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The physical activity paradox in relation to work ability and health-related productivity loss in Korea
Heejoo Ko, Dohwan Kim, Seong-Sik Cho, Mo-Yeol Kang
Epidemiol Health. 2023;45:e2023096.   Published online October 28, 2023
DOI: https://doi.org/10.4178/epih.e2023096
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AbstractAbstract PDF
Abstract
OBJECTIVES
The physical activity paradox suggests that occupational physical activity (OPA), unlike leisure-time physical activity (LTPA), may detrimentally impact health. We explored the relationships of OPA and LTPA with work ability (WA) and health-related productivity loss (HRPL).
METHODS
This study included 5,501 workers in Korea who were recruited in 2021 through a web-based cross-sectional questionnaire. The questionnaire was utilized to quantify OPA and LTPA in metabolic equivalents, while WA and HRPL were also measured. Non-parametric regression, using a generalized additive model (GAM), was employed to visualize the relationships of LTPA and OPA with WA and HRPL. Mean differences in WA and HRPL, in relation to OPA and LTPA, were examined using linear regression models. These models were adjusted for covariates including sex, age, body mass index, education level, alcohol consumption, smoking history, insomnia, occupation, hours worked, and income.
RESULTS
The GAM and linear regression analyses revealed that higher LTPA corresponded with higher WA and lower HRPL. In contrast, as OPA increased, WA decreased and HRPL increased. However, within the group with high OPA, HRPL was not significantly lower in the high-LTPA subgroup relative to the low-LTPA subgroup (mean difference=1.92%, p=0.343). This pattern was especially pronounced among workers aged 60 years and older, with an increase in HRPL observed with increasing LTPA among the respondents with high OPA.
CONCLUSIONS
High LTPA levels were associated with elevated WA and diminished HRPL. In contrast, higher levels of OPA were associated with lower WA and higher HRPL.
Summary
Trends in the effects of socioeconomic position on physical activity levels and sedentary behavior among Korean adolescents
Hunju Lee, Hyowon Choi, Sang Baek Koh, Hyeon Chang Kim
Epidemiol Health. 2023;45:e2023085.   Published online September 8, 2023
DOI: https://doi.org/10.4178/epih.e2023085
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  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We examined trends in physical activity and sedentary behavior in Korean adolescents, and their association with socioeconomic position (SEP).
METHODS
We used data from the Korea Youth Risk Behavior Survey, a nationwide study involving students aged 12-19 conducted between 2009 and 2021. SEP was assessed based on economic status, parental education attainment, and urbanization. Physical activity was categorized into vigorous physical activity, moderate physical activity, and muscle training, and sedentary time was also measured. We conducted the log-binomial regression to calculate prevalence ratios (PRs) and prevalence differences.
RESULTS
Our analysis included a total of 593,896 students. We observed an increasing trend in physical activity, but a worsening trend in sedentary behavior. A positive association was found between an adolescent’s physical activity and SEP indicators, except for urbanization. Adolescents with higher economic status engaged in more vigorous physical activity (high: PR, 1.26; 95% confidence interval [CI], 1.25 to 1.28; middle: PR, 1.03; 95% CI, 1.02 to 1.04). Similar associations were observed for father’s education (tertiary or above: PR, 1.11; 95% CI, 1.09 to 1.13; upper secondary: PR, 1.05; 95% CI, 1.03 to 1.07) and mother’s education (tertiary or above: PR, 1.17; 95% CI, 1.15 to 1.20; upper secondary: PR, 1.06; 95% CI, 1.04 to 1.08). Adolescents with higher economic status also showed a higher compliance rate with the guideline restricting sedentary time to 2 hours per day (high: PR, 1.28; 95% CI, 1.25 to 1.30; middle: PR, 1.03; 95% CI, 1.01 to 1.05).
CONCLUSIONS
Adolescents with higher SEP exhibited more physical activity and less sedentary time than those with lower SEP.
Summary
Korean summary
본 연구는 2009년부터 2021년까지 청소년의 사회경제적 지위가 신체활동과 좌식생활습관에 미치는 영향을 분석하였다. 청소년의 경제적 상태, 아버지와 어머니의 교육수준이 높을수록 청소년의 신체활동이 증가하고 좌식생활이 감소하였다. 그러나 청소년이 사는 지역의 도시화 정도는 영향을 미치지 않았다.
Key Message
This article analyzes the effects of an adolescent's socio-economic position on their physical activity and sedentary behavior from 2009 to 2021. The higher the adolescent's economic status, father's education, or mother's education, the more they engaged in physical activity and the less time they spent in sedentary behaviors. However, the level of urbanization in the area where the adolescent resided had no effect.

