Long-term effects on weight loss and maintenance by intensive start with diet and exercise

AbstractThis 36-month study aimed to determine whether exercise intervention added to weight loss treatment in the beginning or at 6 months is effective for weight loss and long-term weight maintenance. A total of 120 obese adults (body mass index >30) were randomly assigned to intensified behavioral modification (iBM), iBM+ additional exercise from 0 to 3 months (CWT1), iBM+ additional exercise from 6 to 9 months (CWT2), and a control group (CON). Questionnaires and measurements were collected at baseline, 3, 9, 24, and 36 months. The intervention consisted of an 12 months intensified weight-loss period followed by a 24 months weight-maintenance period. Eighty (67%) subjects (mean age 46.0 years, BMI 36.2) completed the trial. Compared with the control group, all three intervention groups had significant weight loss during the 36-month intervention period (p p p p p p p Abstract This 36-month study aimed to determine whether exercise intervention added to weight loss treatment in the beginning or at 6 months is effective for weight loss and long-term weight maintenance. A total of 120 obese adults (body mass index >30) were randomly assigned to intensified behavioral modification (iBM), iBM+ additional exercise from 0 to 3 months (CWT1), iBM+ additional exercise from 6 to 9 months (CWT2), and a control group (CON). Questionnaires and measurements were collected at baseline, 3, 9, 24, and 36 months. The intervention consisted of an 12 months intensified weight-loss period followed by a 24 months weight-maintenance period. Eighty (67%) subjects (mean age 46.0 years, BMI 36.2) completed the trial. Compared with the control group, all three intervention groups had significant weight loss during the 36-month intervention period (p < 0.001). The achieved weight loss remained significant at 36 months in the iBM (−6.8%, p < 0.001), the CWT1 (−5.8%, p < 0.001), and the CWT2 group (−3.9%, p < 0.001). The CWT1 group showed significant reduction in waist circumference at 9 months (−11.3 cm, p < 0.001), at 24 months (−8.8 cm, p < 0.001), and at 36 months (−8.7 cm, p < 0.001). Intensified behavioral modification alone and with exercise resulted in clinically significant weight loss and long-term weight maintenance. The addition of exercise at the onset promoted greater reductions in waist circumference. In the treatment of obesity, including severe obesity, more intensive lifestyle interventions with exercise should be incorporated

Evidence base of economic evaluations of workplace-based interventions reducing occupational sitting time : an integrative review

Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVE: To review the evidence on the economic evaluations of workplace-based interventions that are designed to reduce prolonged periods of occupational sitting. DESIGN: An integrative review. DATA SOURCES: The search was conducted in 11 databases, including PubMed, Scopus, PsychINFO, NHS-EED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, Cochrane library, Sportdiscus, Research Paper in Economics (RePeC), the International Health Economic Association (IHEA) and EconLit. The databases were searched for articles published from inception to January 2022. Subsequent citation searches were also conducted in Google Scholar. The items of the Consensus Health Economic Criteria (CHEC) checklist were used for quality appraisal of the included studies. RESULTS: This review included five randomised control trails, including 757 office-based workers in high-income countries. The median quality appraisal score based on the CHEC items was 14 points (a range of 9-18). The mean duration of interventions was 33 weeks (a range of 4-52 weeks). Overall, the studies reported economic benefit when implemented to reduce occupational sitting time but no effect on absenteeism. From the societal perspective, the interventions (eg, the use of a sit-stand desk) were cost-effective. CONCLUSION: The economic impact of workplace interventions implemented to reduce occupational sitting time is evident; however, the existing evidence is limited, which precludes strong conclusions. Cost-effectiveness is not often evaluated in the studies exploring workplace interventions that address occupational sitting time. Workplace interventions are still in the development and testing phase; thus, the challenge for future studies is to include economic evaluation of interventions addressing sedentary behaviour in workplaces. PROSPERO REGISTRATION NUMBER: CRD42021226275.Peer reviewe

Gaming for health across various areas of life

AbstractLack of physical activity is mostly addressed by implementing programs to promote physical activity but seeing as the major cause for physical inactivity is that of technology. Few studies used the approach to use the very barrier as s mean to try and educate and breed good habits. This paper outlines the design and development of a project that will us various environments, home, gym and outdoors to promote physical activity by means of technology and more specifically games.Abstract Lack of physical activity is mostly addressed by implementing programs to promote physical activity but seeing as the major cause for physical inactivity is that of technology. Few studies used the approach to use the very barrier as s mean to try and educate and breed good habits. This paper outlines the design and development of a project that will us various environments, home, gym and outdoors to promote physical activity by means of technology and more specifically games

