Associations Between Adverse Childhood Experiences and Early Adolescent Physical Activity in the United States.

OBJECTIVE: To determine the associations between the number of adverse childhood experiences (ACEs) and objectively-measured physical activity (PA) in a population-based, demographically diverse cohort of 9-14-year-olds and to determine which subtypes of ACEs were associated with physical activity levels. METHODS: We analyzed data (n = 7046) from the Adolescent Brain Cognitive Development (ABCD) Study 4.0 release at baseline and year 2 follow-up. ACE (cumulative score and subtypes) and physical activity (average Fitbit daily steps assessed at Year 2) were analyzed using linear regression analyses. Covariates included race and ethnicity, sex, household income, parent education, body mass index, study site, twins/siblings, and data collection period. RESULTS: Adjusted models suggest an inverse association between number of ACEs and Fitbit daily steps, with ≥4 (compared to 0) ACEs associated with 567 fewer daily steps (95% CI -902.2, -232.2). Of the ACEs subtypes, emotional abuse (B = -719.3, 95% CI -1430.8, -7.9), physical neglect (B = -423.7, 95% CI -752.8, -94.6), household mental illness (B = -317.1, 95% CI -488.3, -145.9), and household divorce or separation (B = -275.4, 95% CI -521.5, -29.2) were inversely and statistically significant associated with Fitbit daily steps after adjusting for confounders. CONCLUSIONS: Our results suggest that there is an inverse, dose-dependent relationship between cumulative number of ACEs and physical activity as measured by daily steps. This work highlights the importance of screening for ACEs among young people at an early age to help identify those who could benefit from interventions or community programs that support increased physical activity.

The Association Between Midlife Leisure-Time Physical Activity and Hearing Loss in Late Life in the Atherosclerosis Risk in Communities Study.

BACKGROUND: Hearing loss is highly prevalent in older ages and has several health consequences. Some cardiovascular risk factors are associated with worse hearing at older ages. Still, the role of midlife leisure-time physical activity (PA) as a risk factor for hearing loss is yet to be investigated. METHODS: Among 3 198 participants of the Atherosclerosis Risk in Communities study, we investigated the associations of midlife and change from mid- to late-life PA (assessed via modified Baecke questionnaire) with hearing loss (audiometric battery [worse-ear pure-tone average, and speech-in-noise test]) at older ages. We used regression analyses, adjusted for demographics, medical conditions, and noise exposure, to estimate differences in hearing between those who met and did not meet PA recommendations at midlife and at late life. RESULTS: A total of 1 386 (43.3%) participants met PA recommendations at midlife. These participants, compared to those who did not meet recommendations, had lower (better) pure-tone average by 1.51 (0.46, 2.55) decibels, identified 0.37 (0.01, 0.74) more words (better score) in the speech-in-noise test, and had a lower relative risk of having hearing loss at older ages (eg, relative risk ratio for severe hearing loss vs normal hearing = 0.70 [0.52, 0.95]). Similarly, those who persistently met PA recommendations from mid- to late life had, compared with those who did not, a better hearing at older ages. CONCLUSIONS: Meeting PA public health recommendations in midlife and mid- to late life was associated with better hearing at older ages and reduced risk of hearing loss. Promoting adequate levels of PA may be an essential component of hearing care.

Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study: Study Design.

