Participatory development of an mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED).

BACKGROUND: The escalating global prevalence of type 2 diabetes and prediabetes presents a major public health challenge. Physical activity plays a critical role in managing (pre)diabetes; however, adherence to physical activity recommendations remains low. The ENERGISED trial was designed to address these challenges by integrating mHealth tools into the routine practice of general practitioners, aiming for a significant, scalable impact in (pre)diabetes patient care through increased physical activity and reduced sedentary behaviour. METHODS: The mHealth intervention for the ENERGISED trial was developed according to the mHealth development and evaluation framework, which includes the active participation of (pre)diabetes patients. This iterative process encompasses four sequential phases: (a) conceptualisation to identify key aspects of the intervention; (b) formative research including two focus groups with (pre)diabetes patients (n = 14) to tailor the intervention to the needs and preferences of the target population; (c) pre-testing using think-aloud patient interviews (n = 7) to optimise the intervention components; and (d) piloting (n = 10) to refine the intervention to its final form. RESULTS: The final intervention comprises six types of text messages, each embodying different behaviour change techniques. Some of the messages, such as those providing interim reviews of the patients' weekly step goal or feedback on their weekly performance, are delivered at fixed times of the week. Others are triggered just in time by specific physical behaviour events as detected by the Fitbit activity tracker: for example, prompts to increase walking pace are triggered after 5 min of continuous walking; and prompts to interrupt sitting following 30 min of uninterrupted sitting. For patients without a smartphone or reliable internet connection, the intervention is adapted to ensure inclusivity. Patients receive on average three to six messages per week for 12 months. During the first six months, the text messaging is supplemented with monthly phone counselling to enable personalisation of the intervention, assistance with technical issues, and enhancement of adherence. CONCLUSIONS: The participatory development of the ENERGISED mHealth intervention, incorporating just-in-time prompts, has the potential to significantly enhance the capacity of general practitioners for personalised behavioural counselling on physical activity in (pre)diabetes patients, with implications for broader applications in primary care.

Compositional functional regression and isotemporal substitution analysis: Methods and application in time-use epidemiology.

The distribution of time that people spend in physical activity of various intensities has important health implications. Physical activity (commonly categorised by the intensity into light, moderate and vigorous physical activity), sedentary behaviour and sleep, should not be analysed separately, because they are parts of a time-use composition with a natural constraint of 24 h/day. To find out how are relative reallocations of time between physical activity of various intensities associated with health, herewith we describe compositional scalar-on-function regression and a newly developed compositional functional isotemporal substitution analysis. Physical activity intensity data can be considered as probability density functions, which better reflects the continuous character of their measurement using accelerometers. These probability density functions are characterised by specific properties, such as scale invariance and relative scale, and they are geometrically represented using Bayes spaces with the Hilbert space structure. This makes possible to process them using standard methods of functional data analysis in the L2 space, via centred logratio (clr) transformation. The scalar-on-function regression with clr transformation of the explanatory probability density functions and compositional functional isotemporal substitution analysis were applied to a dataset from a cross-sectional study on adiposity conducted among school-aged children in the Czech Republic. Theoretical reallocations of time to physical activity of higher intensities were found to be associated with larger and more progressive expected decreases in adiposity. We obtained a detailed insight into the dose-response relationship between physical activity intensity and adiposity, which was enabled by using the compositional functional approach.

Movement behaviours in paediatric cancer survivors during recovery and school weeks.

