Trajectories of physical activity from mid to older age in women: 21 years of data from the Australian Longitudinal Study on Women’s Health

Background:Women’s physical activity varies across the adult lifespan. However, changes in physical activity among mid-aged women are not well understood. We analysed 21 years of data from women born in 1946–51 to identify: (1) trajectories of physical activity in the transition from mid- to old-age and (2) determinants of different physical activity trajectories. Methods: Data were from the 1946–51 cohort of the Australian Longitudinal Study on Women’s Health (N = 10,371). Surveys were mailed at three-year intervals from 1998 (age 47–52) to 2019 (age 68–73) to collect data on physical activity, sociodemographic factors (country of birth, area of residence, educational attainment, marital status, income management, paid work hours, living with children age &lt; 18, providing care), health indicators (menopause status, BMI, physical and mental health, chronic conditions), and health behaviours (smoking, alcohol status). Group-based trajectory modelling was used to identify trajectories of physical activity. Multinomial logistic regression models were used to examine the determinants of physical activity trajectories. Results:Five trajectories were identified: Low-stable (13.3% of participants), Moderate-stable (50.4%), Moderate-increasing (22.2%), High-declining (7.7%), and High-stable (6.6%). Sociodemographic characteristics (area of residence, education, income management, living with children, and providing care) were determinants of physical activity trajectories, but the strongest factors were BMI, physical and mental health. Women who were overweight/obese and had poor physical and mental health were less likely to be in the High-stable group than in any other group. Changes in these variables (increasing BMI, and declining physical and mental health) and in marital status (getting married) were positively associated with being in trajectories other than the High-stable group. Conclusions:Although most women maintained physical activity at or above current guidelines, very low physical activity levels in the Low-stable group, and declining levels in the High-declining group are concerning. The data suggest that physical activity promotion strategies could be targeted to these groups, which are characterised by socioeconomic disadvantage, high (and increasing) BMI, and poor (and worsening) physical and mental health. Removing barriers to physical activity in these women, and increasing opportunities for activity, may reduce chronic disease risk in older age.</p

Accelerometer-measured physical activity in mid-age Australian adults

BACKGROUND: Raw data from accelerometers can provide valuable insights into specific attributes of physical activity, such as time spent in intensity-specific activity. The aim of this study was to describe physical activity assessed with raw data from triaxial wrist-worn accelerometers in mid-age Australian adults. METHODS: Data were from 700 mid-age adults living in Brisbane, Australia (mean age: 60.4; SD:7.1 years). Data from a non-dominant wrist worn triaxial accelerometer (Actigraph wGT3X-BT), expressed as acceleration in gravitational equivalent units (1 mg = 0.001 g), were used to estimate time spent in moderate-vigorous intensity physical activity (MVPA; >100 mg) using different bout criteria (non-bouted, 1-, 5-, and 10-min bouts), and the proportion of participants who spent an average of at least one minute per day in vigorous physical activity. RESULTS: Mean acceleration was 23.2 mg (SD: 7.5) and did not vary by gender (men: 22.4; women: 23.7; p-value: 0.073) or education (p-value: 0.375). On average, mean acceleration was 10% (2.5 mg) lower per decade of age from age 55y. The median durations in non-bouted, 1-min, 5-min and 10-min MVPA bouts were, respectively, 68 (25th -75th : 45–99), 26 (25th -75th : 12–46), 10 (25th -75th : 3–24) and 8 (25th -75th : 0–19) min/day. Around one third of the sample did at least one minute per day in vigorous intensity activities. CONCLUSION: This population-based cohort provided a detailed description of physical activity based on raw data from accelerometers in mid-age adults in Australia. Such data can be used to investigate how different patterns and intensities of physical activity vary across the day/week and influence health outcomes

Longitudinal association of physical activity during pregnancy with maternal and infant outcomes: Findings from the Australian longitudinal study of women’s health

