Masculinity, optimism bias, and perceived pressure from stakeholders influence on student-athlete concussion reporting intentions and behavior.

Objective: Determine how a) masculinity, b) optimism bias, and c) perceived pressure from stakeholders predict concussion reporting intentions and behavior. Participants: Collegiate student-athletes (n = 369). Methods: Student-athletes completed surveys of Conformity to Masculine Norms Inventory-46 (nine sections), optimism bias (optimist, neutral, pessimist), perceived pressure from stakeholders (six stakeholder sections), reporting intentions (symptom and concussion), and behavior (symptom and concussion). Four separate stepwise multivariate regression analyses were conducted. Results: A one-point increase in playboy, heterosexual self-preservation, being neutral or optimist compared to a pessimist symptom reporting intention decreased. A one-point increase in sport primacy, perceived pressure from athletic administration, being neutral or optimist compared to pessimist concussion reporting intentions increased 0.05, and decreased 0.23, 0.35, and 0.32, respectively. A one-point increase in violence and playboy increased the odds of being a "non-reporter" by 30% and 40%. Conclusions: Pessimistic views regarding concussion risks may result in greater concussion reporting intentions, however these findings did not influence behavior.

Stair walking effects on feelings of energy and fatigue: Is 4-min enough for benefits?

Purpose: Even low intensity exercise bouts of at least 15 min can improve feelings of energy (FOE) and reduce systolic blood pressure. However, little is known about the psychological outcomes of briefer exercise bouts, particularly for modes of exercise that are more intense than level walking, and readily available to many working adults. This study assessed the effects of a 4-min bout of stair walking on FOE and feelings of fatigue (FOF). Methods: Thirty-six young adult participants were randomized to either stair walking or seated control groups. All participants walked on level-ground from a laboratory to a nearby stairwell (~90 s) and were seated for 4 min before beginning their experimental condition. Stair-walking participants walked up and down one flight of 16 stairs at their own pace for 4 min, while control participants remained seated during that time. Participants walked back to the laboratory for post-condition assessments. Measures of blood pressure, heart rate, rated perceived exertion (RPE), and the intensity of feelings of mental energy, mental fatigue, physical energy, and physical fatigue were assessed pre-and post-condition. Separate one-way ANOVAs were conducted on change scores for all variables. Results: The stair climbing group experienced significant increases in heart rate [F(1,34) = 13.167, p < 0.001] and RPE [F(1,34) = 93.844, p < 0.001] that were not observed in the seated control group. Four minutes of self-paced stair climbing resulted in small changes and non-significant differences within and between groups in blood pressure as well as FOE and FOF. Conclusion: Although a 4-min self-paced exercise bout can convey short-term physiological health benefits, a 4-min bout of self-paced indoor stair walking in a stairwell was insufficient to lower blood pressure or change subjective FOE and fatigue in a sample that exhibited better than typical FOE and FOF at the pre-test.

Psychological Aspects of Stair Use: A Systematic Review.

Stair use, a common lifestyle activity, is a moderate-to-vigorous physical activity that, despite often being brief in duration, may contribute to psychological health. A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) method to summarize psychological aspects related to stair use. Included studies examined at least 1 psychological outcome in relation to either objective measures of stair use, such as time or stair height, or subjective measures of, or measures related to, stair use such as perceived difficulty using stairs. A total of 22 studies met the inclusion criteria; 12 used subjective stair use measures and 10 used objective stair use measures. The limited evidence from studies using self-reports supported that (1) perceived difficulty using stairs was positively associated with increased symptoms of anxiety and depression and (2) stair use was not associated with a reduced incidence of mental illnesses such as depression, suicide, or dementia. Studies using objective measures of stair use supported that (3) elevated symptoms of anxiety and depression are negatively associated with stair use performance. Given the widespread use of stairs, there is surprisingly little data about the extent to which, and for whom, stair use influences psychological health.

Investigation of Eating Disorder Risk and Body Image Dissatisfaction among Female Competitive Cheerleaders.