Citations

Citations to this article as recorded by  
  • Using structural equation modeling to explore the influences of physical activity, mental health, well-being, and loneliness on Douyin usage at bedtime
    Hongcheng Luo, Xing Zhang, Songpeng Su, Mingyang Zhang, Mingyue Yin, Siyuan Feng, Rui Peng, Hansen Li
    Frontiers in Public Health.2024;[Epub]     CrossRef
Physical activity, sedentary behavior, and cardiovascular disease risk in Korea: a trajectory analysis
Jina Han, Yeong Jun Ju, Soon Young Lee
Epidemiol Health. 2023;45:e2023028.   Published online February 22, 2023
DOI: https://doi.org/10.4178/epih.e2023028
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  • 1 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
To identify the distinct trajectories of sedentary behavior (SB) and explore whether reduced cardiovascular disease (CVD) risk was associated with a distinct trajectory of physical activity (PA).
METHODS
We analyzed data from 6,425 people who participated in the Korean Health Panel Survey over a period of 10 years. The participants’ self-reported SB and PA were assessed annually, and trajectory groups were identified using a group-based trajectory model for longitudinal data analysis. Logistic regression analysis was performed to assess the association between CVD risk (10-year cumulative incidence) and the trajectories of SB and PA. The adjusted variables included socio-demographic factors, the predisposing diseases of CVD, and baseline health behaviors.
RESULTS
Trajectory analysis identified 4 SB trajectory groups: SB group 1 (low and slightly increasing trend, 53.1%), SB group 2 (high and rapidly decreasing trend, 14.7%), SB group 3 (high and slightly decreasing trend, 9.9%), and SB group 4 (low and rapidly increasing trend, 22.2%). The 3 PA trajectory groups were PA group 1 (moderate and slightly decreasing trend, 32.1%), PA group 2 (low and slightly decreasing trend, 57.3%), and PA group 3 (maintained inactivity, 10.7%). By the 10-year follow-up, 577 cases of incident CVD had occurred. We also noted a 50% reduction in the risk of CVD when SB group 4 was accompanied by PA group 1 (odds ratio, 0.50; 95% confidence interval, 0.28 to 0.90).
CONCLUSIONS
Despite increased time spent in SB, maintaining PA about 2 days to 3 days per week reduced the occurrence of CVD.
Summary

