Eight investments that work for physical activity

Background: The International Society for Physical Activity and Health (ISPAH) is a leading global organization working to advance research, policy, and practice to promote physical activity. Given the expanding evidence base on interventions to promote physical activity, it was timely to review and update a major ISPAH advocacy document—Investments that Work for Physical Activity (2011). Methods: Eight investment areas were agreed upon through consensus. Literature reviews were conducted to identify key evidence relevant to policymakers in each sector or setting. Results: The 8 investment areas were as follows: whole-of-school programs; active transport; active urban design; health care; public education; sport and recreation; workplaces; and community-wide programs. Evidence suggests that the largest population health benefit will be achieved by combining these investments and implementing a systems-based approach. Conclusions: Establishing consensus on ‘what works’ to change physical activity behavior is a cornerstone of successful advocacy, as is having appropriate resources to communicate key messages to a wide range of stakeholders. ISPAH has created a range of resources related to the new investments described in this paper. These resources are available in the ‘advocacy toolkit’ on the ISPAH website (www.ispah.org/resources)

The role of physical activity for recovery after surgical procedures

The aim of this thesis was to determine the association between and effect of preoperative physical activity and postoperative recovery after surgery due to gallbladder disease or colorectal cancer. Paper I examined the association between self-reported level of physical activity before cholecystectomy and postoperative recovery in an observational cohort study. Participants with regular physical activity had lower risk for prolonged sick leave compared to participants who were inactive. Papers II and III determined the association between self-reported level of physical activity before colorectal cancer surgery and recovery in an observational cohort study. Habitual physical activity was not associated with the primary outcome measure, length of hospital stay, but an association was found between higher levels of physical activity and improvements in physical recovery three weeks postoperatively and reduced risk for postoperative complications. Paper IV describes the design of a randomised controlled trial with a pragmatic short-term physical activity intervention before and after colorectal cancer surgery, aimed to improve self-assessed physical recovery four weeks postoperatively as well as several secondary outcome measures of postoperative recovery. Paper V reports the main results from this randomised controlled trial, where the intervention had no effect on any of the primary or secondary short-term outcome measures in the study. The results from the works included in this thesis imply that habitual physical activity is associated with faster postoperative recovery after cholecystectomy and colorectal cancer surgery, but that postoperative recovery cannot be improved by a short-term physical activity intervention

Complete school absenteeism and the meaning of resources : A study about the relationship between unauthorized school absenteeism, psychological,emotional and social resources.

Syftet med denna studie var att undersöka relationen mellan ogiltig skolfrånvaro och grad av psykologiska, emotionella och sociala resurser. Vi undersökte både hemmasittande ungdomar (N = 13) och normalpopulation (N = 235) i två delstudier med en enkätbaserad tvärsnittsdesign. Resultatet visade att hemmasittande ungdomar upplevde mycket låg grad av psykologiska resurser. Resultaten visade även att graden av ogiltig skolfrånvaro hängde samman med graden av psykologiska resurser. Ogiltig skolfrånvaro hängde även till viss del samman med sociala och emotionella resurser. Ogiltigt skolfrånvarande ungdomar använde sig i lägre grad av adaptiv emotionsreglering och upplevde lägre socialt stöd från lärare. Vidare forskning behövs för att bekräfta resursernas betydelse.The aim of this study was to examine the relationship between unauthorized absence from school and psychological, emotional and social resources. We examined two samples, one consisting of students with complete school absence (N = 13) and one population based reference group (N = 235), using a questionnaire based cross-sectional research design. Results showed that students with complete school absence experience a very low level of psychological resources. Results also showed that unauthorized absence from school was related to level of psychological resources. Unauthorized absence from school was also partly related to social and emotional resources. Students with unauthorized absence from school used adaptive emotional regulation strategies to a lesser extent, and experienced a lower level of social support from teachers. Further research is required to confirm the relevance of the psychological, emotional, and social resources

Cardiorespiratory fitness and BMI measured in youth and 5-year mortality after site-specific cancer diagnoses in men : A population-based cohort study with register linkage.

BACKGROUND: Our aim was to assess associations between cardiorespiratory fitness (CRF) and body mass index (BMI) in youth and 5-year mortality after site-specific cancer diagnoses in men. METHODS: Men with cancer from a population who underwent military conscription at ages 16-25 during 1968-2005 in Sweden were included. CRF was assessed as maximal aerobic workload on a cycle ergometer test and was classified as low, moderate, or high. BMI (kg/m2 ) was classified as underweight (<18.5), normal weight (18.5-24.9), overweight (25-29.9), or obesity (>30). Conscription data were linked with register data on cancer diagnosis and mortality. Analyses included CRF, BMI, date of diagnosis, and age, year, and center for conscription. RESULTS: A total of 84,621 cancer cases were included. Mean age at diagnosis was 52 years. Follow-up data were available during a mean of 6.5 years. There were linear protective associations between CRF and mortality after any cancer diagnosis (hazard ratio [HR] for high vs. low CRF 0.70), malignant skin cancer (HR 0.80), non-Hodgkin lymphoma (HR 0.78), and cancer in the lungs (HR 0.80), head and neck (HR 0.68), pancreas (HR 0.83), stomach (HR 0.78), liver (HR 0.84), rectum (HR 0.79), and bladder (HR 0.71). Overweight and/or obesity were associated with increased mortality after any cancer (HR for obesity vs. normal weight 1.89), malignant skin cancer (HR 2.03), Hodgkin lymphoma (HR 2.86) and cancer in the head and neck (HR 1.38), thyroid (HR 3.04), rectum (HR 1.53), kidney (HR 1.90), bladder (HR 2.10), and prostate (HR 2.44). CONCLUSION: We report dose-dependent associations between CRF and BMI in youth and mortality after site-specific cancer diagnoses in men. The associations with mortality could be due to both cancer inhibition and an improved tolerance to withstand cancer treatment. These results strengthen the incentive for public health efforts aimed at establishing a high CRF and normal weight in youth

