Impact of having a child on physical activity in the UK: a scoping review protocol

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordINTRODUCTION: Throughout the life course, there are major life transitions that are associated with reduced physical activity, which may have further implications for health and well-being. Having a child is one such transition that has been identified as a critical transformative experience and window for intervention. We will conduct a scoping review of available evidence exploring the impact of having a child on physical activity in the UK. METHODS AND ANALYSIS: We will use best-practice methodological frameworks to map key concepts and available evidence, summarise and disseminate findings to stakeholders, and identify knowledge gaps. A three-step search strategy will identify primary research studies, including reviews, from published and grey literature, exploring the impact of having a child on physical activity in the UK, from the preconception period, throughout pregnancy, the postpartum period, and into parenthood. An initial limited search will identify relevant reviews, from which keywords and index terms will be extracted. We will conduct searches of CINAHL, Embase, Medline, PsycINFO and Web of Science to identify relevant articles written in English from inception to February 2022. Two reviewers will independently screen titles and abstracts of identified studies for inclusion and chart data, with a third reviewer resolving any conflicts. Backwards citation tracking will identify any additional studies. We will conduct numerical and thematic analysis to map data in tabular and diagrammatic format and provide a description of findings by theme. ETHICS AND DISSEMINATION: Ethical approval is not required for this scoping review. We will disseminate findings to stakeholders through publications, conferences, social media platforms and in-person communications. Consultations with key stakeholders, with their unique expertise and perspectives, will provide greater insight. We will establish the main priorities for future research to inform the research questions of subsequent studies. SCOPING REVIEW REGISTRATION: Open Science Framework (https://osf.io/gtqa4/) DOI 10.17605/OSF.IO/GTQA4.Economic and Social Research Council (ESRC

A single day of bed rest, irrespective of energy balance, does not affect skeletal muscle gene expression or insulin sensitivity

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.The initial metabolic and molecular events that underpin disuse-induced skeletal muscle deconditioning, and the contribution of energy balance, remain to be investigated. Ten young, healthy males (age: 25 ± 1 y; BMI: 25.3 ± 0.8 kg m-2 ) underwent three 24 h laboratory-based experimental periods in a randomized, crossover manner: 1) controlled habitual physical activity with an energy-balanced diet (CON); 2) strict bed rest with a diet to maintain energy balance (BR-B); and 3) strict bed rest with a diet identical to CON, consequently resulting in positive energy balance. Continuous glucose monitoring was performed throughout each visit, with vastus lateralis muscle biopsies and an oral glucose tolerance test performed before and after. In parallel with muscle samples collected from a previous 7-day bed rest study, biopsies were used to examine expression of genes associated with the regulation of muscle mass and insulin sensitivity. A single day of bed rest, irrespective of energy balance, did not lead to overt changes in whole-body substrate oxidation, indices of insulin sensitivity (i.e. HOMA-IR (BR-B: from 2.7 ± 1.7 to 3.1 ± 1.5, P > 0.05), Matsuda (BR-B: from 5.9 ± 3.3 to 5.2 ± 2.9, P > 0.05)), or 24 h glycaemic control/variability compared to CON. Seven days of bed rest led to ∼30-55% lower expression of genes involved in insulin signalling, lipid storage/oxidation, and muscle protein breakdown, whereas no such changes were observed after one day of bed rest. In conclusion, more than one day of physical inactivity is required to observe the insulin resistance and robust skeletal muscle transcriptional responses associated with bed rest and consequent alterations in energy balance.BTW received internal funding from the College of Life and Environmental Sciences, University of Exeter, to support this project. None of the other authors received funding from any funding agency in the public, commercial or not-for-profit sectors to conduct this research

Associations between device-measured physical activity and performance-based physical function outcomes in adults: a systematic review and meta-analysis