Citations

Citations to this article as recorded by  
  • Effects of physical activity and sedentary behaviors on cardiovascular disease and the risk of all-cause mortality in overweight or obese middle-aged and older adults
    Yongqiang Zhang, Xia Liu
    Frontiers in Public Health.2024;[Epub]     CrossRef
Dynamic changes in clinical biomarkers of cardiometabolic diseases by changes in exercise behavior, and network comparisons: a community-based prospective cohort study in Korea
JooYong Park, Jaesung Choi, Ji-Eun Kim, Sang-Min Park, Joo-Youn Cho, Daehee Kang, Miyoung Lee, Ji-Yeob Choi
Epidemiol Health. 2023;45:e2023026.   Published online February 16, 2023
DOI: https://doi.org/10.4178/epih.e2023026
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  • 1 Web of Science
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Lifestyles, including exercise behaviors, change continually over time. This study examined whether the clinical biomarkers (CBs) related to cardiometabolic diseases (CMDs) and their relationships differed with changes in exercise behavior.
METHODS
The Ansan-Ansung cohort study (third to fifth phases; n=2,668) was used in the current study. Regular exercise behavior was investigated using a yes/no questionnaire. Changes in exercise behavior were classified into 4 groups: Y-N, N-Y, Y-Y, and N-N, with “Y” indicating that a participant regularly engaged in exercise at a given time point and “N” indicating that he or she did not. Fourteen CBs related to CMDs were used, and the associations between changes in exercise behavior and relative changes in CBs were examined. CB networks were constructed and topological comparisons were conducted.
RESULTS
Y-N was associated with increases in fasting blood sugar and insulin levels in men, and increased total cholesterol and low-density lipoprotein cholesterol levels in women. Meanwhile, N-Y was inversely associated with body fat percentage, visceral fat percentage, fasting insulin, and triglyceride level. Waist circumference played a central role in most networks. In men, more edges were found in the N-Y and Y-Y groups than in the N-N and Y-N groups, whereas women in the N-Y and Y-Y groups had more edges than those in the N-N and Y-N groups.
CONCLUSIONS
Consistent exercise or starting to engage in regular exercise had favorable effects on CBs related to CMDs, although their network patterns differed between the sexes.
Summary
Korean summary
한국 지역사회기반 코호트 자료를 이용하여, 운동 행태 변화에 따른 심혈관대사질환 관련 임상 생체 지표들의 변화가 남녀에 따라, 변화 행태에 따라 다르게 나타남을 확인하였다. 이런 변화와 차이는 네트워크 분석을 통한 구조적인 차이로도 확인되었다.
Key Message
This study examined that changes in the clinical biomarkers related to cardiometabolic diseases differed with changes in exercise behavior using a community-based prospective cohort study in Korea. Consistent exercise or change into exercise behavior had favorable effects on CB related to CMD, although their network patterns differed between the sexes.
Associations of racial and ethnic discrimination with adverse changes in exercise and screen time during the COVID-19 pandemic in the United States
Tong Xia, Gilbert C. Gee, Jian Li, Xinyue Liu, Jin Dai, Lu Shi, Donglan Zhang, Zhuo Chen, Xuesong Han, Yan Li, Hongmei Li, Ming Wen, Dejun Su, Liwei Chen
Epidemiol Health. 2023;45:e2023013.   Published online January 28, 2023
DOI: https://doi.org/10.4178/epih.e2023013
  • 6,463 View
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  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
During the coronavirus disease 2019 (COVID-19) pandemic, a growing prevalence of racial and ethnic discrimination occurred when many Americans struggled to maintain healthy lifestyles. This study investigated the associations of racial and ethnic discrimination with changes in exercise and screen time during the pandemic in the United States.
METHODS
We included 2,613 adults who self-identified as non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, or Hispanic from the Health, Ethnicity, and Pandemic study, a cross-sectional survey conducted among a nationally representative sample of United States adults between October and November 2020. We assessed self-reported racial and ethnic discrimination by measuring COVID-19-related racial and ethnic bias and examined its associations with changes in exercise and screen time using multivariable logistic regression models. We analyzed data between September 2021 and March 2022.
RESULTS
COVID-19-related racial and ethnic bias was associated with decreased exercise time among non-Hispanic Asian (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.13 to 1.89) and Hispanic people (OR, 1.91; 95% CI, 1.32 to 2.77), and with increased screen time among non-Hispanic Black people (OR, 1.94; 95% CI, 1.33 to 2.85), adjusting for age, sex, education, marital status, annual household income, insurance, and employment status.
CONCLUSIONS
Racial and ethnic discrimination may have adversely influenced exercise and screen time changes among racial and ethnic minorities during the COVID-19 pandemic in the United States. Further studies are needed to investigate the mechanisms through which racial and ethnic discrimination can impact lifestyles and to develop potential strategies to address racial and ethnic discrimination as a barrier to healthy lifestyles.
Summary
Key Message
In this study with a nationally representative sample of Americans, we found that racial discrimination during the COVID-19 pandemic was associated with undesired changes in exercise and screen time, particularly among minorities.