Social agents associated with cheerleading environments are increasingly linked to body image dissatisfaction (BID) and eating disorders (ED). This study examined ED risk across team type, squad type, and position. An additional purpose determined BID in clothing type (daily clothing, midriff uniform, and full uniform), and meta-perceptions from the perspective of peers (MP peers), parents (MP parents), and coaches (MP coaches). Female cheerleaders (n = 268) completed an online survey which included demographics, the Eating Attitudes Test-26, and pathogenic behavior questions. Body image perceptions were assessed by using the Sex-Specific Figural Stimuli Silhouettes. Overall, 34.4% of cheerleaders (n = 268; mean age: 17.9 ± 2.7 years) exhibited an ED risk. Compared to All-Star cheerleaders, college cheerleaders demonstrated significant higher ED risk (p = 0.021), dieting subscale scores (p = 0.045), and laxative, diet pill, and diuretic use (p = 0.008). Co-ed teams compared to all-girl teams revealed higher means for the total EAT-26 (p = 0.018) and oral control subscale (p = 0.002). The BID in clothing type revealed that cheerleaders wanted to be the smallest in the midriff option (p < 0.0001, η2 = 0.332). The BID from meta-perception revealed that cheerleaders felt that their coaches wanted them to be the smallest (p < 0.001, η2 = 0.106). Cheerleaders are at risk for EDs and BID at any level. Regarding the midriff uniform, MP from the perspective of coaches showed the greatest difference between perceived and desired body image.

Examination of the Prevalence of Female Athlete Triad Components among Competitive Cheerleaders.

The purpose of this study was to examine individual and combined Female Athlete Triad components within collegiate cheerleaders, an at-risk group. Cheerleaders (n = 19; age: 20.3 ± 1.2 years) completed anthropometric measurements, health history questionnaires, resting metabolic rate, the eating disorder inventory-3 and symptom checklist, blood sample, and DXA scan. Participants completed dietary and exercise logs for 7 days and used heart rate monitors to track daily and exercise energy expenditure. Proportions were calculated for low energy availability (LEA) risk, disordered eating risk, and pathogenic behaviors. Chi-square analysis was used to determine the difference between cheerleaders who experience low EA with or without disordered eating risk. All cheerleaders demonstrated LEA for the days they participated in cheerleading practice, 52.6% demonstrated LEA with eating disorder risk and 47.4% demonstrated LEA without eating disorder risk, 52.6% self-reported menstrual dysfunction, 14% experienced menstrual dysfunction via hormonal assessment, and 0% demonstrated low bone mineral density. Overall, 47.7% presented with one Triad component, 52.6% demonstrated two Triad components using self-reported menstrual data, and 10.5% demonstrated two Triad components using hormonal assessments. All cheerleaders displayed LEA. These findings support the need for increased education on the individual components of the Triad and their potential consequences by qualified personal.

Associations Between Occupational and Leisure-Time Physical Activity With Employee Stress, Burnout and Well-Being Among Healthcare Industry Workers.

PURPOSE: Examine the associations of occupational and leisure-time physical activity with job stress, burnout, and well-being among healthcare industry workers. DESIGN: Quantitative; cross-sectional. SETTING: Healthcare Industry. SAMPLE: US Amazon Mechanical Turk participants (n = 550) employed in the healthcare industry, worked 35 hours or more per week, had ≥ 1 supervisor and ≥ 1 co-worker, and were ≥ 18 years old. MEASURES: Self-reported measures of occupational physical activity (OPA) and leisure-time physical activity (LTPA), employee well-being, job stress, and burnout operationalized as exhaustion and disengagement. ANALYSIS: Associations between OPA and LTPA with employee well-being, job stress, exhaustion and disengagement were assessed with separate multiple linear regression models. RESULTS: OPA had positive significant associations with job stress (ß = 0.10, P value = .003) and exhaustion (ß = 0.21, P value < .0001). No significant associations were found between OPA with other psychological outcomes. A significant inverse association was found between LTPA and exhaustion (ß = -0.04, P value = .007). CONCLUSION: In a sample of U.S. health care workers, and consistent with prior epidemiological studies, greater LTPA was associated with lower feelings of exhaustion. In contrast, health care workers with greater OPA reported higher perceptions of job stress and exhaustion. The findings underscore the need for more research aimed at understanding relationships between OPA and psychological health among healthcare workers.

Novel use of radio frequency identification (RFID) provides a valid measure of indoor stair-based physical activity.