Purpose: Paediatric cancer survivors (PCS) are a high-risk population, who can suffer from late effects of their treatment, such as metabolic syndrome, cardiovascular conditions, secondary tumours. Optimal movement behaviours (e.g., limited sedentary behaviour [SB] and sufficient physical activity [PA]) can reduce the side effects or avoid late effects of their treatment. The aims of this study were to analyse movement behaviours and meeting the recommendation of 60 minutes of moderate-to-vigorous physical activity (MVPA) a day in Czech PCS, and to compare their movement behaviours during recovery and school weeks in relation to gender, age, and cancer type. Methods: Twenty-six PCS aged 7-15 years in remission stage took part in the cross-sectional study. Movement behaviours were measured with Actigraph wGT3X+ accelerometers worn 24 hour/day for 20 consecutive days covering recovery week (13 days at recovery camp) and school week (7 days). Based on cancer types, the PCS were categorized into haematological malignancy or solid tumours group. Results: In the PCS, movement behaviours differed between recovery and school weeks. During recovery week, the PCS showed less SB (451.8 vs. 552.3 min/day, p < 0.001) and spent more time on light PA (350.3 vs. 255.1 min/day, p < 0.001), moderate PA (73.2 vs. 37.4 min/day, p < 0.001), and vigorous PA (10.3 vs. 4.0 min/day p < 0.001) than during school week. The PA recommendation was met by 77% (n = 20) PCS during recovery week, but only by 15% (n = 4) individuals during school week. Conclusions: The PCS recorded higher levels of PA and lower levels of SB during recovery week than during school week. If provided with appropriate conditions, PCS in the remission stage are able to reach the PA level recommended for the healthy population. Recovery week can be a suitable platform for gaining experience that PCS are able to meet the recommended PA level and could be an integral part of reconditioning and resocialization programmes for PCS after the completion of their treatment.

Surveillance of physical activity and sedentary behaviour in czech children and adolescents: a scoping review of the literature from the past two decades.

BACKGROUND: This study aimed to map the available evidence related to physical activity (PA) and sedentary behaviour (SB) in Czech children and adolescents and suggest future directions and improvements to strengthen the surveillance of PA and SB in the Czech Republic. METHODS: The search of articles published between January 2000 and December 2020 included the Medline and Medvik databases and a manual search in eight Czech journals related to the topic. This review followed the "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews". RESULTS: Out of 350 identified articles, 79 articles met the criteria for selection and referred to 27 studies. The majority of the articles were cross-sectional (89%), approximately two-thirds of the articles (61%) examined only PA, and half of the articles (51%) employed device-based assessments. Approximately 47% of the articles reported the prevalence of physical inactivity on the basis of inconsistently defined recommendations. Approximately 14%, 23%, and 10% of the articles focused on active transportation, organized PA (including physical education or leisure-time PA), and parent-child PA, respectively. CONCLUSIONS: Future studies need to focus on longitudinal design and interventions, randomly selected samples, a mix of device-based and self-reported methods, and the recognition of health-related 24-hour time use patterns. This review advocates the government-supported development of a national surveillance system that will help to reduce insufficient PA and excessive SB.

Changes in sedentary behavior patterns during the transition from childhood to adolescence and their association with adiposity: a prospective study based on compositional data analysis.

BACKGROUND: To date, no longitudinal study using a compositional approach has examined sedentary behavior (SB) patterns in relation to adiposity in the pediatric population. Therefore, our aims were to (1) investigate the changes in SB patterns and adiposity from childhood to adolescence, (2) analyze the prospective compositional associations between changes in SB patterns and adiposity, and (3) estimate the changes in adiposity associated with substituting SB with physical activity (PA) of different intensities. METHODS: The study presents a longitudinal design with a 5-year follow-up. A total of 88 participants (61% girls) were included in the analysis. PA and SB were monitored for seven consecutive days using a hip-worn accelerometer. Adiposity markers (fat mass percentage [FM%], fat mass index [FMI], and visceral adiposity tissue [VAT]) were assessed using the multi-frequency bioimpedance analysis. The prospective associations were examined using compositional data analysis. RESULTS: Over the follow-up period, the proportion of time spent in total SB increased by 154.8 min/day (p < 0.001). The increase in total SB was caused mainly by an increase in middle and long sedentary bouts, as these SB periods increased by 79.8 min/day and 62.0 min/day (p < 0.001 for both), respectively. FM%, FMI, and VAT increased by 2.4% points, 1.0 kg/m2, and 31.5 cm2 (p < 0.001 for all), respectively. Relative to the remaining movement behaviors, the increase in time spent in middle sedentary bouts was significantly associated with higher FM% (ßilr1 = 0.27, 95% confidence interval [CI]: 0.02 to 0.53) at follow-up. Lower VAT by 3.3% (95% CI: 0.8 to 5.7), 3.8% (95% CI: 0.03 to 7.4), 3.9% (95% CI: 0.8 to 6.9), and 3.8% (95% CI: 0.7 to 6.9) was associated with substituting 15 min/week spent in total SB and in short, middle, and long sedentary bouts, respectively, with an equivalent amount of time spent in vigorous PA. CONCLUSIONS: This study showed unfavorable changes in SB patterns and adiposity status in the transition from childhood to adolescence. Incorporating high-intensity PA at the expense of SB appears to be an appropriate approach to reduce the risk of excess adiposity in the pediatric population.