Background: Physical activity has known benefits during pregnancy; however, the optimum volume of physical activity through the different stages of pregnancy is not well known. Objectives: The aims of this study were to investigate the associations of physical activity volume in pregnant women in each trimester of pregnancy with maternal and infant outcomes. Design: The study involved 1657 pregnant women from the Australian Longitudinal Study on Women’s Health, who completed surveys from 2006 to 2012 (aged 28–39 years). Methods: Women reported being in either the first, second or third trimester of pregnancy. Women were grouped into four groups according to their self-reported physical activity during pregnancy: (1) Nil (0–<33.3 MET.min/week), (2) Low (33.3–<500 MET.min/week), (3) Moderate (500–<1000 MET.min/week) and (4) High (⩾1000 MET.min/week). Women who reported their physical activity during pregnancy completed a survey within three years after the birth, relating to outcomes associated with pregnancy and childbirth (gestational diabetes, hypertension, and antenatal depression and anxiety) and infant outcomes (birthweight and prematurity). Results: There was no association of physical activity in any trimester with infant birthweight, prematurity, gestational diabetes, hypertension or antenatal depression. Antenatal anxiety was less prevalent in women who reported low (1.7%) or moderate (1.1%) physical activity than in those who reported no activity (4.7%; p = 0.01). Conclusion: Different amounts of physical activity during pregnancy were not associated with the measured adverse health outcomes. However, low and moderate amounts of physical activity were associated with reduced incidence of antenatal anxiety

High-intensity interval training is safe, feasible and efficacious in nonalcoholic steatohepatitis : a randomized controlled trial

Background: High-Intensity Interval Training (HIIT) involves bursts of high-intensity exercise interspersed with lower-intensity exercise recovery. HIIT may benefit cardiometabolic health in people with nonalcoholic steatohepatitis (NASH). Aims: We aimed to examine the safety, feasibility, and efficacy of 12-weeks of supervised HIIT compared with a sham-exercise control (CON) for improving aerobic fitness and peripheral insulin sensitivity in biopsy-proven NASH. Methods: Participants based in the community [(n = 14, 56 ± 10 years, BMI 39.2 ± 6.7 kg/m2, 64% male), NAFLD Activity Score 5 (range 3–7)] were randomized to 12-weeks of supervised HIIT (n = 8, 4 × 4 min at 85–95% maximal heart rate, interspersed with 3 min active recovery; 3 days/week) or CON (n = 6, stretching; 3 days/week). Safety (adverse events) and feasibility determined a

Socioeconomic position and sedentary behavior in Brazilian adolescents: A life-course approach.

Socioeconomic position (SEP) is a potential correlate of sedentary behavior in adolescents. The aim of this study was to examine the associations between SEP and self-reported and objective measures of sedentary behavior in adolescents, using a life-course approach. Data from the 1993 Pelotas (Brazil) Birth Cohort Study were analyzed (N=5249). Cross-sectional and longitudinal associations between multiple SEP indicators (maternal education, family income, SEP composite, cumulative family income) at birth, 11, 15 and 18years, and five sedentary behavior outcomes (≥4h/day screen time; ≥4h/day TV; ≥2h/day computer; ≥2h/day video game; ≥12.7h/day objectively measured sedentary time) at 11, 15 and 18years, were examined. In cross-sectional analyses, higher SEP was positively associated with more screen time at ages 11 and 15years. There was a consistent and positive association between higher SEP with time spent using a computer, and with sedentary time assessed through accelerometry. SEP at birth had a positive and direct effect on screen, computer and total sedentary time at 18years. Participants in the highest cumulative income group had higher odds of high sedentary behavior in screen (OR: 2.40; 95% CI: 1.50-3.54), computer (OR: 7.35; 95% CI: 4.19-12.89) and total sedentary time (OR: 5.40; 95% CI: 3.53-10.35), respectively, compared with their counterparts with lower cumulative income. Our findings showed that SEP is an early determinant of sedentary behavior in adolescents

Evaluating Evidence-Based Content, Features of Exercise Instruction, and Expert Involvement in Physical Activity Apps for Pregnant Women: Systematic Search and Content Analysis