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordThis systematic review and meta-analysis aimed to examine the association between device-measured physical activity (PA) and performance-based measures of physical function (PF). Databases searched included CINAHL, Embase, MEDLINE/PubMed, SPORTDiscus, and Web of Science (last search conducted on November 11, 2022). Observational studies (cross-sectional or prospective) reporting associations between wearable device-measured PA and PF outcomes in non-clinical adults were eligible. Forty-two studies with a pooled sample of 27 276 participants were eligible, with 34 studies reporting a standardised regression coefficient (β) between at least one of four PA measures and one of six PF outcomes. All measures of PA were positively associated with all measures of PF, except for step count with grip strength. Largest associations were seen with lower-body PF tests; gait speed (βs=0.11–0.26), walk tests (βs=0.18–0.41), chair-rise test (βs=0.10–0.26), balance (βs=0.07–0.24) and Timed Up-and-Go (βs=0.10–0.24) all p<0.01. Small or no association was seen with grip strength (βs=0.02–0.07). In observational studies of general adult populations, there were associations between multiple dimensions of PA and a broad range of PF measures. The findings provide provisional support for the use of device measures of movement to remotely monitor people for risk of low PF. Prospective designs are needed to determine the direction of the relationship. Future studies should also explore a broader range of PA metrics beyond simple aggregate measures of time spent at different acceleration values as there is evidence that the temporal distribution of activity is related to health and functional outcomes.Economic and Social Research Council (ESRC

Acute effect of exercise intensity and duration on acylated ghrelin and hunger in men

Acute exercise transiently suppresses the orexigenic gut hormone acylated ghrelin, but the extent exercise intensity and duration determine this response is not fully understood. The effects of manipulating exercise intensity and duration on acylated ghrelin concentrations and hunger were examined in two experiments. In experiment one, nine healthy males completed three, 4-hour conditions (control, moderate-intensity running (MOD) and vigorous-intensity running (VIG)), with an energy expenditure of ~2.5 MJ induced in both MOD (55 min running at 52% peak oxygen uptake (VO2peak)) and VIG (36 min running at 75% VO2peak). In experiment two, nine healthy males completed three, 9-hour conditions (control, 45 min running (EX45) and 90 min running (EX90)). Exercise was performed at 70% VO2peak. In both experiments, participants consumed standardised meals, and acylated ghrelin concentrations and hunger were quantified at predetermined intervals. In experiment one, delta acylated ghrelin concentrations were lower than control in MOD (ES=0.44, P=0.01) and VIG (ES=0.98, P<0.001); VIG was lower than MOD (ES=0.54, P=0.003). Hunger ratings were similar across the conditions (P=0.35). In experiment two, delta acylated ghrelin concentrations were lower than control in EX45 (ES=0.77, P<0.001) and EX90 (ES=0.68, P<0.001); EX45 and EX90 were similar (ES=0.09, P=0.55). Hunger ratings were lower than control in EX45 (ES=0.20, P=0.01) and EX90 (ES=0.27, P=0.001); EX45 and EX90 were similar (ES=0.07, P=0.34). Hunger and delta acylated ghrelin concentrations remained suppressed at 1.5h in EX90 but not EX45. In conclusion, exercise intensity, and to a lesser extent duration, are determinants of the acylated ghrelin response to acute exercise

Acute effect of exercise intensity and duration on acylated ghrelin and hunger in men.

