Technology for promoting physical activity in young men

Abstract Although the health benefits of physical activity (PA) are well known, the majority of adolescents are not sufficiently physically active. New innovative ways to promote active lifestyles are needed. This study aimed to evaluate the effectiveness of a wrist-worn activity monitor (Polar Active) and a gamified web-based mobile service in promoting PA in young men. The study also examined the convergent validity between three different accelerometer-based PA measurement methods. In this study, two randomized controlled trials (RCT) were conducted in Oulu, Finland among 18-year-old men. The three-month RCT (n=276) was conducted in fall 2012 and the six-month population-based RCT (n=496) between September 2013 and March 2014. In both trials, participants were randomized to an intervention and a control group. The intervention group was given the wrist-worn Polar Active monitor with PA feedback. In the six-month trial, the intervention group also got access to a mobile service developed in this study. During both trials, PA was continuously measured in both study groups. In the control group, PA was measured with an otherwise similar monitor but which provided only the time of day and no feedback. The convergent validity was examined between the agreement in time spent at different PA levels using Polar Active, mean amplitude deviation (MAD) of raw acceleration, and Actigraph with the Freedson thresholds. In the validation study, all three activity monitors were continuously used for two weeks by 41 volunteers. The three-month trial had a short-term positive effect on daily moderate-to-vigorous PA (MVPA) and sedentary time in the intervention group. The positive change in sedentary time was sustained for longer. During the six-month trial, a positive trend in favor of the intervention group was observed in daily MVPA. Low amount of daily vigorous PA at baseline was associated with the increase in MVPA. The functionalities of the mobile service related to PA were perceived as important and motivating, but the overall compliance with using the service and activity monitor remained low. In free-living conditions, the agreement between Polar Active, MAD, and Actigraph was dependent on the activity thresholds used and PA intensity. The information provided by this study can be utilized in future development of technology-based health services for activating young people.Tiivistelmä Vaikka fyysisen aktiivisuuden terveysvaikutukset ovat hyvin tiedossa, valtaosa nuorista ei liiku riittävästi. Tarvitaan uusia menetelmiä edistämään nuorten aktiivista elämäntapaa. Tämän tutkimuksen tarkoituksena oli selvittää ranteessa pidettävän aktiivisuusmittarin ja pelillistetyn mobiilipalvelun vaikutus nuorten miesten fyysiseen aktiivisuuteen. Lisäksi tutkittiin kolmen eri kiihtyvyysmittaukseen perustuvan aktiivisuusmittausmenetelmän yhtenevyyttä. Tutkimuksessa toteutettiin kaksi satunnaistettua, kontrolloitua interventiota, oululaisilla 18-vuotiailla miehillä. Kolmen kuukauden interventio (n=276) toteutettiin syksyllä 2012 ja 6 kuukauden väestöpohjainen interventio (n=496) syyskuun 2013 ja maaliskuun 2014 välillä. Molemmissa interventioissa osallistujat satunnaistettiin interventio- ja kontrolliryhmään. Interventioryhmä sai käyttöönsä aktiivisuusmittarin, joka antoi palautetta aktiivisuudesta. Lisäksi 6 kuukauden interventiossa interventioryhmä sai käyttöönsä tutkimuksessa kehitetyn mobiilipalvelun. Molemmissa interventioissa kaikkien tutkittavien fyysistä aktiivisuutta mitattiin jatkuvasti. Kontrolliryhmä ei saanut aktiivisuuspalautetta. Aktiivisuusmittausmenetelmien yhtenevyyttä fyysisen aktiivisuuden eri tasoilla vietetyn ajan mittaamisessa tutkittiin vertaamalla Polar Active -mittaria, kiihtyvyyssignaalin perustuvaa menetelmää (mean amplitude deviation, MAD) ja Actigraph-mittaria Freedsonin raja-arvoilla. Neljäkymmentäyksi vapaaehtoista käytti kaikkia kolmea mittaria samanaikaisesti kahden viikon ajan. Kolmen kuukauden interventiolla oli lyhytaikainen positiivinen vaikutus kohtuukuormitteisen tai raskaan fyysisen aktiivisuuden ja paikallaanolon määrään. Paikallaanolon muutos säilyi pidempään. Kuuden kuukauden interventiossa havaittiin interventioryhmässä pieni, ei-merkitsevä nousu kohtuukuormitteisessa tai raskaassa aktiivisuudessa. Aktiivisuus lisääntyi intervention aikana niillä miehillä, joilla alussa oli vähän raskasta fyysistä aktiivisuutta. Mobiilipalvelun ja aktiivisuusmittarin käyttö oli vähäistä, vaikka fyysiseen aktiivisuuteen liittyvät palvelun ominaisuudet koettiin tärkeiksi. Polar Activen, MAD:n ja Actigraphin välinen yhtenevyys oli riippuvainen käytetyistä raja-arvoista ja fyysisen aktiivisuuden intensiteetistä. Tämän tutkimuksen tietoja voidaan hyödyntää teknologiapohjaisten terveyspalveluiden kehittämisessä nuorten aktivoimiseksi

