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Au WW, Leung CK, Lin SH, Yu AP, Fong DY, Wong SH, Chan DK, Capio CM, Yu CC, Wong SW, Chen YJ, Thompson WR, Siu PM. Effects of a physical activity-enhanced curriculum on increasing physical activity and improving physical fitness in preschoolers: Study protocol for a cluster randomized controlled trial (KID-FIT study). J Exerc Sci Fit 2025; 23:122-132. [PMID: 40206326 PMCID: PMC11979518 DOI: 10.1016/j.jesf.2025.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 03/06/2025] [Accepted: 03/12/2025] [Indexed: 04/11/2025] Open
Abstract
Objective Physical activity (PA) is critical for healthy development in preschoolers, with long-lasting benefits that can affect later life. The World Health Organization (WHO) recommends that children aged 5-17 years should engage in 60 min of moderate-to-vigorous PA per day. However, physical inactivity in children is on the rise globally, with declines in PA starting at the age of 4 years. Increasing PA during early childhood is important to delay adiposity rebound, promote behavioral changes, improve physical fitness, and facilitate future PA engagement. However, limited evidence has been established on the effects of school-based PA interventions on preschoolers. This study examines the effects and sustainability of a preschool-based PA intervention on increasing PA, improving physical fitness and health in preschoolers, with the exercise dose benchmarked to the WHO PA guidelines. Methods This assessor-blinded, two-arm cluster randomized controlled trial will include 3300 preschoolers (aged 5-6 years) from 110 kindergartens in Hong Kong, China. Kindergartens will be randomized into intervention and control groups in a 1:1 ratio. The control kindergartens will continue their usual curriculum of ∼2.5 h PA/week, whereas preschoolers in the intervention kindergartens will engage in an additional 75-min game-based PA class twice per week (extra 2.5 h PA/week) over the preschool year. This multi-component intervention will also target parents, teachers, and the kindergarten environment to further encourage PA in preschoolers and their families. Objectively measured PA, cardiorespiratory fitness and other physical fitness components (muscle strength and power, agility, balance, flexibility, body composition), and psychological health will be examined at the start (0 month) and end (10 months) of the preschool year. Maintenance effects will be assessed after preschoolers' transition into primary school (16 months). Generalized estimating equations or other appropriate statistical models will be used to examine the treatment effects with adjustment for baseline values. Study impact This study will investigate the effects of a preschool-based PA intervention with PA dose benchmarked to the WHO recommendations on promoting PA, physical fitness, and health in preschoolers, and its sustainability after preschoolers' transition into primary education. The findings will raise public awareness on the importance of PA in young children, and will inform policy making to facilitate early childhood educational reforms to incorporate adequate PA into preschool curriculums to improve children's health in the long run. Trial registration ClinicalTrials.gov (NCT05521490).
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Affiliation(s)
- Whitney W. Au
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Chit K. Leung
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Shine H. Lin
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Angus P. Yu
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Daniel Y. Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Stephen H.S. Wong
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Derwin K.C. Chan
- Department of Early Childhood Education, Faculty of Education and Human Development, The Education University Hong Kong, Hong Kong, China
| | - Catherine M. Capio
- Department of Physiotherapy, School of Nursing and Health Studies, The Hong Kong Metropolitan University, Hong Kong, China
| | - Clare C.W. Yu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Sam W.S. Wong
- Physical Fitness Association of Hong Kong, China, Hong Kong, China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat Sen University, Guangzhou, China
| | - Walter R. Thompson
- College of Education and Human Development, Georgia State University, USA
| | - Parco M. Siu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Chen S. Economic cost of not meeting the 24-h movement guidelines in china: Research gaps and recommendations. SPORTS MEDICINE AND HEALTH SCIENCE 2025; 7:157-160. [PMID: 39811406 PMCID: PMC11726047 DOI: 10.1016/j.smhs.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/14/2024] [Accepted: 05/20/2024] [Indexed: 01/16/2025] Open
Abstract
It is well-known that not meeting the 24-hours (h) movement guidelines, including insufficient physical activity (PA), excessive sedentary behavior (SB), inadequate sleep duration, and their combinations, are independent risk factors for noncommunicable diseases (NCDs). The prevalence of not meeting the guidelines is high across the world, especially in China where has one of the largest population. Some studies have estimated the economic cost of insufficient PA in China, which is useful to guide policymakers to develop and implement effective health actions. However, several research gaps should be discussed and addressed for better evidence base and decision making. This commentary aims to provide a research insight into gaps and recommendations related to the analysis of economic cost of not meeting the 24-h movement guidelines. Some major research gaps can be indicated, including less research attention on excessive SB and inadequate sleep, limited evidence regarding NCDs associated with not meeting all 24-h movement guidelines considered in economic cost analysis, absence of evidence on estimated cost of not meeting the guidelines, and the adherence to methodological guide. Future research is required to address the gaps to guide effective health policy development in China. We hope that this commentary can play an important role in updating research evidence and advancing policy practice.
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Affiliation(s)
- Sitong Chen
- Institute for Health and Sport, Victoria University, VIC, Australia
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Guan J, Downward P. Government Support, Community Recreation Facilities, and Physical Activity in China: A Cross-Sectional Socioecological Analysis. J Phys Act Health 2025; 22:123-131. [PMID: 39500310 DOI: 10.1123/jpah.2024-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 08/11/2024] [Accepted: 08/20/2024] [Indexed: 12/21/2024]
Abstract
BACKGROUND In the context of rising noncommunicable diseases, Chinese authorities emphasize the need for local governments to provide public sports services to support physical activity (PA). METHODS Employing a socioecological theoretical framework, and drawing on a hierarchical data set synthesized from the China Health and Nutrition Survey, China Stock Market & Accounting Research Database, and Wind Financial Terminal from 2015, a multilevel analysis of the association between provincial government expenditure on culture, sports, and media from 12 provinces, the recreation facilities provided by 287 communities, and PA of n = 10,305 individuals is performed. The number of, and time allocated to, PAs undertaken as well as their METs equivalent in relation to World Health Organization guidelines are investigated. RESULTS Controlling for a large set of individual confounders, the results show that community recreation facilities and provincial government expenditure have a significant positive association with PA participation that exceeds health guidelines. CONCLUSIONS The results confirm the importance of government support for sport and the provision of community sport and PA facilities in China. This has implications for public health policy generally including the Western context. It remains, however, that the cultural context of engagement also needs further consideration.
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Affiliation(s)
- Jing Guan
- School of Economics, Beijing Technology and Business University, Beijing, China
| | - Paul Downward
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
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Gong L, Wu T, Zhang L, Lin G, Luo F, Zhang W, Zhong W. The impact of behavioral risks on cardiovascular disease mortality in China between 1990 and 2019. Heliyon 2024; 10:e39706. [PMID: 39524745 PMCID: PMC11550668 DOI: 10.1016/j.heliyon.2024.e39706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 10/21/2024] [Accepted: 10/21/2024] [Indexed: 11/16/2024] Open
Abstract
Aims Behavioral risks including tobacco use, alcohol use, low physical activity and dietary risks had been proven to contribute to the pathological process in cardiovascular diseases (CVD). Herein the lethal effects attributable to behavioral risks on CVD in China were investigated. Methods Data were obtained from the Global Burden of Disease Study 2019. Joinpoint regression analyses and age-period-cohort models were applied. Results In China, the total number of CVD deaths attributable to tobacco use, alcohol use, low physical activity and dietary risks in 2019 was 0.98, 0.19, 0.13 and 1.76 million, with an age-standardized rate of 51.2, 9.9, 8.9 and 101.9 per 100 000 people, respectively. Joinpoint analyses suggested a general favorable trend in age-standardized rate of attributable CVD mortality for tobacco use (average annual percent change [AAPC]: -0.9 %, P < 0.001), alcohol use (AAPC: -0.8 %, P < 0.001) and dietary risks (AAPC: -1.3 %, P < 0.001), but unchanged trend for low physical activity (AAPC: 0.2 %, P = 0.525) since 1990. Period effects suggested an improvement in attributable CVD mortality rate across the study period for alcohol use and dietary risks, but more favorable period trends were observed over the past 15 years for tobacco use and before the period 2000-2004 for low physical activity. The patterns for cohort effects differed markedly between men and women. In women, cohort effects revealed an inverted hook-shaped pattern for all these behavioral risks, with the highest risk in cohort born around 1915. In men, the improvement was mainly observed in cohorts born before 1980 for tobacco use and dietary risks, in cohorts born before 1965 for alcohol use, and in cohorts born between 1925 and 1955 for low physical activity. Conclusion Behavioral risks, especially the dietary risks, brought out huge burden of CVD in China, and their trajectories differed along with time and genders. Much more priorities should be established to ameliorate the impact of behavioral risks on CVD in China.
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Affiliation(s)
- Li Gong
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Tingting Wu
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Lei Zhang
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Guoqiang Lin
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Fanyan Luo
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Weiru Zhang
- Department of General Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Wen Zhong
- Department of General Medicine, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Jarnig G, Kerbl R, van Poppel MNM. Reliability, Objectivity, Validity, and Reference Levels of the Austrian Pole Climbing Test (APCT)-A Novel Monitoring Tool for Assessing General Fitness in Children, Adolescents, and Young Adults. Sports (Basel) 2024; 12:258. [PMID: 39330735 PMCID: PMC11435566 DOI: 10.3390/sports12090258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 09/10/2024] [Accepted: 09/13/2024] [Indexed: 09/28/2024] Open
Abstract
Climbing is an activity involving many major muscle groups and, therefore, it is suitable for assessing general physical fitness. The Austrian pole climbing test (APCT) was developed as a reliable and valid test for the assessment of general fitness levels in children, adolescents, and young adults. In this cross-sectional pilot study, 677 participants (aged 6 to 19 years) were assessed via the APCT. Subsequently, test quality criteria (reliability and objectivity) were assessed, and the test's validity was evaluated through comparisons with other established fitness tests (hand grip strength, standing long jump, and pull- and push-ups). Additionally, age- and gender-specific reference values were generated. The reliability (ICC2.1 = 0.97, 95%CI 0.95 to 0.98) and objectivity (ICC2.1 = 0.99, 95%CI 0.99 to 0.99) of the APCT were found to be excellent. The APCT results correlated strongly with the hand strength per kilogram of body weight (right: r = 0.58; left: r = 0.53), number of pull-ups (with upper grip: r = 0.74; with lower grip: r = 0.69) and standing long jump (r = 0.61); a moderate correlation with the push-up test was observed (r = 0.44). The APCT is reliable, objective, and suitable for children, adolescents, and young adults with an affinity for sports. It offers a novel opportunity to assess fitness without time pressure, considering the anthropometric requirements.