Device-Measured Physical Activity, Sedentary Behaviors, Built Environment, and Adiposity Gain in Older Women: A Seven-Year Prospective Study.

The search for determinants of adiposity gain in older women has become vitally important. This study aimed to (1) analyze the adiposity gain based on the participants' age and (2) determine the prospective associations of baseline intrapersonal, built environment, physical activity, and sedentary behavior variables with the adiposity gain in older women. This was a seven-year prospective study (baseline: 2009 to 2012; follow-up: 2016 to 2019) in older women (n = 178, baseline age = 62.8 ± 4.1 years). Baseline and follow-up adiposity (bioelectrical impedance) and baseline physical activity, sedentary behavior (accelerometers), and intrapersonal and built environment (Neighborhood Environment Walkability Scale questionnaire) variables were included. The body mass index (BMI) increment tended to be inversely associated with the women's age (p = 0.062). At follow-up, 48, 57, and 54% of the women had a relevant increase (d-Cohen > 0.2) in their BMI, percentage of body fat, and fat mass index, respectively. The women that spent ≥8 h/day being sedentary were 2.2 times (1.159 to 4.327 CI95%, p < 0.02) more likely to increase BMI (0.82 to 0.85 kg/m2) than non-sedentary women. No built environment variables were associated with seven-year adiposity gain (all ps > 0.05). A reduction in sedentary time should be promoted for adiposity gain prevention and health preservation in older women.

A study on prospective associations between adiposity and 7-year changes in movement behaviors among older women based on compositional data analysis.

INTRODUCTION: It is unclear whether adiposity leads to changes in movement behaviors, and there is a lack of compositional analyses of longitudinal data which focus on these associations. Using a compositional approach, this study aimed to examine the associations between baseline adiposity and 7-year changes in physical activity (PA) and sedentary behavior (SB) among elderly women. We also explored the longitudinal associations between change in adiposity and change in movement-behavior composition. METHODS: This longitudinal study included 176 older women (mean baseline age 62.8 (4.1) years) from Central Europe. Movement behavior was assessed by accelerometers and adiposity was measured by bioelectrical impedance analysis at baseline and follow-up. A set of multivariate least-squares regression analyses was used to examine the associations of baseline adiposity and longitudinal changes in adiposity as explanatory variables with longitudinal changes in a 3-part movement-behavior composition consisting of SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) as outcome variables. RESULTS: No significant associations were found between baseline adiposity and longitudinal changes in the movement-behavior composition (p > 0.05). We found significant associations of changes in body mass index (BMI) and fat mass percentage (FM%) with changes in the movement-behavior composition. An increase in BMI was associated with an increase of SB at the expense of LPA and MVPA (ß = 0.042, p = 0.009) and with a decrease of MVPA in favor of SB and LPA (ß = - 0.059, p = 0.037). An increase in FM% was significantly associated only with an increase of SB at the expense of LPA and MVPA (ß = 0.019, p = 0.031). CONCLUSIONS: This study did not support the assumption that baseline adiposity is associated with longitudinal changes in movement behaviors among elderly women, but we found evidence for change-to-change associations, suggesting that a 7-year increase in adiposity is associated with a concurrent increase of SB at the expense of LPA and MVPA and with a concurrent decrease of MVPA in favor of LPA and SB. Public health interventions are needed to simultaneously prevent weight gain and promote physically active lifestyle among elderly women.

