Physical activity and nutrition in relation to resilience: a cross-sectional study.

A healthy lifestyle is often discussed as being a characteristic of or a prerequisite for quality of life. In phases of high subjective stress (work overload, negative thoughts), however, its protective function can be limited. The two present survey studies examined two facets of a health-related lifestyle (physical activity and nutritional awareness), in particular, the correlations with general life satisfaction and their adaptive function in respect to stress (resilience). In addition, because episodes of increased stress can have a negative effect on eating, the interactions with the consumption of less healthy food were examined. Two cross-sectional studies were conducted successively with adults aged between 18 and 72 in Germany. Study 1 (N = 685) examined the research questions with correlations, moderated regression analyses, and structural equation models. Study 2 (N = 628) differentiated between sport, occupational and daily activities. Study 1 showed that the amount of physical activity and nutritional awareness are correlated with life satisfaction. The relationship between stress appraisals and general life satisfaction was moderated by physical activity and nutritional awareness (stress-buffer effect). Study 2 replicated the stress-buffer effects of nutritional awareness, daily activities, and occupational activities. Both studies showed that stress is associated with consumption of less healthy food and found interactions with physical activity and nutritional awareness. Discussed are the adaptive role of physical activity and nutritional awareness in times of stress.Trial Registration EK UniBw M 23-06, 12/16/2022.

Diagnostic Accuracy of Single-Lead Electrocardiograms Using the Kardia Mobile App and the Apple Watch 4: Validation Study.

BACKGROUND: To date, the 12-lead electrocardiogram (ECG) is the gold standard for cardiological diagnosis in clinical settings. With the advancements in technology, a growing number of smartphone apps and gadgets for recording, visualizing, and evaluating physical performance as well as health data is available. Although this new smart technology is innovative and time- and cost-efficient, less is known about its diagnostic accuracy and reliability. OBJECTIVE: This study aimed to examine the agreement between the mobile single-lead ECG measurements of the Kardia Mobile App and the Apple Watch 4 compared to the 12-lead gold standard ECG in healthy adults under laboratory conditions. Furthermore, it assessed whether the measurement error of the devices increases with an increasing heart rate. METHODS: This study was designed as a prospective quasi-experimental 1-sample measurement, in which no randomization of the sampling was carried out. In total, ECGs at rest from 81 participants (average age 24.89, SD 8.58 years; n=58, 72% male) were recorded and statistically analyzed. Bland-Altman plots were created to graphically illustrate measurement differences. To analyze the agreement between the single-lead ECGs and the 12-lead ECG, Pearson correlation coefficient (r) and Lin concordance correlation coefficient (CCCLin) were calculated. RESULTS: The results showed a higher agreement for the Apple Watch (mean deviation QT: 6.85%; QT interval corrected for heart rate using Fridericia formula [QTcF]: 7.43%) than Kardia Mobile (mean deviation QT: 9.53%; QTcF: 9.78%) even if both tend to underestimate QT and QTcF intervals. For Kardia Mobile, the QT and QTcF intervals correlated significantly with the gold standard (rQT=0.857 and rQTcF=0.727; P<.001). CCCLin corresponded to an almost complete heuristic agreement for the QT interval (0.835), whereas the QTcF interval was in the range of strong agreement (0.682). Further, for the Apple Watch, Pearson correlations were highly significant and in the range of a large effect (rQT=0.793 and rQTcF=0.649; P<.001). CCCLin corresponded to a strong heuristic agreement for both the QT (0.779) and QTcF (0.615) intervals. A small negative correlation between the measurement error and increasing heart rate could be found of each the devices and the reference. CONCLUSIONS: Smart technology seems to be a promising and reliable approach for nonclinical health monitoring. Further research is needed to broaden the evidence regarding its validity and usability in different target groups.

Corrected QT Interval (QTc) Diagnostic App for the Oncological Routine: Development Study.