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Affiliation(s)
- Gerald Jarnig
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Reinhold Kerbl
- Department of Pediatrics and Adolescent Medicine, LKH Hochsteiermark, 8700 Leoben, Austria
| | - Mireille N M van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
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Yan X, Han F, Wang H, Li Z, Kawachi I, Li X. Years of life lost due to insufficient sleep and associated economic burden in China from 2010-18. J Glob Health 2024; 14:04076. [PMID: 38574358 PMCID: PMC10994670 DOI: 10.7189/jogh.14.04076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
Background Research on the health and economic costs due to insufficient sleep remains scant in developing countries. In this study we aimed to estimate the years of life lost (YLLs) due to short sleep and quantify its economic burden in China. Methods We estimated both individual and aggregate YLLs due to short sleep (ie, ≤6 hours) among Chinese adults aged 20 years or older by sex and five-year age groups in 2010, 2014, and 2018. YLL estimates were derived from 1) the prevalence of short sleep using three survey waves of the China Family Panel Studies, 2) relative mortality risks from meta-analyses, and 3) life tables in China. YLL was the difference between the estimated life expectancy of an individual in the short sleep category vs in the recommended sleep category. We estimated the economic cost using the human capital approach. Results The sample sizes of the three survey waves were 31 393, 31 207, and 28 618. Younger age groups and men had more YLLs due to short sleep compared to their counterparts. For individuals aged 20-24, men had an average YLL of nearly 0.95, in contrast to the approximate 0.75 in women across the observed years of 2010, 2014, and 2018. The trend in individual YLLs remained consistent over these years. In aggregate, China experienced a rise from 66.75 million YLLs in 2010 to 95.29 million YLLs in 2014, and to 115.05 million YLLs in 2018. Compared to 2010 (USD 191.83 billion), the associated economic cost in 2014 increased to USD 422.24 billion, and the cost in 2018 more than tripled (USD 628.15 billion). The percentage of cost to Chinese gross domestic product in corresponding years was 3.23, 4.09, and 4.62%. Conclusions Insufficient sleep is associated with substantial YLLs in China, potentially impacting the population's overall life expectancy. The escalating economic toll attributed to short sleep underscores the urgent need for public health interventions to improve sleep health at the population level.
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Affiliation(s)
- Xumeng Yan
- Department of Sociology, Tsinghua University, Beijing, China
- Department of Community Health Sciences, University of California, Los Angeles, California, USA
| | - Fang Han
- Division of Sleep Medicine, Beijing University People’s Hospital, Beijing, China
| | - Haowei Wang
- Department of Sociology and Aging Studies Institute, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, New York, USA
| | - Zhihui Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ichiro Kawachi
- Department of Social and Behavioural Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Xiaoyu Li
- Department of Sociology, Tsinghua University, Beijing, China
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Lei XL, Gao K, Wang H, Chen W, Chen GR, Wen X. The role of physical activity on healthcare utilization in China. BMC Public Health 2023; 23:2378. [PMID: 38037037 PMCID: PMC10691091 DOI: 10.1186/s12889-023-16625-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/26/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Evidence on the role of physical activity (PA) on healthcare utilization and expenditure is limited in China. We aimed to examine the association between the total physical activity (TPA) per week, healthcare service use and expenditure. METHODS We extracted the data from China Health and Retirement Longitudinal Study (CHARLS) 2011, 2013, and 2015. Participants more than 50 years old who completed the follow-up for the three waves were enrolled. We converted the volume of vigorous physical activity (VPA) into an equivalent volume of moderate physical activity (MPA) and calculated the TPA per week for each participant. 12,927 of the 17,708 participants in CHARLS were included in our analysis. More than one-third of participants over 50 years old never participate in any moderate or intensity activity, and the median of self-reported moderate or intensity PA was about 525 (IQR 0-1680) MET-minutes per week in 2015. RESULTS Compared to inactive subjects, the highest level of TPA was significantly related to the decreased risk number of inpatient visits (IRR: 0.58; 95% CI:0.50-0.67, p < 0.001), inpatient hospital days (IRR: 0.60; 95% CI: 0.42-0.84, p < 0.01), healthcare expenditure (IRR: 0.71; 95% CI: 0.65-0.79, p < 0.001) and catastrophic health expenditures (OR: 0.57; 95% CI: 0.45-0.72, p < 0.001) after adjusting for covariates. CONCLUSIONS Engaging in moderate-to-vigorous PA may drive a potential decrease in healthcare utilization, healthcare expenditure and household financial risk with a dose-response relationship in China, and some possible policy implications in public health may be considered to promote exercise in the middle-aged and elderly to reduce the medical burden on individuals and healthcare systems.
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Affiliation(s)
- Xiao-Lin Lei
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Ke Gao
- Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Huan Wang
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Wei Chen
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Gen-Rui Chen
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China.
| | - Xing Wen
- The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu &The Affiliated Hospital of Southwest, Jiaotong University, Chengdu, 610032, China.
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Tan X, Xie H, Wang D. Nutrition and Physical Activity Counseling by General Practitioners in China. Risk Manag Healthc Policy 2023; 16:2151-2162. [PMID: 37868022 PMCID: PMC10588712 DOI: 10.2147/rmhp.s427481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction To reduce unhealthy lifestyles in China, it is critical to implement effective strategies. Counseling provided by physicians is important for assisting patients in improving their lifestyles, and general practitioners (GPs) are the main providers of lifestyle counseling to patients. However, few studies have focused on the lifestyle counseling practices by GPs in China, particularly in regard to nutrition and physical activity. Objective The aims of this study are: (i) to examine the current practice of Chinese GPs in counseling patients regarding nutrition and physical activity; (ii) to understand the common barriers to such counseling by Chinese GPs; and (iii) to study the association between GPs' personal lifestyle choices and their practices in lifestyle counseling. Methods A cross-sectional, self-reported online questionnaire was conducted among GPs in Hunan province, China. A total of 198 GPs completed the questionnaire. Results The majority of GPs provide nutrition and physical activity counseling to less than 40% of their patients, spending less than three minutes per counseling session. The main reported barriers to counseling on nutrition and physical activity are inadequate time and a lack of knowledge or experience. GPs primarily acquire knowledge through medical books and journals, followed by science popularization. Furthermore, GPs who maintain healthier lifestyle habits, possess a better understanding of lifestyle guidelines, conduct longer office visits, and exhibit higher self-efficacy are more likely to provide counseling to patients. Conclusion This study highlights the need for improvement in nutrition and physical activity counseling among Chinese GPs. GPs' personal nutrition and physical activity habits may measurably influence their counseling practice. We recommend that GPs themselves adopt healthier lifestyle habits to potentially improve their counseling practice. Moreover, proactive measures should be taken to assist GPs in overcoming barriers encountered with lifestyle counseling.
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Affiliation(s)
- Xian Tan
- Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
- Institute for Future Sciences, University of South China, Changsha, Hunan, People's Republic of China
| | - Hebin Xie
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People's Republic of China
| | - Danling Wang
- Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
- Institute for Future Sciences, University of South China, Changsha, Hunan, People's Republic of China
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People's Republic of China
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KARI JAANAT, NERG IIRO, HUIKARI SANNA, LEINONEN ANNAMAIJU, NURKKALA MARJUKKA, FARRAHI VAHID, KORPELAINEN RAIJA, KORHONEN MARKO. The Individual-Level Productivity Costs of Physical Inactivity. Med Sci Sports Exerc 2023; 55:255-263. [PMID: 36125340 PMCID: PMC9815811 DOI: 10.1249/mss.0000000000003037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE This study estimated the long-term individual-level productivity costs of physical inactivity. METHODS The data were drawn from the Northern Finland Birth Cohort 1966, to which the productivity cost variables (sick leaves and disability pensions) from Finnish registries were linked. Individuals ( N = 6261) were categorized into physical activity groups based on their level of physical activity, which was measured in three ways: 1) self-reported leisure-time moderate- to vigorous-intensity physical activity (MVPA) at 46 yr old, 2) longitudinal self-reported leisure-time MVPA at 31-46 yr old, and 3) accelerometer-measured overall MVPA at 46 yr old. The human capital approach was applied to calculate the observed costs (years 2012-2020) and the expected costs (years 2012-2031). RESULTS The results showed that the average individual-level productivity costs were higher among physically inactive compared with the costs among physically active. The results were consistent regardless of the measurement type of physical activity or the period used. On average, the observed long-term productivity costs among physically inactive individuals were €1900 higher based on self-reported MVPA, €1800 higher based on longitudinal MVPA, and €4300 higher based on accelerometer-measured MVPA compared with the corresponding productivity costs among physically active individuals. The corresponding difference in the expected costs was €2800, €1200, and €8700, respectively. CONCLUSIONS The results provide evidence that productivity costs differ according to an individual's level of physical activity. Therefore, investments in physical activity may decrease not only the direct healthcare costs but also the indirect productivity costs paid by the employee, the employer, and the government.
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Affiliation(s)
- JAANA T. KARI
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, FINLAND
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, FINLAND
| | - IIRO NERG
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, FINLAND
| | - SANNA HUIKARI
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, FINLAND
| | - ANNA-MAIJU LEINONEN
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, FINLAND
- Center for Life Course Health Research, University of Oulu, Oulu, FINLAND
| | - MARJUKKA NURKKALA
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, FINLAND
- Center for Life Course Health Research, University of Oulu, Oulu, FINLAND
| | - VAHID FARRAHI
- Research Unit of Medical Imaging, Physics, and Technology, University of Oulu, Oulu, FINLAND
- Center for Machine Vision and Signal Analysis, University of Oulu, Oulu, FINLAND
| | - RAIJA KORPELAINEN
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, FINLAND
- Center for Life Course Health Research, University of Oulu, Oulu, FINLAND
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, FINLAND
| | - MARKO KORHONEN
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, FINLAND
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Liu W, Dostdar-Rozbahani A, Tadayon-Zadeh F, Akbarpour-Beni M, Pourkiani M, Sadat-Razavi F, Barfi V, Shahedi V. Insufficient Level of Physical Activity and Its Effect on Health Costs in Low- and Middle-Income Countries. Front Public Health 2022; 10:937196. [PMID: 35832272 PMCID: PMC9271746 DOI: 10.3389/fpubh.2022.937196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 05/30/2022] [Indexed: 12/02/2022] Open
Abstract
Evidence suggests that mortality attributed to noncommunicable diseases (NCDs) will increase from 38 million in 2012 to 52 million by 2030. The recent epidemiological data show that these diseases are increasing in low- and middle-income countries so that about 80% of all deaths of NCDs occurred in low- and middle-income countries. It has been estimated that an insufficient level of physical activity leads to a large share of the burden of these diseases. Evidence suggests that the rate of insufficient levels of physical activity in low- and middle-income countries has increased over the past 15 years. The authorities and policymakers must be advocated with consistent evidence from low- and middle-income countries on productivity loss and increased healthcare costs due to the absence or insufficient levels of physical activity. It is also necessary to include physical activity across all policies to prevent possible escalation of the economic burden related to physical inactivity in the near future.
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Affiliation(s)
- Wei Liu
- Key Research Base of Humanities and Social Sciences in Colleges and Universities in Anhui Province–Quality Education Research Center for College Students of Anhui Xinhua University, Hefei, China
- Department of Physical Education, Anhui Vocational and Technical College of Sports, Hefei, China
| | - Abbas Dostdar-Rozbahani
- Department of Physical Education and Sport Sciences, Parand Branch, Islamic Azad University, Parand, Iran
| | - Fahime Tadayon-Zadeh
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mohsen Akbarpour-Beni
- Department of Sports Sciences, University of Qom, Qom, Iran
- *Correspondence: Mohsen Akbarpour-Beni
| | - Mohammad Pourkiani
- Department of Sport Management, Shahid Beheshti University, Tehran, Iran
| | | | - Vahid Barfi
- Department of Sports Sciences, University of Qom, Qom, Iran
| | - Valiollah Shahedi
- Department of Physical Education and Sport Sciences, Parand Branch, Islamic Azad University, Parand, Iran
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11
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National Fitness Evaluation of Urban Parks in the National Ecological Garden City: A Case Study in Baoji, China. LAND 2022. [DOI: 10.3390/land11060889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Urban parks are important places for residents to engage in physical activity (PA). Properly designed fitness facilities play a positive role in the PA level of park users. We conducted a quantitative evaluation of urban park systems based on the revised Chinese version of ParkScore (RCPS) from the perspective of national fitness. Baoji, one of the first National Ecological Garden Cities (NEGCs), was selected as a case study. We analyzed 19 parks and found that comprehensive parks and sports parks obtained high evaluation scores. The area of fitness facilities in Baoji urban parks was low, with an average of 1.85 hm2 per park. Professional sports venues and multifunctional sports venues each accounted for about one-third and children’s activity venues for about a quarter. There were many national fitness stations, but they covered a small area. Only 16% of parks had fitness trails, which was the least represented type of fitness facility. About 40% of the parks had children’s activity venues, with a 1:2 ratio of PA venue to amusement area. The area of free open venues accounted for only 0.1% of the total area of the parks. The number of parks per capita was about 52% of the overall NEGCs, accessibility of 500 m was 34%, and of 1000 m was about 54%. Overall, we found that the supply of Baoji urban parks was insufficient. These results directly reflect differences among fitness facilities in urban parks and can help form a quantitative basis for the optimization of urban park systems and advance the national fitness plan and promote public health.
