollment. We achieved complete follow-up into 2003 using record linkages to nationwide registers. We used Cox proportional hazard models to calculate multivariate relative risks (RRs) of dying from any cause. RESULTS: During an average 11.4 years of follow-up, 1,313 women died. Risk of death decreased with increasing physical activity at enrollment (5 categories; P for trend<0.0001) and was reduced by half in the highest compared with the lowest category (RR=0.46; 95% confidence intervals=0.33-0.65). This protective effect was consistent across strata of age at entry, smoking, country, and education. After adjustment for physical activity at enrollment, activity at age 14 and 30 was not associated with mortality. CONCLUSIONS: Current physical activity substantially reduces mortality among women. This association is observed even with low levels of physical activity and is accentuated with increased physical activity.     

Prevalence of breast arterial calcifications in an ethnically diverse population of women

PURPOSE: Breast arterial calcifications (BAC) identified on routine mammography have been associated with coronary heart disease (CHD) risk factors including diabetes and hypertension, angiographically defined CHD, and increased cardiovascular mortality. Accumulating evidence suggests that the mammogram may be an important tool to identify women at risk for CHD, however, the epidemiology of BAC has been poorly defined and previous studies limited to white populations. METHODS: The mammograms of 1905 consecutive women (51.2% Hispanic, 25.8% white, 15.3% black, 5.4% other, 2.2% Asian, ages 35-92 years) were evaluated for the presence of BAC and the number of calcified arteries. RESULTS: The overall prevalence of BAC was 29.4% and was significantly higher for Hispanics compared with whites (34.5% vs. 24.0%, p=0.0002) and lower for Asians compared with whites (7.1% vs. 24.0%, p < 0.02). Among BAC-positive women aged 65 years or less, blacks had more calcified arteries than whites (p < 0.01). The presence of BAC increased with age (p for trend < 0.0001). In age-adjusted models, older Hispanics were more likely to be BAC-positive than whites of similar age (p < 0.02). CONCLUSION: These results indicate that BAC varies significantly by age and race/ethnicity. These findings should be taken into consideration when designing future studies of BAC and CHD.     

Pregnancy intention and preterm birth: differential associations among a diverse population of women

CONTEXT: Studies published to date provide mixed evidence on the relationship between unintended pregnancy and preterm birth, and none take into consideration that the meaning of unintended pregnancy may vary across racial and ethnic groups. METHODS: Data from the 1999-2003 rounds of the Maternal and Infant Health Assessment, a population-based, representative survey of postpartum women in California, were used to assess the relationship between pregnancy intention and preterm birth. For racial and ethnic groups in which an association was found, sequential logistic regression was conducted to further examine the relationship while controlling for socioeconomic characteristics. RESULTS: In unadjusted results, pregnancy intention was associated with preterm birth among both whites and immigrant Latinas, but not among blacks or U.S.-born Latinas. Among whites, compared with women who reported that their pregnancy was intended, those who were unsure about their pregnancy had elevated odds of preterm birth (odds ratio, 1.4), as did those who reported their pregnancy was unwanted (1.7) or mistimed (1.4). Among immigrant Latinas, those who reported being unsure about their pregnancy were at higher risk of preterm birth than were those who reported an intended pregnancy (1.6). After adjustment for socioeconomic factors, the association remained significant for immigrant Latinas who were unsure about their pregnancy (1.5), but none of the associations remained significant for whites. CONCLUSIONS: Women's interpretations of questions about pregnancy intention and their social experiences regarding pregnancy intention may vary by race or ethnicity. Studies on the association between pregnancy intention and preterm birth may need to be group-specific.     

Physical activity in young African American women

African American women are reported to be less physically active than other population groups. This study examined personal behavioral and psychosocial and environmental factors associated with physical activity in African American women living at or below poverty. Most participants engaged in some moderate physical activity through housework and child care; 71% engaged in activity such as walking from one to seven times per week; but only 5% were vigorously active. Seventy-seven percent were active in the past, but 80% dropped out within 6 months, citing "lack of time and feeling bad" as the main reasons. Exercise self-efficacy was positively correlated with beliefs about physical and social outcomes of activity, with more active than inactive women believing that physical activity had more physical health outcomes. One-third of the women reported that family or friends disapproved of their spending time being physically active, and 45% had never been encouraged to be active by a health professional. However, health professionals' influence was positively correlated with weight reduction but not physical activity participation.     

