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Objective: This study aimed to examine the association between physical education classes and PA among adolescents from 50 low- and middle-income countries (LMICs). Methods: A self-reported questionnaire from the Global School-based Student Survey (GSHS) was used to collect information on participation frequency of physical education classes and being physically active over the last week, as well as other control variables (e.g., sex, age, country, sedentary behavior). Multivariable logistic regression and a pooled meta-analysis were performed to explore the association and compared country-wise differences. Results: Included adolescents aged from 13 to 17 years (n = 187,386, %boys = 51.7; mean age = 14.6 years), the prevalence of sufficient PA (meeting the PA guidelines) was 14.9%. The prevalence of 5 days or more to engage in physical education classes was 16.5%. Compared with adolescents who had 0 days for physical education classes, higher participation frequency was more likely related to sufficient PA (OR: 1 day = 1.34, 2 days = 1.66, 3 days = 1.67, 4 days = 1.79, 5 days or more = 2.46), these findings were also observed in both sexes. A moderate inconsistency on the association across the included countries was found (I2 = 53%, p < 0.01), although the pooled OR was 1.50 (95% CI: 1.36-1.65). Conclusions: Participating in more physical education classes may be an effective approach to increase physical activity levels among adolescents in LMICs. However, promoting physical activity levels among adolescents in LMICs through physical education classes should consider more country-specific factors. [ABSTRACT FROM AUTHOR]

Prevention of functional disabilities leading to long-term care and support needs in older population is one of the most urgent social issues facing Japan today. Frailty has been recognized as a pre-stage of functional disabilities leading to long-term care and support needs, and so, it is often treated as a target in their preventive interventions. Furthermore, because reductions of daily physical activities and physical fitness are considered as part of the major causes of physical frailty, their improvements have been also explored in community-based measures to prevent long-term care and support needs. This review paper aimed to summarize present findings regarding associations of frailty, physical activity, and physical fitness with incident long-term care and support needs in community-dwelling older Japanese adults. Through the review of literature, most of the previous prospective cohort studies showed that community- dwelling older Japanese adults who are free from frailty or maintain good physical activities and physical fitness have a reduced risk for the incidence of long-term care and support needs. These findings support an expectation that prevention of frailty and/or improvements of daily physical activities and physical fitness can be effective strategies to prevent older people from undergoing long-term care and support needs. It should be, however, understood that the associations found in the previous studies are not causal. Future prospective cohort studies defining exposure variables based on multipoint observations, as well as well-designed interventional studies are needed to validate the expectation. [ABSTRACT FROM AUTHOR]

Three decades of rapid economic development in China have not only benefited millions of Chinese by improving their living standards but have also dramatically increased the number of people who are part of the country's aging population. However, economic growth has not been accompanied by sufficient attention given to important public health issues, including an increase in the incidence of chronic diseases and a decline in physical activity (PA) that comes with an aging population. The rapid growth in China's older population will soon exert an impact on the nation's economy, population health status, and health behaviors, and will increase stress on its healthcare system. This review article provides a broad perspective on the impact of rapid economic development, industrialization, and urbanization on health-related behaviors, with a specific focus on PA among older adults. Specifically, the article offers an overview of the demographic context, significant public health challenges, evidence on PA and exercise interventions, and knowledge gaps and future directions for research.