The Collaborative Cohort of Cohorts for COVID-19 Research (C4R) is a national prospective study of adults comprising 14 established US prospective cohort studies. Starting as early as 1971, investigators in the C4R cohort studies have collected data on clinical and subclinical diseases and their risk factors, including behavior, cognition, biomarkers, and social determinants of health. C4R links this pre-coronavirus disease 2019 (COVID-19) phenotyping to information on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and acute and postacute COVID-related illness. C4R is largely population-based, has an age range of 18-108 years, and reflects the racial, ethnic, socioeconomic, and geographic diversity of the United States. C4R ascertains SARS-CoV-2 infection and COVID-19 illness using standardized questionnaires, ascertainment of COVID-related hospitalizations and deaths, and a SARS-CoV-2 serosurvey conducted via dried blood spots. Master protocols leverage existing robust retention rates for telephone and in-person examinations and high-quality event surveillance. Extensive prepandemic data minimize referral, survival, and recall bias. Data are harmonized with research-quality phenotyping unmatched by clinical and survey-based studies; these data will be pooled and shared widely to expedite collaboration and scientific findings. This resource will allow evaluation of risk and resilience factors for COVID-19 severity and outcomes, including postacute sequelae, and assessment of the social and behavioral impact of the pandemic on long-term health trajectories.

Physical Activity-Related Metabolites Are Associated with Mortality: Findings from the Atherosclerosis Risk in Communities (ARIC) Study.

Habitual physical activity can diminish the risk of premature death. Identifying a pattern of metabolites related to physical activity may advance our understanding of disease etiology. We quantified 245 serum metabolites in 3802 participants from the Atherosclerosis Risk in Communities (ARIC) study using chromatography-mass spectrometry. We regressed self-reported moderate-to-vigorous intensity leisure-time physical activity (LTPA) against each metabolite, adjusting for traditional risk factors. A standardized metabolite risk score (MRS) was constructed to examine its association with all-cause mortality using the Cox proportional hazard model. We identified 10 metabolites associated with LTPA (p < 2.04 × 10-4) and established that an increase of one unit of the metabolic equivalent of task-hours per week (MET·hr·wk-1) in LTPA was associated with a 0.012 SD increase in MRS. During a median of 27.5 years of follow-up, we observed 1928 deaths. One SD increase of MRS was associated with a 10% lower risk of death (HR = 0.90, 95% CI: 0.85-0.95). The highest vs. the lowest MRS quintile rank was associated with a 22% reduced risk of death (HR = 0.78, 95% CI: 0.62-0.94). The effects were consistent across race and sex groups. In summary, we identified a set of metabolites associated with LTPA and an MRS associated with a lower risk of death. Our study provides novel insights into the potential mechanisms underlying the health impacts of physical activity.

Associations of accelerometer-measured physical activity and sedentary time with chronic kidney disease: The Framingham Heart Study.

BACKGROUND: Few studies examined the individual and conjoint associations of accelerometer-measured physical activity (PA) and sedentary times with the prevalence of chronic kidney disease (CKD) among older adults. METHODS: We evaluated 1,268 Framingham Offspring Study participants (mean age 69.2 years, 53.8% women) between 2011 and 2014. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.732 and/or urine albumin-to-creatinine ratio (UACR) ≥25/35 µg/mg (men/women). We used multivariable logistic regression models to relate time spent being sedentary and active with the odds of CKD. We then performed compositional data analysis to estimate the change in the eGFR and UACR when a fixed proportion of time in one activity behavior (among the following: moderate to vigorous physical activity [MVPA], light intensity physical activity [LIPA], and sedentary) is reallocated to another activity behavior. RESULTS: Overall, 258 participants had prevalent CKD (20.4%; 120 women). Higher total PA ([MVPA+LIPA], adjusted-odds ratio [OR] per 30 minutes/day increase, 0.86; 95% CI, 0.78-0.96) and higher LIPA (OR per 30 minutes/day increase, 0.87; 95% CI, 0.76-0.99) were associated with lower odds of CKD. Additionally, higher sedentary time (OR per 30 minutes/day increase, 1.16; 95% CI, 1.04-1.29) was associated with higher odds of CKD. Reallocating 5% of the time from LIPA to sedentary was associated with the largest predicted difference in eGFR (-1.06 ml/min/1.73m2). Reallocating 1% of time spent in MVPA to sedentary status predicted the largest difference in UACR (14.37 µg/mg). CONCLUSION: The findings suggest that increasing LIPA and maintaining MVPA at the expense of sedentary time may be associated with a lower risk of CKD in community-based older adults.