Published onlineJournal ArticleThis is the author accepted manuscript. The final version is available from BioScientifica via the DOI in this record.Acute exercise transiently suppresses the orexigenic gut hormone acylated ghrelin, but the extent exercise intensity and duration determine this response is not fully understood. The effects of manipulating exercise intensity and duration on acylated ghrelin concentrations and hunger were examined in two experiments. In experiment one, nine healthy males completed three, 4-hour conditions (control, moderate-intensity running (MOD) and vigorous-intensity running (VIG)), with an energy expenditure of ~2.5 MJ induced in both MOD (55 min running at 52% peak oxygen uptake (VO2peak)) and VIG (36 min running at 75% VO2peak). In experiment two, nine healthy males completed three, 9-hour conditions (control, 45 min running (EX45) and 90 min running (EX90)). Exercise was performed at 70% VO2peak In both experiments, participants consumed standardised meals, and acylated ghrelin concentrations and hunger were quantified at predetermined intervals. In experiment one, delta acylated ghrelin concentrations were lower than control in MOD (ES=0.44, P=0.01) and VIG (ES=0.98, P<0.001); VIG was lower than MOD (ES=0.54, P=0.003). Hunger ratings were similar across the conditions (P=0.35). In experiment two, delta acylated ghrelin concentrations were lower than control in EX45 (ES=0.77, P<0.001) and EX90 (ES=0.68, P<0.001); EX45 and EX90 were similar (ES=0.09, P=0.55). Hunger ratings were lower than control in EX45 (ES=0.20, P=0.01) and EX90 (ES=0.27, P=0.001); EX45 and EX90 were similar (ES=0.07, P=0.34). Hunger and delta acylated ghrelin concentrations remained suppressed at 1.5h in EX90 but not EX45. In conclusion, exercise intensity, and to a lesser extent duration, are determinants of the acylated ghrelin response to acute exercise.The research was supported by the National Institute for Health Research (NIHR) Diet, Lifestyle & Physical Activity Biomedical Research Unit based at University Hospitals of Leicester and Loughborough University. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health

Socioeconomic position and childhood sedentary time: evidence from the PEACH project

BACKGROUND: Associations between socioeconomic position (SEP) and sedentary behaviour in children are unclear. Existing studies have used aggregate measures of weekly sedentary time that could mask important differences in the relationship between SEP and sedentary time at different times of the day or between weekdays and weekend days. These studies have also employed a variety of measures of SEP which may be differentially associated with sedentary time. This paper examines associations of multiple indicators of SEP and accelerometer-measured, temporally specific, sedentary time in school children. METHODS: Between 2006 and 2007 sedentary time data (minutes spent below 100 accelerometer counts per minute) for weekdays before-school (7.00-8.59AM), during school-time (9.00AM-2.59PM) and after-school (3.00PM-11.00PM), and weekend days were recorded for 629 10–11 year old children using accelerometers. Ordinary least squares regression was used to examine associations with 5 indicators of SEP (area deprivation, annual household income, car ownership, parental education and access to a private garden). Covariates were; gender, BMI, minutes of daylight, accelerometer wear time and school travel method. Analyses were conducted in 2012. RESULTS: Following adjustments for covariates, having a parent educated to university degree level was associated with more minutes of school (5.87 [95% CI 1.72, 10.04]) and after-school (6.04 [95% CI 0.08, 12.16]) sedentary time. Quartiles of area deprivation (most to least deprived) were positively associated with after-school (Q2: 4.30 [95% CI −6.09, 14.70]; Q3: 10.77 [95% CI 0.47, 21.06]; Q4: 12.74 [95% CI 2.65, 22.84]; P(trend) = 0.04) and weekend (Q2: 26.34 [95% CI 10.16, 42.53]; Q3: 33.28 [95% CI 16.92, 49.65]; Q4: 29.90 [95% CI 14.20, 45.60]; P(trend) = 0.002) sedentary time. Having a garden was associated with less sedentary time after-school (−14.39 [95% CI −25.14, -3.64]) and at weekends (−27.44 [95% CI −43.11, -11.78]). CONCLUSIONS: Associations between SEP and children’s sedentary-time varied by SEP indicator and time of day. This highlights the importance of measuring multiple indicators of SEP and examining context specific sedentary time in children in order to fully understand how SEP influences this behaviour. Further research should combine self-report and objective data to examine associations with specific sedentary behaviours in the contexts within which they occur, as well as total sedentary time