BACKGROUND: Numerous antineoplastic drugs such as chemotherapeutics have cardiotoxic side effects and can lead to long QT syndrome (LQTS). When diagnosed and treated in time, the potentially fatal outcomes of LQTS can be prevented. Therefore, regular electrocardiogram (ECG) assessments are critical to ensure patient safety. However, these assessments are associated with patient discomfort and require timely support of the attending oncologist by a cardiologist. OBJECTIVE: This study aimed to examine whether this approach can be made more efficient and comfortable by a smartphone app (QTc Tracker), supporting single-lead ECG records on site and transferring to a tele-cardiologist for an immediate diagnosis. METHODS: To evaluate the QTc Tracker, it was implemented in 54 cancer centers in Germany. In total, 266 corrected QT interval (QTc) diagnoses of 122 patients were recorded. Moreover, a questionnaire on routine ECG workflow, turnaround time, and satisfaction (1=best, 6=worst) was answered by the centers before and after the implementation of the QTc Tracker. RESULTS: Compared to the routine ECG workflow, the QTc Tracker enabled a substantial turnaround time reduction of 98% (mean 2.67, 95% CI 1.72-2.67 h) and even further time efficiency in combination with a cardiologic on-call service (mean 12.10, 95% CI 5.67-18.67 min). Additionally, nurses and patients reported higher satisfaction when using the QTc Tracker. In particular, patients' satisfaction sharply improved from 2.59 (95% CI 2.41-2.88) for the routine ECG workflow to 1.25 (95% CI 0.99-1.51) for the QTc Tracker workflow. CONCLUSIONS: These results reveal a significant improvement regarding reduced turnaround time and increased user satisfaction. Best patient care might be guaranteed as the exposure of patients with an uncontrolled risk of QTc prolongations can be avoided by using the fast and easy QTc Tracker. In particular, as regular side-effect monitoring, the QTc Tracker app promises more convenience for patients and their physicians. Finally, future studies are needed to empirically test the usability and validity of such mobile ECG assessment methods. TRIAL REGISTRATION: ClinicalTrials.gov NCT04055493; https://classic.clinicaltrials.gov/ct2/show/NCT04055493.

#fitspiration: a comparison of the sport-related social media usage and its impact on body image in young adults.

BACKGROUND: Following and posting sport-related content on social media is wide-spread among young people. To date, little is known about the interdependence between sport-related social media use and the thereby perceived personal body image. METHODS: We conducted an online survey (N = 285) to examine how social media influences the sport-related body image. RESULTS: In general, social media are frequently used for sport (n = 136, 47.7%). Resistance training correlated significantly with several motives of sport-related use of social media, and thus, represents the strong online presence of athletic sports. Less correlations could be found in team or other sports. Regarding the perception of body image, it was found that the group of rejecting (negative) body image significantly correlated with the emulation of social media mediated sport-related beauty and body ideals (r = 0.63, p = 0.001), as well as with increased body dissatisfaction when viewing sport-related posts on social media (r = 0.590, p = 0.001). Perceived social pressure and comparison were found to be mediators of the prevailing influence of social media usage. CONCLUSIONS: These results reveal the importance of taking a closer look at socially shaped beauty and body ideals, especially in sport-related contents, striving for more educational campaigns such as Body Positivity and, above all, filtering information. Finally, future research is needed to gain deeper insight into young persons' usage behavior of social media and its impact on the individual's body image. Trial Registration The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University of the Federal Armed Forces Munich, Germany (01/24/2022).

Agreement of Sleep Measures-A Comparison between a Sleep Diary and Three Consumer Wearable Devices.