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Guan M. Associations of fruit & vegetable intake and physical activity with poor self-rated health among Chinese older adults. BMC Geriatr 2022; 22:10. [PMID: 34979973 PMCID: PMC8722069 DOI: 10.1186/s12877-021-02709-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the existing literature highlights the central roles of sociodemographic factors, fruit & vegetable (F&V) intake, and physical activities for maintaining good health, less is known about the associations in the Chinese context. This study attempted to explore the associations of servings of F&V intake and levels of physical activities with poor self-rated health (SRH) among Chinese older adults. METHODS Data were drawn from the Study on Global Ageing and Adult Health-China (SAGE-China) issued by the World Health Organization and included 7560 respondents aged ≥60 years in China. After screening out the potential confounding factors, multiple logistic regression models were adopted to explore the associations of sociodemographic factors, servings of F&V intake, and levels of physical activities with poor SRH. RESULTS Among the sample, nearly a quarter reported poor health status. There were significant gender differences in the case of servings of F&V intake and levels of physical activities. Logistic regressions indicated that higher fruit intake was associated with lower likelihood of vigorous level of physical activity as compared to zero intake. Likewise, higher vegetable intake (≥10 servings) was associated with a higher likelihood of vigorous & moderate level of physical activity when compared to lower intake (≤ 4 servings). Higher fruit intake was associated with a lower likelihood of poor SRH. Similarly, vegetable intake (5 servings: AOR = 0.69, 95%CI: 0.58-0.83; 6-9 servings: AOR = 0.72, 95%CI: 0.59-0.87) was significantly associated with poor SRH. Additionally, vigorous level of physical activity (AOR = 0.79, 95%CI: 0.65-0.97) and vigorous fitness/leisure (AOR = 0.57, 95%CI: 0.39-0.84) were significantly associated with poor SRH. CONCLUSION This study suggested that older adults with high fruit intake had lower probability of performing vigorous & moderate level of physical activity, while those with high vegetable intake had higher probability of performing vigorous & moderate level of physical activity. Likewise, the older adults with high F&V intake and higher probability of performing vigorous level of physical activity, walk/bike activity, and vigorous/moderate fitness/leisure had less likelihood to face the risk for poor SRH outcomes. The appropriate servings of F&V intake and levels of physical activity should be highlighted.
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Affiliation(s)
- Ming Guan
- Family Issues Center, Xuchang University, Road Bayi 88, Xuchang, Henan, China. .,International Issues Center, Xuchang University, Road Bayi 88, Xuchang, Henan, China. .,School of Business, Xuchang University, Road Bayi 88, Xuchang, Henan, China.
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Zhao Y, He L, Marthias T, Ishida M, Anindya K, Desloge A, D'Souza M, Cao G, Lee JT. Out-Of-Pocket Expenditure Associated with Physical Inactivity, Excessive Weight, and Obesity in China: Quantile Regression Approach. Obes Facts 2022; 15:416-427. [PMID: 35249040 PMCID: PMC9209956 DOI: 10.1159/000522433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/24/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Previous studies exploring associations of physical inactivity, obesity, and out-of-pocket expenditure (OOPE) mainly used traditional linear regression, and little is known about the effect of both physical inactivity and obesity on OOPE across the percentile distribution. This study aims to assess the effects of physical inactivity and obesity on OOPE in China using a quantile regression approach. METHODS Study participants included 10,687 respondents aged 45 years and older from the recent wave of the China Health and Retirement Longitudinal Study in 2015. Linear regression and quantile regression models were used to examine the association of physical activity, body weight with annual OOPE. RESULTS Overall, the proportion of overweight and obesity was 33.2% and 5.8%, respectively. The proportion of individuals performing high-level, moderate-level, and low-level physical activity was 55.2%, 12.7%, and 32.1%, respectively. The effects of low-level physical activity on annual OOPE were small at the bottom quantiles but more pronounced at higher quantiles. Respondents with low-level activity had an increased annual OOPE of 26.9 USD, 150.3 USD, and 1,534.4 USD, at the 10th, 50th, and 90th percentiles, respectively, compared with those with high-level activity. The effects of overweight and obesity on OOPE were also small at the bottom quantiles but more pronounced at higher quantiles. CONCLUSION Interventions that improve the lifestyles and unhealthy behaviors among people with obesity and physical inactivity are likely to yield substantial financial gains for the individual and health systems in China.
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Affiliation(s)
- Yang Zhao
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia,
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China,
| | - Li He
- College of Physical Education and Sport, Beijing Normal University, Beijing, China
| | - Tiara Marthias
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Melbourne, Victoria, Australia
- Department of Public Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Marie Ishida
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Melbourne, Victoria, Australia
| | - Kanya Anindya
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Melbourne, Victoria, Australia
| | - Allissa Desloge
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Melbourne, Victoria, Australia
| | - Monique D'Souza
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Melbourne, Victoria, Australia
| | - Gaofang Cao
- College of Public Health and Management, Binzhou Medical University, Yantai, China
| | - John Tayu Lee
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Melbourne, Victoria, Australia
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
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Chen Y, Wang J, Jing Z, Ordovas JM, Wang J, Shen L. Anti-fatigue and anti-oxidant effects of curcumin supplementation in exhaustive swimming mice via Nrf2/Keap1 signal pathway. Curr Res Food Sci 2022; 5:1148-1157. [PMID: 35875345 PMCID: PMC9304720 DOI: 10.1016/j.crfs.2022.07.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/11/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022] Open
Abstract
Demands for dietary supplements with anti-fatigue effects are growing fast due to increasing societal demands. Moreover, in highly physically active individuals, there are also significant needs for supplements to improve exercise performance. The present study evaluated the potential anti-fatigue and anti-oxidant effects of curcumin in mice using exhaustive swimming test. Male C57BL/6J mice were randomized into six groups: blank control (Rest), swimming control (Con), Vitamin C (Vc), low-dose curcumin (C50), middle-dose curcumin (C100), and high-dose curcumin (C200). After a 4-week intervention, the mice in all groups except the Rest group were subject to an exhaustive swimming test. Then, mice were sacrificed to examine serum biochemical markers and fatigue-related enzymes. Moreover, the gene and protein expressions of signal transduction factors involved in the Nrf2/Keap1 signaling pathway were measured. The results indicated that curcumin significantly enhanced the exercise tolerance of mice in the exhaustive swimming test. Particularly, the swimming time of mice in the C100 group was increased by 273.5% when compared to that of mice in the Con group. The levels of blood urea nitrogen, blood ammonia, lactic acid, creatine kinase and lactate dehydrogenase in the C100 group were decreased by 13.3%, 21.0%, 18.6%, 16.7% and 21.9%, respectively, when compared to those of mice in the Con group. Curcumin alleviated exercise-induced oxidative stress and significantly enhanced the activities of superoxide dismutase, catalase and glutathione peroxidase by activating the Nrf2 signaling. These findings indicated that curcumin supplementation exerted remarkable anti-oxidant and anti-fatigue effects in mice, providing additional evidence supporting the use of curcumin as functional food, especially by those engaged in sports-related activities.
Curcumin exerted remarkable anti-oxidant and anti-fatigue effects in mice. Curcumin can activate anti-oxidant response via Nrf2/Keap1 signaling pathway. Curcumin greatly enhanced the exercise tolerance of mice in exhaustive swimming test. Curcumin alleviated exercise-induced oxidative stress by its anti-oxidant effects. Curcumin can be an anti-fatigue promising candidate improving exercise performance.
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Affiliation(s)
- Yong Chen
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, Zhejiang, China
- School of Food Science and Biotechnology, Zhejiang Gongshang University, Xiasha, Hangzhou, 310018, Zhejiang, China
- Hangzhou Beewords Apiculture Co. Ltd., Hangzhou, China
| | - Jiajun Wang
- Hangzhou Beewords Apiculture Co. Ltd., Hangzhou, China
| | - Ziheng Jing
- Henan ZhongdaHengyuan Biotechnology Co. Ltd., Luohe, China
| | - Jose M. Ordovas
- Human Nutrition Research Center on Aging at Tufts University, Boston, United States
| | - Jing Wang
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, Zhejiang, China
- Ningbo Research Institute, Zhejiang University, Ningbo, Zhejiang, China
- Corresponding author. Ningbo Research Institute, Zhejiang University, Ningbo, 315010, Zhejiang, China.
| | - Lirong Shen
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, Zhejiang, China
- Hangzhou Beewords Apiculture Co. Ltd., Hangzhou, China
- Corresponding author. Department of Food Science and Nutrition, Zhejiang University, 866 Yu-hang-tang Road, Hangzhou, 310058, China.
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Hu R, Hui SSC, Lee EKP, Stoutenberg M, Wong SYS, Yang YJ. Provision of physical activity advice for patients with chronic diseases in Shenzhen, China. BMC Public Health 2021; 21:2143. [PMID: 34814878 PMCID: PMC8611940 DOI: 10.1186/s12889-021-12185-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity (PA) may best be promoted to patients during clinical consultations. Few studies investigated the practice of PA advice given by physicians, especially in China. This study aimed to investigate the prevalence and contents of PA advice given by physicians in China and its association with patients' characteristics. METHODS Face-to-face questionnaire asking the prevalence and contents of PA advice given by physicians was administered to adult patients in three major hospitals in Shenzhen, China. Attitude of compliance, stature, PA level, and socio-demographic information were also collected. Data was analyzed via descriptive statistics and binary logistic regression. RESULTS Of the 454 eligible patients (Age: 47.0 ± 14.4 years), only 19.2% (n = 87) reported receiving PA advice, whereas 21.8%, 23.0%, 32.2%, and 55.2% of patients received advices on PA frequency, duration, intensity, and type, respectively. Male patients were more likely to receive PA advice from physicians [odds ratio (OR): 1.81; 95% confidence interval (CI): 1.08-3.05], whereas patients who were unemployed (OR: 0.16; 95% CI: 0.04-0.67), and who already achieved adequate amount of PA (OR: 0.29; 95% CI: 0.12-0.71) were less likely to receive PA advice. CONCLUSIONS Prevalence of physicians providing physical activity advice to patients is low, there is a pressing need to take intervention measures to educate healthcare providers.