This study sought to test the validity of radio frequency identification (RFID) technology to measure indoor stair walking. RFID and Bluetooth sensors (accelerometers with the proximity function) were placed at landings across three floors within a stairwell. Participants (n = 29) were randomized to stair walking or sedentary control and concomitantly wore RFID tags at the hip, chest and neck. An accelerometer worn at the hip captured criterion physical activity data. RFID devices detected sedentary control and stair walking participants (mean RFID detections: 15.50, 47.33 respectively). Neck lanyard RFID tags were detected most frequently. RFID correctly classified all participants in both groups. RFID-based energy expenditure estimates were strongly correlated with accelerometer estimates (r = 0.78-0.94). Percent agreement for floor detection between the Bluetooth and RFID readers (38.6%) was consistent with known limitations of Bluetooth proximity sensing. It is concluded that, during self-paced stair walking in young adults, RFID devices provide valid data on participant movement and estimated energy expenditure.

A Qualitative Analysis of Concussion-Reporting Behavior in Collegiate Student-Athletes With a History of Sport-Related Concussion.

CONTEXT: Many survey-based methods have been used to explore concussion-reporting behavior. However, because the decision to report or conceal a concussion is likely multifactorial, this may narrow the findings, as the surveys were largely designed by the researchers. OBJECTIVE: To explore student-athletes' perspectives regarding factors that may influence the reporting of sport-related concussion. DESIGN: Qualitative study. SETTING: National Collegiate Athletic Association Division I athletics. PATIENTS OR OTHER PARTICIPANTS: We conducted 17 semistructured interviews with student-athletes who had sustained 1 or more concussions while attending a large university (men = 4, women = 13, age = 20.9 ± 1.3 years). DATA COLLECTION AND ANALYSIS: After data saturation and member checks, a 5-cycle analytic process was completed: topical review, literature review, data collection and summarizing using a codebook developed by a 3-person research team, linking of findings to current research, and final interpretations. RESULTS: We discovered 3 themes. Participants discussed concussion perceptions by describing their understanding of a concussion, their own injury experiences, and their perceptions of symptom severity and duration. Regarding reporting behavior, participants described an order of individuals with whom they would speak, symptoms present in order to report (eg, feeling different from normal), immediate reactions, and influential factors for mitigating short- and long-term consequences. Lastly, participants discussed the value of support systems, such as how coaches can both positively and negatively influence reporting and athletic trainer involvement. CONCLUSIONS: Participants often drew from their own concussion experiences in naming common concussion signs and symptoms. Additionally, they indicated that both short- and long-term health consequences influenced and deterred their seeking care and that their support systems, including coaches and athletic trainers, played a role in their concussion experience. Research is needed to determine if using student-athletes' own words to describe a concussion and incorporating student-athletes' support systems, especially coaches and athletic trainers, is effective in increasing concussion reporting.

Differences in Work and Non-Work Support Associations With Job Stress, Burnout, and Well-Being Between Types of Healthcare Workers.

OBJECTIVE: To determine associations between work and non-work supports with employee well-being, job stress, and burnout among direct and non-direct care healthcare workers. METHODS: Cross-sectional data were collected from 550 full-time (≥ 35 h/wk), US Amazon Mechanical Turk workers (≥ 18 years of age) in the healthcare industry, had at least one supervisor, and at least one coworker. Canonical correlational analysis assessed the shared variance of organizational, supervisor, coworker, and family/friend support on employee outcomes. RESULTS: Non-direct care support workers indicated a significantly stronger association between work supports and employee outcomes than family/friend supports. Direct care support workers had significant support from both work and non-work sources of support. CONCLUSION: Workplace supports are important resources for healthcare workers responsible for ensuring patient care and safety. Workplace interventions may tailor interventions to encourage types of support for subgroups within the healthcare industry.

An evaluation of lipid profile and pro-inflammatory cytokines as determinants of cardiovascular disease in those with diabetes: a study on a Mexican American cohort.

