Weight training and risk of all-cause, cardiovascular disease and cancer mortality among older adults.

BACKGROUND: While previous studies indicate muscle-strengthening exercises may reduce mortality risk, further research is needed to increase certainty of the evidence. We investigated overall and dose-response associations between weight training and the risks of all-cause, cardiovascular disease (CVD) and cancer mortality in a large cohort of older adults with long follow-up time and a large number of deaths. We also investigated the joint associations of weight training and aerobic exercise with mortality risk. METHODS: Weight training was assessed via self-report in 2004-05 in the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study (USA; n = 216 339), with follow-up to 2019. Cox regression estimated the hazard ratios (HR) and 95% confidence intervals (CI) for the associations between weight training and mortality, after adjusting for confounders including aerobic exercise. RESULTS: Around 25% of participants [mean age = 69.9 years (standard deviation = 5.4), 58% men] reported engaging in weight training over the past year, and there were 79 107 (37%) deaths. Engaging in any weight training (vs none) was associated with lower risks of all-cause (HR = 0.94; 95% CI = 0.93-0.96), CVD (HR = 0.92; 95% CI = 0.90-0.95) and cancer mortality (HR = 0.95; 95% CI = 0.92-0.98). More time spent in weight training was associated with only marginally greater risk reductions. Larger risk reductions were observed among women than men. Performing both aerobic exercise and weight training conferred the greatest mortality risk reduction; weight training was not associated with mortality risk among participants who did no aerobic exercise. CONCLUSION: Performing any amount of weight training lowered mortality risk.

Dose-dependent associations of joint aerobic and muscle-strengthening exercise with obesity: A cross-sectional study of 280,605 adults.

BACKGROUND: Emerging epidemiological evidence suggests that compared to engaging in 1 activity mode alone, a combination of moderate-to-vigorous physical activity (MVPA: brisk walking/jogging, cycling) and muscle-strengthening exercise (MSE: push-ups/sit-ups, using weight machines) has more favorable associations with optimal weight status. However, few studies have examined the dose-dependent and joint associations of MVPA and MSE with obesity. METHODS: Based on cross-sectional analyses of the European Health Interview Survey Wave 2 (2013-2014), we examined prevalence ratios (PRs) of joint and stratified associations between MVPA (4 categories: (i) 0 min/week, (ii) 1-149 min/week, (iii) 150-299 min/week, and (iv) ≥300 min/week) and MSE (3 categories: (i) 0 day/week, (ii) 1 day/week, and (iii) ≥2 days/week) with body mass index-defined obesity (body mass index of ≥30.0 kg/m2) using Poisson regression with robust error variance. PRs were examined unadjusted and adjusted for sociodemographic and lifestyle characteristics (e.g., sex, age, education, income, and smoking status). RESULTS: Data were available for 280,456 adults (≥18 years), of which 46,166 (15.5%) were obese. The interaction MVPA × MSE guideline adherence was statistically significant for obesity (p ≤ 0.05). The joint MVPA-MSE analysis showed that compared to the reference group (i.e., no MVPA and no MSE), the PRs followed a dose-dependent pattern, with the lowest observed among those reporting ≥150 MVPA min/week and ≥1 MSE days/week (PR: 0.43; 95% confidence interval: 0.41-0.46). When stratified across each MVPA strata, the PRs were mostly lower among those engaging in MSE 1 day/week, as compared to those doing MSE ≥2 days/week. CONCLUSION: There was evidence for a dose-dependent association between joint MVPA-MSE with a reduced prevalence of obesity. Public health strategies for the prevention and management of obesity should recommend both MVPA and MSE.

Aerobic or Muscle-Strengthening Physical Activity: Which Is Better for Health?

ABSTRACT: The Physical Activity Guidelines recommend performing 150 min of moderate- to vigorous-intensity aerobic physical activity (MVPA) per week. These guidelines also recommend muscle-strengthening physical activity (MSPA) on ≥2 d·wk-1 for additional benefits including muscular fitness and bone health. The majority of the scientific evidence supporting the PA recommendations for health comes from studies of MVPA while the possible contributions of MSPA in these findings have been overlooked historically. Emerging evidence suggests that MSPA can independently protect against major cardiometabolic risk factors, chronic diseases, and mortality. Additional data from clinical trials indicate that many of the well-known health benefits of exercise, like improvements in cardiovascular disease risk factors, are more robust with combined MVPA and MSPA. This review will clarify the relative benefits of MSPA versus MVPA on health-related outcomes to determine the best type of PA for health.

Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis.

INTRODUCTION: This study aimed to systematically review and meta-analyze the relationship between resistance training and all-cause, cardiovascular disease, and cancer mortality. METHODS: Systematic review and meta-analysis following PRISMA guidelines (International Prospective Register of Systematic Reviews Registration Number CRD42019136654) was conducted. MEDLINE (OVID), Embase, Emcare, SPORTDiscus, The Cochrane Library, and SCOPUS were searched from inception to June 6, 2021. Included studies reported resistance training as the exposure and all-cause mortality, cardiovascular disease‒specific mortality, and/or cancer-specific mortality as outcome/s. Only studies conducted among nonclinical adult populations (aged ≥18 years) and written in English were included. RESULTS: A total of 10 studies were included in the meta-analyses. Compared with undertaking no resistance training, undertaking any amount of resistance training reduced the risk of all-cause mortality by 15% (RR of 6 studies=0.85; 95% CI=0.77, 0.93), cardiovascular disease mortality by 19% (RR of 4 studies=0.81; 95% CI=0.66, 1.00), and cancer mortality by 14% (RR of 5 studies=0.86; 95% CI=0.78, 0.95). A dose-response meta-analysis of 4 studies suggested a nonlinear relationship between resistance training and the risk of all-cause mortality. A maximum risk reduction of 27% was observed at around 60 minutes per week of resistance training (RR=0.74; 95% CI=0.64, 0.86). Mortality risk reductions diminished at higher volumes. DISCUSSION: This systematic review and meta-analysis provides the strongest evidence to date that resistance training is associated with reduced risk of all-cause, cardiovascular disease, and cancer-specific mortality. More research is needed to determine whether any potential mortality benefits gained from resistance training diminish at higher volumes.

Risk factors for child stunting in Bangladesh: an analysis using MICS 2019 data.

BACKGROUND: Malnutrition is considered a major public health challenge and is associated with a range of health issues, including childhood stunting. Stunting is a reliable and well-recognized indicator of chronic childhood malnutrition. The objective of this study is to determine the risk factors associated with stunting among 17,490 children below five years of age in Bangladesh. METHODS: Correlates of child stunting were examined using data generated by a cross-sectional cluster survey conducted in Bangladesh in 2019. The data includes a total of 17,490 children (aged < 5 years) from 64,400 households. Multiple logistic regressions were used to determine the risk factors associated with child stunting and severe stunting. RESULTS: The prevalence of stunting and severe stunting for children was 25.96% and 7.97%, respectively. Children aged 24 to < 36 months [Odds Ratio (OR) = 2.65, 95% CI: 2.30, 3.05] and aged 36 to < 48 months [OR = 2.33, 95% CI: 2.02, 2.69] had more risk of stunting compared to the children aged < 6 months. Children from Sylhet division had the greatest risk of stunting of all the eight divisions [OR = 1.26, 95% CI: 1.09, 1.46]. Children of secondary complete or higher educated mothers were less likely to develop stunting [OR = 0.66, 95% CI: 0.56, 0.79] compared with children of mothers having no education at all. Similarly, children of secondary complete or higher educated father [OR = 0.74, 95% CI: 0.63, 0.87] were found to have lower risk of stunting compared with children whose father hadn't any education. Substantially lower risk of stunting was observed among children whose mother and father both completed secondary education or above [OR = 0.59, 95% CI: 0.52, 0.69]. Children from the richest households [OR = 0.49, 95% CI: 0.41, 0.58] had 51% lower odds of stunting compared to children from the poorest households. CONCLUSIONS: After controlling for socioeconomic and demographic factors, parental education and household position in the wealth index were found to be the most important determinants of child stunting in Bangladesh.

Using Wearable Cameras to Categorize the Type and Context of Screen-Based Behaviors Among Adolescents: Observational Study.