Infant motor development and physical activity and sedentary time at midlife

AbstractThis study investigated whether the timing of infant motor development is associated with self-reported and accelerometer-measured physical activity (PA) and sedentary time (ST) in midlife. This population-based study consisted of 4098 people born in 1966 in Northern Finland (NFBC 1966). Data on nine infant motor developmental milestones included making sounds, holding up the head, grabbing objects, turning from back to tummy, sitting without support, standing with support, walking with support, standing without support, and walking without support. At the age of 46, PA at leisure time and sitting time was self-reported. PA and ST were also measured with a wrist-worn Polar Active accelerometer that was instructed to be worn on the non-dominant hand 24 h/d for 14 days. A multiple linear regression analysis was used to analyze the association between infant motor development and PA and ST in midlife. Later infant motor development was weakly associated with higher accelerometer-measured light PA, but not with moderate-to-vigorous PA. Later infant locomotor development was associated with lower accelerometer-measured ST (β −0.07, p = 0.012) and lower self-reported sitting time at work (β −0.06, p = 0.004) in women. In conclusion, later infant motor development was associated with higher light PA and lower sedentary time at middle age. PA is a multifactorial behavior influenced by various factors from early childhood to midlife. Further research is required before more general conclusions can be drawn.Abstract This study investigated whether the timing of infant motor development is associated with self-reported and accelerometer-measured physical activity (PA) and sedentary time (ST) in midlife. This population-based study consisted of 4098 people born in 1966 in Northern Finland (NFBC 1966). Data on nine infant motor developmental milestones included making sounds, holding up the head, grabbing objects, turning from back to tummy, sitting without support, standing with support, walking with support, standing without support, and walking without support. At the age of 46, PA at leisure time and sitting time was self-reported. PA and ST were also measured with a wrist-worn Polar Active accelerometer that was instructed to be worn on the non-dominant hand 24 h/d for 14 days. A multiple linear regression analysis was used to analyze the association between infant motor development and PA and ST in midlife. Later infant motor development was weakly associated with higher accelerometer-measured light PA, but not with moderate-to-vigorous PA. Later infant locomotor development was associated with lower accelerometer-measured ST (β −0.07, p = 0.012) and lower self-reported sitting time at work (β −0.06, p = 0.004) in women. In conclusion, later infant motor development was associated with higher light PA and lower sedentary time at middle age. PA is a multifactorial behavior influenced by various factors from early childhood to midlife. Further research is required before more general conclusions can be drawn

Active transportation policy and practice in the city of Oulu from 1998 to 2016 : A mixed methods study

AbstractLand use and transportation policies have been recognized globally as major sources of physical inactivity, but there has been a gap between research and policy implementation. Our objective for this research was to produce an integrated view of community planning policies and the association between urban form characteristics and transportation mode choices in the city of Oulu from 1998 to 2016.Our findings showed that increasing density and diversity of the urban form, emphasizing active transportation, and developing the city center were highlighted in the community and transportation planning policies. In practice, urban form development focused on the inner city, but in the outer urban area and urban fringe, sprawl and car dependency increased. Overall, the active transportation mode share decreased by 2 percentage points during the follow-up, but increases in density, mix and access networks were associated with increased walking and cycling compared to car use.In conclusion, no consensus was established in Oulu to limit the dominance of private motor vehicles. Decreased active transportation mode share might have been due to inadequately assessed functional mix outside the inner city, increased urban sprawl and building more capacity for cars. In the future, stronger political leadership, increased density, better access to nearby services combined with investments in public transportation will be required to meet the policy goals.Abstract Land use and transportation policies have been recognized globally as major sources of physical inactivity, but there has been a gap between research and policy implementation. Our objective for this research was to produce an integrated view of community planning policies and the association between urban form characteristics and transportation mode choices in the city of Oulu from 1998 to 2016. Our findings showed that increasing density and diversity of the urban form, emphasizing active transportation, and developing the city center were highlighted in the community and transportation planning policies. In practice, urban form development focused on the inner city, but in the outer urban area and urban fringe, sprawl and car dependency increased. Overall, the active transportation mode share decreased by 2 percentage points during the follow-up, but increases in density, mix and access networks were associated with increased walking and cycling compared to car use. In conclusion, no consensus was established in Oulu to limit the dominance of private motor vehicles. Decreased active transportation mode share might have been due to inadequately assessed functional mix outside the inner city, increased urban sprawl and building more capacity for cars. In the future, stronger political leadership, increased density, better access to nearby services combined with investments in public transportation will be required to meet the policy goals