Sedentary life styles coupled with high-calorie diets and unhealthy social habits such as smoking, have put an ever-increasing number of people at risk of cardiovascular disorders (CVD), worldwide. A concomitant increase in the prevalence of type 2-diabetes (hyperglycemia), a risk factor for CVD, has further contributed towards escalating CVD-related mortalities. The increase in number of cases of type 2-diabetes underscores the importance of early diagnosis of cardiovascular disease in those with diabetes. In this work, we have evaluated the sensitivity and specificity of dyslipidemia and proinflammatory cytokines to be used as biomarkers for predicting the risk of CVD in those with diabetes. We hypothesize that interplay between dyslipidemia and diabetes-induced low-grade inflammation in those with type 2-diabetes increases the risk of CVD. A total of 215 participants were randomly recruited from the Cameron County Hispanic Cohort (CCHC). Of these, 99% were Mexican Americans living on Texas-Mexico border. Levels of cytokines, adipokines and lipid profile were measured. Cardiovascular disease (CVD) for this study was defined as prior diagnosis of heart attack, angina and stroke, while diabetes was defined by fasting blood glucose (FBG) of > 100 mg/dL and HbA1c of > 6.5, in accordance with American Diabetes Association (ADA) guidelines. Depending on type and distribution of data, various statistical tests were performed. Our results demonstrated higher rates of heart attack (14% vs 11.8%) and stroke (19.8% vs 10%) in those with diabetes as compared to non-diabetes. The odds of having a heart attack were eight times higher in the presence of elevated triglycerides and pro-inflammatory markers (TNFα and IL6) as compared to presence of pro-inflammatory markers only. The odds for heart attack among those with diabetes, increased by 20 fold in presence of high levels of triglycerides, TNFα, and IL6 when coupled with low levels of high-density lipid cholesterol (HDL-C). Lastly, our analysis showed that poorly controlled diabetes, characterized by HbA1c values of > 6.5 increases the odds of stroke by more than three fold. The study quantifies the role of lipid profile and pro-inflammatory markers in combination with standard risk factors towards predicting the risk of CVD in those with type 2-diabetes. The findings from the study can be directly translated for use in early diagnosis of heart disease and guiding interventions leading to a reduction in CVD-associated mortality in those with type 2-diabetes.

Using the health belief model to predict concussion-reporting intentions and behaviour.

PURPOSE: To determine whether Health Belief Model (HBM) factors predict concussion-reporting intentions and behaviour. Methods: Participants completed a cross-sectional survey to measure the HBM constructs of concussion knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action. We also asked participants to indicate their concussion-reporting intentions and behaviourfor symptom and concussion reporting. Four separate multivariable regressions were conducted to predict concussion-reporting intentions and behaviour based on HBM constructs. Results: Cues to action (ß = 0.25, p= .016) predicted symptom reporting intentions (F7,318 = 4.44, p< .001, R2 = 0.089), while perceived benefits (ß = 0.12, p= .018), perceived barriers (ß = -0.11, p= .034) and cues to action (ß = 0.29, p< .001) predicted concussion-reporting intentions (F7,318 = 11.34, p < .001, R2 = 0.200). The HBM did not predict symptom or concussion-reporting behavior (symptom: Χ2 = 5.51, p= .138, Nagelkerke R2 = 0.096; concussion: Χ2 = 5.20, p= .157, Nagelkerke R2 = 0.159). Conclusions: Strategies to reduce perceived barriers and increase benefits of reporting concussion symptoms may improve reporting intentions. This may include cues to action in sharing a positive view toward long-term health and dispelling that reporting a concussion would let down teammates. .

Associations Between Office Location and Adiposity in Office Workers.

OBJECTIVE: Evaluate whether having to walk longer distances to common destinations within office buildings is associated with less adiposity and greater occupational physical activity. METHODS: Distances between offices and amenities were measured for 108 office-based workers, as was body fat percentage, waist circumference, number of sedentary breaks at work, and duration and intensity of activity at work. RESULTS: Being further away from the building entrance was correlated with lower body fat percentage. Greater distance from a participant's office to the copier was associated with smaller waist circumferences. Correlations were found between distance to the bathroom and work activity, and sedentary breaks with distance to the break room and distance from the printer or copier. CONCLUSIONS: Worksites interested in improving the health of their employees should consider how building design affects occupational physical activity and health.

A Mixed-Methods Approach to Understanding the Palliative Needs of Parkinson's Patients.

Parkinson's disease (PD) is the second-most common age-related neurodegenerative disorder. Despite recommendations for a palliative approach, little is known about what palliative needs are unmet by standard care. This study aims to (a) identify palliative needs of PD patients, (b) determine the relationship between palliative needs and health-related quality of life (HRQoL), and (c) probe into factors affecting HRQoL. PD patients and neurologists were recruited for a survey on palliative need; a subset of patients was interviewed. Significant differences between physicians and patients were found in Physical, Psychological, Social, Financial, and Spiritual domains. Physical and Psychological needs predicted HRQoL. Primary themes across interviews included (a) lack of healthcare education and (b) need for care coordination. Secondary themes included (a) the importance of support groups, (b) the role of spirituality/religion, and (c) the narrow perceived role of the neurologist. Findings highlight the importance of coordinated individualized care.

