Psychological and physiological correlates of sleep in HIV infection

Insomnia, a common problem associated with HIV disease, is most likely caused by a multitude of factors. This study investigated the correlations between a selected group of physiological and psychological factors and sleep quality in an HIV-infected population. A convenience sample of 79 ethnically diverse HIVpositive adults, ages 24 to 63, completed a number of questionnaires and released their laboratory records for CD4+ cell count and viral load information. Variables significantly related to sleep quality were HIV-related symptoms, total pain, fatigue, depression, state anxiety, and the number of adults in the household. Findings support the need for health care providers to consider factors that contribute to impaired sleep when developing effective care for HIV-infected individuals with sleep disturbance

Subjective Estimation of Physical Activity Using the IPAQ Varies by Fitness Level

Background: Subjective measures of moderate and vigorous physical activity (MVPA) rely on ‘relative’ intensity while objective measures capture ‘absolute’ intensity, thus fit individuals may perceive the same activity differently than unfit individuals. Methods: Adults (N=211) wore the SenseWear Armband (SWA) for ten consecutive days to objectively assess sedentary time and MVPA. On day eight participants completed the International Physical Activity Questionnaire (IPAQ) to subjectively assess sitting time and MVPA. Fitness was assessed via a maximal treadmill test, and participants were classified as ’unfit’ if the result was in the bottom tertile of the study population by sex or ‘fit’ if in the upper two tertiles. Results: Overall, estimates of MVPA between the IPAQ and SWA were not significantly different (IPAQ minus SWA, 67.4±919.1 MVPA minutes/week, P=.29). However, unfit participants overestimated MVPA using the IPAQ by 37.3% (P=.02), but fit participants did not (P=.99). This between-group difference was due to overestimation using the IPAQ of moderate activity by 93.8 minutes/week among the unfit individuals, but underestimation of moderate activity among the fit participants by 149.4 minutes/week. Conclusion: Subjective measures of MVPA using the IPAQ varied by fitness category, with unfit participants overestimating their MVPA and fit participants accurately estimating their MVPA

The Association Between Sedentary Behaviors During Weekdays and Weekend with Change in Body Composition in Young Adults

Background: High sedentary time has been considered an important chronic disease risk factor but there is only limited information on the association of specific sedentary behaviors on weekdays and weekend-days with body composition. The present study examines the prospective association of total sedentary time and specific sedentary behaviors during weekdays and the weekend with body composition in young adults. Methods: A total of 332 adults (50% male; 27.7 ±3.7 years) were followed over a period of 1 year. Time spent sedentary, excluding sleep (SED), and in physical activity (PA) during weekdays and weekend-days was objectively assessed every 3 months with a multisensor device over a period of at least 8 days. In addition, participants reported sitting time, TV time and non-work related time spent at the computer separately for weekdays and the weekend. Fat mass and fat free mass were assessed via dual x-ray absorptiometry and used to calculate percent body fat (%BF). Energy intake was estimated based on TDEE and change in body composition. Results: Cross-sectional analyses showed a significant correlation between SED and body composition (0.18 ≤ r ≤ 0.34). Associations between body weight and specific sedentary behaviors were less pronounced and significant during weekdays only (r ≤ 0.16). Nevertheless, decrease in SED during weekends, rather than during weekdays, was significantly associated with subsequent decrease in %BF (β = 0.06, p \u3c0.01). After adjusting for PA and energy intake, results for SED were no longer significant. Only the association between change in sitting time during weekends and subsequent %BF was independent from change in PA or energy intake (β%BF = 0.04, p = 0.01), while there was no significant association between TV or computer time and subsequent body composition. Conclusions: The stronger AIMS Public Health Volume 3, Issue 2, 375-388. prospective association between sedentary behavior during weekends with subsequent body composition emphasizes the importance of leisure time behavior in weight management

The Association Between Sedentary Behaviors During Weekdays and Weekend with Change in Body Composition in Young Adults

Background: High sedentary time has been considered an important chronic disease risk factor but there is only limited information on the association of specific sedentary behaviors on weekdays and weekend-days with body composition. The present study examines the prospective association of total sedentary time and specific sedentary behaviors during weekdays and the weekend with body composition in young adults. Methods: A total of 332 adults (50% male; 27.7 ±3.7 years) were followed over a period of 1 year. Time spent sedentary, excluding sleep (SED), and in physical activity (PA) during weekdays and weekend-days was objectively assessed every 3 months with a multisensor device over a period of at least 8 days. In addition, participants reported sitting time, TV time and non-work related time spent at the computer separately for weekdays and the weekend. Fat mass and fat free mass were assessed via dual x-ray absorptiometry and used to calculate percent body fat (%BF). Energy intake was estimated based on TDEE and change in body composition. Results: Cross-sectional analyses showed a significant correlation between SED and body composition (0.18 ≤ r ≤ 0.34). Associations between body weight and specific sedentary behaviors were less pronounced and significant during weekdays only (r ≤ 0.16). Nevertheless, decrease in SED during weekends, rather than during weekdays, was significantly associated with subsequent decrease in %BF (β = 0.06, p \u3c0.01). After adjusting for PA and energy intake, results for SED were no longer significant. Only the association between change in sitting time during weekends and subsequent %BF was independent from change in PA or energy intake (β%BF = 0.04, p = 0.01), while there was no significant association between TV or computer time and subsequent body composition. Conclusions: The stronger AIMS Public Health Volume 3, Issue 2, 375-388. prospective association between sedentary behavior during weekends with subsequent body composition emphasizes the importance of leisure time behavior in weight management