Nowadays, self-tracking and optimization are widely spread. As sleep is essential for well-being, health, and peak performance, the number of available consumer technologies to assess individual sleep behavior is increasing rapidly. However, little is known about the consumer wearables' usability and reliability for sleep tracking. Therefore, the aim of the present study was to compare the sleep measures of wearable devices with a standardized sleep diary in young healthy adults in free-living conditions. We tracked night sleep from 30 participants (19 females, 11 males; 24.3 ± 4.2 years old). Each wore three wearables and simultaneously assessed individual sleep patterns for four consecutive nights. Wearables and diaries correlated substantially regarding time in bed (Range CCCLin: 0.74-0.84) and total sleep time (Range CCCLin: 0.76-0.85). There was no sufficient agreement regarding the measures of sleep efficiency (Range CCCLin: 0.05-0.34) and sleep interruptions (Range CCCLin: -0.02-0.10). Finally, these results show wearables to be an easy-to-handle, time- and cost-efficient alternative to tracking sleep in healthy populations. Future research should develop and empirically test the usability of such consumer sleep technologies.

High sleep quality can increase the performance of CrossFit® athletes in highly technical- and cognitive-demanding categories.

BACKGROUND: In current sports science, the important role of sleep quality for health and peak performance is well acknowledged. More precisely, it is evident that the negative combination of stressful factors, low resources, and bad sleep habits causes short-term performance losses as well as long-term health consequences. As the maximization of human performance consisting of multiple fixed workloads is the main motivation in CrossFit® (CF), the aim of the present study was to investigate the influence of high sleep quality on performance in CrossFit® athletes (CFA) and the different training categories that are addressed in CF. METHODS: In total, 149 CFA (81 females, 68 males; 32.01 ± 7.49 years old, 2.56 ± 1.77 active years in CF) filled in the online survey comprising the Pittsburgh Sleep Quality Index (PSQI) and CF performance-specific questions. RESULTS: It was found that CFA with high sleep quality reported higher values in all performance-related outcomes. Especially in Hero-/Girl-Workouts (χ2 = (1, n = 83) = 9.92, p = .002, φ = 0.37) and Gymnastics (χ2 = (1, n = 129) = 8.74, p = .003, φ = 0.28), performance differed significantly between good and poor sleeping CFA. Since those CF categories are highly technical- and cognitive-demanding high sleep quality seems to play a fundamental role in complex motor skill learning and performance development. CONCLUSIONS: These results reveal for the first time the positive effects of high sleep quality for performance in CFA and could be used as basis for future studies. Future research should also develop and empirically test suitable interventions to foster high sleep quality in CFA. TRIAL REGISTRATION: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University of the Federal Armed Forces Munich, Germany (06/04/2018).

Acute Effects of Resistance Exercise on Cognitive Function in Healthy Adults: A Systematic Review with Multilevel Meta-Analysis.

BACKGROUND: Recent research has revealed a beneficial impact of chronic resistance exercise (RE) on brain function. However, it is unclear as to whether RE is also effective in an acute setting. OBJECTIVE: To investigate the immediate effects of a single RE session on cognitive performance in healthy adults. METHODS: A multilevel meta-analysis with random effects meta-regression model was used to pool the standardized mean differences (SMD) between RE and no-exercise (NEX) as well as between RE and aerobic exercise (AE). In addition to global cognitive function, effects on reported sub-domains (inhibitory control, cognitive flexibility, working memory, attention) were examined. RESULTS: Twelve trials with fair methodological quality (PEDro scale) were identified. Compared to NEX, RE had a positive effect on global cognition (SMD: 0.56, 95% CI 0.22-0.90, p = 0.004), but was not superior to AE (SMD: - 0.10, 95% CI 0.01 to - 0.20, p = 0.06). Regarding cognitive sub-domains, RE, compared to NEX, improved inhibitory control (SMD: 0.73, 95% CI 0.21-1.26, p = 0.01) and cognitive flexibility (SMD: 0.36, 95% CI 0.17-0.55, p  = 0.004). In contrast, working memory (SMD: 0.35, 95% CI - 0.05 to 0.75, p  = 0.07) and attention (SMD: 0.79, 95% CI - 0.42 to 2.00, p = 0.16) remained unaffected. No significant differences in sub-domains were found between RE and AE (p > 0.05). CONCLUSION: RE appears to be an appropriate method to immediately enhance cognitive function in healthy adults. Further studies clearly elucidating the impact of effect modifiers such as age, training intensity, or training duration are warranted.