Role of Organizational Support on Implementation of an Environmental Change Intervention to Improve Child Fruit and Vegetable Intake: a Randomized Cross-Over Design.

Little is known about the role of organizational or administrative support in implementation of health promotion interventions, particularly outside of school settings. The purpose was to determine the change in fruit and vegetable (FV) intake among children living in residential children's homes (RCHs) and assess the relationships among change in organizational support, intervention implementation, and child nutrition outcomes. Data were collected from 29 RCHs and 614 children living in RCHs, as part of a group randomized design with delayed intervention, at three cross-sectional waves: 2004, 2006, and 2008. RCH staff made environmental changes to increase intake of FV. Implementation and organizational support data were collected from staff at the RCHs. Child FV intake were measured via 24-h dietary recalls. A two-way (condition by time) repeated measures ANOVA was conducted to test whether FV intake increased in response to the intervention. A two-level path analysis with a robust maximum likelihood estimator was used to explore the relationships among organizational support, intervention implementation fidelity, and child FV intake. There was a significant increase in FV intake within all RCHs from 2004 to 2006 (P = 0.022 for the intervention group, P = 0.015 for the control group). This increase was maintained in both groups from 2006 to 2008 (post-intervention mean servings: intervention = 3.2 vs control = 3.4). Increases in organizational support resulted in greater overall implementation fidelity. When RCH staff, supervisors, and the RCH CEO were perceived to be supportive of the intervention, more environmental changes were made to encourage eating FV. Fostering organizational support may improve implementation of interventions.

Body image and weight management among Hispanic American adolescents: Differences by sport type.

BACKGROUND: Adolescents' body image concerns vary by sex, ages, and participation in different types of sports. Little is known about variability of body image and weight management behaviors by sport type in Hispanic American adolescents. This study examined whether body image distortion and dissatisfaction are associated with weight management behaviors by sex and sport type in Hispanic adolescents. METHODS: A sample of 728 Hispanic participants from the United States (61.6% female, Mage = 12.36 ±â€¯2.35) completed the Stunkard Figural Stimuli, reported weight management behaviors and sport participation. Sports were classified as non-aesthetic (such as soccer), aesthetic (such as cheerleading), or non-sport participation. Separate multiple linear regression and multinomial logistic regression models were conducted to test adjusted associations between body image dissatisfaction and distortion, and sport type with weight management behaviors. RESULTS AND CONCLUSIONS: Participants in non-aesthetic sports (51.2% male) were more dissatisfied with their body image (want to be bigger; B = -0.17; p = .01) and were 1.5 times more likely to use exercise to lose weight than non-sport participants. Greater body image dissatisfaction increased the likelihood of weight management behaviors. As year in school increased, participants perceived themselves as smaller than their actual BMI and wanted to be smaller. Hispanic females exhibited similar trends to other ethnicities. However, Hispanic males may have interpreted a desire to be "smaller" as a more lean, muscular physique. Subsequent studies should focus on reasons for weight management, and whether those behaviors are healthy.

Relationship between Meditation and Waking Salivary Cortisol Secretion among Long-Term MBSR Instructors.

BACKGROUND: A potential relationship between long-term meditation practice and stress reduction remains virtually unexplored. The purpose of this study was to characterize stress using salivary waking cortisol in a group of long-term meditators with training in the Mindfulness-Based Stress Reduction (MBSR) program. MATERIALS AND METHODS: Four salivary cortisol samples were collected from meditators (n = 84) during the first hour of awakening. The waking cortisol rhythm was summarized using cortisol area under the curve (AUC) with respect to increased secretion above baseline (AUCI) and cortisol AUC above ground (above zero, AUCG); data on meditation duration and depth, perceived stress, and other covariates were collected via self-reported questionnaire. RESULTS: Individuals in the highest quartile of years meditating (> 26 years) had statistically significantly elevated AUCG values (p = 0.01) as compared to individuals in the lowest quartile of years meditating (≤10 years). This relationship was more pronounced among individuals waking at or before 6: 30 a.m. CONCLUSIONS: Overall, an increasing number of years of meditation practice was related to a higher waking cortisol response. These intriguing findings warrant additional exploration, as the stress response can be complex.

