Social Support Network and Sedentary Behavior Among US Adults With and Without Mobility Impairment.

PURPOSE: Evidence suggests that sedentary behavior is increased among those with mobility impairment, but the evidence examining the impact of social support networks (SSN) on this relationship remains limited. This study examines the relationship between SSN and sedentary behavior among adults with and without mobility impairment. DESIGN: Cross-sectional. SETTING: National Health and Nutrition Examination Survey (NHANES) 2007-2008. SUBJECTS: U.S. adults (≥40 years of age) with (n = 962) and without (n = 1393) mobility impairment. MEASURES: The Social Support Network (SSN) score was created using self-reported emotional, financial, church, friends, and marital support/status. The dependent variable in this study was the upper quartile of sedentary time in minutes. RESULTS: Both higher SSN score (AOR .43; 95% CI 0.25-.76, P = .045) and poverty to income ratio (PIR) (AOR 2.60; 95% CI 1.40-4.82, P = .01) were significant predictors of increased sedentary time among adults with mobility impairment. Among adults without mobility impairment, higher PIR was the only significant predictor of increased sedentary time (OR 3.59; 95% Cl 1.80-7.15, P < .0001). CONCLUSION: Higher SSN score was associated with significantly lower odds of increased sedentary time among adults with mobility impairment. A similar relationship was not revealed among adults without mobility impairment. Higher PIR was associated with significantly higher odds of increased sedentary time among adults with and without mobility impairment.

Sedentary Time and Prescription Medication Use Among US Adults: 2017-2018 National Health and Nutrition Examination Survey.

BACKGROUND: Prescription medication usage has been used as a predictor of disease prevalence and overall health status. Evidence suggests an inverse relationship exists between polypharmacy, which is the use of 5 or more medications, and physical activity participation. However, there is limited evidence examining the relationship between sedentary time and polypharmacy in adults. The aim of this study was to examine the associations between sedentary time and polypharmacy in a large nationally representative sample of US adults. METHODS: Study sample (N = 2879) included nonpregnant adult (≥20 y old) participants from the 2017-2018 National Health and Nutrition Examination Survey. Self-reported minutes per day of sedentary time were converted to hours per day. The dependent variable was polypharmacy (≥5 medications). RESULTS: Analysis revealed that for every hour of sedentary time, there was 4% greater odds of polypharmacy (odds ratio, 1.04; 95% confidence interval, 1.00-1.07, P = .04) after adjusting for age, race/ethnicity, education, waist circumference, and the interaction term between race/ethnicity and education. CONCLUSION: Our findings suggest increased sedentary time is associated with an increased risk of polypharmacy among a large nationally representative sample of US adults.

Total brachial artery reactivity and incident heart failure and heart failure subtypes: multi-ethnic study of atherosclerosis.

Endothelial dysfunction may be a phenotypic expression of heart failure (HF). Total brachial artery reactivity (TBAR) is a non-invasive measurement of endothelial function that has been associated with increased risk of cardiovascular outcomes. Limited information is currently available on the impact of TBAR on incident HF and its subtypes. The aim of this study was to investigate whether TBAR is associated with overall incident HF, and the two HF subtypes, HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) in a community-based study. The sample included 5499 participants (45-84 years of age) from the Multi-Ethnic Study of Atherosclerosis who were free of cardiovascular disease at baseline. Brachial artery was imaged via ultrasound after five minutes of cuff occlusion at the right forearm. TBAR was calculated as the difference between maximum and minimum brachial artery diameters following cuff release, divided by the minimum diameter multiplied by 100%. A dichotomous TBAR variable was created based on the median value (below or above 7.9%). Participants with EF ≤ 40% were considered HFrEF and those with EF ≥ 50% were considered HFpEF. Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). Over a mean follow-up period of 12.5 years, incident HF was diagnosed in 250 participants: 98 classified as HFrEF, 106 as HFpEF, and 46 with unknown or borderline EF (41-49%). Crude analysis revealed that those with TBAR below the median had a significantly greater risk of HF (HR 1.46; 95% CI 1.13-1.88, p < 0.01) and HFrEF (HR 1.61; 95% CI 1.07-2.43, p < 0.05). Following adjustment for known HF risk factors (e.g., age, sex, race, blood pressure), the strength of these relationships was attenuated. Borderline significant results were revealed in those with HFpEF (HR 1.43; 95% CI 0.97-2.12, p = 0.06). Kaplan-Meier curves suggest significantly lower risks of developing HF and HFrEF in those with TBAR above the median (log-rank p ≤ 0.05 for both). When examined as a continuous variable, with a cut point of 50% for EF, every 1-standard deviation (9.7%) increase in TBAR resulted in a 19 and 29% decrease in risk of HF (p < 0.05) and HFrEF (p = 0.05), respectively. Lower TBAR values were associated with higher rates of incident HF and HFrEF, suggesting a possible role of endothelial dysfunction in HF pathogenesis. The impact of other known HF risk factors may mediate this relationship, thus further research is warranted.