The Association of Self-Reported Muscle-Strengthening Activities With Carotid Intima-Media Thickness in Older Adults: Cooper Center Longitudinal Study.

The purpose of the current investigation was to examine the cross-sectional associations of participation in muscle-strengthening activities (MSAs) with carotid intima-media thickness (CIMT) among older adults. The data are from 2,557 older adult participants enrolled in an observational cohort who reported no history of cardiovascular disease. MSA was determined using a questionnaire. Carotid ultrasound was performed to measure the CIMT of the common carotid artery bilaterally. Logistic regression models were constructed to estimate the association of MSA with CIMT after adjustment for potential confounders. The participants were aged 68.6 ± 7.0 years, and the majority were male (71.7%) and White (96.5%); 18% had abnormal CIMT. Meeting the physical activity guidelines for MSA was inversely associated with abnormal CIMT after adjustment for age and sex. However, this observed inverse relation became statistically null after further adjustment for cardiovascular disease risk factors, including aerobic physical activity.

The Association of Physical Activity With Carotid Intima Media Thickening in a Healthy Older Population: Cooper Center Longitudinal Study.

The purpose of this study was to examine the association between self-reported physical activity (PA) and mean common carotid artery intima-media thickness (CCA IMT) among older adults. The data are from 1,811 Cooper Center Longitudinal Study participants, who were aged ≥60 years, with no history of cardiovascular disease. A medical history questionnaire was used to assess PA. Carotid ultrasound was performed to measure CCA IMT and the presence of plaque and stenosis. Logistic regression models were constructed to estimate the association between PA and CCA IMT after adjustment for covariates. The participants were aged 69.2 ± 5.9 years, and the majority were male (73.3%) and White (96.7%). The odds ratio of abnormal thickening of CCA IMT was 0.72 (95% confidence interval [0.54, 0.96]) in physically active participants (≥500 metabolic equivalent·min/week) after adjustment for covariates. In the current study, meeting PA guidelines in older adulthood was associated with lower odds of abnormal thickening of CCA IMT.

Cost-Effectiveness of Improvements to the Built Environment Intended to Increase Physical Activity.

Background: Improving sidewalks may encourage physical activity by providing safe, defined, and connected walking spaces. However, it is unknown if reduced health care expenditures assumed by increased physical activity offset the investment for sidewalk improvements. Methods: This cost-effectiveness analysis of sidewalk improvements in Houston, TX, was among adults enrolled in the Houston Travel-Related Activity in Neighborhoods Study, 2013-2017 . The 1-year change in physical activity was measured using self-report (n = 430) and accelerometry (n = 228) and expressed in metabolic equivalent (MET) hours per year (MET·h·y-1). Cost-effectiveness ratios were calculated by comparing annualized sidewalk improvement costs (per person) with 1-year changes in physical activity. Results: The estimated cost-effectiveness ratio were $0.01 and -$0.46 per MET·h·y-1 for self-reported and accelerometer-derived physical activity, respectively. The cost-effectiveness benchmark was $0.18 (95% confidence interval, $0.06-$0.43) per MET·h·y-1 gained based on the volume of physical activity necessary to avoid health care costs. Conclusions: Improving sidewalks was cost-effective based on self-reported physical activity, but not cost-effective based on accelerometry. Study findings suggest that improving sidewalks may not be a sufficient catalyst for changing total physical activity; however, other benefits of making sidewalks more walkable should be considered when deciding to invest in sidewalk improvements.

