Keeping older adults active: Are activity trackers effective?

Introduction & Aims: Despite the significant number of benefits associated with regular physical activity participation, Australian older adults are largely inactive. As such, greater support is required to assist older adults to maintain physical activity levels. This study aimed to investigate the effects of a wearable activity tracker (AT) combined with tailored feedback from an Accredited Exercise Physiologist via text message, compared to telephone counselling (TC) and usual care (UC) on physical activity maintenance following a structured lifestyle intervention.Methods: 117 participants were recruited from a 12-week structured lifestyle intervention and were randomised to receive either AT (n=37), TC (n=38) or UC (n=42) for 12-months from the conclusion of the lifestyle intervention. The primary outcome measure was daily steps measured by an ActivPAL accelerometer measured at baseline, 3, 6 and 12 months. Secondary outcomes included body composition, blood pressure and functional strength.Results: Participants were 72.4 ± 6.4 years and predominantly female (64%). Both the AT and TC groups maintained daily step count and lean mass throughout the 12-month intervention while UC showed a significant reduction in both daily steps and lean mass at 12-months (MD; -981 steps, 95%CI; -1668 steps to -294 steps, p>0.01, MD; 1.13 kg, 95%CI; -2.26 kg to 0.01 kg, p=0.05 respectively).Conclusion: Both a wearable activity tracker and telephone counselling are effective at maintaining daily step count and lean mass in older adults over a 12-month period. A wearable activity tracker may provide an effective alternative to telephone counselling which is the current gold standard for providing ongoing support. Through connected healthcare technologies, activity trackers can provide health professionals with objectively measured physical activit

Effects of activity tracker use with health professional support or telephone counseling on maintenance of physical activity and health outcomes in older adults: Randomized controlled trial

Background: Despite a range of efforts to increase physical activity participation in Australia, inactivity levels in older adults have remained high over recent decades, contributing to increased rates of chronic health conditions. Lifestyle interventions, including telephone counseling (TC), improve physical activity participation and associated health outcomes over the short term; however, ongoing feedback and support is required to maintain these changes. Newer technologies such as wearable activity trackers (ATs) may offer an alternative method for providing ongoing support. Objective: This study aims to investigate whether newer technologies such as wearable ATs assist in providing ongoing support to maintain physical activity levels and health outcomes. Methods: Older adults aged >60 years who had just completed a 12-week face-to-face individualized community exercise program in Tasmania, Australia, participated in the study. They were randomized to receive AT, TC, or usual care (UC). All groups received a home exercise program and an optional referral to a community-based exercise program. The AT group also received an AT and text message feedback from an accredited exercise physiologist (AEP). The TC group received phone calls from an AEP throughout the 12-month intervention. The primary outcome was daily steps measured by an ActivPAL (TM) accelerometer at baseline and at 3, 6, and 12 months. Secondary outcome measures included body composition, blood pressure, 10-time sit-to-stand (TTSTS) test, timed up and go test, and cardiorespiratory fitness. This trial was approved by the Tasmanian Health and Medical Human Research Ethics Committee (H0014713). Results: A total of 117 participants were randomized to the study (AT, n=37; TC, n=38; UC, n=42). At baseline, the participants (75/117, 64.1% female; mean age 72.4 years, SD 6.4) completed an average of 6136 steps (SD 2985) per day. Although there were no significant differences between groups, the TC and AT groups maintained daily step counts (mean difference [MD] −79 steps, 95% CI −823 to 663 steps; P=.81; and MD −588 steps, 95% CI −1359 to 182 steps; P=.09), and UC showed a reduction in daily steps (MD 981 steps, 95% CI −1668 to −294 steps; P=.003) during the 12-month period. Diastolic blood pressure was significantly higher after AT than after UC (MD 5.62 mm Hg, 95% CI 1.30 to 9.94 mm Hg; P=.01), and TTSTS was significantly slower on TC compared with UC (MD 2.36 seconds, 95% CI −0.14 to 4.87 seconds; P=.03). Conclusions: The use of an AT with AEP support or TC is effective at maintaining daily step count in older adults over a 12-month period, suggesting that wearable ATs are as effective as TC. Further research to investigate which option is more cost-effective would be beneficial. Trial Registration: Australian New Zealand Clinical Trial Registry ACTRN12615001104549; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369118.</p

Women in the workplace:promoting healthy lifestyles and mitigating weight gain during the preconception, pregnancy, and postpartum periods

Overweight and obesity before, during, and after pregnancy are associated with adverse outcomes for mothers and their offspring. Workplaces have been identified as important settings for improving health and wellbeing. However, the value of workplace interventions for women across the reproductive life stages has yet to be realized. This paper aims to explore the potential of workplaces to facilitate healthy lifestyle behaviors, prevent further weight gain, and devise tailored interventions for working women, specifically during the preconception, pregnancy, and postpartum periods. Workplaces can be used to engage women, including preconception women, who are detached from clinical settings. Potential benefits of workplace health promotion for women and employers include improved employee wellbeing, productivity, and corporate competitiveness. However, workplaces also need to overcome implementation barriers such as activity scheduling and availability. A systems approach may address these barriers. Consequently, designing and implementing workplace health promotion interventions to meet the specific needs of working women of reproductive age will necessitate collaboration with a range of key stakeholders across all stages of intervention design. Given that these women make up a considerable proportion of the workforce, workplaces can help optimize the health status of employees and prevent excess weight gain during the preconception, pregnancy, and postpartum periods

30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data

Background: There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. Materials and methods: This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien–Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. Results: In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). Conclusions: This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts. © 2021, The Author(s)