BACKGROUND: Automated wearable cameras present a new opportunity to accurately assess human behavior. However, this technology is seldom used in the study of adolescent's screen exposure, and the field is reliant on poor-quality self-report data. OBJECTIVE: This study aimed to examine adolescents' screen exposure by categorizing the type and context of behaviors using automated wearable cameras. METHODS: Adolescents (mean age 15.4 years, SD 1.6 years; n=10) wore a camera for 3 school evenings and 1 weekend day. The camera captured an image every 10 seconds. Fieldwork was completed between February and March 2020, and data were analyzed in August 2020. Images were date and time stamped, and coded for screen type, content, and context. RESULTS: Data representing 71,396 images were analyzed. Overall, 74.0% (52,842/71,396) of images contained screens and 16.8% (11,976/71,396) of images contained multiple screens. Most screen exposures involved television sets (25,950/71,396, 36.3%), smartphones (20,851/71,396, 29.2%), and laptop computers (15,309/71,396, 21.4%). The context of screen use differed by device type, although most screen exposures occurred at home (62,455/64,856, 96.3%) and with solitary engagement (54,430/64,856, 83.9%). The immediate after-school period saw high laptop computer use (4785/15,950, 30.0%), while smartphone use (2059/5320, 38.7%) peaked during prebedtime hours. Weekend screen exposure was high, with smartphone use (1070/1927, 55.5%) peaking in the early morning period and fluctuating throughout the day. CONCLUSIONS: There was evidence for high screen use during the after-school and weekend period, mostly through solitary engagement, and within the home environment. The findings may inform the basis of larger studies aimed at examining screen exposure in free-living conditions.

Muscle-Strengthening Exercise Questionnaire (MSEQ): an assessment of concurrent validity and test-retest reliability.

OBJECTIVES: Muscle-strengthening exercise (MSE) has multiple independent health benefits and is a component of global physical activity guidelines. However, the assessment of MSE in health surveillance is often limited to the constructs of frequency (days/week), with little focus on constructs such as MSE type, muscle groups targeted and intensity. This study describes the test-retest reliability and concurrent validity of the Muscle-Strengthening Exercise Questionnaire (MSEQ), which was developed to assess multiple MSE participation constructs. METHODS: The MSEQ was developed to assess the weekly frequency, session duration and intensity, types of MSE (eg, weight machines, bodyweight exercise) and muscle groups targeted. Two convenience samples of adult participants were recruited. Test-retest reliability was completed online by 85 participants. Concurrent validity was assessed for 54 participants using an online 7-day MSE log. RESULTS: The MSEQ shows high test-retest reliability for frequency, duration and level of intensity for each of the four MSE types (using weight machines, bodyweight exercises, resistance exercises and holistic exercises), and for the four types combined (ρ range 0.76-0.91). For muscle groups targeted, the reliability ranged mostly from moderate-to-substantial for each of the four MSE types (κ range 0.44-0.78) and fair-to-moderate for the four types combined (κ range 0.35-0.51). Concurrent validity for frequency, duration and level of intensity for each of the four MSE types, and the four types combined, was moderate-to-high (ρ range 0.30-0.77). CONCLUSION: The MSEQ shows acceptable reliability and validity for four key MSE constructs. This new MSEQ survey instrument could be used to assess adults' MSE.

Prevalence, Trends, and Correlates of Joint Patterns of Aerobic and Muscle-Strengthening Activity and Sleep Duration: A Pooled Analysis of 359,019 Adults in the National Health Interview Survey 2004-2018.

BACKGROUND: Physical activity (PA) and sleep duration have established associations with health outcomes individually but tend to co-occur and may be better targeted jointly. This study aimed to describe the cross-sectional prevalence, trends, and population characteristic correlates of activity-sleep patterns in a population-representative sample of US adults from the National Health Interview Survey (2004-2018). METHODS: Participants (N = 359,019) self-reported aerobic and muscle-strengthening activity and sleep duration. They were categorized as "meeting both"/"meeting PA only"/"meeting sleep only"/"meeting neither" of the 2018 US PA guidelines and age-based sleep duration recommendations. Trends in activity-sleep patterns were analyzed using weighted multinomial logistic regression, and correlates were identified using weighted binary Poisson regressions, with P ≤ .001 considered significant. RESULTS: "Meet sleep only" was most prevalent (46.4%) by 2018, followed by "meet neither" (30.3%), "meet both" (15.6%), and "meet PA only" (7.7%). Many significant sociodemographic, biological, and health-behavior correlates of the activity-sleep groups were identified, and the direction and magnitude of these associations differed between groups. CONCLUSIONS: Public health campaigns should emphasize the importance of both sufficient PA and sleep; target women and older adults, current smokers, and those with lower education and poorer physical and mental health; and consider specific barriers experienced by minority ethnic groups.

Associations between duration and volume of muscle-strengthening exercise and clinically assessed hypertension among 10 519 UK adults: a cross-sectional study.