Citations

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  • Asian American Women’s Experiences of Discrimination and Health Behaviors during the COVID-19 Pandemic
    Katarina Wang, Alice Guan, Janice Seto, Debora L. Oh, Kathie Lau, Christine Duffy, Esperanza Castillo, Valerie McGuire, Michelle Wadhwa, Clifford G. Tepper, Heather A. Wakelee, Mindy C. DeRouen, Salma Shariff-Marco, Iona Cheng, Scarlett Lin Gomez
    Journal of Immigrant and Minority Health.2023;[Epub]     CrossRef
Associations between digital media use and lack of physical exercise among middle-school adolescents in Korea
Gyeongmin Kim, Hyunsuk Jeong, Hyeon Woo Yim
Epidemiol Health. 2023;45:e2023012.   Published online January 10, 2023
DOI: https://doi.org/10.4178/epih.e2023012
  • 4,572 View
  • 228 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The reported effects of digital media overuse on physical activity among adolescents are inconsistent. This study examined the association between hours of digital media use and lack of moderate-intensity physical exercise (mPE) according to the type of digital media.
METHODS
This study included 1,837 middle school students from the iCURE (Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence) study conducted in Korea. Hours spent using digital media were measured by self-reported daily usage time for Internet games, messengers, social media, and watching game streaming on weekdays. Lack of mPE was defined as performing a minimum of 30 minutes at a time less than twice weekly. Multivariable logistic regression analysis stratified by sex was performed.
RESULTS
Among male students, the group with the highest hours of using either Internet games or watching game streaming was more likely to lack mPE than each non-user group. In contrast, among male students, the group using either messengers or social media had a higher rate of mPE compared to each non-user group. Female students showed no association between hours spent using Internet games, messengers, social media, or watching game streaming and a lack of mPE.
CONCLUSIONS
Among male middle school students in Korea, the excessive use of Internet games or watching game streaming was associated with a lack of mPE. Thus, guidelines should be established regarding adolescent use of internet games and watching game streaming.
Summary
Korean summary
한국에서 남, 여 중학생을 대상으로 4개 인터넷 매체(인터넷 게임, 메신저, 소셜미디어, 게임 스트리밍 시청) 과다사용과 신체 운동 부재와의 연관성을 알아보기 위한 단면조사 연구를 시행하였다. 남자 중학생에서 인터넷 게임 사용 또는 게임 스트리밍 시청 시간이 가장 높은 사분위 그룹은 비이용 그룹보다 중간 강도의 신체운동 부재율이 유의하게 높았다.
Key Message
A cross-sectional study was conducted to find out the relationship between excessive use of four Internet media (internet games, messengers, social media, and game streaming) and lack of physical exercise targeting male and female middle school students in Korea. Among male middle school students, the upper quartile group with the highest Internet game use or game streaming viewing time had a significantly higher moderate-intensity physical exercise absence rate than the non-use group.

Citations

Citations to this article as recorded by  
  • Trends in the effects of socioeconomic position on physical activity levels and sedentary behavior among Korean adolescents
    Hunju Lee, Hyowon Choi, Sang Baek Koh, Hyeon Chang Kim
    Epidemiology and Health.2023; 45: e2023085.     CrossRef
The associations of job strain and leisure-time physical activity with the risk of hypertension: the population-based Midlife in the United States cohort study
Xinyue Liu, Timothy A. Matthews, Liwei Chen, Jian Li
Epidemiol Health. 2022;44:e2022073.   Published online September 7, 2022
DOI: https://doi.org/10.4178/epih.e2022073
  • 6,773 View
  • 227 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Job strain is positively associated with incident hypertension, while increasing leisure-time physical activity (LTPA) can reduce incident hypertension. However, the joint associations of job strain and LTPA with incident hypertension among United States workers have yet to be investigated. This study examined the independent and joint associations of job strain and LTPA with incident hypertension.
METHODS
This prospective cohort study (n=1,160) utilized data from the population-based Midlife in the United States study. The associations of job strain and LTPA at baseline with incident hypertension during follow-up were examined using Cox proportional hazards models. High job strain was derived from a combination of high job demands and low job control, and high LTPA was defined as engagement in moderate or vigorous LTPA at least once per week.
RESULTS
During 9,218 person-years of follow-up, the hypertension incidence rate was 30.6 (95% confidence interval [CI], 27.3 to 34.3) per 1,000 person-years. High job strain was associated with a higher risk for hypertension than low job strain (adjusted hazard ratio [aHR], 1.29; 95% CI, 1.00 to 1.67). High LTPA was associated with lower hypertension risk than low LTPA (aHR, 0.77; 95% CI, 0.60 to 0.98). Hypertension risk was higher among workers with high job strain and low LTPA than among those with low job strain and high LTPA (aHR, 1.70; 95% CI, 1.18 to 2.43).
CONCLUSIONS
Job strain and LTPA showed positive and inverse associations, respectively, with incident hypertension. The combination of high job strain and low LTPA was associated with the highest risk for hypertension.
Summary
Key Message
High job strain and low leisure-time physical activity are independent risk factors for hypertension among workers, and those with high job strain and low leisure-time physical activity are at the highest risk, so it is critical that policy interventions target job strain and leisure-time physical activity to reduce hypertension.