Mortality Risk Reductions for Replacing Sedentary Time With Physical Activities.

INTRODUCTION: Excess sitting is a risk factor for early mortality. This may be resulting, at least in part, from the displacement of physical activity with sedentary behaviors. The purpose of this observational study was to examine the mortality risk reductions associated with replacing 30minutes/day sitting for an equivalent duration of light or moderate to vigorous physical activity (MVPA). METHODS: Participants included 37,924 men and 54,617 women in the Cancer Prevention Study-II Nutrition Cohort, of which 14,415 men and 13,358 women died during follow-up (1999-2014). An isotemporal substitution approach to the Cox proportional hazards regression model was used to estimate adjusted hazard ratios and 95% CIs for mortality associated with the substitution of 30minutes/day self-reported sitting for light physical activity or MVPA. Analyses were conducted in 2018. RESULTS: Among the least active participants (≤17minutes/day MVPA), the replacement of 30minutes/day sitting with light physical activity was associated with a 14% mortality risk reduction (hazard ratio=0.86, 95% CI=0.81, 0.89) and replacement with MVPA was associated with a 45% mortality risk reduction (hazard ratio=0.55, 95% CI=0.47, 0.62). Similar associations were seen among moderately active participants (light physical activity replacement, hazard ratio=0.94, 95% CI=0.91, 0.97; MVPA replacement, hazard ratio=0.83, 95% CI=0.76, 0.88). However, for the most active (MVPA >38 minutes/day), substitution of sitting time with light physical activity or MVPA was not associated with a reduction in mortality risk (hazard ratio=1.00, 95% CI=0.97, 1.03, and hazard ratio=0.99, 95% CI=0.95, 1.02, respectively). CONCLUSIONS: These findings suggest that the replacement of modest amounts of sitting time with even light physical activity may have the potential to reduce the risk of premature death among less active adults.

Demographic-specific Validity of the Cancer Prevention Study-3 Sedentary Time Survey.

PURPOSE: This study examined the 1-yr test-retest reliability and criterion validity of sedentary time survey items in a subset of participants from a large, nationwide prospective cohort. METHODS: Participants included 423 women and 290 men age 31 to 72 yr in the Cancer Prevention Study-3. Reliability was assessed by computing Spearman correlation coefficients between responses from prestudy and poststudy surveys. Validity was assessed by comparing survey-estimated sedentary time with a latent variable representing true sedentary time estimated from the 7-d diaries, accelerometry, and surveys through the method of triads. Sensitivity analyses were restricted to 566 participants with an average of 14+ h of diary and accelerometer data per day for 7 d per quarter. RESULTS: Reliability estimates for total sitting time were moderate or strong across all demographic strata (Spearman ρ ≥ 0.6), with significant differences by race (P = 0.01). Reliability estimates were strongest for the TV-related sedentary time item (Spearman ρ, 0.74; 95% confidence interval, 0.70-0.77). The overall validity coefficient (VC) for survey-assessed total sedentary time was 0.62 (95% confidence interval, 0.55-0.69), although VC varied by age group and activity level (P < 0.05). However, VC were similar across groups (P < 0.05) when restricting to highly compliant participants in a sensitivity analysis. CONCLUSIONS: The Cancer Prevention Study-3 sedentary behavior questionnaire has acceptable reliability and validity for ranking or categorizing participants according to sedentary time. Acceptable reliability and validity estimates persist across various demographic subgroups.

Occupational Physical Activity Opposes Obesity: A Cross-Sectional Modern Replication of the Morris 1953 London Busmen Study.

OBJECTIVE: Examine the importance of occupational light-intensity physical activity (PA) and short bouts of moderate-vigorous PA (LSBPA), to opposing obesity, including an approximate replication of the London busmen study comparing waist circumference of workers with high versus low levels of occupational activity. METHODS: Working adults wore an accelerometer, completed anthropometric measurements, and provided work schedules. Participants' (n = 435) activity was classified as either occupational or non-occupational minutes, and by intensity. RESULTS: Body fat percentage was inversely associated with occupational-LSBPA in participants who did not meet PA guidelines, but not in those who met guidelines. In the London busmen replication, more active workers had smaller waist circumferences than sedentary workers, controlling for non-occupational activity. CONCLUSIONS: Work-related LSBPA may be an important and under-recognized source of PA that opposes adiposity for people who do not meet PA guidelines.