BACKGROUND: Clinical evidence shows that muscle-strengthening exercise (MSE) is important for the treatment and management of hypertension. However, the links between MSE and hypertension in epidemiological research are currently poorly understood. This study examines the association between MSE duration and volume with clinically assessed hypertension. METHODS: Cross-sectional data (n = 10519, adults ≥ 16 years) were pooled from the Health Survey for England (2012, 2016). Self-reported MSE mode (own bodyweight; gym-based), duration, and volume were tested for associations with sphygmomanometer measured hypertension (SBP ≥ 130 mmHg or DBP ≥ 80 mmHg). Poisson regressions with robust error variance were used to calculate the prevalence ratios of hypertension (outcome variable) across MSE (exposure variables: duration (minutes [0 (reference); 10-20; 21 -59; ≥60/session]); and volume [0 (reference); low

Associations between muscle-strengthening exercise and prevalent chronic health conditions in 16,301 adults: Do session duration and weekly volume matter?

OBJECTIVES: Muscle-strengthening exercise (MSE) has multiple health benefits and is part of the global physical activity guidelines. However, with epidemiological research largely focussing on participation frequency (times/week), little is known about the health associations of other parameters. Hence, this study aimed to determine if MSE duration and volume are associated with prevalent chronic health conditions. DESIGN: Cross-sectional. METHODS: Cross-sectional data (n = 16,301 adults ≥16 years) were pooled from the Health Survey for England (2012, 2016). Respondents self-reported MSE mode (own-bodyweight, gym-based), duration and volume, and the prevalence of five chronic conditions (diabetes, anxiety/depression, heart, respiratory, or musculoskeletal condition). Poisson regressions with robust error variance were used to calculate the prevalence ratios (PR) of each chronic condition (outcome variable) across MSE parameters [exposure variables: duration (0 [reference]; 10-20; 21-59; ≥60 min/session); and volume (0 [reference]; low

Longitudinal trends and predictors of muscle-strengthening activity guideline adherence among Canadian youths.

OBJECTIVES: Muscle-strengthening activity (MSE e.g. push-ups, sit-ups, use of weight machines) is linked to multiple health benefits for youth, and is part of the global physical activity guidelines for children and adolescents (5-17 years). However, MSE is rarely assessed in youth health surveillance. This study describes the longitudinal trends and predictors of MSE among a cohort of Canadian youths. DESIGN: Longitudinal. METHODS: Data were drawn from a cohort of 3366 youths who participated in three waves of COMPASS, a longitudinal study of secondary school students across Canada [Wave 1 (T1) 2015/16, Wave 2 (T2) 2016/17, Wave 3 (T3) 2018/19]. The prevalence of the sample meeting the MSE guideline (≥3 days/week) was calculated for each wave. A multivariable logistic regression assessed the odds of meeting the MSE guideline for each wave (T1 and T2 and T3) across sociodemographic/lifestyle characteristics (e.g. sex, race, regionally, Body Mass Index, and aerobic physical activity). RESULTS: For the total sample, MSE guideline adherence significantly declined across each study wave (T1 = 57.0%; T2 = 52.0%; T3 = 48.5%; p < 0.001 for linear trend). Population sub-groups less likely to meet the guideline at each wave included females, youth who were underweight or obese, those reporting insufficient aerobic physical activity, those from large urban settings, and youth who identify as Asian. CONCLUSIONS: Among a large sample of Canadian youths, approximately half met the MSE guideline, with this prevalence declining over time. Large-scale MSE interventions are needed to address the low and decreasing adherence to this key modifiable health-related behavior among Canadian youths.

Association of meeting both muscle strengthening and aerobic exercise guidelines with prevalent overweight and obesity classes - results from a nationally representative sample of German adults.