Citations

Citations to this article as recorded by  
  • Prospective associations of occupational and leisure-time physical activity with risk of diabetes: a cohort study from the United States
    Timothy A Matthews, Xinyue Liu, Liwei Chen, Jian Li
    Annals of Work Exposures and Health.2024;[Epub]     CrossRef
  • 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension
    Giuseppe Mancia, Reinhold Kreutz, Mattias Brunström, Michel Burnier, Guido Grassi, Andrzej Januszewicz, Maria Lorenza Muiesan, Konstantinos Tsioufis, Enrico Agabiti-Rosei, Engi Abd Elhady Algharably, Michel Azizi, Athanase Benetos, Claudio Borghi, Jana Br
    Journal of Hypertension.2023; 41(12): 1874.     CrossRef
  • Adulthood Psychosocial Disadvantages and Risk of Hypertension in U.S. Workers: Effect Modification by Adverse Childhood Experiences
    Timothy A. Matthews, Yifang Zhu, Wendie Robbins, Mary Rezk-Hanna, Paul M. Macey, Yeonsu Song, Jian Li
    Life.2022; 12(10): 1507.     CrossRef
  • Associations of COVID-19 Related Work Stressors with Psychological Distress: Racial and Ethnic Disparities in Californian Workers
    Timothy A. Matthews, Megan Guardiano, Negar Omidakhsh, Lara Cushing, Wendie Robbins, OiSaeng Hong, Jian Li
    International Journal of Environmental Research and Public Health.2022; 20(1): 144.     CrossRef
COVID-19: Special Article
Smoking, drinking, and physical activity among Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Sunhye Choi, Jinwook Bahk, Suyeon Park, Kyungwon Oh, Kyunghee Jung-Choi
Epidemiol Health. 2022;44:e2022043.   Published online April 25, 2022
DOI: https://doi.org/10.4178/epih.e2022043
  • 12,186 View
  • 574 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to describe trends in health behaviours between 2011 and 2020 and compare the changes in these behaviours between the 2020 COVID-19 pandemic and previous periods according to socio-demographic variables.
METHODS
This study used data from the 2011 to 2020 Korea National Health and Nutrition Examination Survey. Current cigarette smoking, high-risk drinking, and inadequate physical activity levels were used as health behaviour indicators. The age-standardized prevalence, differences in prevalence between the periods, and the annual percentage change (APC) were calculated.
RESULTS
Current cigarette smoking showed a decreasing trend (APC, -2.6), high-risk drinking remained unchanged, and inadequate physical activity levels increased (APC, 3.5) during 2011-2020. There were significant differences in high-risk drinking (3.1%p; 95% confidence interval [CI], 0.3 to 5.9) and inadequate physical activity levels (4.3%p; 95% CI, 0.4 to 8.1) between 2019 and 2020 in men. Among men, increased high-risk drinking was found in those aged 40-49 years, non-single households, urban residents, and the middle and highest income groups between 2019 and 2020. The low educational group and manual workers among men aged 30-59 years also showed an increased proportion of high-risk drinking. Inadequate physical activity levels also increased among men between 2019 and 2020 in those aged 30-39 years, non-single households, urban residents, and the upper-middle-income group.
CONCLUSIONS
In the first year of the COVID-19 pandemic, Korean men’s high-risk drinking and inadequate physical activity levels increased. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.
Summary
Korean summary
코로나 대유행 첫 해인 2020년, 한국 남성에서 고위험음주와 부적절한 신체 활동 수준이 증가하였다. 감염성 질환 대유행 시기, 확산을 차단하기 위한 사회적 노력과 더불어 건강행태에 부정적인 여파가 미치지 않도록 적극적인 대책이 필요함을 시사한다.
Key Message
In the first year of the COVID-19 pandemic, Korean men’s high-risk drinking and inadequate physical activity levels increased. Despite Korea's positive performance in various indicators during the COVID-19 pandemic, the socioeconomic and cultural effects of COVID-19 have affected people's health behaviour. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.