Intensity and temporal patterns of physical activity and cardiovascular disease risk in midlife

Abstract Physical activity (PA) and sedentary time (SED) are associated with the risk of cardiovascular disease (CVD), but the temporal patterns of these behaviors most beneficial for cardiovascular health remain unknown. We aimed to identify the intensity and temporal patterns of PA and SED measured continuously by an accelerometer and their relationship with CVD risk. At the age of 46 years, 4582 members (1916 men; 2666 women) of the Northern Finland Birth Cohort 1966 study underwent continuous measurement of PA with Polar Active (Polar Electro, Finland) accelerometers for one week. X-means clustering was applied based on 10 min average MET (metabolic equivalent) values during the measurement period. Ten-year risk of CVD was estimated using the Framingham risk model. Most of the participants had low risk for CVD. Four distinct PA clusters were identified that were well differentiable by the intensity and temporal patterns of activity (inactive, evening active, moderately active, very active). A significant difference in 10-year CVD risk across the clusters was found in men (p = 0.028) and women (p < 0.001). Higher levels of HDL cholesterol were found in more active clusters compared to less active clusters (p < 0.001) in both genders. In women total cholesterol was lower in the moderately active cluster compared to the inactive and evening active clusters (p = 0.001). Four distinct PA clusters were recognized based on accelerometer data and X-means clustering. A significant difference in CVD risk across the clusters was found in both genders. These results can be used in developing and promoting CVD prevention strategies

Prolonged bouts of sedentary time and cardiac autonomic function in midlife

Abstract Excessive sedentary time (SED) and long SED bouts are associated with cardiovascular diseases (CVD) and increased mortality. Low heart rate variability (HRV), indicating autonomic dysfunction, increases mortality and CVD morbidity. Information about the association between prolonged SED and HRV is lacking. The aim was to assess the relationship between SED bouts and HRV. Physical activity (PA), SED, HRV, and cardiorespiratory fitness (CRF) were collected from a birth‐cohort sample (n = 4150) at 46 years. PA and SED were measured for 14 days with an activity monitor (Polar Active, Polar Electro, Finland). SED accumulating in bouts of at least 30 and 60 minutes (SED30, SED60) was calculated. Linear regression was used to study the relationship between prolonged SED and HRV accounting for CRF, PA, and health covariates. Higher SED60 and in women SED30 were associated with higher root mean square of differences in R‐R intervals (rMSSD) after adjustments (β = .082‐.104). In women, higher SED60 was associated with lower ratio between low‐ and high‐frequency powers (β = −.060). Sedentary bouts were not associated with resting HR or post‐exercise HR recovery. A positive relationship between SED bouts and rMSSD independent of PA and CRF was found, prolonged SED being positively associated with cardiac parasympathetic activity in midlife

Association of accelerometer-measured physical activity and midlife income:a Northern Finland Birth Cohort 1966 Study

Abstract This study investigated the association between physical activity (PA) and midlife income. The population-based data comprised employed members of the Northern Finland Birth Cohort 1966 (N = 2797). Using binned scatterplots and polynomial regressions, we evaluated the association between accelerometer-measured moderate PA (MPA), vigorous PA (VPA), and moderate-to-vigorous PA (MVPA) at 46 years old and register-based income at 50 years old. The models were adjusted for sex, marital status, number of children, education, adolescent PA, occupational physical strenuousness, and time preference. We found MPA (p < 0.001), VPA (p < 0.05), and MVPA (p < 0.001) to associate curvilinearly with income. In subgroup analyses, a curvilinear association was found between MPA (p < 0.01) and MVPA (p < 0.01) among those with physically strenuous work, VPA among all females (p < 0.01) and females with physically light work (p < 0.01), and MPA and MVPA among all males and males with physically strenuous work (p < 0.05; p < 0.01; p < 0.05; p < 0.05, respectively) and income. The highest income benefits occurred at PA volumes higher than current PA guidelines. Linear associations between PA and income were found among females for MPA (p < 0.05) and MVPA (p < 0.05), among those with physically light work for MPA (p < 0.05), VPA (p < 0.05), and MVPA (p < 0.05), and among females with physically strenuous work for VPA (p < 0.05). We conclude that PA up to the current recommended level is associated with income, but MPA exceeding 505.4 min/week, VPA exceeding 216.4 min/week, and MVPA exceeding 555.0 min/week might have a negative association with income