OBJECTIVES: German national physical activity guidelines specify adults (≥18 years) should engage in at least: (i) 150 min of aerobic moderate-to-vigorous-intensity physical activity/week (MVPA); and (ii) muscle-strengthening exercise (MSE) 2 days/week. However, the relationship between MVPA and MSE and overweight/obesity has not been examined among German adults. Aim of this study was to examine whether meeting the guidelines for both MVPA and MSE is associated with a lower prevalence of overweight/obesity compared to meeting MVPA or MSE alone or none of them, among a nationally representative sample of German adults. METHODS: The cross-sectional study drew data from the 2014 German Health Update (GEDA) (n=22,822; ≥18 years). Physical activity (MVPA-MSE), height/weight, socio-demographic, health and lifestyle factors were assessed by self-report via validated questionnaires. Generalized linear models with Poisson regression were used to assess prevalence ratios of Body Mass Index-derived (BMI) overweight/obesity across categories of physical activity guideline adherence (met neither; MSE only; MVPA only; met both). RESULTS: Compared to other physical activity groups, meeting both the MVPA-MSE guidelines was associated with the lowest prevalence rate of overweight/obesity (Adjusted Prevalence Ratios [APR] range: 0.25-0.73). Associations between BMI and physical activity were strongest among Class II obesity (APR range: 0.25-0.45). The associations remained consistent after adjusting sociodemographic and lifestyle factors. CONCLUSIONS: Meeting the combined MVPA-MSE guideline, as suggested in the German national physical activity recommendations, showed the lowest overweight/obesity prevalence. Promoting uptake and adherence of both MVPA and MSE at the population level could help to reduce the public health burden of obesity.Highlights Meeting both muscle strengthening and aerobic exercise guidelines show the lowest overweight/obesity prevalence in a German representative sample of adults. Promoting uptake and adherence of both MVPA and MSE at the population level could help to reduce the public health burden of obesity.

Health-Enhancing Physical Activity in Europe-Combined Aerobic Physical Activity and Muscle-Strengthening Exercise Guideline Adherence Among 280,605 Adults From 28 European Countries.

BACKGROUND: Compared with engaging in aerobic physical activity (aerobic PA; eg, walking, running, cycling) or muscle-strengthening exercise (MSE; eg, weight/resistance training) alone, epidemiological evidence suggests that combining both is linked to better health. However, the assessment of both PA modes is rare in health surveillance. This article provides the first multicountry study on the descriptive epidemiology of combined moderate to vigorous PA-MSE guideline adherence. METHODS: Data were drawn from the European Health Interview Survey wave 2 (2013-2014), comprising samples from 28 European countries (n = 280,605). Self-reported aerobic PA and MSE were assessed using the validated European Health Interview Survey Physical Activity Questionnaire. The authors calculated the weighted proportions meeting the health-enhancing PA guideline (aerobic PA ≥ 150 min/wk and MSE ≥ 2 sessions/wk). Poisson regression assessed the prevalence ratios for meeting the combined guideline across sociodemographic factors and by country. RESULTS: A total of 15.0% met the health-enhancing PA guideline. The lowest prevalence was from respondents from Southern and Central European countries (Romania, Poland, and Croatia, range: 0.5%-5.7%). Poorer self-rated health, older age, lower income, being female, and being obese had a lower likelihood of meeting the combined guideline. CONCLUSIONS: Most European adults do not meet the health-enhancing PA guideline that includes both aerobic PA and MSE.

The epidemiology of muscle-strengthening activity among adolescents from 28 European countries.

AIMS: This study aimed to describe the prevalence and socio-demographic and lifestyle-related correlates of muscle-strengthening activity (MSA; strength/resistance training, sit-ups/push-ups, etc.) among a large sample of European adolescents. METHODS: Data were drawn from the European Health Interview Survey Wave 2 (2013-2014), including 8818 adolescents (15-17 years) from 28 European countries. Self-reported MSA was assessed using a previously validated survey item. Population-weighted prevalence ratios were calculated for (a) 'none' (0 days/week), (b) 'insufficient MSA' (1-2 days/week) or (c) 'sufficient MSA' (⩾3 days/week). Generalised linear models using Poisson regression with robust error variance were used to calculate the prevalence ratios for adolescents reporting sufficient MSA by socio-demographic/lifestyle characteristics and by European region. RESULTS: Overall, 19.4% (95% confidence interval (CI) 18.3-20.7) reported sufficient (⩾3 days/week) MSA and 57.9% (95% CI 56.4-59.6) reported none. Females, adolescents from Southern and Eastern European regions, those not meeting the aerobic guideline and adolescents classified as overweight were significantly associated with a lower likelihood of reporting sufficient MSA, independent of other characteristics. CONCLUSIONS: The majority of European adolescents do not meet the MSA guidelines. Future large-scale MSA public-health interventions should target female and currently inactive adolescents, as well as those from Southern and Eastern European regions.

Resistance exercise, alone and in combination with aerobic exercise, and obesity in Dallas, Texas, US: A prospective cohort study.