sj-docx-1-sjs-10.1177_14574969221123389 – Supplemental material for The effect of nonsupervised physical activity before and after breast cancer surgery on quality of life: Results from a randomized controlled trial (PhysSURG-B)

Supplemental material, sj-docx-1-sjs-10.1177_14574969221123389 for The effect of nonsupervised physical activity before and after breast cancer surgery on quality of life: Results from a randomized controlled trial (PhysSURG-B) by Jenny Heiman, Aron Onerup, David Bock, Eva Haglind and Roger O. Bagge in Scandinavian Journal of Surgery</p

Associations between cardiorespiratory fitness in youth and the incidence of site-specific cancer in men : a cohort study with register linkage.

OBJECTIVES: To assess the associations between cardiorespiratory fitness (CRF) in young men and the incidence of site-specific cancer. METHODS: A Swedish population-based cohort study with register linkage of men who underwent military conscription in 1968-2005 was undertaken. CRF was assessed by maximal aerobic workload cycle test at conscription. Cox regression models assessed linear associations and included CRF, age, year and site of conscription, body mass index and parental level of education. CRF was also categorised into low, moderate and high for facilitated interpretation and results comparing high and low CRF are reported. RESULTS: Primary analyses were performed in 1 078 000 men, of whom 84 117 subsequently developed cancer in at least one site during a mean follow-up of 33 years. Higher CRF was linearly associated with a lower hazard ratio (HR) of developing cancer in the head and neck (n=2738, HR 0.81, 95% CI 0.74 to 0.90), oesophagus (n=689, HR 0.61, 95% CI 0.50 to 0.74), stomach (n=902, HR 0.79, 95% CI 0.67 to 0.94), pancreas (n=1280, HR 0.88, 95% CI 0.76 to 1.01), liver (n=1111, HR 0.60, 95% CI 0.51 to 0.71), colon (n=3222, HR 0.82, 95% CI 0.75 to 0.90), rectum (n=2337, HR 0.95, 95% CI 0.85 to 1.05), kidney (n=1753, HR 0.80, 95% CI 0.70 to 0.90) and lung (n=1635, HR 0.58, 95% CI 0.51 to 0.66). However, higher CRF predicted a higher hazard of being diagnosed with prostate cancer (n=14 232, HR 1.07, 95% CI 1.03 to 1.12) and malignant skin cancer (n=23 064, HR 1.31, 95% CI 1.27 to 1.36). CONCLUSION: We report a number of protective associations between higher CRF in healthy young men and the subsequent hazard of site-specific cancers. These results have implications for public health policymaking, strengthening the incentive to promote health through improving CRF in youth

The effect of pre- and post-operative physical activity on recovery after colorectal cancer surgery (PHYSSURG-C): study protocol for a randomised controlled trial

Abstract Background Surgery for colorectal cancer is associated with a high risk of post-operative adverse events, re-operations and a prolonged post-operative recovery. Previously, the effect of prehabilitation (pre-operative physical activity) has been studied for different types of surgery, including colorectal surgery. However, the trials on colorectal surgery have been of limited methodological quality and size. The aim of this trial is to compare the effect of a combined pre- and post-operative intervention of moderate aerobic physical activity and inspiratory muscle training (IMT) with standard care on post-operative recovery after surgery for colorectal cancer. Methods/design We are conducting a randomised, controlled, parallel-group, open-label, multi-centre trial with physical recovery within 4 weeks after cancer surgery as the primary endpoint. Some 640 patients planned for surgery for colorectal cancer will be enrolled. The intervention consists of pre- and post-operative physical activity with increased daily aerobic activity of moderate intensity as well as IMT. In the control group, patients will be advised to continue their normal daily exercise routine. The primary outcome is patient-reported physical recovery 4 weeks post-operatively. Secondary outcomes are length of sick leave, complication rate and severity, length of hospital stay, re-admittances, re-operations, post-operative mental recovery, quality of life and mortality, as well as changes in insulin-like growth factor 1 and insulin-like growth factor-binding protein 3, perception of pain and a health economic analysis. Discussion An increase in moderate-intensity aerobic physical activity is a safe, cheap and feasible intervention that would be possible to implement in standard care for patients with colorectal cancer. If shown to be effective, this lifestyle intervention could be a clinical parallel to pre-operative smoke cessation that has already been implemented with good clinical results. Trial registration ClinicalTrials.gov identifier: NCT02299596 . Registered on 17 November 2014