Does physical activity lower the risk for metabolic syndrome: a longitudinal study of physically active older women.

BACKGROUND: The associations between physical activity and metabolic syndrome (MetS) have been mainly found in cross-sectional studies. The aim of this longitudinal study was to examine the relationship between meeting step-based guidelines and changes in the risk of metabolic syndrome. METHODS: This study included data from older women (baseline age 62.9 ± 4.3 years) from a 7-year longitudinal study in Central Europe. At baseline and follow-up, physical activity was measured by an accelerometer, and the risk for MetS was assessed according to the NCEP-ATP III criteria. In 59 women, multivariate repeated measures ANOVA was used to compare differences in changes in the risk of MetS in groups based on meeting step-based guidelines (10,000 steps/day and 9000 steps/day for women aged <65 and ≥ 65 years, respectively). RESULTS: Over 7 years, steps/day increased from 10,944 ± 3560 to 11,652 ± 4865, and the risk of MetS decreased from 41 to 12% in our sample. Women who longitudinally met step-based guidelines had a significantly higher mean concentration of high-density cholesterol (HDL-C) (64.5 and 80.3 mg/dL at baseline and follow-up, respectively) and a lower concentration of triglycerides (TGs) (158.3 and 123.8 mg/dL at baseline and follow-up, respectively) at follow-up compared to baseline. Moreover, women who increased their daily steps over 7 years to the recommended steps/day value significantly decreased the concentration of TGs (158.3 mg/dL and 123.8 mg/dL at baseline and follow-up, respectively). CONCLUSIONS: Our study might suggest that the long-term meeting of step-based guidelines or an increase in daily steps/day to achieve the recommended value could be related to a lower risk of MetS, specifically in concentrations of HDL-C and TG. These findings may help in designing interventions aiming to decrease the risk of MetS in older women.

Prospective study on sedentary behaviour patterns and changes in body composition parameters in older women: A compositional and isotemporal substitution analysis.

BACKGROUND & AIMS: The aims of this study were to examine the prospective compositional associations between sedentary behaviour (SB) patterns and longitudinal changes in body composition parameters, and to use compositional isotemporal substitution modelling to analyse the longitudinal changes in body composition parameters associated with time reallocation from SB to physical activity (PA) in older women. METHODS: The study included women aged 60 years and older (n = 182) with valid data at baseline and at the subsequent 7-year follow-up. For both time points, the ActiGraph GT1M accelerometer was used for SB and PA assessments and multi-frequency bioimpedance analysis was used to assess the body composition parameters related to adiposity and muscle mass. Compositional regression models were used to analyse the associations between proportion of time spent in sedentary bouts of different duration and longitudinal changes in body composition parameters. A compositional isotemporal substitution model was created to estimate the differences in body composition parameters associated with one-to-one time reallocations between baseline SB and PA. RESULTS: A significant increase in fat mass index (ßilr1 = 0.61, 95% confidence interval [CI]: 0.18, 1.04) and visceral adipose tissue (ßilr1 = 6.01, 95% CI: 1.52, 10.5) was associated with a higher baseline proportion of time spent in long sedentary bouts (i.e. sedentary bout of ≥30 min). Reallocating 1 h/week and 3.5 h/week from the time spent in long sedentary bouts in favour of light PA was associated with a significant decrease in fat mass index by 0.78% (95% CI: 0.24, 1.32) and 3.13% (95% CI: 0.97, 5.29), respectively. No association was found for indicators of muscle mass. CONCLUSIONS: This study suggests that long-term adiposity status could be improved by increasing the proportion of time spent in light PA at the expense of time spent in prolonged SB. This finding may help in designing more effective and feasible interventions for the maintenance of healthy body composition in advanced age.

Influence of Nutritional Education on the Diet and Nutritional Behaviors of Elderly Women at the University of the Third Age.