25-Year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

OBJECTIVE: To evaluate 25-year physical activity (PA) trajectories from young to middle age and assess associations with the prevalence of coronary artery calcification (CAC). PATIENTS AND METHODS: This study includes 3175 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who self-reported PA by questionnaire at 8 follow-up examinations over 25 years (from March 1985-June 1986 through June 2010-May 2011). The presence of CAC (CAC>0) at year 25 was measured using computed tomography. Group-based trajectory modeling was used to identify PA trajectories with increasing age. RESULTS: We identified 3 distinct PA trajectories: trajectory 1, below PA guidelines (n=1813; 57.1%); trajectory 2, meeting PA guidelines (n=1094; 34.5%); and trajectory 3, 3 times PA guidelines (n=268; 8.4%). Trajectory 3 participants had higher adjusted odds of CAC>0 (adjusted odds ratio [OR], 1.27; 95% CI, 0.95-1.70) vs those in trajectory 1. Stratification by race showed that white participants who engaged in PA 3 times the guidelines had higher odds of developing CAC>0 (OR, 1.80; 95% CI, 1.21-2.67). Further stratification by sex showed higher odds for white males (OR, 1.86; 95% CI, 1.16-2.98), and similar but nonsignificant trends were noted for white females (OR, 1.71; 95% CI, 0.79-3.71). However, no such higher odds of CAC>0 for trajectory 3 were observed for black participants. CONCLUSION: White individuals who participated in 3 times the recommended PA guidelines over 25 years had higher odds of developing coronary subclinical atherosclerosis by middle age. These findings warrant further exploration, especially by race, into possible biological mechanisms for CAC risk at very high levels of PA.

Completion of Multidisciplinary Treatment for Persistent Postconcussive Symptoms Is Associated With Reduced Symptom Burden.

OBJECTIVE: To investigate the pre- to posttreatment changes in both posttraumatic stress disorder (PTSD) and persistent postconcussive symptoms (PPCSs). SETTING AND PARTICIPANTS: We studied 257 active-duty patients with a history of mild traumatic brain injury (mTBI) who completed multidisciplinary outpatient treatment at Brooke Army Medical Center TBI Clinic from 2008 to 2013. This treatment program included cognitive rehabilitation; vestibular interventions; headache management; and integrated behavioral healthcare to address co-occurring psychiatric conditions such as PTSD, depression, and sleep disturbance. DESIGN: A 1-group; preexperimental, pre- to posttreatment study. MAIN MEASURES: The Neurobehavioral Symptom Inventory (NSI) was used to assess PPCSs, and the PTSD Checklist-Military Version (PCL-M) was used to asses PTSD symptoms. RESULTS: Global PPCS resolution (mean NSI: 35.0 pre vs 23.8 post; P < .0001; d = 0.72) and PTSD symptom resolution (mean PCL-M: 43.2 pre vs 37.7 post; P < .0001; d = 0.34) were statistically significant. Compared with those with only mTBI, patients with mTBI and PTSD reported greater global PPCS impairment both pretreatment (mean NSI: 48.7 vs 27.9; P < .0001) and posttreatment (mean NSI: 36.2 vs 17.4; P < .0001). After adjusting for pretreatment NSI scores, patients with comorbid PTSD reported poorer PPCS resolution than those with mTBI alone (mean NSI: 27.9 pre vs 21.7 post; P = .0009). CONCLUSION: We found a reduction in both self-reported PPCSs and PTSD symptoms; however, future studies are needed to identify specific components of care associated with symptom reduction.

The Association of Trip Distance With Walking To Reach Public Transit: Data from the California Household Travel Survey.

INTRODUCTION: Use of public transit is cited as a way to help individuals incorporate regular physical activity into their day. As a novel research topic, however, there is much we do not know. The aim of this analysis was to identify the correlation between distance to a transit stop and the probability it will be accessed by walking. We also sought to understand if this relation was moderated by trip, personal or household factors. METHODS: Data from the 2012 California Household Travel Survey was used for this cross-sectional analysis. 2,573 individuals were included, representing 6,949 transit trips. Generalized estimating equations modeled the probability of actively accessing public transit as a function of distance from origin to transit stop, and multiple trip, personal and household variables. Analyses were conducted in 2014 and 2015. RESULTS: For each mile increase in distance from the point of origin to the transit stop, the probability of active access decreased by 12%. With other factors held equal, at two miles from a transit stop there is a 50% chance someone will walk to a stop versus non-active means. The distance-walking relation was modified by month the trips were taken. CONCLUSIONS: Individuals appear to be willing to walk further to reach transit than existing guidelines indicate. This implies that for any given transit stop, the zone of potential riders who will walk to reach transit is relatively large. Future research should clarify who transit-related walkers are, and why some are more willing to walk longer distances to transit than others.