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Affiliation(s)
- Rui Hu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
| | - Stanley Sai-Chuen Hui
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong.
| | - Eric Kam-Pui Lee
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
| | - Mark Stoutenberg
- Department of Kinesiology, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Samuel Yeung-Shan Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
| | - Yi-Jian Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
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Abstract
BACKGROUND Promotion of physical activity (PA) among populations is a global health investment. However, evidence on economic aspects of PA is sparse and scattered in low-income and middle-income countries (LMICs). OBJECTIVE The objective of this study was to summarise the available evidence on economics of PA in LMICs, identify potential target variables for policy and report gaps in the existing economic evidence alongside research recommendations. DATA SOURCES A systematic review of the electronic databases (Scopus, Web of Science and SPORTDiscus) and grey literature. STUDY ELIGIBILITY CRITERIA Cost-of-illness studies, economic evaluations, interventions and descriptive studies on economic factors associated with PA using preset eligibility criteria. STUDY APPRAISAL AND SYNTHESIS OF METHODS Screening, study selection and quality appraisal based on standard checklists performed by two reviewers with consensus of a third reviewer. Descriptive synthesis of data was performed. RESULTS The majority of the studies were from upper-middle-income countries (n=16, 88.8%) and mainly from Brazil (n=9, 50%). Only one economic evaluation study was found. The focus of the reviewed literature spanned the economic burden of physical inactivity (n=4, 22%), relationship between PA and costs (n=6, 46%) and socioeconomic determinants of PA (n=7, 39%). The findings showed a considerable economic burden due to insufficient PA, with LMICs accounting for 75% of disability-adjusted life years (DALYs) globally due to insufficient PA. Socioeconomic correlates of PA were identified, and inverse relationship of PA with the cost of chronic diseases was established. Regular PA along with drug treatment as a treatment scheme for chronic diseases showed advantages with a cost-utility ratio of US$3.21/quality-adjusted life year (QALY) compared with the drug treatment-only group (US$3.92/QALY) by the only economic evaluation conducted in the LMIC, Brazil. LIMITATIONS Meta-analysis was not performed due to heterogeneity of the studies. CONCLUSIONS AND RECOMMENDATIONS Economic evaluation studies for PA promotion interventions/strategies and local research from low-income countries are grossly inadequate. Setting economic research agenda in LMICs ought to be prioritised in those areas. PROSPERO REGISTRATION NUMBER CRD42018099856.
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Affiliation(s)
- Priyanga Diloshini Ranasinghe
- Health Economics Research Group, Division of Global Public Health, Department of Health Sciences, Brunel University London, UB8 3PH, UK
- Ministry of Health, Nutrition, Indegenous Medicine, Colombo 10, Sri Lanka
| | - Subhash Pokhrel
- Health Economics Research Group, Division of Global Public Health, Department of Health Sciences, Brunel University London, UB8 3PH, UK
| | - Nana Kwame Anokye
- Health Economics Research Group, Division of Global Public Health, Department of Health Sciences, Brunel University London, UB8 3PH, UK
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Gomes GAO, Brown WJ, Codogno JS, Mielke GI. Twelve year trajectories of physical activity and health costs in mid-age Australian women. Int J Behav Nutr Phys Act 2020; 17:101. [PMID: 32778110 PMCID: PMC7418418 DOI: 10.1186/s12966-020-01006-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/29/2020] [Indexed: 12/19/2022] Open
Abstract
Background Few studies have examined relationships between physical activity (PA) during mid-age and health costs in women. The aim of this study was to investigate associations between PA levels and trajectories over 12 years with medical and pharmaceutical costs in mid-age Australian women. Methods Data from 6953 participants in the Australian Longitudinal Study on Women’s Health (born in 1946–1951) were analysed in 2019. PA was self-reported in 2001 (50-55y), 2007 (56-61y) and 2013 (62-67y). PA data were linked with 2013–2015 data from the Medicare (MBS) and Pharmaceutical (PBS) Benefits Schemes. Quantile regression was used to examine associations between PA patterns [always active, increasers, decreasers, fluctuaters or always inactive (reference)] with these medical and pharmaceutical costs. Results Among women who were consistently inactive (< 500 MET.minutes/week) in 2001, 2007 and 2013, median MBS and PBS costs (2013 to 2015) were AUD4261 and AUD1850, respectively. Those costs were AUD1728 (95%CI: 443–3013) and AUD578 (95%CI: 426–729) lower among women who were consistently active in 2001, 2007 and 2013 than among those who were always inactive. PBS costs were also lower in women who were active at only one survey (AUD205; 95%CI: 49–360), and in those whose PA increased between 2001 and 2013 (AUD388; 95%CI: 232–545). Conclusion Maintaining ‘active’ PA status was associated with 40% lower MBS and 30% lower PBS costs over three years in Australian women. Helping women to remain active in mid-life could result in considerable savings for both women and the Australian government.
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Affiliation(s)
- Grace A O Gomes
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luiz, s/n, São Carlos, SP, 13565-905, Brazil. .,School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia QLD, Brisbane, Queensland, 4072, Australia.
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia QLD, Brisbane, Queensland, 4072, Australia
| | - Jamile S Codogno
- Department of Physical Education, Presidente Prudente, São Paulo State University, R. Roberto Símonsen, 305 - Centro Educacional, Pres. Prudente, SP, 19060-900, Brazil
| | - Gregore I Mielke
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia QLD, Brisbane, Queensland, 4072, Australia
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Wang K, Wang X. Providing Sports Venues on Mainland China: Implications for Promoting Leisure-Time Physical Activity and National Fitness Policies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145136. [PMID: 32708630 PMCID: PMC7400163 DOI: 10.3390/ijerph17145136] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/12/2020] [Accepted: 07/12/2020] [Indexed: 12/21/2022]
Abstract
Leisure-time physical activity (LTPA) has been well documented as having substantial health benefits. The 2014 Chinese Fitness Survey Report stated that a lack of physical activity (PA) spaces is the most important non-human factor, leading to 10% of leisure-time physical inactivity in people aged 20 and above. We investigated the provision of sports venues in China and discussed the development of sports venues and national fitness policies in the context of promoting LTPA and public health. We analyzed information from China’s most recent sport venue census, the Sixth National Sports Venues Census, conducted in 2013. The number of sports venues increased between 2000 and 2013, with an inflection point around the year 2008. At the end of 2013, there were 12.45 venues for every 10,000 residents, and the per capita area was 1.46 m2. However, numbers were still small compared with the United States and Japan. The percentages of full-time access, part-time access and membership venues were 51.5%, 14.3% and 34.2% respectively. Only half of sports venues were fully open to the public, meaning that the realized number and area per capita could be even lower. A lack of sports venues forces people who want to engage in PA to occupy other urban spaces that are not planned and designed for PA. Urban parks had 119,750 fitness station facilities (3.32% of the total), and 2366 urban fitness trails (19.24%), with a combined length of 6450 km (32.91%). On average, urban and rural areas had 13.17 and 10.80 venues per 10,000 persons, and 1.83 m2 and 0.97 m2 per capita. The urban-rural gap in sports venues exactly embodies some aspects of the “urban-rural dual structure” in China’s society. Measures to promote PA should focus on new and existing sports venues. In the policy making process, Chinese governments need to pay attention to the potential impact of related, external factors such as the gap between the urban and the rural and the potential advantage of indoor venues against summer heat and air pollution.
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Affiliation(s)
- Kai Wang
- College of Landscape Architecture and Arts, Northwest A&F University, Yangling 712100, China;
- Centre for Urban Research, RMIT University, Melbourne, VIC 3001, Australia
- Correspondence: ; Tel.: +86-29-8708-0269
| | - Xuhui Wang
- College of Landscape Architecture and Arts, Northwest A&F University, Yangling 712100, China;
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Bao R, Chen ST, Wang Y, Xu J, Wang L, Zou L, Cai Y. Sedentary Behavior Research in the Chinese Population: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:3576. [PMID: 32443711 PMCID: PMC7277100 DOI: 10.3390/ijerph17103576] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/12/2020] [Accepted: 05/17/2020] [Indexed: 12/11/2022]
Abstract
Background: The negative effects of sedentary behavior (SB) on public health have been extensively documented. A large number of studies have demonstrated that high prevalence of SB is a critical factor of all-cause mortality. Globally, the frequency of SB research has continued to rise, but little is known about SB in the Chinese population. Therefore, this review was conducted to scope the research situation and to fill the gaps related to the effects of SB in the Chinese population. Methods: Using a scoping review based on York methodology, a comprehensive search of published journal articles and grey literature was carried out through 12 databases. The literature research was conducted by two authors in July 2019, and included journal articles that targeted on the Chinese population were published between 1999 and 2019. The two authors screened the records independently and included those research topics related to SB in the Chinese population. Results: The number of included studies increased from 1 to 29 per year during the analyzed period, during which, a remarkable climb happened from 8 in 2013 to 19 in July 2019. Out of the 1303 screened studies, a total of 162 studies (81 English and 81 Chinese journal articles) met the inclusion criteria in this review. Most of the included studies (66.0%) reported the overall estimated prevalence of SB, in which, 43.2% of studies reported the average time of SB, and 40.0% of studies reported the cutoff point of SB. Besides this, 54.9% and 23.5% of studies focused on the outcomes and correlates/determinants of SB, and the proportions of studies based on testing the validation of measurement tools and on interventions were 3.7% and 4.9%, respectively. Nearly all of the reviewed articles used data from cross-sectional studies (75.9%) and longitudinal studies (13.6%), while intervention trials are less developed. The majority of the studies (64.8%) used self-reported surveys, and only 3.7% studies used device-based measurement tools. Furthermore, 35.8% of the included studies were focused on children and adolescents, while only a few studies investigated infants/toddlers and older adults. Both female and male were examined in most studies, and non-clinical populations were investigated in the context of SB in a relatively large number of studies. Conclusions: The number of research articles on SB in the Chinese population published per year has increased year by year, indicating a growing interest in this research area. More studies using population subgroup samples are needed, particularly among infants/toddlers, older adults, and clinical populations. To provide stronger evidence of the determinants and outcomes of SB, longitudinal studies using device-based measures of SB are required.
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Affiliation(s)
- Ran Bao
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China; (R.B.); (J.X.); (L.W.)
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne 3000, Australia;
| | - Yanlei Wang
- Harbin Institute of Physical Education, Harbin 150006, China;
| | - Jun Xu
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China; (R.B.); (J.X.); (L.W.)
| | - Lei Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China; (R.B.); (J.X.); (L.W.)
| | - Liye Zou
- Exercise and Mental Health Laboratory, Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen 518060, China;
| | - Yujun Cai
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China; (R.B.); (J.X.); (L.W.)
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Zou Q, Su C, Du W, Ouyang Y, Wang H, Wang Z, Ding G, Zhang B. The association between physical activity and body fat percentage with adjustment for body mass index among middle-aged adults: China health and nutrition survey in 2015. BMC Public Health 2020; 20:732. [PMID: 32429924 PMCID: PMC7238529 DOI: 10.1186/s12889-020-08832-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/01/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The inverse association between physical activity and body fat percentage (%) varies among different populations. We aim to examine whether the significant association between them was uniform across the subpopulations after taking into account body mass index (BMI). METHODS Our study relied on data from China Health and Nutrition Surveys in 2015, including 5763 participants aged 40-64 years from 15 regions. Physical activity was calculated as metabolic equivalent task hours per day (MET·h/d). Body fat% was measured by bioelectrical impedance analysis. Body mass index < 24 kg/m2 was defined as normal weight and BMI ≥ 24 kg/m2 was overweight/obese. The effects of physical activity on body fat% were estimated using the Kruskal-Wallis test among sex, age, BMI groups, education, income, region and urbanization. Quantile regression analyses were utilized to describe the relationship between physical activity and body fat% distribution. RESULTS Older adults, overweight/obese, higher education, higher income, residents of central China and those living in areas of higher urbanization had the lower physical activity. Participants who engaged in the highest level of physical activity had 2.0 and 1.5% lower body fat% than the lowest level of physical activity group (23.4, 34.8%) for men and women, respectively. There were 10.4 and 8.8% of normal weight males and females called normal weight obese. Overall, 1 h extra 4.5 MET•h/d was significantly associated with 0.079 and 0.110% less total body fat% at the 75th and 90th percentiles in normal weight males, with 0.071% less at the 25th percentiles in overweight/obese males, with 0.046-0.098% less at the 25th to 90th percentiles in normal weight females, and with 0.035-0.037% less from the 50th to 90th percentiles in overweight/obese females. The inverse association between physical activity and total body fat% was stronger in normal weight obese participants than other subgroups. CONCLUSIONS In middle-aged Chinese adults, the inverse association between physical activity and body fat% was only in particular subpopulations rather than the entire population. We should pay much attention to normal weight obese and give a suitable physical activity guideline taking into account people with different body fat%.