BACKGROUND: Obesity is a significant and growing public health problem in high-income countries. Little is known about the relationship between resistance exercise (RE), alone and in combination with aerobic exercise (AE), and the risk of developing obesity. The purpose of this prospective cohort study was to examine the associations between different amounts and frequencies of RE, independent of AE, and incident obesity. METHODS AND FINDINGS: Participants were 11,938 healthy adults ages 18-89 years with a BMI < 30 kg/m2 at baseline who completed at least 2 clinical examinations during 1987-2005 as part of the Aerobics Center Longitudinal Study. Self-reported RE participation in minutes/week and days/week was collected from a standardized questionnaire. Incident obesity was defined as a BMI ≥ 30 kg/m2 at follow-up. Incident obesity was also defined by waist circumference (WC) > 102/88 cm for men/women and percent body fat (PBF) ≥ 25%/30% for men/women at follow-up in participants who were not obese by WC (n = 9,490) or PBF (n = 8,733) at baseline. During the average 6-year follow-up, 874 (7%), 726 (8%), and 1,683 (19%) developed obesity defined by BMI, WC, or PBF, respectively. Compared with no RE, 60-119 min/wk of RE was associated with 30%, 41%, and 31% reduced risk of obesity defined by BMI (hazard ratio [95% CI], 0.70 [0.54-0.92], p = 0.008), WC (0.59 [0.44-0.81], p < 0.001), and PBF (0.69 [0.57-0.83], p < 0.001), respectively, after adjusting for confounders including age, sex, examination year, smoking status, heavy alcohol consumption, hypertension, hypercholesterolemia, diabetes, and AE. Compared with not meeting the RE guidelines of ≥2 d/wk, meeting the RE guidelines was associated with 18%, 30%, and 30% reduced risk of obesity defined by BMI (hazard ratio [95% CI], 0.82 [0.69-0.97], p = 0.02), WC (0.70 [0.57-0.85], p < 0.001), and PBF (0.70 [0.62-0.79], p < 0.001), respectively. Compared with meeting neither guideline, meeting both the AE and RE guidelines was associated with the smallest hazard ratios for obesity. Limitations of this study include limited generalizability as participants were predominantly white men from middle to upper socioeconomic strata, use of self-reported RE, and lack of detailed diet data for the majority of participants. CONCLUSIONS: In this study, we observed that RE was associated with a significantly reduced risk of obesity even after considering AE. However, meeting both the RE and AE guidelines was associated with the lowest risk of obesity.

Feasibility of Reducing and Breaking Up University Students' Sedentary Behaviour: Pilot Trial and Process Evaluation.

Background: Accumulating high levels of sedentary behaviour has been linked to poor health outcomes. This study examined the feasibility and preliminary, short-term effects of a theory-based intervention aimed at reducing total and prolonged sedentary behaviour in University students. Design: A quasi-experimental (pre-post) pilot study. Methods: Nine ambulatory undergraduate students (Mean age = 22 ± 2.32) participated in a one-on-one session, including an educational component around the health effects of sedentary behaviour and three distinct activities (feedback, "pros and cons" exercise, and suggested behaviour change strategies). In addition, automated daily text messages targeting sedentary behaviour were sent for 6 days (four messages per day at fixed intervals). The Behaviour Change Wheel framework guided the intervention design process. Outcomes were assessed over 6 days in pre- and post-intervention periods and included accelerometer-based (activPAL) and self-reported (Nightly-Week-U) total sedentary time, as well as accelerometer-based number of steps and prolonged sedentary time. Students completed a process evaluation interview upon completing the trial. Results: From pre- to post-intervention, there was a significant reduction in accelerometer-based total and prolonged sedentary time during weekend days. In addition, there was a significant increase in accelerometer-based standing time and stepping during weekend days. There were no statistically significant changes in accelerometer-based sedentary time, standing time or number of steps during weekdays. Process evaluation results indicated that the intervention and its assessment is feasible. Reductions in sedentary time were likely to be mediated by positive changes in the student's reflective and automatic motivation. Conclusions: Findings from this small, short-term intervention suggest that a single one-on-one session, together with automated text messages, may help University students reduce sedentary behaviour and enhance movement during weekend days. Additional strategies to maximise the intervention effects are discussed (e.g., establishing a collaboration with University staff, introducing sit-to-stand desks, and/or facilitating social support). A randomised control trial assessing sedentary behaviour over a longer period is needed to adequately study the intervention's effectiveness.