Mode of physical activity participation by body mass index: 2015 behavioural risk factor surveillance system.

Body mass index (BMI) continues to be used as a marker of health due its strong correlation with adiposity and health. Physical activity (PA) has been shown to be favourably associated with a desirable BMI. Few studies have examined mode of PA participation across BMI indices with a mutually exclusive underweight BMI range. The purpose of this study was to examine the relationship between modes of PA and BMI. Data from the 2015 Behavioral Risk Factor Surveillance System was analysed. Underweight, overweight, and obese BMI categories possessed 35, 20, and 46% lower odds of meeting current PA guidelines. The obese BMI group was found to have lower odds of meeting the aerobic only and strength only guidelines. Underweight, overweight, and obese groups possessed 63, 18, and 76% greater odds of meeting neither PA guideline, respectively.

Dietary Fiber, C-Reactive Protein, and Leisure-Time Physical Activity Among U.S. Adults.

BACKGROUND: Some evidence suggests an inverse association between increased fiber intake and C-reactive protein (CRP). However, few studies have examined the associations among CRP, dietary fiber, and leisure-time physical activity (LTPA) in a nationally representative sample of U.S. adults. METHODS: Sample (n = 8372) included adults (≥20 years of age) who participated in the 2007-2010 National Health and Nutrition Examination Survey. Tertiles of reported fiber intake were created. The dependent variable was elevated CRP (>3-10 mg/L). Logistic regression models were stratified by LTPA participation and adjusted for age, gender, race, waist circumference (WC), and standing height. RESULTS: In adults reporting any volume of LTPA participation, increased fiber intake was significantly (P < 0.05 for the upper tertile of fiber intake) associated with lower odds of having an elevated CRP concentration when compared with the lowest tertile. Similar associations were not revealed in analyses limited to adults reporting no LTPA participation. After additional adjustment for WC and standing height, this protective association was no longer statistically significant. CONCLUSIONS: Results suggest that WC and standing height may mediate the beneficial association between increased fiber intake and lower odds of elevated CRP in adults reporting LTPA participation.

Physical Activity, Body Mass Index, and Clustered Metabolic Risk in U.S. Adolescents: 2007-2012 Nhanes.

BACKGROUND: While studies to date have shown that children and adolescents who meet the current physical activity (PA) recommendations and maintain a healthy body weight demonstrate significantly lower cardiometabolic risk, there are some studies that suggest that the relationship between PA and metabolic risk may be mediated by adiposity. The aim of the present study was to examine variation in clustered metabolic risk (cMetS) in adolescents classified as not overweight/active (NOA), not overweight/not active (NONA), overweight/active (OA), and overweight/not active (ONA). METHODS: The sample included adolescent participants (n = 875; 12-17 years) of the 2007-2012 National Health and Nutrition Examination Survey (NHANES). The cMetS score included triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, and mean arterial pressure. Age- and sex-specific body mass index (BMI) percentiles were utilized; overweight was defined as BMI percentile ≥85th. Activity data included self-reported frequency of moderate-to-vigorous PA. Adolescents reporting ≥60 min/day of PA were considered "active." General linear models, adjusted for age, sex, and race-ethnicity, were used. A 6-year fasting sample weight was applied to the analyses to ensure representativeness of the data. RESULTS: The cMetS scores were significantly (P < 0.05) higher in OA and ONA adolescents compared to NOA (ß = 1.08 and ß = 1.57, respectively). In ONA males, cMetS was significantly (P < 0.01) higher compared to NOA males. In OA and ONA females, cMetS scores were significantly higher compared to the referent group (P < 0.01 for both). CONCLUSIONS: The cMetS scores were increased in overweight adolescents compared to those who were not overweight, regardless of their reported activity level.