The Finnish recommendations for health-enhancing physical activity ( PA) for adults (≥18 years) recommend: (i) ≥150 minutes of moderate-to-vigorous-intensity physical activity ( MVPA) and (ii) activities that develop muscle strength and balance ≥2 days/week. However, adherence to these recommendations among the Finnish adults is currently unknown. This study reports on the self-reported adherence to the PA recommendations and associations with sociodemographic factors among Finnish adults. Data were used from the Finnish ' Regional Health and Well-being Study.' In 2013-2014, postal questionnaires were sent to 132,560 persons, with 69,032 responding (response rate =52.1%). The weighted proportions adhering to the: (i) MVPA recommendation, (ii) sufficient muscle-strengthening activity (≥2 days/week), (iii) sufficient balance training (≥2 days/week), and (iv) Finnish health-enhancing PA recommendations (Finnish recommendations) were calculated. Associations with sociodemographic variables (eg, age, education level, self-rated health) were assessed using multiple logistic regression analyses. Of 69,032 respondents, 92.6% (n=64,380, response rate =48.6%, 18-98 years) reported on their physical activity levels. A total of 31.2% (95% CI: 30.8%-31.6%) met the aerobic MVPA recommendation, 17.2% (95% CI: 16.9%-17.6%) reported sufficient muscle-strengthening activity, 6.7% (95% CI: 6.4%-6.9%) reported sufficient balance training, and 10.8% (95% CI: 10.5%-11.1%) met the Finnish recommendations. In the adjusted analysis, those with poorer self-rated health, older age, lower education levels, and those classified overweight or obese were independently associated with lower odds of meeting the Finnish recommendations. The vast majority of Finnish adults do not meet the full PA recommendations. Public health action is needed to increase PA in Finland. [ABSTRACT FROM AUTHOR]

Three decades of rapid economic development in China have not only benefited millions of Chinese by improving their living standards but have also dramatically increased the number of people who are part of the country's aging population. However, economic growth has not been accompanied by sufficient attention given to important public health issues, including an increase in the incidence of chronic diseases and a decline in physical activity (PA) that comes with an aging population. The rapid growth in China's older population will soon exert an impact on the nation's economy, population health status, and health behaviors, and will increase stress on its healthcare system. This review article provides a broad perspective on the impact of rapid economic development, industrialization, and urbanization on health-related behaviors, with a specific focus on PA among older adults. Specifically, the article offers an overview of the demographic context, significant public health challenges, evidence on PA and exercise interventions, and knowledge gaps and future directions for research. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the association between physical education classes and PA among adolescents from 50 low- and middle-income countries (LMICs)., Methods: A self-reported questionnaire from the Global School-based Student Survey (GSHS) was used to collect information on participation frequency of physical education classes and being physically active over the last week, as well as other control variables (e.g., sex, age, country, sedentary behavior). Multivariable logistic regression and a pooled meta-analysis were performed to explore the association and compared country-wise differences., Results: Included adolescents aged from 13 to 17 years (n=187,386, %boys=51.7; mean age=14.6 years), the prevalence of sufficient PA (meeting the PA guidelines) was 14.9%. The prevalence of 5 days or more to engage in physical education classes was 16.5%. Compared with adolescents who had 0 days for physical education classes, higher participation frequency was more likely related to sufficient PA (OR: 1 day=1.34, 2 days=1.66, 3 days=1.67, 4 days=1.79, 5 days or more=2.46), these findings were also observed in both sexes. A moderate inconsistency on the association across the included countries was found (I 2 =53%, p<0.01), although the pooled OR was 1.50 (95% CI: 1.36-1.65)., Conclusions: Participating in more physical education classes may be an effective approach to increase physical activity levels among adolescents in LMICs. However, promoting physical activity levels among adolescents in LMICs through physical education classes should consider more country-specific factors., (Copyright © 2021 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

A growing body of research has investigated the level of participation in muscle-strengthening (MS) activities and their correlates among Western populations; however, scarce attention has been paid to this issue among Chinese adults. This study aimed to describe the level of MS activities and to explore the relationships between sociodemographic correlates and level of MS activities in a large sample of Chinese adults. For this study, 3073 adults were recruited from 13 cities in Hubei Province. A self-reported questionnaire was utilized to collect data on MS activities and sociodemographic information among participants in this study. According to World Health Organization physical activity guidelines, MS activities should be undertaken at least two days per week. Multivariate logistic regression was used to explore the sociodemographic correlates of MS activities. The statistical significance level was set up as p < 0.05. The prevalence of MS activities among participants was 28.5%. MS activities among the total samples were associated with sex (adjusted odds ratios (aORs) for male = 1.98, 95% confidence intervals (95% CI): 1.67-2.34) and family composition (aOR for multiple children = 1.35, 95%CI: 1.12-1.64). Among males, normal weight status (aOR = 1.39, 95%CI: 1.08-1.78) and multiple children (aOR = 1.58, 95% CI: 1.21-2.05) were associated with MS activities. There was no association of sociodemographic factors with MS activities among females. Our results suggest that approximately 70% of adults in Hubei Province do not engage in recommended MS activities. These activities were associated with sex and family composition, which differed between sexes. This study provides sex-specific information on MS activity interventions. Future studies should use improved designs to explore more sociodemographic (e.g., health status, marital status and smoking status) and other dimensional correlates of MS activities among Chinese adults, to provide an evidence base for improved health behavior interventions., Competing Interests: The authors declare no conflict of interest.