Is all activity equal? Associations between different domains of physical activity and depressive symptom severity among 261,121 European adults.

BACKGROUND: Physical activity is often associated with better mental health. However, there is evidence that the domain of physical activity influences the strength and direction of this association. Therefore, this study aimed to examine the associations between different domains of physical activity and depression among a large sample of adults living in the European Union. METHODS: Cross-sectional analyses were conducted on 261,121 adults, recruited in the European Health Interview Survey (wave 2). Validated items were used to assess physical activity domains (i.e., work-related, transport-related, leisure-time aerobic, and muscle-strengthening) and depression symptom severity (8-item personal health questionnaire). Generalized linear models with Poisson regressions provided adjusted prevalence ratios (APR) of depressive symptom severity categories across the physical activity domains. RESULTS: Compared to doing no physical activity, any physical effort at work (APR: 0.82-0.86), moderate, high, and very high levels of transport-related (APR: 0.69-0.83) and aerobic leisure-time activity (APR: 0.78-0.87), and 3 days/week of muscle-strengthening (APR: 0.93) were associated with a lower prevalence of mild depressive symptom severity. Moreover, doing any level of physical activity in any domain was mostly associated with a lower prevalence of moderate (APR: 0.43-0.80), moderate-severe (APR: 0.34-0.82), and severe (APR: 0.26-0.56) depressive symptoms. CONCLUSION: Favorable associations were seen between any domain (leisure-time, transport- and work-related) of physical activity and depressive symptom severity. The more severe the symptoms, the stronger the associations. Both modalities of leisure-time physical activity (aerobic and muscle-strengthening) demonstrated beneficial associations with depression, but slightly more so for aerobic physical activity.

Assessment of muscle-strengthening exercise in public health surveillance for adults: A systematic review.

There is strong scientific evidence that muscle-strengthening exercise (i.e. use of weight machines, push-ups, sit-ups) is independently associated with a reduced risk of multiple chronic diseases (e.g. diabetes, hypertension, cardiovascular disease). However, prevalence rates for meeting the muscle-strengthening exercise guideline (≥2 times/week) are significantly lower (~20%) than those reported to meet the aerobic physical activity guideline (e.g. walking, jogging, cycling) (~50%). It is therefore important to understand public health surveillance approaches to assess muscle-strengthening exercise. The aim of this review was to describe muscle-strengthening exercise assessment in public health surveillance. Informed by the PRISMA guidelines, an extensive keyword search was undertaken across 7 electronic data bases. We identified 86,672 possible articles and following screening (n = 1140 in full-text) against specific inclusion criteria (adults aged ≥18 years, English, studies containing <1000 participants), extracted data from 156 manuscripts. Fifty-eight different survey systems were identified across 17 countries. Muscle-strengthening exercise frequency (85.3%), duration (23.7%) and intensity (1.3%) were recorded. Muscle-strengthening exercise questions varied significantly, with some (11.5%) requiring a singular 'yes' vs 'no' response, while others (7.7%) sought specific details (e.g. muscle groups targeted). Assessments of duration and intensity were inconsistent. Very few studies measured the validity (0.6%) and reliability (1.3%) of muscle-strengthening exercise questions. Discrepancy exists within the current assessment systems/surveys used to assess muscle-strengthening exercise in public health surveillance. This is likely to impede efforts to identify at risk groups and trends within physical activity surveillance, and to accurately assess associations between muscle-strengthening exercise and health-related outcomes.

Physical Activity Tracking Among Sri Lankan Adults: Findings From a 7-Year Follow-up of the Ragama Health Study.

Limited data are available on physical activity tracking among adults in low- and middle-income countries. Using a longitudinal design, we assessed trends and correlates of physical activity among Sri Lankan adults. Individuals selected through age-stratified random sampling, were screened initially in 2007 (n = 2986) and reevaluated in 2014 (n = 2148). On both occasions, structured interviews and clinical measurements were completed. Approximately 40% of the participants engaged in recommended levels of physical activity both at baseline and follow-up. One-fifth reported increased physical activity at follow-up, a similar proportion reported being persistently inactive or a reduction in physical activity. In the adjusted analysis, being persistently active was associated with male sex, a lower educational level and income, being free of any chronic disease conditions, better self-rated health, and sitting time <8 hours. Our findings support public health interventions to help maintain recommended physical activity levels over time, particularly for subgroups at high-risk of physical inactivity.