Background: Guidelines for physical activity and exercise during pregnancy recommend that all women without contraindications engage in regular physical activity to improve both their own health and the health of their baby. Many women are uncertain how to safely engage in physical activity and exercise during this life stage and are increasingly using mobile apps to access health-relatedinformation. However, the extent to which apps that provide physical activity and exercise advice align with current evidence-based pregnancy recommendations is unclear. Objective: This study aims to conduct a systematic search and content analysis of apps that promote physical activity and exercise in pregnancy to examine the alignment of the content with current evidence-based recommendations; delivery, format, and features of physical activity and exercise instruction; and credentials of the app developers. Methods: Systematic searches were conducted in the Australian App Store and Google Play Store in October 2020. Apps were identified using combinations of search terms relevant to pregnancy and exercise or physical activity and screened for inclusion (with a primary focus on physical activity and exercise during pregnancy, free to download or did not require immediate paid subscription, and an average user rating of ≥4 out of 5). Apps were then independently reviewed using an author-designed extraction tool. Results: Overall, 27 apps were included in this review (Google Play Store: 16/27, 59%, and App Store: 11/27, 41%). Two-thirds of the apps provided some information relating to the frequency, intensity, time, and type principles of exercise; only 11% (3/27) provided this information in line with current evidence-based guidelines. Approximately one-third of the apps provided information about contraindications to exercise during pregnancy and referenced the supporting evidence. None of the apps actively engaged in screening for potential contraindications. Only 15% (4/27) of the apps collected information about the user\u27s current exercise behaviors, 11% (3/27) allowed users to personalize features relating to their exercise preferences, and a little more than one-third provided information about developer credentials. Conclusions: Few exercise apps designed for pregnancy aligned with current evidence-based physical activity guidelines. None of the apps screened users for contraindications to physical activity and exercise during pregnancy, and most lacked appropriate personalization features to account for an individual\u27s characteristics. Few involved qualified experts during the development of the app. There is a need to improve the quality of apps that promote exercise in pregnancy to ensure that women are appropriately supported to engage in exercise and the potential risk of injury, complications, and adverse pregnancy outcomes for both mother and child is minimized. This could be done by providing expert guidance that aligns with current recommendations, introducing screening measures and features that enable personalization and tailoring to individual users, or by developing a recognized system for regulating apps

Influence of center-based child care on development of two-year-olds in a Brazilian cohort

OBJECTIVE To investigate the association between child care attendance since birth and development in two-years-old Brazilian children. METHODS The study used longitudinal data from the 2015 Pelotas Birth Cohort. The childhood development (cognitive, fine and gross motor skills, and language) at two-years-old children was assessed using INTER-NDA (INTERGROWTH-21st Neurodevelopment Assessment). The child care attendance was measured at ages one and two years and categorized as: a) never attended child care; b) attended some child care (one or two years); and c) always attended child care (one and two years). Demographic, socioeconomic, health, and child stimulation variables were considered as confounders. Crude and adjusted analyses of child care attendance and development were carried out using linear regression. RESULTS Out of the 3,870 infants included in the analyses, around 1/3 attended center-based child care. In crude analyses, attending center-based child care was associated with positive developmental outcomes, except in motor domains. In adjusted analyses, compared to those children that have never attended child care, children who did attend presented higher scores for cognitive development (always in child care: β: 2.44, 95%CI: 0.83–4.05; some child care: β: 1.35, 95%CI: 0.17–2.53). CONCLUSIONS This study suggests that center-based child care may help improve child cognitive development in the Brazilian context. Furthermore, the association was higher for early and continued attendance. Considering the low prevalence of children in external care, it is recommended to improve child care opportunities in early childhood

Prevalência de programas de promoção da saúde em unidades básicas de saúde no Brasil