Moving through Motherhood:Involving the Public in Research to Inform Physical Activity Promotion throughout Pregnancy and Beyond

open access articleInformation received by women regarding physical activity during and after pregnancy often lacks clarity and may be conflicting and confusing. Without clear, engaging, accessible guidance centred on the experiences of pregnancy and parenting, the benefits of physical activity can be lost. We describe a collaborative process to inform the design of evidence-based, user-centred physical activity resources which reflect diverse experiences of pregnancy and early parenthood. Two iterative, collaborative phases involving patient and public involvement (PPI) workshops, a scoping survey (n = 553) and stakeholder events engaged women and maternity, policy and physical activity stakeholders to inform pilot resource development. These activities shaped understanding of challenges experienced by maternity and physical activity service providers, pregnant women and new mothers in relation to supporting physical activity. Working collaboratively with women and stakeholders, we co-designed pilot resources and identified important considerations for future resource development. Outcomes and lessons learned from this process will inform further work to support physical activity during pregnancy and beyond, but also wider health research where such collaborative approaches are important. We hope that drawing on our experiences and sharing outcomes from this work provide useful information for researchers, healthcare professionals, policy makers and those involved in supporting physical activity behaviour

Physical activity, sleep, and fatigue in community dwelling Stroke Survivors

Stroke can lead to physiological and psychological impairments and impact individuals’ physical activity (PA), fatigue and sleep patterns. We analysed wrist-worn accelerometry data and the Fatigue Assessment Scale from 41 stroke survivors following a physical rehabilitation programme, to examine relationships between PA levels, fatigue and sleep. Validated acceleration thresholds were used to quantify time spent in each PA intensity/sleep category. Stroke survivors performed less moderate to vigorous PA (MVPA) in 10 minute bouts than the National Stroke guidelines recommend. Regression analysis revealed associations at baseline between light PA and fatigue (p = 0.02) and MVPA and sleep efficiency (p = 0.04). Light PA was positively associated with fatigue at 6 months (p = 0.03), whilst sleep efficiency and fatigue were associated at 9 months (p = 0.02). No other effects were shown at baseline, 6 or 9 months. The magnitude of these associations were small and are unlikely to be clinically meaningful. Larger trials need to examine the efficacy and utility of accelerometry to assess PA and sleep in stroke survivorsStroke Association for funding this research (TSA – 2014-03) and the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula at the Royal Devon and Exeter NHS Foundation Trus

Mobile Health Biometrics to Enhance Exercise and Physical Activity Adherence in Type 2 Diabetes (MOTIVATE-T2D): protocol for a feasibility randomised controlled trial

Introduction Exercise and physical activity (PA) are fundamental to the treatment of type 2 diabetes. Current exercise and PA strategies for newly diagnosed individuals with type 2 diabetes are either clinically effective but unsuitable in routine practice (supervised exercise) or suitable in routine practice but clinically ineffective (PA advice). Mobile health (mHealth) technologies, offering biometric data to patients and healthcare professionals, may bridge the gap between supervised exercise and PA advice, enabling patients to engage in regular long-term physically active lifestyles. This feasibility randomised controlled trial (RCT) will evaluate the use of mHealth technology when incorporated into a structured home-based exercise and PA intervention, in those recently diagnosed with type 2 diabetes.Methods and analysis This feasibility multicentre, parallel group RCT will recruit 120 individuals with type 2 diabetes (diagnosis within 5–24 months, aged 40–75 years) in the UK (n=60) and Canada (n=60). Participants will undertake a 6-month structured exercise and PA intervention and be supported by an exercise specialist (active control). The intervention group will receive additional support from a smartwatch and phone app, providing real-time feedback and enabling improved communication between the exercise specialist and participant. Primary outcomes are recruitment rate, adherence to exercise and loss to follow-up. Secondary outcomes include a qualitative process evaluation and piloting of potential clinical outcome measures for a future RCT. Ethics and dissemination The trial was approved in the UK by the South East Scotland Research Ethics Committee 01 (20/SS/0101) and in Canada by the Clinical Research Ethics Board of the University of British Columbia (H20-01936), and is being conducted in accordance with the Declaration of Helsinki and Good Clinical Practice. Results will be published in peer-reviewed journals and presented at national and international scientific meetings.Trial registrationnumbers,ISRCTN14335124; ClinicalTrials.gov: NCT04653532