Background: The association between physical activity (PA), sedentary behavior, and incident diabetes has been assessed in whites but is less well investigated in multiethnic populations., Objective: To assess the association between PA, sedentary behavior, and incident diabetes in the Multi-Ethnic Study of Atherosclerosis., Research Design and Methods: Incident diabetes was assessed among adults without prevalent baseline diabetes (2000-2002) at 5 in-person examinations between 2002 and 2012. Baseline PA (moderate, vigorous, and exercise-specific; metabolic equivalents of task-hours/week) and sedentary behaviors (television watching, reading; hours/day) were assessed by questionnaire. HRs were estimated using Cox proportional hazard models., Results: Among 5829 adults (mean age 61.8 years, 54% female, 42% white, 12% Chinese-American, 26% African-American, 21% Hispanic-American), there were 655 incident diabetes cases (median follow-up 11.1 years). After adjustment, diabetes risk was lower in those with brisk or striding compared with none or casual walking pace (HR 0.67; 95% CI 0.54 to 0.84), higher levels of exercise PA (HR for highest vs lowest quartile 0.79; 95% CI 0.63 to 0.98), and any compared with no vigorous PA (HR 0.79; 95% CI 0.66 to 0.95). Race/ethnicity influenced the association of walking pace, exercise PA, and any vigorous PA on diabetes risk, which was only significant among whites. Total leisure sedentary behaviors (HR for highest vs lowest quartile 1.65; 95% CI 1.26 to 2.14) and television watching (HR for highest vs lowest quartile 2.68; 95% CI 1.38 to 5.21) were significantly associated with diabetes risk in multiethnic analyses and were influenced by race/ethnicity., Conclusions: These results confirm the importance of PA and sedentary behavior on diabetes risk in a multiethnic population and demonstrate potential variations across race/ethnic groups.

Objective: Type 2 diabetes mellitus (T2DM) is associated with high levels of disability and mortality. Regular exercise prevents premature disability and mortality, but people with T2DM are generally sedentary for reasons that are not fully established. We previously observed that premenopausal women with T2DM report greater effort during exercise than their counterparts without diabetes, as measured by the Rating of Perceived Exertion (RPE) scale. We hypothesized that RPE is greater in older women with T2DM versus no T2DM., Research Design and Methods: We enrolled overweight, sedentary women aged 50-75 years with (n=26) or without T2DM (n=28). Participants performed submaximal cycle ergometer exercise at 30 W and 35% of individually-measured peak oxygen consumption (35% VO2peak). We assessed exercise effort by RPE (self-report) and plasma lactate concentration., Results: VO2peak was lower in T2DM versus controls (p=0.003). RPE was not significantly greater in T2DM versus controls (30 W: Control, 10.4±3.2, T2DM, 11.7±2.3, p=0.08; 35% VO2peak: Control, 11.1±0.5, T2DM, 12.1±0.5, p=0.21). However, lactate was greater in T2DM versus controls (p=0.004 at 30 W; p<0.05 at 35% VO2peak). Greater RPE was associated with higher lactate, higher heart rate, and a hypertension diagnosis (p<0.05 at 30 W and 35% VO2peak)., Conclusions: Taken together, physiological measures of exercise effort were greater in older women with T2DM than controls. Exercise effort is a modifiable and thereby targetable end point. In order to facilitate regular exercise, methods to reduce exercise effort in T2DM should be sought., Trial Number: NCT00785005.