Influence of hyper-energetic, high-fat feeding on circulating hepatokines in healthy men: a randomised crossover study [Abstract]

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Isotemporal substitution of inactive time with physical activity and time in bed: Cross-sectional associations with cardiometabolic health in the PREDIMED-Plus study

© 2019 The Author(s). Background: This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-To-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Methods: This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55-75 years, BMI 27-40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Results: Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05). Conclusions: Inactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health. Trial registration: The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered

Associations between musculoskeletal conditions risk, sedentary behaviour, sleep and markers of mental health: A cross-sectional observational study in Heavy Goods Vehicle drivers: Musculoskeletal conditions risk in HGV drivers

Objective: To explore the risk of having musculoskeletal conditions (MSKs) associated with sitting and sleeping time during workdays, presenteeism, work engagement anxiety and depression in a sample of UK HGV drivers. Methods: 88 male drivers participated in this cross-sectional study. Binary logistic regression analyses were performed to explore the associations between two-or-more MSKs and common health risk factors. Results: Possessing two or more MSKs is associated with prolonged sitting time (OR 4.34) and working hours per day (OR 3.10) and per week (OR 3.12), severe sleep deprivation (OR 33.19), presenteeism (OR 4.22) and borderline or abnormal scores of depression (OR 11.69) and anxiety (OR 4.44), compared with the reference categories. Conclusion: Workplace policies and health promotion interventions to improve HGV drivers working environment are required to minimise the risk of MSK's across this sector

A structured health intervention for truckers (SHIFT): A process evaluation of a pilot health intervention in a transport company

Objectives: To undertake a process-evaluation of a Structured Health Intervention for Truckers (SHIFT) implemented in a sample of UK lorry drivers. Methods: A combination of ‘debrief interviews’, focus groups and one-to-one interviews, in addition to observations and reflections of the two lead researchers were used to collect data on the acceptability of SHIFT from a group of 16 lorry drivers and 4 transport managers. Results: The SHIFT program was considered relevant and acceptable to lorry drivers. It provided them with health information tailored to their specific health needs, long-lasting tools and techniques, which helped to raise their awareness of key health issues and helped to stimulate lifestyle changes during their daily routine. Conclusion: This process-evaluation suggests that the SHIFT program should now be evaluated on a larger scale and tested through fully randomised controlled trials

Evaluation of a natural workspace intervention with active design features on movement, interaction and health

Background: There is increasing focus on designing workspaces that promote less sitting, more movement and interaction to improve physical and mental health. Objective: This study evaluates a natural intervention of a new workplace with active design features and its relocation to a greener and open space. Methods: An ecological model was used to understand how organisations implement change. Pre and post survey data from 221 matched cases of workers and accelerometery data (n=50) were analysed. Results: Results show a decrease in occupational sitting (-20.65 mins/workday, p=.001) and an increase in workplace walking (+5.61 mins/workday, p=.001) using survey data, and accelerometery data (occupational sitting time: -31.0 mins/workday, p=.035, standing time: +22.0 mins/workday, p=.022, stepping time: +11.0 mins/workday, p=.001). Improvements in interaction, musculoskeletal pain and mental health were reported. Conclusions: Application of the ecological model shows that the organisation understands how to target the built environment and social/cultural environment but not how to target behaviour change at the individual level

Attenuated cardiovascular reactivity to acute psychological stress predicts future fatigue symptoms in truck drivers

Objectives: This study aimed to investigate the impact of a 6-month health intervention on truck drivers’ CVR to stress and whether CVR was predictive of depression, anxiety, or fatigue symptoms at 6-months follow-up. Methods: 238 truck drivers completed a 6-month cluster RCT to increase physical activity and completed a stress protocol (Stroop and Mirror tracing tasks) with measurements of heart rate (HR), systolic (SBP), and diastolic (DBP) blood pressure taken, alongside fatigue, anxiety, and depressive symptoms assessment. Measures were taken at 0-months and 6-months. Results: Analyses showed a negative relationship between 0-month DBP reactivity and 6-month persistent fatigue. Trends towards negative relationships between SBP reactivity and future anxiety and fatigue symptoms at 6-months were evident. Conclusions: Our findings may have serious implications, as fatigue can be a major cause of road traffic collisions in truck drivers.</p

Attenuated cardiovascular reactivity to acute psychological stress predicts future fatigue symptoms in truck drivers

Objectives: This study aimed to investigate the impact of a 6-month health intervention on truck drivers’ CVR to stress and whether CVR was predictive of depression, anxiety, or fatigue symptoms at 6-months follow-up. Methods: 238 truck drivers completed a 6-month cluster RCT to increase physical activity and completed a stress protocol (Stroop and Mirror tracing tasks) with measurements of heart rate (HR), systolic (SBP), and diastolic (DBP) blood pressure taken, alongside fatigue, anxiety, and depressive symptoms assessment. Measures were taken at 0-months and 6-months. Results: Analyses showed a negative relationship between 0-month DBP reactivity and 6-month persistent fatigue. Trends towards negative relationships between SBP reactivity and future anxiety and fatigue symptoms at 6-months were evident. Conclusions: Our findings may have serious implications, as fatigue can be a major cause of road traffic collisions in truck drivers.</p