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Affiliation(s)
- Qinpei Zou
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
- Chongqing Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Wenwen Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Yifei Ouyang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
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Wang X, Wu C. An Observational Study of Park Attributes and Physical Activity in Neighborhood Parks of Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2080. [PMID: 32245096 PMCID: PMC7143081 DOI: 10.3390/ijerph17062080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 12/20/2022]
Abstract
Evidence shows that neighborhood parks provide opportunities for urban residents to participate in physical activity, but little is known about the space-behavior relationship of physical settings. This study explored the patterns of use in neighborhood parks, and focused particularly on visitors' levels of activity supported by the specific landscape features and attributes. Behavior mapping data, including the users' characteristics, their behaviors and activity levels, and the landscape characteristics, were obtained in three neighborhood parks of Shanghai, China. A total of 6126 park users were documented during the observations, and most of them were involved in sedentary activity. This study found that different environmental settings such as water, plaza, lawn, and architecture supported different types and levels of activity. Although more men than women visited the neighborhood parks, women were more active than men in park-based physical activity. In this Chinese sample, the findings demonstrate behavior mapping is a promising tool to measure park-based physical activity. As this study associated the levels of use with the landscape features, the results are expected to be useful in design practice for promoting regular physical activity.
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Affiliation(s)
- Xinxin Wang
- Department of Landscape Architecture, College of Horticulture, Post-doctoral Research Station in Public Administration, Nanjing Agricultural University, Nanjing 210095, China
| | - Chengzhao Wu
- Department of Landscape Studies, Key Lab of Ecology and Energy Saving in High-density Human Settlements, College of Architecture and Urban Planning, Tongji University, Shanghai 200092, China;
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22
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Zou Q, Wang H, Du W, Su C, Ouyang Y, Wang Z, Ding G, Zhang B. Trends in Leisure-Time Physical Activity Among Chinese Adults - China, 2000-2015. China CDC Wkly 2020; 2:135-139. [PMID: 34594841 PMCID: PMC8392884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 02/12/2020] [Indexed: 11/03/2022] Open
Abstract
What is already known about this topic? The monitoring report on nutrition and health status of Chinese residents from 2010 to 2013 reported that the participation rate of leisure-time physical activity (LTPA) was 13.8% among those 6 years and older. What is added by this report? Among 18 years old and older, the age-standardized LTPA prevalence increased from 7.13% in 2000 to 11.79% in 2011 before dropping to 7.33% in 2015. What are the implications for public health practice? As levels of LTPA participation are low, further research is necessary to develop and test valid interventions to encourage people to take part in more LTPA especially for residents in rural areas and with low-income.
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Affiliation(s)
- Qinpei Zou
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenwen Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yifei Ouyang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,Bing Zhang,
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Aoyagi K, Ishii K, Shibata A, Arai H, Fukamachi H, Oka K. A qualitative investigation of the factors perceived to influence student motivation for school-based extracurricular sports participation in Japan. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2019. [DOI: 10.1080/02673843.2019.1700139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Kenryu Aoyagi
- College of Economics, Kanto Gakuin University , Kanagawa, Japan
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University , Saitama, Japan
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba , Ibaraki, Japan
| | | | - Hanako Fukamachi
- Japan Sport Association, JAPAN SPORT OLYMPIC SQUARE , Tokyo, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University , Saitama, Japan
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24
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The Limits of Cognitive Reappraisal: Changing Pain Valence, but not Persistence, during a Resistance Exercise Task. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193739. [PMID: 31590219 PMCID: PMC6801546 DOI: 10.3390/ijerph16193739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 09/25/2019] [Accepted: 09/30/2019] [Indexed: 11/16/2022]
Abstract
Physiological discomfort is commonly cited as a barrier for initiating and persisting with exercise. Although individuals may think of physiological discomfort as determined by physical sensations, it can also be influenced by cognitive and emotional factors. We explored the impacts of interpreting the purpose of pain as a sign of muscle building (helpful) vs. a sign of muscle tearing and possible injury (harmful) and tested the effect of cognitive reappraisals, or shifting interpretations of pain, on exercise persistence and the subjective experience of discomfort during exercise. Seventy-eight participants were randomized to listen to voice recordings that framed exercise-related pain as helpful vs. harmful before participating in a standard muscular endurance test using the YMCA protocol. Although the two experimental groups did not differ in the overall number of resistance training repetitions achieved, participants who were asked to think about the benefits (rather than the negative consequences) of pain reported less negative pain valence during exercise. Thus, the experience of pain was influenced by appraisals of the meaning of pain, but differences in pain valence did not impact exercise persistence. Theoretical implications and applications for affect-based exercise interventions are discussed.
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de Oliveira Segundo VH, Piuvezam G, de Azevedo KPM, de Medeiros HJ, Leitão JC, Knackfuss MI. Can people self-select an exercise intensity sufficient to enhance muscular strength during weight training?: A systematic review protocol of intervention studies. Medicine (Baltimore) 2019; 98:e17290. [PMID: 31568013 PMCID: PMC6756739 DOI: 10.1097/md.0000000000017290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Previous studies have reported that self-selection of the training intensity can be an interesting strategy to improve adherence in aerobic exercise programs. However, its effectiveness with weight training has not been systematically reviewed and remains unclear. In this study, we will describe a systematic review protocol that aims to investigate if people are able to self-select an intensity during weight training sufficient to enhance muscular strength. METHODS This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. In this study, we will search the following electronic databases: PubMed, Science Direct, Scopus, Web of Science and SPORTDiscus. Intervention studies with at least one weight training session performed at self-selected intensity, with people from both genders and all age ranges will be included. The Downs & Black checklist will be used for methodological quality assessment. Two experienced reviewers will independently perform the selection of studies, data extraction, and evaluation of the methodological quality. CONCLUSION This will be the first systematic review describing the results of weight training intervention studies with self-selected intensity. This study will provide high-quality and reliable evidence for health professionals and may direct methodological recommendations for further studies. PROSPERO REGISTRATION NUMBER CRD42019120323.
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Affiliation(s)
| | - Grasiela Piuvezam
- Department of Public Health, Federal University of Rio Grande do Norte (UFRN), Natal/RN
| | | | | | - José Carlos Leitão
- Center for Research in Sport, Health and Human Development, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Maria Irany Knackfuss
- Department of Physical Education, University of the State of Rio Grande do Norte (UERN), Mossoró/RN, Brazil
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Woodward A, Baumgartner J, Ebi KL, Gao J, Kinney PL, Liu Q. Population health impacts of China's climate change policies. ENVIRONMENTAL RESEARCH 2019; 175:178-185. [PMID: 31129527 DOI: 10.1016/j.envres.2019.05.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/04/2019] [Accepted: 05/14/2019] [Indexed: 06/09/2023]
Abstract
Rapid and wide-ranging reductions in greenhouse gas emissions are required to meet the climate targets agreed upon at the 2015 Paris climate conference. There will be significant transition risks for health, livelihoods, and ecosystems associated with large-scale mitigation, but also opportunities. The aim of this study was to investigate the impacts, positive and negative, of climate policies on population health in China. We review the Intended Nationally Determined Contribution (INDC) that China took to the Paris meeting, link commitments in the INDC to national planning documents relevant to environment and health, and search the literature for Chinese publications on health trade-offs and synergies. Synergies are evident in the measures taken to reduce local air pollution in China: controls on coal burning have materially improved local air quality and benefited health. But there may be risks to health also, depending on how policies are implemented and what safeguards are provided. To date most assessments of the health impacts of climate policies in China have been modelling studies. We recommend work of this kind is complemented by observational research to identify unexpected impacts and vulnerabilities. It will become even more important to undertake this work as emission reductions accelerate to meet the Paris climate targets.
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Affiliation(s)
- Alistair Woodward
- University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Jill Baumgartner
- McGill University, 1110 Pine Avenue West, Montreal, Quebec, H3A 1A3, Canada.
| | | | - Jinghong Gao
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | | | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
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27
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Television Viewing Time and Stroke Risk: Australian Diabetes Obesity and Lifestyle Study (1999-2012). J Stroke Cerebrovasc Dis 2019; 28:963-970. [PMID: 30683493 DOI: 10.1016/j.jstrokecerebrovasdis.2018.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/05/2018] [Accepted: 12/14/2018] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Having a low level of physical activity is an established risk factor for stroke, but little is known about the importance of common sedentary behavior-television viewing-to stroke risk. METHODS We conducted a retrospective analysis of data that were collected as part of the longitudinal Australian Diabetes, Obesity, and Lifestyle study. Stroke events reported during the study (between baseline assessment in 1999-2000 and April 2011) were confirmed using adjudication based on medical records. Baseline data on minutes per week spent watching television were used as the exposure variable. Other variables were collected in assessments at wave 2 (2004-05) and wave 3 (2011-2012). Univariable and multivariable logistic regression analyses were performed. RESULTS Among the full Australian Diabetes, Obesity, and Lifestyle study population (n = 11,247), there were 153 participants with confirmed stroke during the study period, and 9207 participants with no stroke in this period. Participants who went on to have their first stroke during the study had significantly higher levels of TV viewing time at baseline than those who did not have a stroke (P = .001). This association was not present (P = .83), however, when age and sex were included in the regression model. CONCLUSION In the Australian Diabetes, Obesity, and Lifestyle study dataset, there was no evidence that more TV viewing is independently associated with risk of stroke, although analyses may have been underpowered.
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Bolin K. Physical inactivity: productivity losses and healthcare costs 2002 and 2016 in Sweden. BMJ Open Sport Exerc Med 2018; 4:e000451. [PMID: 30364588 PMCID: PMC6196961 DOI: 10.1136/bmjsem-2018-000451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2018] [Indexed: 11/11/2022] Open
Abstract
Objectives To estimate the costs associated with physical inactivity in Sweden for the year 2016. Methods The costs associated with insufficient physical activity was calculated employing population attributable fractions (PAFs) and register information on healthcare utilisation, mortality and disability pensions. The PAFs were calculated using information on exercise habits and morbidity-specific relative risks. The healthcare cost components were calculated based on registry data on inpatient-care, outpatient-care and primary care utilisation. Registry data on cause-specific mortality and granted disability pensions were used to calculate the productivity loss components. Costs associated with pharmaceutical utilisation were not included due lack of data. Results Physical exercise habits improved somewhat between 2002 and 2016. Thus, the associated morbidity-specific PAFs decreased over the same time period. Conclusions The economic costs attributable to insufficient physical activity decrease between the year 2002 and 2016. Healthcare costs attributable to insufficient physical activity as share of total healthcare expenses increased from 0.86 % in 2002 to 0.91 % in 2016.
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Affiliation(s)
- Kristian Bolin
- Department of Economics, University of Gothenburg, Gothenburg, Sweden.,Centre for Health Economics, University of Gothenburg, Gothenburg, Sweden
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29
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Mattli R, Wieser S, Probst-Hensch N, Schmidt-Trucksäss A, Schwenkglenks M. Physical inactivity caused economic burden depends on regional cultural differences. Scand J Med Sci Sports 2018; 29:95-104. [PMID: 30260508 DOI: 10.1111/sms.13311] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/14/2018] [Accepted: 09/19/2018] [Indexed: 12/16/2022]
Abstract
Physical inactivity is a major risk factor for numerous non-communicable diseases which dominate the overall burden of disease in Switzerland. We aimed to estimate the burden attributable to adult physical inactivity in Switzerland and its three culturally different language regions from a societal perspective in terms of disability-adjusted life years (DALYs), medical costs, and productivity losses. The burden of physical inactivity was estimated with a population attributable fractions (PAFs) approach. PAFs were calculated based on the prevalence of physical inactivity in the Swiss Health Survey and literature-based adjusted risk ratios of disease incidence. These PAFs were then applied to the total burden of the diseases related to physical inactivity. Physical inactivity was responsible for 2.0% (95%CI 1.7%-2.2%) of total DALYs lost and 1.2% (95%CI 1.0%-1.3%) of total medical costs in 2013. This is equivalent to 116 (95%CI 99-135) Swiss francs per capita per year. Productivity losses were valued at 117 (95%CI 94-142) Swiss francs per capita per year. The two diseases which caused the highest economic burden were low back pain and depression. The analysis of regional differences revealed that the per capita burden of physical inactivity is about twice as high in the French- and Italian-speaking regions compared to the German-speaking region. Reasons include a higher prevalence of physical inactivity, higher per capita health care spending, and higher disease prevalence. Cost-effectiveness analysis of related interventions should consider regional differences for optimal resource allocation in physical activity promotion policies.