BACKGROUND: The objective of this study was to evaluate the diet composition, body fat content, and physical activity (PA), considering blood lipid levels and insulin resistance markers, in elderly women who were well educated in nutrition and healthy lifestyle choices. METHODS: A total of 106 postmenopausal women took part in the study. The study group included 62 students from the University of the Third Age (U3A); the control group (CG) included 44 females from the Silesia region. We evaluated their daily macro and micronutrient intake, levels of PA, percent of body fat (PBF), and the visceral fatty area (VFA). We also evaluated the lipid profile, insulin and glucose levels, homeostatic model assessment of insulin resistance (HOMA-IR), and C-reactive protein (CRP) levels. RESULTS: Significant differences were observed in carbohydrate, protein, fiber, as well as vitamins and minerals consumption between the U3A group and the CG. There were no differences in the PBF and VFA between the groups. Furthermore, no differences were shown in the measured blood variables. The U3A group walked more than 11,000 steps a day and performed 46.15 min/day of PA with a moderate intensity of 3-6 metabolic equivalents of task (METs, min/week). CONCLUSIONS: Despite the fact that the U3A group were physically active females, well educated on healthy, balanced diets and had the motivation to learn about proper nutritional behaviors, they did not follow these recommendations in everyday life.

Are longitudinal reallocations of time between movement behaviours associated with adiposity among elderly women? A compositional isotemporal substitution analysis.

BACKGROUND: This study aimed to use compositional data analysis to: (1) investigate the prospective associations between changes in daily movement behaviours and adiposity among elderly women; and (2) to examine how the reallocation of time between movement behaviours was associated with longitudinal changes in adiposity. SUBJECTS/METHODS: This is a 7-year longitudinal study in Central European older women (n = 158, baseline age 63.9 ± 4.4 years). At baseline and follow-up, light-intensity physical activity (LIPA), moderate-to-vigorous physical activity (MVPA) and sedentary behaviour were measured by accelerometer and body adiposity (body mass index [BMI], body fat percentage [%BF]) was assessed from measured height and weight and bioelectrical impedance analyser. Compositional regression with robust estimators and compositional longitudinal isotemporal substitution analysis explored if, and how, changes in movement behaviours were associated with adiposity. RESULTS: Over 7 years, the prevalence of obesity in the sample increased by 10.1% and 14.6% according to BMI and %BF, respectively, and time spent in sedentary behaviour increased by 14%, while time spent in LIPA and MVPA decreased by 14% and 21%, respectively. The increase in sedentary behaviour at the expense of LIPA and MVPA during the 7-year period was associated with higher BMI and %BF at follow-up (both p < 0.01). The increase in LIPA or MVPA at the expense of sedentary behaviour was associated with reduced BMI and %BF at follow-up. In our sample, the largest change in BMI (0.75 kg/m2; 95% confidence interval [CI]: 0.37-1.13) and %BF (1.28 U; 95% CI: 0.48-2.09) was associated with longitudinal reallocation of 30 min from MVPA to sedentary behaviour. CONCLUSIONS: We found an association between longitudinal changes in daily movement behaviours and adiposity among elderly women in Central Europe. Our findings support public health programmes to increase or maintain time spent in higher-intensity physical activity among elderly women.

Adiposity and changes in movement-related behaviors in older adult women in the context of the built environment: a protocol for a prospective cohort study.