Physical activity among older Filipino-American women

Filipino women (N = 530, mean age 63 years, predominantly low income) were recruited through various community based organizations and churches in Los Angeles County. All women were randomly invited to attend a single group session with a Filipino health educator to discuss breast and cervical cancer screening or the health benefits of exercise. At 3 months after the group session, the exercise assessment tool used in the National Health and Nutrition Examination Survey III was completed by 487 women (92 percent retention rate). This paper describes the pattern of physical activity among older Filipino-American women and a physical activity intervention specifically designed for this group.     

Physical activity of urban adults: a general population survey in Geneva

OBJECTIVES: Describing the distribution of physical activity in populations is of major importance for developing public health campaigns to prevent sedentarism. METHODS: A population-based survey conducted during 1997-1999 in Geneva, Switzerland, included 3410 randomly selected men (n = 1707) and women (n = 1703), aged 35 to 74 years. Percentiles P10, P50, and P90 summarised the distributions of the total energy expenditure and of the percents used in moderate intensity activities (3 to 3.9 times the basal metabolism rate (BMR), e.g., normal walking, household chores), and in high and very high intensity activities (> or = 4 BMR, e.g., brisk walking, sports). RESULTS: The total energy expenditure (median 2929 kcal/day in men, 2212 kcal/day in women) decreased with age. Prevalence of sedentarism, defined as less than 10% of total energy expended in > or = 4 BMR activities, was 57% in men and 70% in women. Men expended 12% (median) of their total energy in 3 to 3.9 BMR and 8% in > or = 4 BMR activities. Corresponding percentages in women were 11% and 5%. The highest prevalence of sedentarism was in older age, women, and lower socio-economic status persons. CONCLUSION: Most of Geneva population is sedentary. Promoting physical activity should target children, adults and elderly, and physical activities which would be both attractive and financially affordable by most people.     

Physical activity and the metabolic syndrome in a tri-ethnic sample of women

OBJECTIVE: To determine the association of moderate-intensity physical activity (PA), vigorous-intensity PA, and maximal treadmill duration with the metabolic syndrome among African-American (n = 49), Native-American (n = 46), and white (n = 51) women (ages, 40 to 83 years), enrolled in the Cross-Cultural Activity Participation Study. RESEARCH METHODS AND PROCEDURES: The metabolic syndrome was defined as three or more of the following risk factors: waist circumference >88 cm, blood pressure > or =130/85 mm Hg, fasting glucose > or =110 mg/dL, hypertriglyceridemia (> or =150 mg/dL), and high-density lipoprotein-cholesterol <50 mg/dL. PA was determined from detailed PA records that included all PA performed during two consecutive 4-day periods. Maximal treadmill duration was determined from a graded exercise test. Women were categorized into quartiles of moderate-intensity PA, vigorous-intensity PA, and maximal treadmill duration. Multiple logistic regression was used to estimate odds ratios of the metabolic syndrome as a function of the four PA categories, adjusted for age, ethnicity, study site, menopausal status, and use of hormone-replacement therapy. RESULTS: The adjusted odds ratio for the metabolic syndrome was 0.18 (95% confidence interval, 0.33 to 0.90) for women in the highest category of moderate-intensity PA compared with women in the lowest category (p = 0.01 for trend). Similar associations were observed for the metabolic syndrome with vigorous-intensity PA (p = 0.01 for trend) and maximal treadmill duration (p = 0.0004 for trend). DISCUSSION: Higher levels of moderate and vigorous-intensity PA and greater maximal treadmill duration were inversely associated with the metabolic syndrome among an ethnically diverse sample of women.     