Citations

Citations to this article as recorded by  
  • Changes in food and nutrient intakes in Korean adults before and during the COVID-19 pandemic: data from the 2011-2020 Korea National Health and Nutrition Examination Survey
    Kyungwon Oh, Suyeon Park, Sihyun Park, Sungha Yun, Hongseok Choi, Eun Kyeong Jeong
    Epidemiology and Health.2023; 45: e2023015.     CrossRef
  • Factors affecting decreased physical activity during the COVID-19 pandemic: an age-, gender-, and body mass index-matched study
    Jhin-Yi Shin, Jaemoo Lee, Jung-Min Lee, Nam Yoon Ho
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • The serotype-specific prevalence of pneumococci in hospitalized pneumonia patients with COPD: a prospective, multi-center, cohort study
    Jae Yeol Kim, Jae-Woo Jung, Min-Jong Kang, Deog Kyeom Kim, Hayoung Choi, Young-Jae Cho, Seung Hun Jang, Chang-Hoon Lee, Yeon Mok Oh, Ji Sook Park
    The Korean Journal of Internal Medicine.2023; 38(5): 714.     CrossRef
  • Association between individuals’ locus of control and mental health during the COVID-19 pandemic
    Filiz Eren, Isabelle Kousignian, Solène Wallez, Maria Melchior, Murielle Mary-Krause
    Journal of Affective Disorders Reports.2023; 14: 100678.     CrossRef
  • Changes in the management of hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the coronavirus disease 2019 pandemic: data from the 2010–2020 Korea National Health and Nutrition Examination Survey
    Yoonjung Kim, Suyeon Park, Kyungwon Oh, Hongseok Choi, Eun Kyeong Jeong
    Epidemiology and Health.2023;[Epub]     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak
    Ji-Young Kwon, Sang-Wook Song
    Epidemiology and Health.2022; 44: e2022101.     CrossRef
Original Articles
Accelerometer-measured stepping cadence patterns in Korean adults: an analysis of data from the 2014-2015 Korea National Health and Nutrition Examination Survey
Geon Hui Kim, Hoyong Sung, Yeun Ryu, Jungjun Lim, Joon-Sik Kim, Hak Kyun Kim, Yeon Soo Kim
Epidemiol Health. 2021;43:e2021056.   Published online August 17, 2021
DOI: https://doi.org/10.4178/epih.e2021056
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The aim of this study was to identify the stepping cadence patterns in Korean adults by using objectively measured accelerometer data to analyze the time spent in each cadence category by sex and age.
METHODS
During the 2014-2015 Korean National Health and Nutrition Examination Survey, 1,703 males and females aged 19-64 years provided at least 1 valid day of data (wearing an accelerometer ≥ 10 hr/d). The mean cumulative time and percentage per day in 8 cadence categories (0, 1-19, 20-29, 30-59, 60-79, 80-99, 100-119, and ≥ 120 steps/min) by sex and age group were calculated.
RESULTS
Cumulative time and percentage per day decreased across the incremental cadence categories. Participants spent 360.08± 2.56 min/d in the non-movement cadence category and 361.50± 2.28 min/d in the incidental movement cadence category. However, they spent only about 18.1 min/d (2.1%) at ≥ 100 steps/min. Males spent significantly more time in the cadence categories of sporadic movement, purposeful steps, slow walking, and medium walking, but the other categories, except for brisk walking, had higher values in females (p< 0.001). The older age group spent less time in non-movement cadence categories, and the youngest and oldest groups spent more time at a higher cadence (≥ 100 steps/min) than the other age groups. Similar patterns were found in a subgroup analysis by sex.