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Affiliation(s)
- Renato Mattli
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland.,Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Simon Wieser
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Wu Z, Jin T, Weng J. A thorough analysis of diabetes research in China from 1995 to 2015: current scenario and future scope. SCIENCE CHINA-LIFE SCIENCES 2018; 62:46-62. [DOI: 10.1007/s11427-018-9377-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 07/26/2018] [Indexed: 12/16/2022]
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Yu H, Schwingel A. Associations Between Sedentary Behavior, Physical Activity, and Out-of-Pocket Health Care Expenditure: Evidence From Chinese Older Adults. J Aging Phys Act 2018; 27:1-8. [PMID: 29893610 DOI: 10.1123/japa.2017-0206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study examined the associations between sedentary behavior, physical activity, and health care expenditures among Chinese older adults. METHOD We conducted a survey on 4,165 older men and women living in major cities in China. Sedentary behavior and physical activity were measured by the Physical Activity Scale for the Elderly questionnaire. Health care costs were assessed by self-reported out-of-pocket health care expenditures across outpatient care, inpatient care, medication, and formal caregiver expenses. RESULTS Sedentary behavior was associated with an increase in annual out-of-pocket health care expenditures by approximately USD$37 for each additional sedentary hour (p < .001). Physical activity was associated with a decrease in annual health care expenditures by approximately USD$1.2 for each one Physical Activity Scale for the Elderly score (p < .001). Physical activity was a less salient indicator of health care expenditure for men than women. CONCLUSIONS Reducing sedentary behavior among older men and women and promoting physical activity, especially among men, may be important strategies to reduce out-of-pocket health care expenditures in China.
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Wang D. Improving school physical education to increase physical activity and promote healthy growth of Chinese school-aged children-Time for action. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:384-385. [PMID: 30356607 PMCID: PMC6189237 DOI: 10.1016/j.jshs.2017.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 09/28/2017] [Indexed: 05/24/2023]
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Dallmeyer S, Wicker P, Breuer C. How an aging society affects the economic costs of inactivity in Germany: empirical evidence and projections. Eur Rev Aging Phys Act 2017; 14:18. [PMID: 29075352 PMCID: PMC5646132 DOI: 10.1186/s11556-017-0187-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/13/2017] [Indexed: 12/18/2022] Open
Abstract
Background Aging societies represent a major challenge for health care systems all over the world. As older people tend to be more physically inactive, economic costs of inactivity are likely to increase notably. The present study aims to investigate this relationship between an aging society and economic costs of inactivity using the example of Germany. Methods Using data from the German Socio-Economic Panel, this study applied the comparative risk assessment method developed by the WHO to estimate the direct costs of inactivity for the period 2001–2013 differentiated by gender-specific age-groups (15–29; 30–44; 45–64; 65+). Based on population statistics predicting the aging of the German population for the years 2014–2060, this research projects the development of future costs of inactivity and potential effects of interventions promoting physical activity among the German population. Results The results reveal an increase in the level of physical activity during the observed period (2001–2013) which compensated the negative effect of aging and resulted in a decline of inactivity costs. The projections for the years 2014–2060 indicate a constant increase in direct per capita costs until 2060 because of an aging society. Scenarios indicating how a short-term reduction of physical inactivity impacts costs of inactivity reveal the crucial role of the oldest age-group in this context. Conclusion The findings indicate that the aging of the German population demands further actions and initiatives to promote physical activity, especially for the oldest age-group.
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Affiliation(s)
- Sören Dallmeyer
- Department of Sport Economics and Sport Management, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Pamela Wicker
- Department of Sport Economics and Sport Management, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Christoph Breuer
- Department of Sport Economics and Sport Management, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
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Jiang B, Liang S, Peng ZR, Cong H, Levy M, Cheng Q, Wang T, Remais JV. Transport and public health in China: the road to a healthy future. Lancet 2017; 390:1781-1791. [PMID: 29047445 PMCID: PMC5704968 DOI: 10.1016/s0140-6736(17)31958-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/27/2017] [Accepted: 07/05/2017] [Indexed: 01/15/2023]
Abstract
Transportation-related risk factors are a major source of morbidity and mortality in China, where the expansion of road networks and surges in personal vehicle ownership are having profound effects on public health. Road traffic injuries and fatalities have increased alongside increased use of motorised transport in China, and accident injury risk is aggravated by inadequate emergency response systems and trauma care. National air quality standards and emission control technologies are having a positive effect on air quality, but persistent air pollution is increasingly attributable to a growing and outdated vehicle fleet and to famously congested roads. Urban design favours motorised transport, and physical activity and its associated health benefits are hindered by poor urban infrastructure. Transport emissions of greenhouse gases contribute substantially to regional and global climate change, which compound public health risks from multiple factors. Despite these complex challenges, technological advances and innovations in planning and policy stand to make China a leader in sustainable, healthy transportation.
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Affiliation(s)
- Baoguo Jiang
- Department of Traumatology and Orthopedics, Peking University People's Hospital, Beijing, China; Peking University Trauma Medicine Center, Beijing, China
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Zhong-Ren Peng
- Department of Urban and Regional Planning, University of Florida, Gainesville, FL, USA; China Institute for Urban Governance, Beijing, China; Center for Intelligent Transportation Systems and Unmanned Aerial System Applications, Shanghai Jiaotong University, Shanghai, China
| | - Haozhe Cong
- Road Traffic Safety Research Center of the Ministry of Public Security, Beijing, China
| | - Morgan Levy
- Environmental Health Sciences, University of California, Berkeley, CA, USA
| | - Qu Cheng
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Tianbing Wang
- Department of Traumatology and Orthopedics, Peking University People's Hospital, Beijing, China; Peking University Trauma Medicine Center, Beijing, China
| | - Justin V Remais
- Environmental Health Sciences, University of California, Berkeley, CA, USA.
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Yong J, Lin D, Tan XR. Primary prevention of cardiovascular disease in older adults in China. World J Clin Cases 2017; 5:349-359. [PMID: 29026833 PMCID: PMC5618113 DOI: 10.12998/wjcc.v5.i9.349] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 05/22/2017] [Accepted: 06/12/2017] [Indexed: 02/05/2023] Open
Abstract
Over the past two decades, the percentage of Chinese who is 60 years or older has increased from 5.2% in 1995 to 10.5% in 2015. Approximately 16% of the population in China was 60 years old and above in 2015. Since 1990, cardiovascular disease (CVD) has been the leading cause of death in China. Cardiovascular medications of older adults are usually more complicated than younger age groups due to polypharmacy, the presence of comorbidities and more susceptible to treatment-related adverse outcomes. Therefore, effective primary prevention of CVD for older adults is important in sustaining the health of older adults and reducing the burden of the healthcare system. Proper management of CVD-related risk factors, such as hypertension, dyslipidemia, diabetes and obesity, can remarkably reduce risks of CVDs in older Chinese. These risk factors can be modified by managing blood pressure, glucose and lipids via lifestyle modifications or receiving medications. Smoking cessation, healthy diets, strict alcohol intake and moderate physical exercise are examples of recommended lifestyle changes for remarkably recovering health conditions of older adults who have hypertension, dyslipidemia, obesity, diabetes or complications. Treatment prescriptions of older adults, in general, are recommended to be individualized and to be initiated at a low dose. The future directions for better primary CVD prevention in older adults include establishing guidelines for primary prevention of CVD for different older adults and further research on better management strategies of CVD risks for elderly Chinese.
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Affiliation(s)
- Jian Yong
- First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
| | - Dong Lin
- First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
| | - Xue-Rui Tan
- First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
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Xu J, Gao C, Lee JKW, Zhao J. PM 2.5: A barrier to fitness and health promotion in China. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:292-294. [PMID: 30356613 PMCID: PMC6189240 DOI: 10.1016/j.jshs.2017.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 02/22/2017] [Indexed: 06/08/2023]
Affiliation(s)
- Jincheng Xu
- Sport Biological Center, China Institute of Sport Science, Beijing 100061, China
| | - Can Gao
- Sports Hospital, National Institute of Sports Medicine, Beijing 100061, China
| | - Jason Kai Wei Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Jiexiu Zhao
- Sport Biological Center, China Institute of Sport Science, Beijing 100061, China
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The Risk Factors of High Blood Pressure among Young Adults in the Tujia-Nationality Settlement of China. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8315603. [PMID: 28932747 PMCID: PMC5592392 DOI: 10.1155/2017/8315603] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/13/2017] [Accepted: 07/27/2017] [Indexed: 01/02/2023]
Abstract
Demographics questionnaires, and fitness tests were utilized to identify the risk factors of hypertension among younger adults in the years 2005, 2010, and 2014 in China's southwest province of Hubei. The results demonstrated that the prevalence of hypertension was higher between 2011 and 2014 among the young people in this area. The main risk factors of developing hypertension were found to be sex (as man), individuals over 40 years old, blue collar employees who worked in rural areas, overweight/obesity, and those with the low CRF.
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Turi BC, Codogno JS, Fernandes RA, Lynch KR, Kokubun E, Monteiro HL. Time trends in physical activity of adult users of the Brazilian National Health System: 2010-2014. Longitudinal study. SAO PAULO MED J 2017; 135:369-375. [PMID: 28793130 PMCID: PMC10016000 DOI: 10.1590/1516-3180.2017.0025190317] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 03/19/2017] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE: In this longitudinal study, we aimed to describe time trends of physical activity (PA) in different domains from 2010 to 2014 among users of the Brazilian National Health System, taking into account the effects of sex, age and economic status (ES). DESIGN AND SETTING: Longitudinal study conducted in five primary care units in Bauru (SP), Brazil. METHODS: The sample was composed of 620 men and women who were interviewed in 2010, 2012 and 2014. The same group of researchers conducted the interviews, using the questionnaire developed by Baecke et al. Scores for occupational, exercise/sport, leisure-time/transportation and overall PA were considered in this longitudinal survey. Time trends of PA over the four years of follow-up were assessed according to sex, age and ES. RESULTS: We found that after four years of follow-up, the reduction in overall PA (-13.6%; 95% confidence interval, CI = -11.9 to -15.3) was statistically significant. Additionally, declines in the occupational domain and exercise/sports participation were affected by age, while the reduction in overall PA was affected by sex, age and ES. CONCLUSIONS: Overall PA decreased significantly from 2010 to 2014 among these outpatients of the Brazilian National Health System, and age and male sex were important determinants of PA in its different domains.
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Affiliation(s)
- Bruna Camilo Turi
- MSc, PhD. Researcher, Postgraduate Program on Kinesiology, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Rio Claro (SP), Brazil.
| | - Jamile Sanches Codogno
- MSc, PhD. Professor, Department of Physical Education, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Presidente Prudente (SP), Brazil.
| | - Rômulo Araújo Fernandes
- MSc, PhD. Professor, Department of Physical Education, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Presidente Prudente (SP), Brazil.
| | - Kyle Robinson Lynch
- Master’s Student, Postgraduate Program on Kinesiology, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP-RC), Rio Claro (SP), Brazil.
| | - Eduardo Kokubun
- MSc, PhD. Professor, Department of Physical Education, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Presidente Prudente (SP), Brazil.
| | - Henrique Luiz Monteiro
- MSc, PhD. Professor, Department of Physical Education, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Presidente Prudente (SP), Brazil.