Compositional association of 24-h movement behavior with incident major adverse cardiac events and all-cause mortality

Cardiovascular disease (CVD) causes a high disease burden. Physical activity (PA) reduces CVD morbidity and mortality. We aimed to determine the relationship between the composition of moderate-to-vigorous PA (MVPA), light PA (LPA), sedentary behavior (SB), and sleep during midlife to the incidence of major adverse cardiac events (MACE) and all-cause mortality at a 7-year follow-up. The study population consisted of Northern Finland Birth Cohort 1966 members who participated in the 46-year follow-up in 2012 and were free of MACE (N = 4147). Time spent in MVPA, LPA, and SB was determined from accelerometer data. Sleep time was self-reported. Hospital visits and deaths were obtained from national registers. Participants were followed until December 31, 2019, or first MACE occurrence (acute myocardial infarction, unstable angina pectoris, stroke, hospitalization due to heart failure, or death due to CVD), death from another cause, or censoring. Cox proportional hazards model was used to estimate hazard ratios of MACE incidence and all-cause mortality. Isotemporal time reallocations were used to demonstrate the dose–response association between time spent in behaviors and outcome. The 24-h time composition was significantly associated with incident MACE and all-cause mortality. More time in MVPA relative to other behaviors was associated with a lower risk of events. Isotemporal time reallocations indicated that the greatest risk reduction occurred when MVPA replaced sleep. Higher MVPA associates with a reduced risk of incident MACE and all-cause mortality after accounting for the 24-h movement composition and confounders. Regular engagement in MVPA should be encouraged in midlife

Chronotypes and objectively measured physical activity and sedentary time at midlife

AbstractMorning, day, or evening chronotypes differ by the circadian timing of alertness and the preferred timing of sleep. It has been suggested that evening chronotype is associated with low physical activity (PA) and high sedentary time (SED). Our aim was to investigate whether such an association is confirmed by objectively measured PA and SED. In 46‐year follow‐up of the Northern Finland Birth Cohort 1966 study, total PA (MET min/day) and SED (min/day) among 5156 participants were determined using wrist‐worn accelerometers for 14 days. We used the shortened Morningness‐Eveningness Questionnaire to define participants’ chronotypes. As covariates, we used self‐reported physical strenuousness of work, health, and demographics, and clinical measures. We used adjusted general linear models (B coefficients with 95% confidence intervals, CI) to analyze how chronotype was related to total PA or SED. As compared to evening chronotype, men with day and morning chronotypes had higher total PA volumes (adjusted B 75.2, 95% CI [8.1, 142.4], P = .028, and 98.6, [30.2, 167.1], P = .005). Men with day and morning chronotypes had less SED (−35.8, [−53.8, −17.8], P CorrectionIn the abstract, a typo (missing − -sign) was corrected in the sentence : Men with day and morning chronotypes had less SED (−35.8, [−53.8, −17.8], p Abstract Morning, day, or evening chronotypes differ by the circadian timing of alertness and the preferred timing of sleep. It has been suggested that evening chronotype is associated with low physical activity (PA) and high sedentary time (SED). Our aim was to investigate whether such an association is confirmed by objectively measured PA and SED. In 46‐year follow‐up of the Northern Finland Birth Cohort 1966 study, total PA (MET min/day) and SED (min/day) among 5156 participants were determined using wrist‐worn accelerometers for 14 days. We used the shortened Morningness‐Eveningness Questionnaire to define participants’ chronotypes. As covariates, we used self‐reported physical strenuousness of work, health, and demographics, and clinical measures. We used adjusted general linear models (B coefficients with 95% confidence intervals, CI) to analyze how chronotype was related to total PA or SED. As compared to evening chronotype, men with day and morning chronotypes had higher total PA volumes (adjusted B 75.2, 95% CI [8.1, 142.4], P = .028, and 98.6, [30.2, 167.1], P = .005). Men with day and morning chronotypes had less SED (−35.8, [−53.8, −17.8], P < .0001, and − 38.6, [−56.9, −20.2], P < .0001). Among women, morning chronotype was associated with higher total PA (57.8, [10.5, 105.0], P = .017), whereas no association between chronotype and SED emerged. Evening chronotype was associated with low objectively measured PA in both sexes and with high SED in men, even after adjustments for established potential confounders. Chronotype should be considered in PA promotion.Correction In the abstract, a typo (missing − -sign) was corrected in the sentence : Men with day and morning chronotypes had less SED (−35.8, [−53.8, −17.8], p < 0.0001, and −38.6, [−56.9, −20.2], p < 0.0001)