CONCLUSIONS
Korean adults spent most of their time at a low cadence and only a few minutes at a high cadence (≥100 steps/min); this trend was consistent across sex and age groups.
Summary
Korean summary
본 연구에서는 2014-2015년도 국민건강영양조사자료의 가속도계 자료를 활용하여 한국 성인의 성별, 연령별 케이던스 패턴을 확인하였다. 한국 성인은 하루 평균 약 12시간(약 87%)을 분당 20보 이하의 낮은 케이던스에서 보냈고, 분당 100보 이상의 높은 케이던스에서는 하루 중 단지 약 18분 (약 2%)의 시간을 보냈다. 성별 및 연령대에 따라 약간의 차이는 있으나, 대부분 유사한 양상을 보였다.
Key Message
Korean adults spent approximately 12 hours per day (about 87%) at a low cadence (<20 steps per minute) while spending only about 18 minutes per day (about 2%) at a high cadence (≥ 100 steps per minute). Even though certain amount of differences between sex and age groups do exist, most have shown similar patterns.
Associations of physical activity at work and household income with obesity: a cross-sectional study among rural adults in Korea
Su Yeon Kye, Heeyoun Cho, Tran Thi Phuong Thao, Jin-Kyoung Oh, Min Kyung Lim
Epidemiol Health. 2021;43:e2021003.   Published online December 29, 2020
DOI: https://doi.org/10.4178/epih.e2021003
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study was performed to identify the effect of physical activity at work on obesity and to analyze the contribution of socioeconomic factors and health behaviors to this association, which has been relatively little studied.
METHODS
From the Korean National Cancer Center Community Cohort, a total of 5,587 adults (2,125 men; 3,462 women) aged more than 30 years living in rural areas were enrolled. Information on socio-demographic factors, health behaviors, and body mass index was gathered using face-to-face interviews and measurements of height and weight.
RESULTS
Inverse associations were identified between vigorous-intensity physical activity at work and obesity in both men and women, while no association was found between vigorous-intensity physical activity during leisure time and obesity. High household income was independently associated with a lower risk of obesity among those who had low levels of vigorous-intensity physical activity at work. Vigorous physical activity at work showed an inverse association with obesity in rural areas where heavy manual labor is common.
CONCLUSIONS
Our findings indicate the necessity to account for various types of physical activity to improve the assessment and prevention of obesity.
Summary
Korean summary
신체활동의 종류에 따라 비만에 미치는 영향의 차이가 있는지를 보기 위하여 육체 노동이 많은 농촌지역 성인을 대상으로 직무신체활동과 비만과의 관련성을 다른 잠재요인을 보정하여 분석하였다. 남녀 모두에서 고강도 직무신체활동과 비만과의 역연관성이 확인된 반면 여가신체활동과 비만과의 연관성은 확인되지 않았다. 가구소득이 높은 경우 직무신체활동의 강도가 낮은 경우에도 비만과 역연관성을 보였다. 향후 비만 예방 및 중재 전략 수립 시 대상집단의 특성을 고려하여 다양한 종류의 신체활동에 대한 평가가 고려되어야 할 것이다.
Key Message
Regarding the inverse association of physical activity at work and household income with obesity identified in the study, various type of physical activity including physical activity at work and characteristics of target population might be concerned for assessment and prevention of obesity.