The association between physical fitness and academic achievement in Texas state house legislative districts: an ecologic study.

BACKGROUND: The association of physical fitness with cognitive function in children and adolescents is unclear. The purpose of this ecological study was to describe the association between academic achievement, body mass index (BMI), and cardiovascular fitness (CVF) in a large sample of elementary, middle, and high school students in Texas. METHODS: FITNESSGRAM(®) results for 2,550,144 students were matched with standardized composite academic test (TAKS) results from 2008 to 2009. Analyses were conducted on the percent of students meeting TAKS standards by BMI and CVF quintiles. Analyses of variance with Tukey adjustment examined differences between the most favorable 5th quintile (referent) and all other quintiles. RESULTS: The prevalence of students meeting the TAKS standard was significantly higher in the highest fitness category for BMI and CVF compared to all other categories, regardless of sex or grade category (p < .05). Linear modeling suggested a 5% increase in the prevalence of students meeting healthy BMI and CVF standards would result in a 2.25% and 0.65% increase in the prevalence of students meeting the TAKS standard (both p < .05). CONCLUSION: Findings suggest a healthy BMI and CVF are associated with higher academic achievement, and the need for additional research examining the role of potential confounders and/or effect modifiers longitudinally.

The impact of change in physical activity on change in arterial stiffness in overweight or obese sedentary young adults.

Arterial stiffness is associated with cardiovascular events and mortality. Lifestyle factors such as physical activity (PA) may reduce arterial stiffness. The purpose of this study is to determine the impact of change in PA on 1-year change in arterial stiffness in 274 overweight/obese sedentary young adults. The Slow Adverse Vascular Effects of excess weight (SAVE) trial was a study evaluating the relationships between weight loss, dietary sodium, and vascular health. PA was measured with the ActiGraph AM7164 accelerometer. Intensity of activity was determined using established cut-points. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV) using an automated device. Analysis of covariance compared changes in total accelerometer counts, minutes/day in light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and sedentary time, by categories of change in baPWV. Models were adjusted for time since baseline visit, age, sex, race, homeostatis model of assessment of insulin resistance, mean arterial pressure, heart rate, and weight change. Total accelerometer counts and time spent in MVPA increased from baseline to 12 months while time spent in LPA significantly decreased. Mean baPWV was similar at each time point. Those who showed decreased baPWV also showed an increase in total accelerometer counts per day and time spent in MVPA in the fully adjusted models (p<0.001). Changes in sedentary time and time spent in LPA were not associated with changes in baPWV. These results indicate that even modest increases in MVPA can reduce arterial stiffness, a risk factor for future cardiovascular events.

Sleep and executive function in older women: the moderating effect of physical activity.

BACKGROUND: Sleep and physical activity are both important for cognition. However, few cognitive function studies include comprehensive measurement of both sleep and physical activity. The purpose of this study was to examine the independent and interactive associations of sleep and physical activity in relation to cognitive function in older women. METHODS: A subset of 121 women from the Healthy Women Study, mean age 73.3 ± 1.7 years, wore an actigraphy sleep monitor, physical activity accelerometer, and kept sleep and physical activity diaries for 7 consecutive days. Executive function was measured with the Digit Symbol Substitution Test and the Trail Making Test B. Verbal fluency was assessed with a word generation task. RESULTS: In adjusted models, greater actigraphy-assessed sleep efficiency was associated with more correct responses on the Digit Symbol Substitution Test (ß = 0.35, SE = 0.15, p < 0.02). Sleep was not associated with verbal fluency. A significant interaction (p < 0.05) was observed between accelerometer-assessed physical activity and actigraphy-assessed sleep efficiency. Specifically, lower sleep efficiency was associated with poorer performance on both the Digit Symbol Substitution Test and the Trail Making Test B among women with low levels of physical activity but not among women with high levels of physical activity. CONCLUSIONS: Our findings suggest that greater levels of physical activity may attenuate the negative impact of poor sleep on executive function in older women, with the clearest effects observed using direct measurements of sleep and physical activity.

