Sitting time and risk of cardiovascular disease and diabetes: a systematic review and meta-analysis

Context: Whether physical activity attenuates the association of total daily sitting time with cardiovascular disease (CVD) and diabetes incidence is unclear. This systematic review and meta-analysis examined the association of total daily sitting time with CVD and diabetes with and without adjustment for physical activity. Evidence Acquisition: PubMed, Web of Science, BASE, MEDLINE, Academic Search Elite and ScienceDirect were searched for prospective studies published between 1st January 1989 and 15th February 2019 examining the association of total daily sitting time with CVD or diabetes outcomes. Data extraction and  study quality assessments were conducted by two independent reviewers. Pooled Hazard Ratios (HRs) were calculated using a fixed-effects model. The quality assessment and meta-analytic procedures were completed in 2018. Evidence Synthesis: Nine studies with 448,285 40 participants were included. Higher total daily sitting time was associated with a significantly increased risk of CVD (HR 1.29; 95%CI 1.27-1.30, p=<0.001) and diabetes (HR 1.13; 95%CI 1.04-1.22, p=<0.001) incidence when physical activity was not adjusted for. The increased risk for diabetes was unaffected when adjusting for physical activity (HR 1.11;  95%CI 1.01-1.19, p=<0.001). For CVD, the increased risk was attenuated but remained significant (HR 1.14; 95%CI 1.04-1.23, p=<0.001). Conclusions: Higher levels of total daily sitting time are associated with an increased risk of CVD and diabetes, independent of physical activity. Reductions in total daily sitting may thus be recommended in public health guidelines

Adherence and retention to the self-managed community-based Step Into Health program in Qatar (2012–2019)

Purpose: Investigate adherence and retention to the “Step Into Health (SIH)” initiative (www.stepintohealth.qa [website access only available from within the State of Qatar]), a Qatari self-managed community-based health program, from 2012 to 2019. Methods: Participants (16,711; 16–80 years; 37% females, 34% Qatari) used a pedometer or smartphone application (app) to measure step count. Absolute adherence (ADH) and retention (RET) were calculated, with ADH (%) the ratio between number of days data and SIH enrollment length (RET). Linear Mixed Models identified differences in ADH between RET groups, main effects (i.e., sex, device, age, BMI, nationality) and interaction effects for ADH (RET entered as a covariate). Results: Average ADH and RET to SIH (irrespective of sex, age, device and BMI) was 50% (±31%), and 16% (±20%), respectively, with ADH differing significantly between RET groups (F = 460.2, p < 0.001). RET (as a covariate) revealed a significant main effect for device (F = 12.00, p < 0.001) and age (F = 4.31, p = 0.001) on ADH observed. There was a significant association between RET and sex (p < 0.001), device (p < 0.001), and age groups 16–25 y (p < 0.001), and 26–35 y (p < 0.001). There were no significant main effects for sex or BMI on ADH, and no interaction effects (p ≥ 0.21) observed. Conclusions: Follow-up data (e.g., interviews, focus groups, etc.) determining why differences in ADH and RET are observed appears prudent. To convert those that lapsed and/or abandoned SIH/PA into committed long-term PA adherers. This would be a first step to develop targeted public health promotions and initiatives to enhance health outcomes at a population level.Open Access funding provided by the Qatar National Library

Change in the structures, dynamics and disease-related mortality rates of the population of Qatari nationals: 2007–2011

Background: Developing effective public health policies and strategies for interventions necessitates an assessment of the structure, dynamics, disease rates and causes of death in a population. Lately, Qatar has undertaken development resurgence in health and economy that resulted in improving the standard of health services and health status of the entire Qatari population (i.e., Qatari nationals and non-Qatari residents). No study has attempted to evaluate the population structure/dynamics and recent changes in disease-related mortality rates among Qatari nationals. Objective: The present study examines the population structure/dynamics and the related changes in the cause-specific mortality rates and disease prevalence in the Qatari nationals. Methods: This is a retrospective, analytic descriptive analysis covering a period of 5 years (2007–2011) and utilizes a range of data sources from the State of Qatar including the population structure, disease-related mortality rates, and the prevalence of a range of chronic and infectious diseases. Factors reflecting population dynamics such as crude death (CDR), crude birth (CBR), total fertility (TFR) and infant mortality (IMR) rates were also calculated. Results: The Qatari nationals is an expansive population with an annual growth rate of ∼4% and a stable male:female ratio. The CDR declined by 15% within the study period, whereas the CBR was almost stable. The total disease-specific death rate, however, was decreased among the Qatari nationals by 23% due to the decline in mortality rates attributed to diseases of the blood and immune system (43%), nervous system (44%) and cardiovascular system (41%). There was a high prevalence of a range of chronic diseases, whereas very low frequencies of the infectious diseases within the study population. Conclusion: Public health strategies, approaches and programs developed to reduce disease burden and the related death, should be tailored to target the population of Qatari nationals which exhibits characteristics that vary from the entire Qatari population

Results from Lebanon's 2018 Report Card on Physical Activity for Children and Youth

The prevalence of childhood obesity in Lebanon nearly doubled between 1997 and 2009.1 This shift in population health is extremely alarming, given that obesity is associated with a host of chronic diseases (eg, cardiovascular diseases, diabetes mellitus, cancer)1 representing the primary causes of death and disease burden in 2012.2 Low physical activity (PA) levels and engagement in greater sedentary activities have been used to explain such trends.1 However, little is known about PA indicators among Lebanese children and youth. This led to the development of Lebanon’s first Physical Activity Report Card for Children and Youth (Figure 1)

Image_1_The effects of the first wave of COVID-19 restrictions on physical activity: a longitudinal study from “step into health” program in Qatar.JPEG

IntroductionThe COVID-19 pandemic led to restrictions that prevented physical activity in public places. This study sought to conduct a comprehensive longitudinal analysis of how lockdown policies in an Arabian Gulf country influenced the patterns of physical activity during first wave.MethodsIn a longitudinal study design, members of the ongoing “Step into health” community-based health promotion program who provided valid pedometer data from January to August 2020, covering pre, during and post-covid first wave period met the inclusion criteria.Results420 (76.7% men, 13.8% ≤40 years) were included in the study. Overall, significant decline in daily step counts was recorded (−1,130 ± SE302) after the implementation of lockdown policies (p DiscussionThe present study confirms immediate decline in daily steps imposed indirectly through the COVID-19 lockdown measures. Participants with higher physical activity levels pre-covid experienced significant decline in step count during and even after restrictions were uplifted.</p

Table_1_The effects of the first wave of COVID-19 restrictions on physical activity: a longitudinal study from “step into health” program in Qatar.DOCX

IntroductionThe COVID-19 pandemic led to restrictions that prevented physical activity in public places. This study sought to conduct a comprehensive longitudinal analysis of how lockdown policies in an Arabian Gulf country influenced the patterns of physical activity during first wave.MethodsIn a longitudinal study design, members of the ongoing “Step into health” community-based health promotion program who provided valid pedometer data from January to August 2020, covering pre, during and post-covid first wave period met the inclusion criteria.Results420 (76.7% men, 13.8% ≤40 years) were included in the study. Overall, significant decline in daily step counts was recorded (−1,130 ± SE302) after the implementation of lockdown policies (p DiscussionThe present study confirms immediate decline in daily steps imposed indirectly through the COVID-19 lockdown measures. Participants with higher physical activity levels pre-covid experienced significant decline in step count during and even after restrictions were uplifted.</p