Effect of wrist-worn activity monitor feedback on physical activity behavior: A randomized controlled trial in Finnish young men

AbstractThe purpose of this study is to evaluate whether the use of an activity monitor providing feedback has an effect on physical activity (PA) in young men. A population-based sample of 276 conscription-aged (mean=17.9, SD=0.7years) men participated in a 3-month randomized controlled trial in Oulu in 2012. Participants were randomized to an intervention group (INT, N=137) and a control group (CON, N=139). INT received a wrist-worn monitor (Polar Active) showing daily activity, and CON received identical monitors without feedback. Main outcome was the change from baseline in objectively measured weekly time spent in moderate-to-vigorous PA (MVPA) and sedentary activity (SED), as assessed by generalized estimation equations (GEE). Other lifestyle factors were assessed by a questionnaire at baseline and at 3months. Weekly physical activity data (≥4days with ≥8h each) were obtained from 72 (53%) and 90 (65%) men in the INT and CON, respectively. Based on GEE, time spent in MVPA increased (p=0.012) and SED decreased (p=0.032) in the INT compared with the CON. During the first 7weeks, the INT spent on average 1h less sedentary than the CON (t-test, p<0.05). During the first week, the INT showed 12minutes more MVPA compared to the CON (t-test, p=0.034). Based on questionnaire data, the proportion of the most sedentary men decreased in the INT (Wilcoxon test, 28% vs. 10%, p=0.029), with no change in the CON (20% vs. 19%, p=0.546). To conclude, a wrist-worn activity monitor providing feedback had a short-term positive effect on PA and SED in young men.Trial registrationThis is a pilot study for a larger randomized controlled trial registered to the clinical trials register NCT01376986

Accelerometry-Based Characteristics of Overall Sedentary Behavior and Sitting in Middle-Aged Adults

AbstractThe purpose of this study was to describe the accelerometry-based characteristics of overall sedentary behavior (SB) and sitting among adults under free-living conditions. Thirty-six (mean age 47.6 years) volunteers carried a waist-worn accelerometer for ≥4 days with data ≥600 min/d during 14 consecutive days. A machine learning (ML) based method was used to classify the patterns of SB and sitting from raw 3D acceleration. The participants spent most (69.3%) of their waking time in SB, and a half (52.2%) of the SB was performed in a sitting posture. Men broke their overall sedentary time less often (4.1 vs. 6.1 bouts/h), but women sat more; however, women broke their sitting time as often as men (7.6 bouts/h). This study confirms that SB and sitting can be distinguished using ML methods, and more information about SB can be achieved when overall SB and sitting are analyzed separately in free-living conditions.Abstract The purpose of this study was to describe the accelerometry-based characteristics of overall sedentary behavior (SB) and sitting among adults under free-living conditions. Thirty-six (mean age 47.6 years) volunteers carried a waist-worn accelerometer for ≥4 days with data ≥600 min/d during 14 consecutive days. A machine learning (ML) based method was used to classify the patterns of SB and sitting from raw 3D acceleration. The participants spent most (69.3%) of their waking time in SB, and a half (52.2%) of the SB was performed in a sitting posture. Men broke their overall sedentary time less often (4.1 vs. 6.1 bouts/h), but women sat more; however, women broke their sitting time as often as men (7.6 bouts/h). This study confirms that SB and sitting can be distinguished using ML methods, and more information about SB can be achieved when overall SB and sitting are analyzed separately in free-living conditions

More Physical Activity, More Work Engagement? : A Northern Finland Birth Cohort 1966 Study

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