Physical activity patterns during pregnancy through postpartum

Background  

Realizing the importance of regular physical activity, particularly in the prevention of chronic diseases and unhealthy weight gain, it is important to study how physical activity changes during and after pregnancy using prospective study designs. The aim of this study was to describe the mode, duration, intensity, and changes in physical activity during pregnancy through one year postpartum among a cohort of women.     

Physical activity and mortality: a prospective study among women

OBJECTIVES: This study examined the association between recreational physical activity and mortality in middle-aged and older women and the possibility that physical activity serves as an important marker of health. METHODS: Analyses were conducted among participants in the Nurses' Health Study. Levels of physical activity were assessed by questionnaire in 1980 and updated every 2 to 4 years. RESULTS: Levels of physical activity were inversely associated with mortality risk; however, each activity level above the reference level had approximately the same level of risk reduction (20%-30%). The inverse association was stronger for cardiovascular deaths than for cancer deaths and was strongest for respiratory deaths. Women who died of noncardiovascular, noncancer causes were more likely to have reported that poor health limited their physical activity than were women who died of other causes or who remained alive. CONCLUSIONS: Part of the link between physical activity and mortality risk is probably spurious and difficult to remove analytically; however, on the basis of epidemiologic evidence, much of the health benefit of activity is real.     

Physical activity and diabetes risk in postmenopausal women

BACKGROUND: To evaluate the hypothesis that physical activity independently predicts type 2 diabetes risk in postmenopausal African-American, Hispanic, Asian, and Caucasian women. METHODS: We prospectively evaluated the relationship between incident type 2 diabetes, walking, and total physical activity at baseline in the Women's Health Initiative Observational Study. Baseline data were collected between September 1994 and December 1998; incident diabetes was identified through August 2002. Hazard ratios for self-reported diabetes adjusted for body mass index (BMI) and other variables were evaluated across categories of physical activity in Caucasian, African-American, Hispanic, and Asian/Pacific Islander women. RESULTS: Incident diabetes was reported by 2.2% of Caucasian, 6.2% of African-American, 4.5% of Hispanic, 3% of Asian, and 5.7% of American Indian women (p <0.0001 across ethnic groups) during 458,018 woman-years of follow-up. Among Caucasian women, walking (multivariate-adjusted hazard ratios 1.00, 0.85, 0.87, 0.75, 0.74; p <0.001 for trend across exercise quintiles) and total physical activity score (hazard ratios 1.00, 0.88, 0.74, 0.80, 0.67; p =0.002) demonstrated a strong inverse relationship with diabetes risk. In BMI-adjusted models, African-American women in higher physical activity categories were less likely to develop diabetes than women in the lowest physical activity category. After adjusting for age and multiple risk factors, however, no significant association between physical activity and diabetes risk was apparent for African-American, Hispanic, or Asian women. CONCLUSIONS: These findings suggest a stronger and more independent association of physical inactivity with development of diabetes in Caucasian women than in minority women, but could also be explained by less precise risk estimates in minority women or the role of chance.     

Physical activity in a multiethnic population of third graders in four states.

OBJECTIVES: This research assessed the amount of daily physical activity in a multiethnic sample of US third-grade students. METHODS: Physical activity interviews were conducted with 2410 third graders from 96 schools in four states. Blood pressure, cholesterol, body mass index, timed run for distance, physical-activity self-efficacy, and perceived support for physical activity were also assessed. RESULTS: Students reported a daily average of 89.9 minutes of moderate to vigorous physical activity, 34.7 minutes of vigorous activity, and 120.4 minutes of sedentary behavior; however, 36.6% obtained less than 60 minutes of moderate to vigorous physical activity daily, and 12.8% reported less than 30 minutes. Boys reported more physical and sedentary activity than girls; White children reported more activity than Black or Hispanic children; California children reported the most activity and Louisiana children the least. Geographic location, male gender, lower cholesterol, higher perceived efficacy in physical activity, and higher social support were associated with more physical activity. CONCLUSIONS: Average reported activity met the Year 2000 objectives; however, many students reported less than recommended amounts of activity. These findings support the need for health promotion programs that increase the number of physically active children.     