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González K, Fuentes J, Márquez JL. Physical Inactivity, Sedentary Behavior and Chronic Diseases. Korean J Fam Med 2017; 38:111-115. [PMID: 28572885 PMCID: PMC5451443 DOI: 10.4082/kjfm.2017.38.3.111] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/25/2017] [Indexed: 12/22/2022] Open
Abstract
New research into physical activity suggests that it is no longer sufficient just to meet minimum levels recommended by health guidelines in order to reduce cardiovascular risk. Both physical inactivity and sedentary behavior have their own health hazards and need to be addressed separately, in order to explore their different deleterious mechanisms. The aim of this review was to define and to characterize both concepts, and their relationship with major non-communicable chronic diseases. A PubMed database search was undertaken, using the following key words: physical activity, physical inactivity, sedentarism, sedentary behavior, and non-communicable chronic disease. This literature review provides an updated view on physical inactivity and sedentary behavior, and reevaluates their prevalence and association with major non-communicable chronic disease.
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Affiliation(s)
- Karimé González
- Student of Master of Science in Kinesiology, Universidad Católica del Maule, Talca, Chile
| | - Jorge Fuentes
- Departament of Kinesiology, Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile.,Rehab Med Faculty, University of Alberta, Edmonton, Canada
| | - José Luis Márquez
- School of Kinesiology, Faculty of Medical Sciences, Universidad de Santiago de Chile, Santiago, Chile
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Ding D, Kolbe-Alexander T, Nguyen B, Katzmarzyk PT, Pratt M, Lawson KD. The economic burden of physical inactivity: a systematic review and critical appraisal. Br J Sports Med 2017; 51:1392-1409. [PMID: 28446455 DOI: 10.1136/bjsports-2016-097385] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To summarise the literature on the economic burden of physical inactivity in populations, with emphases on appraising the methodologies and providing recommendations for future studies. DESIGN Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42016047705). DATA SOURCES Electronic databases for peer-reviewed and grey literature were systematically searched, followed by reference searching and consultation with experts. ELIGIBILITY CRITERIA Studies that examined the economic consequences of physical inactivity in a population/population-based sample, with clearly stated methodologies and at least an abstract/summary written in English. RESULTS Of the 40 eligible studies, 27 focused on direct healthcare costs only, 13 also estimated indirect costs and one study additionally estimated household costs. For direct costs, 23 studies used a population attributable fraction (PAF) approach with estimated healthcare costs attributable to physical inactivity ranging from 0.3% to 4.6% of national healthcare expenditure; 17 studies used an econometric approach, which tended to yield higher estimates than those using a PAF approach. For indirect costs, 10 studies used a human capital approach, two used a friction cost approach and one used a value of a statistical life approach. Overall, estimates varied substantially, even within the same country, depending on analytical approaches, time frame and other methodological considerations. CONCLUSION Estimating the economic burden of physical inactivity is an area of increasing importance that requires further development. There is a marked lack of consistency in methodological approaches and transparency of reporting. Future studies could benefit from cross-disciplinary collaborations involving economists and physical activity experts, taking a societal perspective and following best practices in conducting and reporting analysis, including accounting for potential confounding, reverse causality and comorbidity, applying discounting and sensitivity analysis, and reporting assumptions, limitations and justifications for approaches taken. We have adapted the Consolidated Health Economic Evaluation Reporting Standards checklist as a guide for future estimates of the economic burden of physical inactivity and other risk factors.
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Affiliation(s)
- Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia.,Centre for Chronic Disease Prevention, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia
| | - Tracy Kolbe-Alexander
- Department of Human Biology, Research Unit for Exercise Science and Sports Medicine (ESSM), Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,School of Health and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Binh Nguyen
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Michael Pratt
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Kenny D Lawson
- Centre for Chronic Disease Prevention, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia.,Centre for Health Research, School of Medicine, Western Sydney University, Penrith, Australia
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Wei X, Zang Y, Jia X, He X, Zou S, Wang H, Shen M, Zang J. Age, period and cohort effects and the predictors of physical activity and sedentary behaviour among Chinese children, from 2004 to 2011. BMC Public Health 2017; 17:353. [PMID: 28438157 PMCID: PMC5402654 DOI: 10.1186/s12889-017-4215-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 04/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Very few studies have explored the effects of age, time period, and cohort in association with biological, behavioral, economic, and environmental factors predictors on physical activity (PA) and sedentary behaviour (SB) among Chinese children. METHODS We used data from a cohort study of the China Health and Nutrition Survey (CHNS) between 2004 and 2011 (2004, 2006, 2009 and 2011). The outcomes of interest were metabolic equivalent of task (MET) hours per week from both active and sedentary activities. Age, gender, individual characteristics, household size, asset ownership, and urbanisation were included as covariates. Age, period and cohort effects analyses for PA and SB of children (6-17 y, n = 3528) was conducted to explicitly assess differences in PA and SB due to age vs. period effects, and implicitly assess differences by cohorts due to the period-specific experiences across individuals of varying ages. RESULTS The mean age of the sample in each time point fluctuated from 12.6 to 11.3 years and PA slightly decreased from 50.0 ± 63.2 MET hours per week (MET-hr./wk) in 2004 to 47.1 ± 54.9 MET-hr./wk. in 2011. However, SB increased from 31.8 ± 22.0 MET-hr./wk. to 37.6 ± 22.2 MET-hr./wk. Girls had lower PA and higher SB levels than boys. Controlling for age effects, marginal period effects on PA were observed in some survey years. Higher levels of urbanisation and number of household computers served as negative and positive predictors for PA and SB, respectively. Higher household income was a positive predictor of SB. Surprisingly, bigger household size was the only negative predictor of SB (P < 0.05). CONCLUSIONS This longitudinal study followed a large cohort of children over a significant period of their childhood. We observed potential age and secular trends in PA levels. Higher community urbanisation and number of home computers were associated with both PA and SB levels. Larger household size was the only factor that was negatively associated with SB. These findings shed light on health policy and preventative health strategies for China and other countries that are now facing similar public health challenges.
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Affiliation(s)
- Xinping Wei
- Gu Mei Community Service Center, 668 Longming Road, Shanghai, 200010, People's Republic of China
| | - Yu Zang
- Department of Neurology, the Affiliated Hospital of North China University of Science and Technology, No.73 south construction road, Tangshan, Hebei, People's Republic of China
| | - Xiaodong Jia
- Department of Nutrition Hygiene, Division of Health Risk Factor Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Changning District, Shanghai, 200336, People's Republic of China
| | - Xiangui He
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, 200040, People's Republic of China
| | - Shurong Zou
- Department of Nutrition Hygiene, Division of Health Risk Factor Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Changning District, Shanghai, 200336, People's Republic of China
| | - Hui Wang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, 101 Longmian Ave, Jiangning District, Nanjing, 211166, Jiangsu, People's Republic of China
| | - Meihua Shen
- Department of Intensive Care Unit, Shanghai Provincial Crops Hospital, Chinese People's Armed Police Forces, 831 Hongxu Road, Shanghai, 201103, People's Republic of China. .,Key Laboratory of Biomedical Information, Engineering, Ministry of Education, Institute of Mitochondrial Biology and Medicine, Xi'an Jiaotong University School of Life Science and Technology, Xi'an, 710049, People's Republic of China.
| | - Jiajie Zang
- Department of Nutrition Hygiene, Division of Health Risk Factor Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Changning District, Shanghai, 200336, People's Republic of China.
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Traditional Chinese Mind and Body Exercises for Promoting Balance Ability of Old Adults: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:7137362. [PMID: 27990168 PMCID: PMC5136631 DOI: 10.1155/2016/7137362] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 10/08/2016] [Accepted: 10/13/2016] [Indexed: 12/21/2022]
Abstract
The purpose of this study was to provide a quantitative evaluation of the effectiveness of traditional Chinese mind and body exercises in promoting balance ability for old adults. The eligible studies were extensively searched from electronic databases (Medline, CINAHL, SportDicus, and Web of Science) until 10 May 2016. Reference lists of relevant publications were screened for future hits. The trials used randomized controlled approaches to compare the effects of traditional Chinese mind and body exercise (TCMBE) on balance ability of old adults that were included. The synthesized results of Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and static balance with 95% confidence intervals were counted under a random-effects model. Ten studies were selected based on the inclusion criteria, and a total of 1,798 participants were involved in this review. The results of the meta-analysis showed that TCMBE had no significant improvement on BBS and TUG, but the BBS and TUG could be obviously improved by prolonging the intervention time. In addition, the results showed that TCMBE could significantly improve the static balance compared to control group. In conclusion, old adults who practiced TCMBE with the time not less than 150 minutes per week for more than 15 weeks could promote the balance ability.
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Zhu W, Chi A, Sun Y. Physical activity among older Chinese adults living in urban and rural areas: A review. JOURNAL OF SPORT AND HEALTH SCIENCE 2016; 5:281-286. [PMID: 30356525 PMCID: PMC6188614 DOI: 10.1016/j.jshs.2016.07.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/20/2016] [Accepted: 05/21/2016] [Indexed: 05/21/2023]
Abstract
With an increase in rural-to-urban migration, a rapidly aging population, and the rising risk of developing noncommunicable diseases in China, it is important to understand the epidemiology of physical activity (PA) and health in the context of disease prevention and population health. Despite its public health importance, there is a significant lack of knowledge about PA in older Chinese adults that may hamper primary prevention efforts of health promotion in an increasingly aging population. To fill this gap, this article presents a narrative review of PA in the older Chinese adult population with a special focus on residential settings (i.e., urban and rural). Using existing studies, the review examines overall PA patterns and their correlates and discusses public health implications and future research. Although there are some preliminary indications of urban and rural differences in PA in the aging population in China, continued research efforts are needed to facilitate primary prevention efforts aimed at reducing noncommunicable diseases and promoting an active lifestyle among the largest population of older people in the world.
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Abstract
With one-fifth of the world's total population, China's prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. Understanding China's current cardiovascular epidemic requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The latter have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the healthcare system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that 4 priorities should be taken: pursue multisectorial government and nongovernment strategies targeting the underlying causes of CVD (the whole-of-government and whole-of-society policy); give priority to prevention; reform the healthcare system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the 4 priorities, the pandemic of CVD and other major noncommunicable diseases in China will be reversed and the global sustainable development goal achieved.
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Affiliation(s)
- Yangfeng Wu
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.).
| | - Emelia J Benjamin
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.)
| | - Stephen MacMahon
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.)