Measuring physical activity in free-living conditions:comparison of three accelerometry-based methods

Abstract We examined the agreement in time spent on different physical activity (PA) levels using (1) mean amplitude deviation (MAD) of raw acceleration from the hip, (2) wrist-worn Polar Active, and (3) hip-worn Actigraph counts using Freedson’s cut-points among adults under free-living conditions. PA was measured in 41 volunteers (mean age 47.6 years) for 14 days. Two MET-based threshold sets were used for MAD and Polar Active for sedentary time (ST) and time spent in light (LPA), moderate (MPA), and vigorous (VPA) PA. Actigraph counts were divided into PA classes, ≤100 counts/min for ST and Freedson’s cut-points for LPA, MPA, and VPA. Analysis criteria were simultaneous use of devices for at least 4 days of >500 min/d. The between-method differences were analyzed using a repeated measures analysis of variance test. Bland-Altman plots and ROC graphs were also employed. Valid data were available from 27 participants. Polar Active produced the highest amount of VPA with both thresholds (≥5 and ≥6 MET; mean difference 17.9–30.9 min/d, P <0.001). With the threshold 3–6 MET for MPA, Polar Active indicated 19.2 min/d more than MAD (95% CI 5.8–32.6) and 51.0 min/d more than Actigraph (95% CI 36.7–65.2). The results did not differ with 3.5–5 MET for MPA [F(1.44, 37.43) = 1.92, P = 0.170]. MAD and Actigraph were closest to each other for ST with the threshold <1.5 MET (mean difference 22.2 min/d, 95% CI 7.1–37.3). With the threshold <2 MET, Polar Active and Actigraph provided similar results (mean difference 7.0 min/d, 95% CI −17.8–31.7). Moderate to high agreement (area under the ROC curve 0.806–0.963) was found between the methods for the fulfillment of the recommendation for daily moderate-to-vigorous PA of 60 min. In free-living conditions the agreement between MAD, Polar Active, and Actigraph for measuring time spent on different activity levels in adults was dependent on the activity thresholds used and PA intensity. ROC analyses showed moderate to high agreement for the fulfillment of the recommendation for daily MVPA. Without additional statistical adjustment, these methods cannot be used interchangeably when measuring daily PA, but any of the methods can be used to identify persons with insufficient daily amount of MVPA

Feasibility of gamified mobile service aimed at physical activation in young men:population-based randomized controlled study (MOPO)

Abstract Background: The majority of young people do not meet the recommendations on physical activity for health. New innovative ways to motivate young people to adopt a physically active lifestyle are needed. Objective: The study aimed to study the feasibility of an automated, gamified, tailored Web-based mobile service aimed at physical and social activation among young men. Methods: A population-based sample of 496 young men (mean age 17.8 years [standard deviation 0.6]) participated in a 6-month randomized controlled trial (MOPO study). Participants were randomized to an intervention (n=250) and a control group (n=246). The intervention group was given a wrist-worn physical activity monitor (Polar Active) with physical activity feedback and access to a gamified Web-based mobile service, providing fitness guidelines, tailored health information, advice of youth services, social networking, and feedback on physical activity. Through the trial, the physical activity of the men in the control group was measured continuously with an otherwise similar monitor but providing only the time of day and no feedback. The primary outcome was the feasibility of the service based on log data and questionnaires. Among completers, we also analyzed the change in anthropometry and fitness between baseline and 6 months and the change over time in weekly time spent in moderate to vigorous physical activity. Results: Mobile service users considered the various functionalities related to physical activity important. However, compliance of the service was limited, with 161 (64.4%, 161/250) participants visiting the service, 118 (47.2%, 118/250) logging in more than once, and 41 (16.4%, 41/250) more than 5 times. Baseline sedentary time was higher in those who uploaded physical activity data until the end of the trial (P=.02). A total of 187 (74.8%, 187/250) participants in the intervention and 167 (67.9%, 167/246) in the control group participated in the final measurements. There were no differences in the change in anthropometry and fitness from baseline between the groups, whereas waist circumference was reduced in the most inactive men within the intervention group (P=.01). Among completers with valid physical activity data (n=167), there was a borderline difference in the change in mean daily time spent in moderate to vigorous physical activity between the groups (11.9 min vs −9.1 min, P=.055, linear mixed model). Within the intervention group (n=87), baseline vigorous physical activity was inversely associated with change in moderate to vigorous physical activity during the trial (R=−.382, P=.01). Conclusions: The various functionalities related to physical activity of the gamified tailored mobile service were considered important. However, the compliance was limited. Within the current setup, the mobile service had no effect on anthropometry or fitness, except reduced waist circumference in the most inactive men. Among completers with valid physical activity data, the trial had a borderline positive effect on moderate to vigorous physical activity. Further development is needed to improve the feasibility and adherence of an integrated multifunctional service