Attenuated cardiovascular reactivity is related to higher anxiety and fatigue symptoms in truck drivers

Depression and anxiety have been linked with reduced stress-induced cardiovascular reactivity (CVR), which could be indicative of autonomic dysregulation. Less is known about the association between work-related fatigue and CVR. Truck drivers experience high levels of depression, anxiety, and fatigue, with repeated psychophysiological stressors on the road, yet little is known about the effects of these conditions on their CVR. 386 truck drivers completed the Hospital Anxiety and Depression Scale (HADS) and the Occupational Fatigue Exhaustion/Recovery Scale (OFER-15). Systolic (SBP) and diastolic (DBP) blood pressure, and heart rate (HR) were measured at rest and during a stressor protocol to measure CVR. Multivariate regression analyses were used to determine relationships between variables and adjusted for nine key covariates. Higher symptoms of persistent fatigue were related to a reduced SBP reactivity (β = -0.237, p = .008) and reduced DBP reactivity (β = -0.256, p = .005), whilst there was a positive trend between acute fatigue and DBP reactivity (β = 0.168, p = .053). Higher symptoms of anxiety were related to a reduced SBP reactivity (β = -0.167, p = .011). This study demonstrated in a population of truck drivers, both anxiety and persistent fatigue were related to an attenuated SBP reactivity in a combined model, whereas there was a positive trend between acute fatigue solely and DBP reactivity. These novel findings may have serious implications for cardiovascular disease risk in truck drivers, and future research should attempt to establish the causal effect of these associations and the underlying physiological mechanisms.</div

A cluster randomised controlled trial to investigate the effectiveness of a Structured Health Intervention for Truckers (SHIFT)

Introduction: Heavy goods vehicle (HGV) drivers’ exhibit higher than nationally representative rates of obesity, and obesity-related co-morbidities, in comparison to other occupational groups. Their working environments are not conducive to a healthy lifestyle, yet there has been limited attention to health promotion efforts. We have developed a Structured Health Intervention For Truckers (the SHIFT programme), a multicomponent, theory-driven, health-behaviour intervention targeting physical activity, diet, and sitting in HGV drivers. This paper describes the protocol of a cluster randomised controlled trial designed to evaluate the effectiveness and cost-effectiveness of the SHIFT programme. Methods and analysis: HGV drivers will be recruited from a logistics company in the UK. Following baseline measurements, depots (clusters) will be randomised to either the SHIFT intervention or usual-care control arm (12 clusters in each, average cluster size 14 drivers). The 6-month SHIFT intervention includes a group-based interactive 6-hour education session, worksite champion support, and equipment provision (including a Fitbit® and resistance bands/balls to facilitate a ‘cab workout’). Objectively measured total daily physical activity (steps/day) will be the primary outcome. Secondary outcomes include: objectively measured light-intensity physical activity and moderate-vigorous physical activity, sitting time, sleep quality, markers of adiposity, blood pressure, and capillary blood markers (HbA1c, LDL-HDL-cholesterol). Self-report questionnaires will examine fruit and vegetable intake, psychosocial and work outcomes, and mental health. Quality of life and resources used (e.g. GP visits) will also be assessed. Measures will be collected at baseline, 6 and 12-months and analysed according to a modified intention-to treat principle. A full process evaluation and cost-effectiveness analysis will be conducted

Time in nature associated with decreased fatigue in UK truck drivers

Heavy goods vehicle (HGV) driving is recognised as a highly hazardous occupation due to the long periods of sedentary behaviour, low levels of physical activity and unhealthy food options when working. These risk factors combine with shift work and concomitant irregular sleep patterns to increase the prevalence of fatigue. Fatigue is closely linked with stress and, subsequently, poor physiological and psychological health. In parallel, a wealth of evidence has demonstrated the health and wellbeing benefits of spending time in nature. Here, we sought to examine whether spending time in nature was associated with lower levels of fatigue, anxiety and depression in HGV drivers. 89 long-distance drivers (98.9% male, mean ± SD age: 51.0 ± 9 years, body mass index: 29.8 ± 4.7 kg/m2) participating in a wider health promotion programme reported time spent in nature (during and before the Covid-19 pandemic) and symptoms of occupational fatigue, depression and anxiety. After controlling for covariates, truck drivers who visited nature at least once a week exhibited 16% less chronic fatigue prior to the pandemic, and 23% less chronic fatigue and 20% less acute fatigue during the pandemic. No significant differences were observed for either anxiety or depression. As fatigue has a range of physical and mental health sequelae, we propose that increased exposure to natural settings may make a valuable contribution to interventions to promote the health and wellbeing of this underserved group