Effect of exercise on slowing breastfeeding-induced bone loss: A meta-analysis and trial sequential analysis.

AIM: This study systematically reviewed evidence regarding the effectiveness of exercise in slowing breastfeeding-induced bone loss. METHODS: The evidence-based approach of a systematic review (PROSPERO registration No. CRD42019111623) was adopted. The inclusion criteria were randomized controlled trials or observational studies. Study samples were breastfeeding women, the intervention was any form of exercise, and bone mineral density (BMD) of the total body, lumbar spine and hip/femur neck before 6 months and at 1 year were the outcome measures. Meta-analyses were performed using a random effect model, and calculations of mean differences of BMD change and 95% confidence intervals (CIs) were carried out. Studies were further evaluated through trial sequential meta-analysis (TSA), and the 'Grading of Recommendations Assessment, Development and Evaluation' methodology was used to assess the certainty of evidence (CoE). RESULTS: A total of 1049 studies were screened, and 4 met the inclusion criteria. Weight-bearing aerobic exercise and resistance training before the 6-month evaluation slowed breastfeeding-induced bone loss in the lumbar spine (1.62% BMD change [95% CI = 0.53-2.71]; I2 = 8%). The TSA Z-curve revealed crossing of the TSA boundary and line of information size, indicating sufficient sampling and significance. The CoE of exercise benefit in the lumbar spine at 6 months was low, whereas the CoE for other areas ranged from low to very low. CONCLUSION: This first systematic review and meta-analysis provided some evidence of the advantages of exercise for slowing breastfeeding-induced bone loss. However, additional randomized controlled trials are warranted to generate more conclusive evidence.

Exercise engagement in people with prediabetes--a qualitative study.

AIMS AND OBJECTIVES: To explore the experiences of people with prediabetes who engage in exercise, from the initiation of exercise to the discontinuation or continuation of exercise. BACKGROUND: People with prediabetes are the high-risk group for developing type 2 diabetes. Engaging in exercise is an important health behaviour to prevent or delay this. However, many people with prediabetes fail to develop and maintain a regular exercise regime. DESIGN: A grounded theory study. METHODS: Data were collected from August 2011-November 2012. Twenty participants with impaired fasting glucose from a medical centre in Taiwan were enrolled in this study for in-depth interview. The data were entered into NVivo 8·0 qualitative data management software after transcription and were analysed by constant comparative method. RESULTS: A theory of the process by which people with prediabetes approach the development of exercise behaviour was developed, comprising four stages: developing awareness, creating the health blueprint, action cycle of internal struggle and developing spontaneous regular exercise. Developing awareness was the starting point for the process of implementing exercise. The core category was action cycle of struggle that all participants experienced this stage, and the spontaneous regular exercise was the highest level of exercise process. CONCLUSION: It is not easy for people with prediabetes to develop a regular exercise regime. Exercise behaviour will be either continued or discontinued secondary to driving and resistive forces. RELEVANCE TO CLINICAL PRACTICE: This study provides useful information to help practitioners design exercise intervention strategies and provide psychological support to people with prediabetes.

A comparison of factors associated with physical inactivity among East Asian college students.

BACKGROUND: Little is known on the level of physical inactivity and its behavioral and cultural correlates among East Asian college students. PURPOSE: The aim of this study is to examine and compare the level and behavioral and cultural correlates of physical inactivity among college students in Taiwan, Hong Kong, South Korea, Singapore, and Malaysia. METHOD: Data were collected from a representative sample of college students (N = 12,137) in five East Asian economies during the 2008-2009 academic year. The stratified random sampling (stratum: geographic region) was used to select participating institutions. The overall response rate was 77%. RESULTS: The percentage of physically inactive students was 7.2% for Singapore, 8.0% for Malaysia, 13.5% for Taiwan, 16.8% for Hong Kong, and 28.5% for South Korea. When gender, age, and body mass index were controlled, fruit and vegetable consumptions were significant correlates for physical inactivity across all the five economies. In Hong Kong, Korea, and Taiwan, those who engaged in binge drinking at least once during the past 2 weeks were less likely to be physically inactive than those who did not. Religion and military experience did not independently predict physical inactivity in any of the five economies. CONCLUSION: Physical inactivity varies greatly across different economies in East Asia that are usually grouped together and considered a single homogeneous entity by some researchers. However, in terms of correlates of physical inactivity, findings of the current study indicate that the transversal value of physical activity might be transformed into a universal.

Sex-Specific Temporal Trends in Overweight and Obese Among Schoolchildren From 2009 to 2018: An Age Period Cohort Analysis.

Background: Our study examined the age, period, and cohort effects on overweight and obesity in children using a 10-year dataset collected from schoolchildren in Hualien, Taiwan. Methods: We used data from the annual health checkup of a total of 94,661 schoolchildren in primary schools and junior high schools in Hualien from 2009 to 2018. Children were defined as overweight or obese by the gender- and age-specific norm of the body mass index. We conducted the age-period-cohort (APC) analysis in boys and girls separately. Results: From 2009 to 2018, the rates of children overweight and obese were 12.78 and 14.23%, respectively. Boys had higher rates of overweight and obesity than girls (29.73 vs. 24.03%, P < 0.001). Based on APC analysis results, positive age effect existed regardless of gender. The risk of overweight or obesity of children aged 9 or 12 years was significantly higher compared to the average rate. As for period effect, a fluctuating downward trend in overweight was evident in 2016, and a similar trend in obesity was seen in 2017 across gender groups. The birth cohort of 2007 to 2009 had a significant higher proportion of overweight and obese than other birth cohorts. This indicated that the proportion of children overweight and obese in the young generation is higher than that in the old generation. Conclusion: An increased risk of children overweight or obese was associated with age and later birth cohort. For the period effect, the trend in the prevalence of overweight and obesity fluctuated downward slowly from 2016 to 2017.