Physical Activity and Immunity in HIV-Infected Individuals

The purpose of this study was to determine what relationship exists among physical activity levels and viral load and CD4+ cell count in HIV-infected individuals. Increased viral load is associated with disease progression and symptom severity. A convenience sample of 66 male and female subjects between the ages of 18 and 64 years of age (mean 399/8) was recruited from a hospital-based HIV/AIDS clinic. Components of PA were assessed for three continuous days using a mini-motion logger wrist actigraph. These components included mean PA level, and PA index and acceleration index. Pearson’s correlational analysis was used to test the strength of association between PA components and viral load or CD4+ cell count. A significant inverse relationship was found between mean PA level and viral load (p=0.047). An inverse relationship was also observed between PA index and viral load (p=0.0061). Neither mean PA nor PA index scores correlated with CD4+ cell counts. Acceleration index, a measure of PA intensity, showed no correlation to viral load or CD4+ cell counts. These findings suggest that increasing levels of physical activity might have beneficial effects on viral load in HIV-infected individuals

A home-based exercise intervention to increase physical activity among people living with HIV: study design of a randomized clinical trial

Background While combination antiretroviral therapy has extended the life expectancy of those infected with human immunodeficiency virus (HIV), there is a high prevalence of comorbidities that increase the risk of cardiovascular morbidity and mortality among people living with HIV/AIDS (PLWHA). The side effects associated with antiretroviral therapy (ART) lead to multiple metabolic disorders, making the management of these metabolic issues and risk of cardiovascular disease (CVD) in those treated with ART a critical issue. Clinical research trials, primarily clinical exercise, rarely include this population due to unique challenges in research methods with underserved minority populations living with a life threatening illness like HIV/AIDS. This paper describes the rationale and design of a randomized clinical trial evaluating the feasibility of a home-based exercise program designed to increase physical activity (PA) and reduce the risk of CVD in PLWHA. Methods/design PLWHA being treated with ART will be randomly assigned to one of two groups: a home-based PA intervention or standard care. All participants will receive an educational weight loss workbook and pedometer for self-monitoring of PA. Only those in the intervention group will receive additional elastic Thera-bands® for strength training and behavioral telephone based coaching. Discussion This study will evaluate the feasibility of a home-based program designed to increase PA among PLWHA. Further, it will evaluate the effectiveness of such a program to decrease modifiable risk factors for CVD as a secondary outcome. This study was funded by the NIH/NINR R21 Grant 1R21NRO11281

The Association of Physical Activity during Weekdays and Weekend with Body Composition in Young Adults

Physical activity (PA) is a key contributor in long-term weight management but there remains limited research on the association between weekly PA patterns and weight change. The purpose of the present study was to examine the prospective association between weekly PA patterns and weight change in generally healthy young adults. Anthropometric measurements, including dual X-ray absorptiometry, were obtained every 3 months over a period of one year in 338 adults (53% male). At each measurement time, participants wore a multisensor device for a minimum of 10 days to determine total daily energy expenditure and time spent sleeping, sedentary, in light PA (LPA), in moderate PA (MPA), and in vigorous PA (VPA). PA did not differ between weekdays and the weekend at baseline. Twenty-four-hour sleep time, however, was significantly longer during weekends compared to weekdays, which was associated with less time spent sedentary. Weight loss was associated with a significant increase in LPA at the expense of sedentary time during the weekend but not during weekdays. Regression analyses further revealed an inverse association between change in VPA during the weekend and body composition at 12-month follow-up. Taken together, these results suggest that weekend PA plays an important role in long-term weight management

The Association of Physical Activity during Weekdays and Weekend with Body Composition in Young Adults

Physical activity (PA) is a key contributor in long-term weight management but there remains limited research on the association between weekly PA patterns and weight change. The purpose of the present study was to examine the prospective association between weekly PA patterns and weight change in generally healthy young adults. Anthropometric measurements, including dual X-ray absorptiometry, were obtained every 3 months over a period of one year in 338 adults (53% male). At each measurement time, participants wore a multisensor device for a minimum of 10 days to determine total daily energy expenditure and time spent sleeping, sedentary, in light PA (LPA), in moderate PA (MPA), and in vigorous PA (VPA). PA did not differ between weekdays and the weekend at baseline. Twenty-four-hour sleep time, however, was significantly longer during weekends compared to weekdays, which was associated with less time spent sedentary. Weight loss was associated with a significant increase in LPA at the expense of sedentary time during the weekend but not during weekdays. Regression analyses further revealed an inverse association between change in VPA during the weekend and body composition at 12-month follow-up. Taken together, these results suggest that weekend PA plays an important role in long-term weight management