BACKGROUND: In older adults, sedentary behaviors increase while physical activity decreases over time following the compositional nature of 24-h behaviors. These changes in movement-related behaviors (MRBs) might be associated with unhealthy weight gain and several health comorbidities. However, information is lacking on how obesity influences longitudinal changes in the composition of MRBs in older adults. Furthermore, the moderating effect of the built environment on prospective associations between obesity and MRBs in older adults is not fully understood. Therefore, using an integrated time-use approach, this study aims to identify prospective associations between obesity and MRBs together with an assessment of the moderating effect of the built environment in elderly women. METHODS: The study was designed as a prospective 7-year follow-up study. It is based on two previous cross-sectional studies that enable the use of participant data (women aged 60+ years, n = 409) as a baseline dataset in the current study. All methods designed for 7-year follow-up are based on previous studies. The data collection comprises device-based measurement of MRBs (ActiGraph GT1M accelerometer), objective assessment of body adiposity (multi-frequency bioelectrical impedance analysis), subjective assessment of the built environment (NEWS-A questionnaire), and other possible confounding factors. Time spent in sedentary behavior, light physical activity, and moderate-to-vigorous physical activity will be used as three components in a composition reflecting individual MRBs. In linear multiple compositional regression analysis assessing the prospective association between obesity and MRBs, the 7-year follow-up composition of the three mentioned components represents the dependent variable. The 7-year changes in the percentage of body fat (body adiposity), baseline composition of MRBs, and parameters of the built environment represent regressors. DISCUSSION: This study will use an integrated time-use approach to explore causality from obesity to device-measured behaviors in older women. The design and respective analysis consider the compositional nature of MRBs data and the potential moderating effects of various factors. A comprehensive assessment of causality may help to develop multilevel interventional models that enhance physical activity in older adults.

Sedentary behaviour and adiposity in community-dwelling women aged 55 and older.

This study aimed to describe sedentary behaviour in detail and assess its association with adiposity in older adult women. Data from 314 community-dwelling women (mean age 66.6 ± 6.5 years) from Czech Republic, Poland, and Slovakia were analyzed. Fat mass percentage was used as an indicator of adiposity, measured by bioelectrical impedance analysis. The patterns of sedentary behaviour were monitored using an accelerometer, and 1-9, 10-29 and 30 min. bouts were analyzed. We performed a multiple linear regression analysis to assess the association between variables. There was a significant association of fat mass percentage with time spent in bouts with a duration 10-29 min. (β = 0,03, p < 0,01) and the frequency of all analyzed bouts (β ranging -0,08-0,6; p < 0,05) which was independent of age, physical activity, demographic, socio-economic and health factors. Our results suggest that the sedentary behaviour patterns are significantly associated with adiposity. Reducing of sedentary time should be considered when planning a prevention programs or interventions.

Reallocating Time from Sedentary Behavior to Light and Moderate-to-Vigorous Physical Activity: What Has a Stronger Association with Adiposity in Older Adult Women?

This study is the first to use compositional data analysis to investigate movement behaviors of elderly women and their relationships with fat mass percentage (FM%). The focus of the study is on the associations of time reallocations from sedentary behavior (SB) to light physical activity (LIPA) or moderate-to-vigorous physical activity (MVPA) with adiposity. Over 400 older adult women were recruited as part of the cross-sectionally conducted measurements of older adults aged 60+ in Central European countries. An accelerometer was used to assess daily movement behaviors. Body mass index (BMI) and fat mass percentage (FM%) were assessed as adiposity indicators using InBody 720 MFBIA. Using LS-regression, we found positive relationships of BMI and FM% with SB (relative to remaining movement behaviors) (p < 0.001 for both), while their relationship with MVPA (relative to remaining movement behaviors) were negative (p < 0.001 for both). The estimated BMI and FM% associated with a 30-min SB-to-MVPA reallocation were reduced by 1.5 kg/m² and 2.2 percentage points, respectively, whereas they were not reduced significantly with the reallocation of 30 min from SB to LIPA. The findings highlight that SB and MVPA, but not LIPA, are significantly associated with adiposity in elderly women. The reallocation of time from SB to MVPA could be advocated in weight loss interventions in older women.

Associations of visceral fat area and physical activity levels with the risk of metabolic syndrome in postmenopausal women.

