Public health research on physical activity and COVID-19:Progress and updated priorities

1.Introduction Before coronavirus disease 2019 (COVID-19) became a global health emergency in early 2020,there was substantial evidence of physical activity’s (PA’s) multiple benefits with direct relevance to reducing the harms of the pandemic:improved immune functioning and reduced inflammation to lessen severity of infections,enhanced efficacy of vaccines.

An international physical activity and public health research agenda to inform coronavirus disease-2019 policies and practices

Physical activity(PA)has strong relevance for limiting the harms to human health and well-being due to the coronavirus disease-2019(COVID-19)pandemic.1 Active muscles produce chemicals that improve immune functioning,which in turn reduces the extent of infections,and decreases inflammation,and these are the main causes of the lung damage from severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.PA is a powerful preventive and therapeutic intervention for the most common pre-existing chronic conditions that increase risk of severe COVID-19 infections and mortality.

Effect and feasibility of wearable physical activity trackers and pedometers for increasing physical activity and improving health outcomes in cancer survivors:A systematic review and meta-analysis

Purpose:This systematic review and meta-analysis aimed to evaluate the effect of wearable devices for improving physical activity and healthrelated outcomes in cancer survivors.Methods:CINAHL,Cochrane,Ebscohost,MEDLINE,Pubmed,ProQuest Health and Medical Complete,ProQuest Nursing and Allied Health Source,ScienceDirect,and SPORTDiscus databases were searched for randomized controlled trials published before September 1,2020,that evaluated interventions involving wearable devices in cancer survivors.Standardized mean differences(SMDs)were calculated to assess effects on physical activity and health-related outcomes.Subgroup analyses were conducted to assess whether the effects differed by interventions and cancer characteristics.Risk of bias was assessed using the Cochrane risk of bias tool.Results:Thirty-five trials were included(breast cancer,n=15,43%).Intervention durations ranged between 4 weeks and 1 year.Most trials(n=25,71%)involved pedometer-based physical activity interventions.Seven(20%)involved Fitbit-based interventions,and 3(9%)involved other wearable physical activity trackers(e.g.,Polar,Garmin).Compared to usual care,wearable devices had moderate-to-large effects(SMD range 0.54-0.87,p<0.001)on moderate-intensity physical activity,moderate-to-vigorous-intensity physical activity,total physical activity,and daily steps.Compared to usual care,those in the intervention had higher quality of life,aerobic fitness,physical function,and reduced fatigue(SMD range=0.18-0.66,all p<0.05).Conclusion:Wearable physical activity trackers and pedometers are effective tools that increase physical activity and improve health-related outcomes in individuals with cancer.Identifying how these devices can be implemented for longer-term use with other intervention components remains an area for future research.

Differences in transportation and leisure physical activity by neighborhood design controlling for residential choice

Background:Cross-sectional studies provide useful insight about the associations between the built environment and physical activity(PA),particularly when reasons for neighborhood choice are considered.Our study analyzed the relationship between levels of weekly transportation and leisure PA among 3 neighborhood designs,statistically adjusting for sociodemographic characteristics and reasons for neighborhood choice.Methods:A stratified random sample of adults(age>20 years)living in Calgary(Canada)neighborhoods with different neighborhood designs(grid,warped-grid,and curvilinear)and socioeconomic status completed a self-administered questionnaire capturing PA,sociodemographic characteristics,and reasons for neighborhood choice(response rate=10.1%;n=1023).Generalized linear models estimated associations between neighborhood design and transportation and leisure PA outcomes(participation(any vs.none)and volume(metabolic equivalent:h/week)),adjusting for neighborhood socioeconomic status,sociodemographic characteristics(gender,age,ethnicity,education,household income,marital status,children,vehicle access,dog ownership,and injury),and reasons for neighborhood choice(e.g.,proximity and quality of recreational and utilitarian destinations,proximity to work,highway access,aesthetics,and sense of community).Results:Overall,854 participants had resided in their neighborhood for at least 12 months and provided complete data.Compared with those living in curvilinear neighborhoods,grid neighborhood participants had greater odds(p<0.05)of participating in any transportation walking(odds ratio(OR)=2.17),transportation and leisure cycling(OR=2.39 and OR=1.70),active transportation(OR=2.16),and high-intensity leisure PA(≥6 metabolic equivalent;OR=1.74),respectively.There were no neighborhood differences in the volume of any transportation or leisure PA undertaken.Adjustment for neighborhood selection had minimal impact on the statistical or practical importance of model estimates.Conclusion:Neighborhood design is associated with PA patterns in adults,independent of reasons for neighborhood choice and sociodemogranhic factors.

Using compositional data analysis to explore accumulation of sedentary behavior,physical activity and youth health

Purpose:The study aimed to describe youth time-use compositions,focusing on time spent in shorter and longer bouts of sedentary behavior and physical activity(PA),and to examine associations of these time-use compositions with cardiometabolic biomarkers.Methods:Accelerometer and cardiometabolic biomarker data from 2 Australian studies involving youths 7-13 years old were pooled(complete cases with accelerometry and adiposity marker data,n=782).A 9-component time-use composition was formed using compositional data analysis:time in shorter and longer bouts of sedentary behavior;time in shorter and longer bouts of light-,moderate-,or vigorous-intensity PA;and"other time"(i.e.,non-wear/sleep).Shorter and longer bouts of sedentary time were defined as<5 min and>5 min,respectively.Shorter bouts of light-,moderate-,and vigorous-intensity PA were defined as<1 min;longer bouts were defined as≥1 min.Regression models examined associations between overall time-use composition and cardiometabolic biomarkers.Then,associations were derived between ratios of longer activity patterns relative to shorter activity patterns,and of each intensity level relative to the other intensity levels and"other time",and cardiometabolic biomarkers.Results:Confounder-adjusted models showed that the overall time-use composition was associated with adiposity,blood pressure,lipids,and the summary score.Specifically,more time in longer bouts of light-intensity PA relative to shorter bouts of light-intensity PA was significantly associated with greater body mass index z-score(zBMI)(β=1.79;SE=0.68)and waist circumference(β=18.35,SE=4.78).When each activity intensity was considered relative to all higher intensities and"other time",more time in light-and vigorous-intensity PA,and less time in sedentary behavior and moderate-intensity PA,were associated with lower waist circumference.Conclusion:Accumulating PA,particularly light-intensity PA,in frequent short bursts may be more beneficial for limiting adiposity compared to accumulating the same amount of PA at these intensities in longer bouts.