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil.OBJETIVO Estimar a prevalência de programas de promoção da saúde nas unidades básicas de saúde no Brasil. MÉTODOS Estudo transversal descritivo realizado por meio de entrevistas telefônicas com coordenadores de unidades básicas de saúde. Do total de 42.486 unidades básicas de saúde cadastradas pelo Ministério da Saúde, 1.600 foram aleatoriamente selecionadas. As unidades foram amostradas nas cinco regiões do País de acordo com a proporção de unidades em cada região. Foi analisada a presença ou não de cinco programas de promoção da saúde: promoção de atividade física, cessação de tabagismo, cessação de uso de álcool e drogas ilícitas, alimentação saudável e ambiente saudável. Foram coletados dados sobre o tipo de ações desenvolvidas nos programas e a presença ou não da Estratégia de Saúde da Família na unidade. RESULTADOS A maioria das unidades básicas de saúde (62,0%) referiu ter pelo menos três programas de promoção da saúde e apenas 3,0% não tinha nenhum. A promoção do ambiente saudável e da alimentação saudável foram os programas mais prevalentes (77,0% e 72,0%, respectivamente), enquanto o controle do tabaco e do álcool foram referidos em 54,0% e 42,0% das unidades de saúde, respectivamente. A promoção de atividade física foi referida em menos de 40,0% das unidades e teve grande variação regional, com prevalência de 51,0% nas unidades do Sudeste e apenas 21,0% nas do Norte. A maioria das unidades de saúde (61,0%) oferecia Estratégia de Saúde da Família, porém não foi verificada maior prevalência de programas de promoção da saúde nessas unidades em relação às outras. CONCLUSÕES Este estudo mostrou que programas de promoção da saúde estão presentes na maioria das unidades básicas de saúde. Políticas públicas devem fortalecer a infraestrutura das unidades básicas de saúde e melhorar a capacitação dos trabalhadores de saúde para executar adequadamente a agenda de promoção de saúde do governo brasileiro

Atividade física de lazer na população adulta brasileira: Pesquisa Nacional de Saúde 2013 e 2019

Objective: The aim of this study was to analyze the prevalence of leisure-time physical activity (PA) in 2013 and 2019 according to sociodemographic characteristics in Brazilian adults. Methods: We analyzed data from the National Health Surveys (PNS) conducted in 2013 and 2019. Prevalence of leisure-time PA (150+ minutes per week in physical activities) was calculated according to sex, age, education, race/skin color, Federative Units and regions of Brazil in 2013 and 2019. Poisson regression models and 95% confidence intervals (CI) were used to compare leisure-time PA across different groups in 2013 and 2019. Results: The proportion of Brazilian adults active in leisure-time increased from 22.7% (95%CI: 22.06-23.34 in 2013 to 30.1% (95%CI: 29.44-30.67) in 2019. The prevalence of leisure-time physical activity increased between 2013 and 2019 in 23 of the 27 Federative Units in Brazil. Both in 2013 and in 2019, the proportion of active people during leisure time was higher in men, young people, with a high level of education and individuals with white skin color. Overall, the magnitude of the observed differences in leisure-time PA between sociodemographic groups slightly decreased from 2013 to 2019. Conclusion: Despite the increase in the prevalence of leisure-time physical activity among Brazilian adults in the last six years, marked sociodemographic inequalities persist. The success of future public policies to promote physical activity in leisure must be evaluated from the perspective of social determinants of health and the reduction of inequalities in the practice of physical activity.Objetivo: Analisar a prática de atividade física (AF) no lazer de 2013 e 2019 na população adulta brasileira e segundo características sociodemográficas. Métodos: Análise da base de dados da Pesquisa Nacional de Saúde (PNS), comparando-se o indicador de AF no lazer na PNS 2013 e 2019. A prevalência de AF no lazer (150+ minutos por semana em atividades físicas) foi calculada de acordo com sexo, idade, escolaridade, raça/cor da pele, Unidades Federativas e regiões do Brasil em 2013 e 2019. Análises de regressão de Poisson e intervalos de confiança (IC) de 95% foram utilizados para a comparação da atividade física no lazer entre diferentes grupos populacionais em 2013 e 2019. Resultados: A proporção de adultos brasileiros ativos no lazer aumentou de 22,7% (IC95%: 22,06-23,34) em 2013 para 30,1% (IC95%: 29,44-30,67) em 2019. A prevalência de atividade física no lazer aumentou entre 2013 e 2019 em 23 das 27 Unidades Federativas do Brasil. Tanto em 2013 quanto em 2019, a proporção de ativos no lazer foi maior em homens, jovens, com alta escolaridade e indivíduos com cor da pele branca. De uma forma geral, a magnitude da diferença na prática de atividade física entre grupos sociodemográficos observada em 2013 diminuiu ligeiramente em 2019. Conclusão: Apesar do aumento na prevalência de atividade física no lazer em adultos brasileiros nos últimos seis anos, marcadas desigualdades sociodemográficas ainda persistem. O sucesso de futuras políticas públicas de promoção da atividade física no lazer deve ser avaliado sob a ótica dos determinantes socias de saúde e da redução de desigualdades na prática de atividade física