Experimenting with cigarettes and physical activity among Mexican origin youth: a cross sectional analysis of the interdependent associations among sensation seeking, acculturation, and gender.

BACKGROUND: Sensation seeking tendencies tend to manifest during adolescence and are associated with both health-compromising behaviors and health-enhancing behaviors. The purpose of this study is to evaluate the relationship between sensation seeking and physical activity, a health-enhancing behavior, and between sensation seeking and experimenting with cigarettes, a health compromising-behavior, among a cohort of Mexican origin adolescents residing in the United States with different levels of acculturation. METHODS: In 2009, 1,154 Mexican origin youth (50.5% girls, mean age 14.3 years (SD = 1.04)) provided data on smoking behavior, physical activity, linguistic acculturation, and sensation seeking. We conducted Pearson's χ2 tests to examine the associations between categorical demographic characteristics (i.e. gender, age, country of birth and parental educational attainment) and both cigarette experimentation and physical activity and Student's t-tests to examine mean differences on the continuous variables (i.e. sensation seeking subscale) by the behaviors. We examined mean differences in the demographic characteristics, acculturation, and both behaviors for each of the sensation seeking subscales using analysis of variance (ANOVA). To examine relationships between the sensation seeking subscales, gender, and both behaviors, at different levels of acculturation we completed unconditional logistic regression analyses stratified by level of acculturation. RESULTS: Overall, 23.3% had experimented with cigarettes and 29.0% reported being physically active for at least 60 minutes/day on at least 5 days/week. Experimenting with cigarettes and being physically active were more prevalent among boys than girls. Among girls, higher levels of sensation seeking tendencies were associated with higher levels of acculturation and experimentation with cigarettes, but not with physical activity. Among boys, higher levels of sensation seeking tendencies were associated with higher levels of acculturation, experimenting with cigarettes and being physically active. CONCLUSIONS: Our results suggest that interventions designed to prevent smoking among Mexican origin youth may need to address social aspects associated with acculturation, paying close attention to gendered manifestations of sensation seeking.

The relationship between media use and psychological and physical assets among third- to fifth-grade girls.

BACKGROUND: Media use is associated with an increased risk of chronic disease and reduced quality of life among children. This study examined the relationship between media use during discretionary hours after school and psychological and physical assets among preadolescent girls. METHODS: A cross-sectional analysis was conducted using data from a larger quasi-experimental evaluation of a positive youth development program through sport for third- to fifth-grade girls. Indicators of media use were the number of hours per school day spent watching television and videos and using computers. Psychological assets included global self-esteem, body size satisfaction, and commitment to physical activity; physical assets included physical activity. Nested random effects analysis of variance (ANOVA) models were used to examine the relationship between media use and psychological and physical assets controlling for relevant confounding factors. RESULTS: The analytic sample included 1027 participants; most were ≥10 years old, non-White; 27% self-reported ≥4 hours of media use on school days. In adjusted results, media use was inversely associated with self-esteem (p = .008) and commitment to physical activity (p < .001). Time spent using media was not associated with body size satisfaction or physical activity in this age group. CONCLUSIONS: Media use was negatively associated with self-esteem and commitment to physical activity. It may be useful for school professionals to encourage after-school programs that offer opportunities for girls to reduce sedentary pursuits and improve important psychological and physical assets.