The impact of height-adjustable desks and classroom prompts on classroom sitting time,social,and motivational factors among adolescents

Purpose:This quasi-experimental study examined the impact of height-adjustable desks in combination with prompts to break up prolonged sitting time during class time and identified social and motivational factors associated with breaking up sitting time among adolescents.Teachers’perceptions of strategies were also examined.Methods:Over 17 weeks,1 classroom in a government secondary school in Melbourne,Australia,was equipped with 27 height-adjustable desks and prompts(posters and desk stickers)to break up classroom sitting time.Teachers received professional development in the use of the desks and prompts.One group of adolescents(n=55)had 2-5 lessons/week using the height-adjustable desks in an intervention classroom,and a comparison group matched by year level and subject(n=50)was taught in traditional“seated”classrooms.Adolescents wore an activPAL monitor at baseline(T0),4 weeks(T1),and 17 weeks(T2)and completed a survey at T0 and T2.Six teachers participated in interviews at T2.Effect sizes were calculated(d).Results:Linear mixed models found that,compared to the traditional“seated”classrooms,the adolescents in the intervention classroom had significantly lower sitting time(T1:-9.7 min/lesson,d=-0.96;T2:-6.7 min/lesson,d=-0.70)and time spent in sitting bouts>15 min(T2:-11.2 min/lesson,d=-0.62),and had significantly higher standing time(T1:7.3 min/lesson,d=0.84;T2:5.8 min/lesson,d=0.91),number of breaks from sitting(T1:1.3 breaks/lesson,d=0.49;T2:1.8 breaks/lesson,d=0.67),and stepping time(T1:2.5 min/lesson,d=0.66).Intervention classroom adolescents reported greater habit strength(d=0.58),self-efficacy for breaking up sitting time(d=0.75),and indicated that having a teacher/classmate remind them to stand as helpful(d=0.50).Conclusion:This intervention shows promise for targeting sitting behaviors in the classroom and indicates that incorporating social and motivational strategies may further enhance outcomes.

The Beijing 2022 Winter Olympics:An opportunity to promote physical activity and winter sports in Chinese youth

TagedPIn February and March 2022,China will host the Beijing 2022 Olympic and Paralympic Winter Games.The vision for this landmark event promises a“joyful rendezvous upon pure ice and snow uniting the passion of hundreds of millions for winter sports”.1 Themes have been developed to create a positive environmental impact with new development for the northern region of the country and to promote winter sports and improve the health and well-being of the Chinese people.The key messages for the winter games include inspiring youth with the Olympic spirit and encouraging millions to embrace winter sports.Notably,the Chinese government aims to mobilize at least 300 million of its citizens to engage in winter sports as an outcome of hosting the Winter Olympic Games.

Does light-intensity physical activity moderate the relationship between sitting time and adiposity markers in adolescents?

Background:While the relationship between sedentary time and adiposity markers may be independent of moderate-to-vigorous intensity physical activity(MVPA) among adolescents,little is known about the role of light-intensity physical activity(LIPA) in this relationship.The aim of this cross-sectional study was to examine whether device-measured LIPA and MVPA moderate the associations between objectively measured sitting time and adiposity markers(body mass index(BMI)) and waist circumference(WC)) among adolescents.Methods:This study included accelerometer and inclinometer data obtained from 219 adolescents(age=14.9±1.6 years,mean± SD),collected during 2014 and 2015 in Melbourne,Australia.ActiGraph GT3 X accelerometers were used to determine time spent in total-LIPA(101 counts/min to 3.99 metabolic equivalents(METs)) was dichotomized into low-LIPA(101-799 counts/min) and high LIPA(800 counts/min to 3.99 METs),and MVPA(> 4 METs).The average time spent sitting was obtained from activPAL inclinometers.Anthropometric measures were assessed by trained staff.Interactions between sitting and total-LIPA,low-LIPA,high-LIPA,and MVPA on BMI z-score(zBMI) and WC z-score(zWC),respectively,were examined using linear regression,adjusting for age and sex;and moderation by total-LIPA,low-LIPA,high-LIPA,and MVPA were examined by adding interaction terms.Significant interaction effects were probed by comparing associations at the mean and at 1 SD below and above the mean.Results:Total-LIPA significantly moderated the association between sitting time and zBMI,and low-LIPA significantly moderated the association between sitting time and zBMI and zWC.No other associations were found for total-LIPA,high-LIPA,or MVPA.Specifically,at high levels of total-LIPA(+1 SD),there is a negative association between sitting time and zBMI.In addition,at high levels of low-LIPA(+1 SD),there is a negative association between sitting time and zBMI and zWC.Conclusion:Associations between sitting and adiposity depended on time spent in total-LIPA and low-LIPA,but not high-LIPA or MVPA.Results suggest that increasing time spent in LIP A may provide protection from the deleterious effects of sitting on adiposity markers among adolescents.Experimental evidence is needed to support these conclusions.