Effect of tailored, gamified, mobile physical activity intervention on life satisfaction and self-rated health in young adolescent men:a population-based, randomized controlled trial (MOPO study)

Abstract Background: Online behavior-change programs may increase physical activity in adolescents, but their effects on subjective health and wellbeing are not well known. Purpose: We investigated the effects of a mobile physical activity intervention on life satisfaction and self-rated health among young adolescent men. Methods: In this population-based study, 496 men (17.8y, SD 0.6y) participated in a 6-month trial. They were randomized into an intervention (n = 250) and a control group (n = 246). Only the intervention group had access to a tailored mobile service. Life satisfaction and self-rated health were inquired about at baseline and at the end of the trial. Results: Life satisfaction improved in the intervention (p < 0.001) and control group (p = 0.01). Life satisfaction was most likely to improve among men with low baseline satisfaction (OR 13.8; 95% CI 3.7–51.8) and mood-related exercise motive (2.5 (1.1–5.6)). There were no statistically significant changes in self-rated health, but those who reported poor health at baseline (OR 9.6; 95% CI 3.7–24.9) and improved self-rated fitness during the trial (4.2 (1.5–11.9)) were more likely to gain improvements in self-rated health. Conclusion: In this mobile physical activity intervention, improvements in self-rated health and life satisfaction were associated with low life satisfaction and poor self-rated health at baseline within the intervention group

Dose-response relation of self-reported and accelerometer-measured physical activity to perceived health in middle age:the Northern Finland Birth Cohort 1966 study

Abstract Background: Regular physical activity (PA) promotes health and decreases mortality. The positive relationship between PA and perceived health (PH) is well known. However, previous research in the field has often used self-reported PA measures. The aim of this population-based NFBC1966 birth cohort study was to assess the relationship between both self-reported and objectively measured PA and PH in midlife. Methods: A sample group of 6384 participants (2878 men, 3506 women, response rate 62%) aged 46 completed a questionnaire on PH and health behaviors, including items on weekly leisure time physical activity (LTPA) and daily sitting time (ST). PH was dichotomized as good (very good or good) and other (fair, poor, or very poor). PA was measured with a wrist-worn Polar Active (Polar Electro, Finland) accelerometer for 14 days (n = 5481, 98%) and expressed as daily average time spent in moderate to vigorous intensity PA (MVPA). Odds ratios (OR) and 95% confidence intervals for good PH were calculated using binary logistic regression and adjusted for relevant demographic, socioeconomic, and health characteristics, and ST. Results: The level of PA was positively associated with PH after adjustments with covariates and ST. There was a dose-response relationship across the PA quartiles according to the adjusted multivariable models. Self-reported LTPA was more strongly associated with good PH (OR from 1.72 to 4.33 compared to lowest PA quartile) than objectively measured PA (OR from 1.37 to 1.66 compared to lowest PA quartile). Conclusions: In this large population-based birth cohort study, we for the first time show a positive dose-response relationship of both self-reported and objectively measured PA to PH, the relationship being stronger for self-reported LTPA. Despite the cross-sectional design of this study, the results from this large sample suggest that both self-reported and objectively measured physical activity are strongly associated with PH, which is a predictor of morbidity and mortality, and regular PA should be encouraged in midlife