孕期运动模式与抑郁的队列研究

目的了解舟山地区孕妇孕期抑郁和运动现状,探讨孕期体育运动模式对孕期抑郁的影响,为推荐孕期适宜运动模式,促进孕妇身心健康提供理论依据。方法以2016年7月-2018年7月在舟山市妇幼保健院进行产检的孕妇作为队列研究对象,采用抑郁自评量表和自编孕期体力活动量表,分别在孕早、中和晚期进行问卷调查。结果孕妇在孕早、中和晚期抑郁症状的检出率分别为36. 22%、23. 91%和25. 41%。随着孕程进展,孕早、中和晚期一直运动率分别为12. 20%,9. 06%,8. 54%。多因素Logistic回归模型分析显示孕前运动模式与孕妇孕中、晚期抑郁负相关(OR=0. 648、OR=0. 686)。全孕期运动模式和孕妇在孕早、中、晚期抑郁均负相关(OR=0. 502、OR=0. 455和OR=0. 480)。结论舟山地区孕妇在各孕期抑郁发生率较高,尤其要关注孕早期的抑郁和体力活动变化情况,孕前和全孕程的体育活动模式是孕妇孕期健康心理的保护因素,应在孕妇保健中制定相关干预措施。     

Physical activity patterns and metabolic syndrome in Costa Rica

ObjectiveTo examine whether total physical activity or activity patterns are associated with metabolic syndrome and its components.MethodsParticipants include 1994 controls from a case–control study of non-fatal myocardial infarction in Costa Rica (1994–2004). Physical activity was assessed via self-administered questionnaire and patterns were identified using principal components analysis. Metabolic syndrome was assessed via blood samples and anthropometry measurements from in-home study visits. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using log binomial regression. Adjusted least squares means of metabolic syndrome components were calculated by quintile of total activity and pattern scores.ResultsFour activity patterns were identified: rest/sleep, agricultural, light indoor activity, and manual labor. Total activity was not associated with metabolic syndrome. Metabolic syndrome prevalence was 20% lower in participants with the highest scores on the agricultural job pattern compared to those with the lowest (PR: 0.80, 95% CI: 0.68–0.94). Higher total activity was associated with lower triglycerides and lower HDL cholesterol. Higher scores on each pattern were inversely associated with metabolic syndrome components, particularly waist circumference and fasting blood glucose.ConclusionsPatterns or types of physical activity may be more strongly associated with metabolic syndrome and its components than total activity levels.     

Physical activity and sleep among pregnant women

Borodulin K, Evenson KR, Monda K, Wen F, Herring AH, Dole N. Physical activity and sleep among pregnant women. Paediatric and Perinatal Epidemiology 2010; 24: 45–52.
Sleep disturbances are common among pregnant women and safe treatments to improve sleep are needed. Generally, physical activity improves sleep, but studies are lacking on the associations of physical activity with sleep among pregnant women. Our aim was to investigate the cross-sectional association of various modes of physical activity and activity clusters with sleep quality and duration among 1259 pregnant women. Participants were recruited into the Pregnancy, Infection, and Nutrition Study from prenatal clinics at the University of North Carolina Hospitals. Women self-reported sleep quality and duration and physical activity in the past week. We used cluster analysis to create seven physical activity profiles and multivariable logistic regression analysis, with adjustments for age, race/ethnicity, education, marital status, parity, self-rated general health, anxiety and depressive symptoms.
Women with higher levels of occupational physical activity were more likely to report either short or normal sleep duration than longer duration. Women with higher levels of indoor household physical activity were less likely to report normal sleep duration than shorter duration. Women in the recreational-indoor household activity cluster were less likely than women in the inactivity cluster to report normal sleep duration as compared with longer duration. Our data suggest weak associations of physical activity with sleep duration and quality in late pregnancy. Physical activity is recommended to pregnant women for health benefits, yet more research is needed to understand if physical activity should be recommended for improving sleep.