2 Minute Medicine is pleased to announce that we are launching Wellness Check, a new series dedicated to exploring new research evidence focused on wellness. Each week, we will report on articles examining different aspects of wellness, including (but not limited to) nutrition, sleep, reproductive health, substance use and mental health. This week, we explore the latest evidence-based updates in exercise.
1. This study found that overall, 7.12% of youth met all three 24-hour movement guidelines, whereas 19.21% met none of the movement guidelines.
2. Furthermore, adolescents, girls, and those from countries with a lower human development index were less likely to meet the three 24-hour movement guidelines.
Evidence Rating Level: 1 (Excellent)
Physical activity, screen time, and sleep duration are behaviors that are co-dependent because they are distributed across a 24-hour period. These three behaviors provide the rationale for the development of the 24-Hour Movement Guidelines. In youth (3-18 years), meeting all three of these guidelines has been associated with physical, psychosocial and cognitive benefits. However, there has not been an analysis investigating how a country’s human development index (HDI), age, or sex moderate this adherence. Consequently, the present systematic review and meta-analysis aimed to evaluate the adhere to the overall guidelines as well as factors affecting adherence.
Of 17,551 screened records, 63 (n=387,437 participants) were included between January 2016 and May 2021. Studies were included if they investigated the adherence to the 24-hour movement guidelines in healthy participants aged 3-18 years. Studies were excluded if they were conducted exclusively with overweight/obese participants, or if they had physical or mental disorders. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-sectional studies. A random-effects model was used to pool the prevalence of multiple studies.
Results demonstrated that overall, 7.12% of youth met all three 24-hour movement guidelines, and 19.21% met none of them. Furthermore, adolescents, girls, and those from countries with a lower Human Development Index were less likely to meet the three 24-hour movement guidelines. However, this study was limited by the fact that pooled estimates originated from cross-sectional data which prevents inference of causality. Nonetheless, these results suggest that the low adherence to current 24-hour movement guidelines may present a public health concern for youth and the need to promote these movement behaviours.
1. A nonlinear dose-response association was observed between step count and all cause death and cardiovascular disease.
2. A 1000 step increment of steps per day was associated with a 23% decreased risk of all-cause mortality. For every 500 steps increased per day, the risk of cardiovascular disease was 6% lower.
Evidence Rating Level: 1 (Excellent)
Walking is a well-known sustainable form of physical activity that can be performed anywhere. Society has touted a goal of 10,000 steps per day as being ideal for health but there is little evidence to support this claim. Most studies associated with walking and life expectancy use self-declared indicators of daily steps and walking time and are therefore inadequate. As a result, the present meta-analysis sought to study the dose-response relationship between step count and all-cause mortality and cardiovascular disease.
Of 9673 identified studies, 16 were included from database inception to July 2021. Studies were included if they had a prospective design or a clinical trial and evaluated the influence of daily step count on at least one outcome of: all-cause mortality or cardiovascular disease (death, coronary heart disease or stroke). Studies were excluded if participants were not recruited from the general population in good health. Quality assessment was done following the Newcastle-Ottawa Quality Assessment scale.
Results demonstrated a nonlinear dose-response association between step count and all cause death and cardiovascular disease. Furthermore, a 1,000 step increment of steps per day was associated with a 23% decreased risk of all-cause mortality. For every 500 steps increased per day, the risk of cardiovascular disease was 6% lower. However, the present study was limited by its generalizability due to a sample size comprised primarily of adults with higher socioeconomic status. Despite this, the quality of the results were high due to the measurement of step count by wearable devices and the inclusion of prospective designs/clinical trials. This study overall was significant in suggesting the value of walking on all-cause mortality and cardiovascular health.
1. This study demonstrated an inverse dose-response association between cardiorespiratory fitness with all-cause, cardiovascular disease and cancer mortality.
2. Per one metabolic equivalent increase in CRF, there was a decrease of 12%, 13% and 7% in all-cause, CVD and cancer mortality respectively.
Evidence Rating Level: 1 (Excellent)
Cardiorespiratory fitness (CRF) reflects the body’s ability to transport oxygen from the atmosphere to the mitochondria during exercise and is considered to reflect total body health. The literature suggests an association between CRF and several health outcomes; however, none have been updated recently. Therefore, the objective of the present meta-analysis was to assess the qualitative and quantitative associations between CRF and all-cause, cardiovascular disease (CVD) and cancer mortality in healthy patients.
Of 27,360 records, 34 studies were included from database inception to December 2019. There were 625,400 participants and 34,734 outcomes. Studies were included if they investigated the association between CRF and all-cause, CVD and cancer mortality. Studies were excluded if study participants had an underlying disease. CRF was evaluated by an exercise stress test. Generalized least-squares regression models were used to assess the quantitative relation of CRF with outcomes.
Results demonstrated an inverse dose-response association between CRF with all-cause, cardiovascular disease and cancer mortality. Furthermore, per one metabolic equivalent increase in CRF, there was a decrease of 12%, 13% and 7% in all-cause, CVD and cancer mortality respectively. However, this study was limited by the high heterogeneity found in the studies. Nonetheless, this meta-analysis represents the first to quantify the dose-response relationship between CRF with all-cause, CVD and cancer mortality which may help encourage public health recommendations to increase CRF.
1. This study found intrinsic factors that were significantly associated with injury included: more running experience, being classified as a level A runner, and a higher score on the “sports accident questionnaire (PAD-22).
2. Extrinsic factors significantly associated with injury included: neglecting warm up, no specialized running plan, training on asphalt, double training sessions per day, and physical labor occupations.
Evidence Rating Level: 2 (Good)
While running is well known to improve overall health, trail running is a subcategory that may present with higher injury risk due to the nature of the terrain and training. The severity of some of these injuries highlights the need to identify risk factors of injury before training and race participation to ensure that participants reap the health benefits of running. As a result, the objective of the present living systematic review was to provide an up-to-date summary on factors associated with injury in trail running.
Of 2755 identified studies, 19 were included (n=2785 participants) from 2011-2021. All studies that met the criteria of trail running as defined by the International Trail Running Association and which investigated injury risk factors were included. A modified Downs and Black assessment tool was used to assess the quality of each included study. The level of evidence was determined using the Oxford Centre of Evidence-Based Medicine (OCEBM) model.
After data analysis, researchers found that the intrinsic factors significantly associated with injury included: more running experience, level A runner and a higher score on the “sports accident questionnaire (PAD-22). In addition, extrinsic factors significantly associated with injury included: neglecting warm up, no specialized running plan, training on asphalt, double training sessions per day, and physical labor occupations. However, this study was limited by the relatively low mean quality score attributed to the lack of sample size calculations. Nonetheless, the study’s living systematic review design helps inform up to date evidence-based medical practice on modifying risk factors pertinent to trail running.
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