This study was aimed at the evaluation of relationship between visceral fat area (VFA) and physical activity (PA) with the metabolic syndrome (MetS) risk in the physically active postmenopausal women. A total of 85 attendants of the University of the Third Age (U3A) aged 62.8 ± 5.9 years (median time since menopause 11.8 y), participated in this study. VFA was assessed by bioimpedance method using InBody 720 analyzer. PA was assessed using the ActiGraph GT1 M accelerometer. Fasting levels of serum lipids (TG, HDL), serum glucose, waist circumference (WC) and blood pressure were measured to diagnose MetS according to NCEP-ATP III criteria. In 73 out of 85 participants the VFA exceeded the upper normal level of 100 cm2, however, in almost a half of this group (n = 36) with elevated VFA (139.5 ± 26.1 cm2 on average), only 2 out of 5 criteria for MetS diagnosis were met. Participants were physically active, making on average 10,919 ± 3435 steps/day. The risk of MetS occurrence in women with VFA > 100 cm2 was twelve times higher (OR 12.33; CI 95% [1.5; 99.8]) than in the group with VFA < 100 cm2. The participants from the group with the highest PA level (≥12,500 steps/day) were at almost 4 times lower risk for MetS, than their less active counterparts (OR 3.84; CI 95% [1.27;11.64]). Increased level of VFA is a strong risk factor for the MetS in postmenopausal women, however high level of regular PA above the threshold of 12,500 steps/day may substantially reduce it.

Is Pedometer-Determined Physical Activity Decreasing in Czech Adults? Findings from 2008 to 2013.

Objective measured trend data are important for public health practice. However, these data are rare for an adult population. Therefore, the aim of this study was to describe time trends in pedometer-determined physical activity of Czech adults (25-65 years) from 2008 to 2013. Participants were Czech national citizens whose physical activity was assessed objectively using a Yamax Digiwalker SW-700 pedometer (Yamax Corporation, Tokyo, Japan) for seven consecutive days in the period 2008 to 2013. The final sample was 4647 Czech adults [M age 41.4 ± 10 years; M body mass index (BMI) 25.1 ± 3.7 kg/m²]. The results showed that men took more steps/day (M (Mean) = 10,014; 95% CI (Confidence Interval) = 9864-10,164) than women (M = 9448; 95% CI = 9322-9673) in all age and BMI groups. Mean steps/day declined from 2008 to 2013 by 852 steps/day in men and 1491 steps/day in women. In the whole sample, the proportion of participants who had a sedentary lifestyle (<5000 steps/day) increased by 5.8%; the proportion taking ≥10,000 steps/day decreased by 15.8%. In 2013, men and women were 2.67 and 2.05 times, respectively, more likely to have a physically inactive lifestyle (<7500 steps/day) than in 2008. Conversely, in 2008, men and women were 1.68 and 2.46 times, respectively, less likely to have very active lifestyle (>12,500 steps/day). In conclusion, this study suggests that there has been a substantial reduction in physical activity in Czech adults over time.

The effect of brisk walking on postural stability, bone mineral density, body weight and composition in women over 50 years with a sedentary occupation: a randomized controlled trial.

BACKGROUND: To assess the effect of brisk walking on postural stability, bone mineral density (BMD) and body composition in women over 50 years of age with a sedentary occupation. METHODS: A 10-week walking intervention based on self-regulated brisk walking (BW) to or from work of 30-35 min at least 5 times per week. The research included a total of 104 women (58 women in intervention group). The mean center of pressure (COP) velocity in medial-lateral and anterior-posterior directions, mean total COP velocity with eyes open and closed, BMD of the distal forearm and the calcaneus, body weight, fat mass, and lean body mass were assessed. RESULTS: The BW intervention was completed by 76 % of participants. A significant effect (time × group interaction) was confirmed only in the mean COP velocity in the anterior-posterior direction with eyes closed (F = 7.41, P = 0.008). The effect of BW was not confirmed in BMD, body weight, or body composition. The results indicate that the effect of the intervention is influenced by baseline body mass index in body weight, fat mass and visceral adipose tissue. CONCLUSIONS: BW prevents the deterioration of postural stability with eyes closed, which can have a direct effect on reducing the risk of falls under worse spatial orientation and visibility. The presented intervention model is insufficient for weight loss, changes in BMD, or body composition, and its effect should be assessed during a longer period of time. TRIAL REGISTRATION: German Clinical Trials Register DRKS00007638 , registered March 10, 2015 (retrospectively registered).

Physical activity, body composition and general health status of physically active students of the University of the Third Age (U3A).