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45
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Keegan R, Middleton G, Henderson H, Girling M. Auditing the socio-environmental determinants of motivation towards physical activity or sedentariness in work-aged adults: a qualitative study. BMC Public Health 2016; 16:438. [PMID: 27229854 PMCID: PMC4880852 DOI: 10.1186/s12889-016-3098-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 05/12/2016] [Indexed: 12/02/2022] Open
Abstract
Background There is a lack of understanding of work aged adults’ (30–60 years old) perspectives on the motivation of physical activity versus sedentariness. This study aims to: (1) identify which socio-environmental factors motivate physical activity and/or sedentary behavior, in adults aged 30–60 years; and (2) explore how these motivators interact and combine. Method Fifteen work-aged adults who, were able to engage in physical activity (Mean age = 43.9 years; SD 9.6, range 31–59), participated in semi-structured interviews. Inductive content analysis was used to generate an inventory of socio-environmental factors and their specific influences on motivation towards physical activity or sedentariness. Results Key socio-environmental agents found to influence motivation included: Spouse/partner, parents, children, siblings, whole family, grandchildren, friends, work-mates, neighbors, strangers, team-mates and class-mates, instructors, health care professionals, employers, gyms and health companies, governments, media and social media, cultural norms, and the physical environment. Mechanisms fell into five broad themes of socio-environmental motivation for both physical activity and sedentariness: (1) competence and progress; (2) informational influences, (3) emotional influences, (4) pragmatics and logistics, and (5) relationships. Similar socio-environmental factors were frequently reported as able to motivate both activity and sedentariness. Likewise, individual categories of influence could also motivate both behaviors, depending on context. Conclusion The findings of this paper ‘unpack’ theoretical concepts into specific and targeted behavioral recommendations. The data suggested no simple solutions for promoting physical activity or reducing sedentariness, but rather complex and interacting systems surrounding work-aged adults. Findings also suggest that health professionals should be encouraged to support adults’ health by examining the socio-environmental motivational influences, or ‘motivational atmosphere’.
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Affiliation(s)
- Richard Keegan
- Research Institute for Sport and Exercise Science, Faculty of Health, University of Canberra, Haydon Drive, Bruce, ACT, 2601, Australia.
| | - Geoff Middleton
- School of Sport and Exercise Sciences, College of Social Sciences, University of Lincoln, Lincoln, UK
| | - Hannah Henderson
- School of Sport and Exercise Sciences, College of Social Sciences, University of Lincoln, Lincoln, UK
| | - Mica Girling
- School of Sport and Exercise Sciences, College of Social Sciences, University of Lincoln, Lincoln, UK
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Zang J, Ng SW. Age, period and cohort effects on adult physical activity levels from 1991 to 2011 in China. Int J Behav Nutr Phys Act 2016; 13:40. [PMID: 27094983 PMCID: PMC4837527 DOI: 10.1186/s12966-016-0364-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/16/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND To date no work has differentiated the effects of age, period, and cohort on physical activity (PA) among Chinese adults, while also considering biological, behavioral, economic, and environmental factors over time. METHODS We used data from the China Health and Nutrition Survey (CHNS) between 1991 and 2011 (20 years). The outcomes of interest are metabolic equivalent of task (MET) hours per week from work and domestic activities. Age, individual characteristics, household size, asset ownership, urbanization were included as covariates. Analyses for adult (≥20y) males (n = 29,343) and females (n = 31,094) was conducted to explicitly assess differences in PA due to age vs period effects, and implicitly assess differences by cohorts due to the period-specific experiences across individuals of varying ages. RESULTS The mean age of the sample rose from 41.31 to 50.8 years and PA decreased from 427.75 ± 264.35 MET hours per week (MET-hr/wk) in 1991 to 245.99 ± 206.65 MET-hr/wk in 2011, with much steeper declines for women compared to men. For both genders, we found non-linear decreases in PA with age over time. Controlling for age effects, negative period effects on PA were observed in each survey year, and were substantial from 1993 to 2000 for males and from 1993 to 2011 for females. The interaction between survey year and age (P < 0.05) were observed from 2004 to 2011. Higher community urbanicity, vehicle ownership, TV and computer ownership, overweight and obese, higher education served as negative predictors. Bicycle ownership, bigger household size, non-professional jobs, being married and having more children (for women) were positive predictors of PA (P < 0.05). Furthermore, at any given age, individuals who were younger at baseline had higher mean PA compared with individuals older at baseline. CONCLUSION This study followed a large cohort of adults over a significant portion of their lives. Strong age and secular trends were observed, resulting in an increasing number of participants who have or are likely to lower their PA levels. These trends suggest that tackling the rapid PA decline among its population is of high priority for China's public health outlook as its population ages and continues to experience significant economic and environmental changes.
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Affiliation(s)
- Jiajie Zang
- Department of Nutrition Hygiene, Division of Health Risk Factor Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Carolina Population Center and Gillings School of Global Public Health, University of North Carolina, 137 E. Franklin St., CB # 8120, Chapel Hill, NC, 27516, USA.
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Bueno DR, Marucci MDFN, Codogno JS, Roediger MDA. [The costs of physical inactivity in the world: a general review]. CIENCIA & SAUDE COLETIVA 2016; 21:1001-10. [PMID: 27075999 DOI: 10.1590/1413-81232015214.09082015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/18/2015] [Indexed: 11/22/2022] Open
Abstract
There is convincing evidence in the scientific literature of the effectiveness of regular physical activity and physical exercise in the conservation of health and the prevention of various ailments. However, studies into the association between costs of medical services and physical inactivity have not been duly addressed. International studies have quantified these costs and revealed the association between physical activity and/or sedentary behavior. Therefore, this review sought to gather information available from several countries and analyze the global costs associated with physical inactivity over the past few decades. The results of twenty-four original and well-researched articles in nine countries, including Brazil, were analyzed. The results showed that physical inactivity, irrespective of the method of classification, is burdensome to the economy of health worldwide, and directly responsible for the high cost of medication, the incidence of hospitalization and the frequency of medical appointments. The costs of the group of the physically inactive population affected by chronic diseases feature among the major components of the total costs involved in public health.
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Affiliation(s)
| | | | - Jamile Sanches Codogno
- Faculdade de Ciências e Tecnologia de Presidente Prudente, Universidade Estadual Paulista Júlio de Mesquita Filho, São Paulo, SP, Brasil
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Korber K. Quality assessment of economic evaluations of health promotion programs for children and adolescents-a systematic review using the example of physical activity. HEALTH ECONOMICS REVIEW 2015; 5:35. [PMID: 26603159 PMCID: PMC4658341 DOI: 10.1186/s13561-015-0071-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 11/12/2015] [Indexed: 06/05/2023]
Abstract
An increasing number of primary prevention programs aimed at promoting physical exercise in children and adolescents are being piloted. As resources are limited, it is important to ascertain the costs and benefits of such programs. The aim of this systematic review is to evaluate the currently available evidence on the cost-effectiveness of programs encouraging physical activity in children and adolescents and to assess their quality. A systematic review was conducted searching in well established literature databases considering all studies before February 2015. Citation tracking in Google Scholar and a manual search of the reference lists of included studies were used to consolidate this. The fundamental methodological elements of the included economic evaluations were extracted, and the quality of the included studies was evaluated using the Pediatric Quality Appraisal Questionnaire (PQAQ). In total, 14 studies were included. Considering the performance of the economic evaluation, the studies showed wide variation. Most of the studies used a societal perspective for their analyses and discounted costs and effects. The findings ranged from US$11.59 for a person to become more active (cheapest intervention) up to US$669,138 for a disability adjusted life year (DALY) saved (most expensive intervention), with everything in between. Overall, the results of three studies are below a value of US$3061, with one of them even below US$200.00, for the achieved effects. For the other programs, the context-specific assessment of cost-effectiveness is problematic as there are different thresholds for cost-effectiveness in different countries or no clearly defined thresholds at all. There are multiple methodological difficulties involved in evaluating the cost-effectiveness of interventions aimed at increasing physical activity, which results in little consistency between different evaluations. The quality of the evaluations ranged from poor to excellent while a large majority of them was of very good methodological quality. Better comparability could be reached by greater standardization, especially regarding systematic consideration of implementation costs.
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Affiliation(s)
- Katharina Korber
- Munich School of Management and Munich Center of Health Sciences, Ludwig-Maximilians-University, Ludwigstraße 28/RG, 80539, Munich, Germany.
- Institute for Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH)-German Research Center for Environmental Health, 85764, Neuherberg, Germany.
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Bielemann RM, Silva BGCD, Coll CDVN, Xavier MO, Silva SGD. Burden of physical inactivity and hospitalization costs due to chronic diseases. Rev Saude Publica 2015; 49:S0034-89102015000100307. [PMID: 26487291 PMCID: PMC4603264 DOI: 10.1590/s0034-8910.2015049005650] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 12/05/2014] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate the physical inactivity-related inpatient costs of chronic non-communicable diseases. METHODS This study used data from 2013, from Brazilian Unified Health System, regarding inpatient numbers and costs due to malignant colon and breast neoplasms, cerebrovascular diseases, ischemic heart diseases, hypertension, diabetes, and osteoporosis. In order to calculate the share physical inactivity represents in that, the physical inactivity-related risks, which apply to each disease, were considered, and physical inactivity prevalence during leisure activities was obtained from Pesquisa Nacional por Amostra de Domicílio (Brazil’s National Household Sample Survey). The analysis was stratified by genders and residing country regions of subjects who were 40 years or older. The physical inactivity-related hospitalization cost regarding each cause was multiplied by the respective share it regarded to. RESULTS In 2013, 974,641 patients were admitted due to seven different causes in Brazil, which represented a high cost. South region was found to have the highest patient admission rate in most studied causes. The highest prevalences for physical inactivity were observed in North and Northeast regions. The highest inactivity-related share in men was found for osteoporosis in all regions (≈ 35.0%), whereas diabetes was found to have a higher share regarding inactivity in women (33.0% to 37.0% variation in the regions). Ischemic heart diseases accounted for the highest total costs that could be linked to physical inactivity in all regions and for both genders, being followed by cerebrovascular diseases. Approximately 15.0% of inpatient costs from Brazilian Unified Health System were connected to physical inactivity. CONCLUSIONS Physical inactivity significantly impacts the number of patient admissions due to the evaluated causes and through their resulting costs, with different genders and country regions representing different shares.
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50
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Ouyang Y, Wang H, Su C, Wang Z, Song Y, Xiao Y, Du W, Zhang B. Use of quantile regression to investigate changes in the body mass index distribution of Chinese adults aged 18-60 years: a longitudinal study. BMC Public Health 2015; 15:278. [PMID: 25885045 PMCID: PMC4374289 DOI: 10.1186/s12889-015-1606-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 03/02/2015] [Indexed: 01/05/2023] Open
Abstract
Background Traditional linear regression analyses have detected increasing trends in the incidence of overweight/obesity among both genders in China. However, these previous regression analyses were limited in their ability to capture cross-distribution variations among effects. The objective of our study was to analyze the change in the body mass index (BMI) distribution of adults and investigated the relationships between the key covariates and the BMI distribution. Methods We used longitudinal data from the China Health and Nutrition Surveys (CHNS) in 1991, 1993, 1997, 2000, 2004, 2006, 2009, and 2011, with at least two waves of data collection. In total, 17,819 participants aged 18–60 years (N = 8587 men and 9232 women) were included in the final analysis with 48,900 observations. The lambda-mu-sigma (LMS) method was used to describe changes in the BMI distribution. Separate sex-stratified longitudinal quantile regression (QR) analyses were used to investigate changes in the BMI distribution over time. Results The main characteristics of the BMI changes in both genders were that the curves shifted to the right and the distributions became wider. All of the BMI percentile curves tended to increase from 1991 to 2011, where the levels increased more in the higher percentiles. The QR analyses showed that these patterns remain consistent after adjusting for individual and community level factors. Physical activity (PA) had a negative association with BMI for both genders in all percentiles. Income and energy intake were associated with positive changes in male BMI in the upper percentile. Sedentary time had a positive association with female BMI in the middle percentile. Compared with less educated women, women with senior school education at 75th percentile had 0.951 kg/m2 lower BMIs. Conclusions This longitudinal quantile regression suggests that effects of different covariates worked differently across the BMI distribution. Since social and economic characteristics in China have underlined the significant disparities in many aspects, national strategies to tackle overweight/obesity should be tailored as appropriate for various segments.
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Affiliation(s)
- Yifei Ouyang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Yiqi Song
- Department of Physical Education, North China Institute of Science and Technology, Hebei, China.
| | - Yingting Xiao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Wenwen Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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