OBJECTIVE: To evaluate general health status of a group of older adults, physically active students of the University of the Third Age (U3A), based on results of biochemical analyses of blood, assessment of their physical activity (PA) level, body composition and cognitive function with respect to age and sex. METHODS: A total of 104 students (85 women and 19 men, aged 63.7±6.6 y) of the U3A's located in the Upper Silesia region of Poland volunteered to participate in this study. A habitual PA level and body composition were objectively assessed by using ActiGraph GT1M and InBody 720, respectively. Serum lipid profile and glucose metabolism markers were measured for assessment of cardiovascular disease risk factors. Moreover, subjects' cognitive functions were tested. RESULTS: Most of the study participants reached the daily step goal of 10,000 steps and thus fulfilled the ACSM recommendations for the quantity and quality of cardiorespiratory exercise. Highly negative correlations between the number of steps per day and body adiposity markers, serum insulin and HOMA-IR confirmed that vigorous physical activity at the recommended level was associated with better body composition and lower levels of risk markers of coronary heart disease and diabetes. Most of the U3A students were characterized by a favorable lipid profile, prevalence of normal blood pressure, low rates of HOMA-estimated insulin resistance and normal cognitive function. CONCLUSION: Adherence to ACSM recommendations is associated with beneficial changes in risk factors related to cardiovascular disease.

Postmenopausal obesity: 12,500 steps per day as a remedy? Relationships between body composition and daily steps in postmenopausal women.

INTRODUCTION: To verify relationships between physical activity (steps per day) and obesity (components of body composition) among postmenopausal women. MATERIAL AND METHODS: Physical activity (ActiGraph GT1M accelerometer; worn for 7 days) and obesity (body composition analyzer InBody 720) were assessed among 79 healthy postmenopausal women (age 63.25 ± 5.51 years; range: 51-81 years). In order to determine differences in body composition in women with different levels of physical activity, one-way analysis of covariance (ANCOVA) was conducted, with age of participants as a covariate. RESULTS: Significant intergroup differences in almost all analyzed components of the body composition (weight, body mass index, waist-hip ratio, visceral fat area, body fat mass and percent of body fat) were obtained. Highly active women (≥ 12,500 steps/day) had lower weight and adiposity parameters than those that represented low (< 7,500 steps/day) or somewhat active (7,500-9,999 steps/day) groups. Besides, a noteworthy difference between active (10,000-12,499 steps/day) and low active women was recorded. Noticeably, only in the most active group was the BMI within normal ranges. CONCLUSIONS: The higher physical activity, the lower obesity in postmenopausal women. The recommended 10,000 steps/day seems insufficient for this age group. Based on the obtained results, postmenopausal women should walk at least 12,500 steps per day to improve their health.

Gender-specific associations between perceived neighbourhood walkability and meeting walking recommendations when walking for transport and recreation for Czech inhabitants over 50 years of age.

Few studies have investigated the different effects that the built environment may have on the physical activity behaviours of men and women. Therefore, the aim of this study was to estimate the gender differences in meeting walking recommendations in relation to perceived neighbourhood walkability attributes within the active transportation and leisure-time domains for Czech inhabitants over 50 years of age. The sample included 1,417 men and 1,422 women who were randomly selected. The Abbreviated Neighbourhood Environment Walkability Scale (ANEWS) was used to obtain information about the perceived environment. The self-administered long version of the IPAQ was used to assess physical activity levels. When walking for transport, men living in neighbourhoods with high street connectivity (OR = 1.47, CI = 1.04-2.9) and higher traffic and crime safety (OR = 1.28, CI = 1.02-1.6) and women living in neighbourhoods with high proximity (OR = 1.36, CI = 1.04-1.77) and high neighbourhood aesthetics (OR = 1.36, CI = 1.04-1.76) were more likely to meet recommended levels of walking. No environmental attributes were found to significantly influence the accomplishment of walking recommendations by men or women when walking for leisure. The study results indicate the gender-specific associations between transportation-related walking and the environment factors. The consideration of those factors in the design of gender-specific walking interventions for Czech inhabitants may help the interventions to be more effective in promotion of physical activity.