Citations

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  • The association between different types of physical activity and smoking behavior
    Jipeng Zhang, Yiwen Cao, Hongfei Mo, Rui Feng
    BMC Psychiatry.2023;[Epub]     CrossRef
  • Efectividad de la actividad física en la prevención y tratamiento de la obesidad: una revisión de la literatura
    Yudi Alexandra González, Diana Lucia Vega-Díaz
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Comparison between walking and moderate-to-vigorous physical activity: associations with metabolic syndrome components in Korean older adults
Ki-Yong An
Epidemiol Health. 2020;42:e2020066.   Published online October 28, 2020
DOI: https://doi.org/10.4178/epih.e2020066
  • 9,562 View
  • 141 Download
  • 8 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The purpose of this study was to compare moderate-to-vigorous physical activity (MVPA) with walking in terms of associations with metabolic syndrome components in Korean older adults.
METHODS
Data on 1,388 older adults (age ≥65 years) from the Korea National Health and Nutrition Examination Survey 2018 were analyzed in this study. MVPA time and walking time per week were used as physical activity variables and blood pressure, waist circumference, glucose, high-density lipoprotein cholesterol, and triglyceride levels were analyzed as metabolic syndrome components. Partial correlations, analysis of covariance, and multinomial logistic regression were used for statistical analysis after adjusting for age, sex, smoking, and alcohol consumption.
RESULTS
High-density lipoprotein cholesterol levels were significantly higher in the low MVPA/high walking and high MVPA/ high walking groups than in the low MVPA/low walking group. Triglyceride levels were significantly lower in the high MVPA/ high walking group than in the low MVPA/low walking and low MVPA/high walking groups. Engaging in <150 min/wk of MVPA increased the likelihood of abnormal blood pressure and metabolic syndrome by 1.81 times and 1.89 times, respectively, compared to ≥150 min/wk of MVPA. Engaging in <180 min/wk of walking raised the likelihood of having abnormal highdensity lipoprotein levels by 1.32 times compared to ≥180 min/wk of walking.
CONCLUSIONS
Not only MVPA but also walking was significantly associated with metabolic syndrome components in Korean older adults. Considering older adults’ preferences and exercise barriers, walking should be considered as an essential component of physical activity guidelines to prevent chronic diseases in older adults.
Summary
Korean summary
현재까지 저강도 신체활동 (걷기)은 중고강도 신체활동에 비해 상대적으로 그 중요성이 간과되어 왔다. 하지만 본 연구는 저강도 신체활동도 중고강도 신체활동 못지 않게 노인들에게서 대사증후군을 예방할 수 있는 중요한 역할을 할 수 있음을 보여준다. 게다가 노인들의 신체적 제약, 부상의 위험, 운동 선호도 등을 감안하면 걷기와 같은 저강도 신체활동은 노인들의 건강유지를 위한 신체활동 권고사항의 필수요소로 고려되어야 함을 제안한다.

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Review
A systematic review of barriers and motivators to physical activity in elderly adults in Iran and worldwide
Soudabeh Yarmohammadi, Hossein Mozafar Saadati, Mohtasham Ghaffari, Ali Ramezankhani
Epidemiol Health. 2019;41:e2019049.   Published online November 29, 2019
DOI: https://doi.org/10.4178/epih.e2019049
  • 18,162 View
  • 433 Download
  • 45 Web of Science
  • 55 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This study was conducted to identify and characterize the barriers and motivations to physical activity (PA) for elderly adults in Iran and other countries.
METHODS
We searched 6 databases (PubMed, Embase, Scopus, Web of Science, Magiran, and the Scientific Information Database) from 2000 to the November 2017, using “aged 60 and over,” “physical activity” or “exercise,” and “motivator” and “barrier” as keywords. Two reviewers independently performed the search, screening, and quality assessment of the studies.
RESULTS
In total, 34 papers were finally included in the study. The most important barriers, based on the frequency of factors, included physical problems, having no companions, and physical barriers to walking. The motivators included improving one’s physical condition, being social, and suitability of the physical environment.
CONCLUSIONS
Important motivators and barriers to PA were more closely related to intrapersonal factors than to the interpersonal and environmental domains. The barriers and motivators to PA in the elderly were not markedly different between Iran and other countries. Therefore, a general strategy could be designed to improve PA in the elderly.
Summary

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Original Articles
Physical activity level in Korean adults: the Korea National Health and Nutrition Examination Survey 2017
Ki-Yong An
Epidemiol Health. 2019;41:e2019047.   Published online November 9, 2019
DOI: https://doi.org/10.4178/epih.e2019047
  • 34,536 View
  • 250 Download
  • 21 Web of Science
  • 20 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated physical activity (PA) participation based on demographic, physical, and psychological variables in Korean adults.
METHODS
Participants were divided into four groups (combined, aerobic only, resistance only, and neither) based on meeting the PA guidelines using moderate and vigorous PA time and resistance exercise frequency from the Korea National Health and Nutrition Examination Survey 2017. The association between meeting the PA guidelines and demographic, medical, fitness, lifestyle, and psychological variables were analyzed using complex samples crosstabs and a general linear model.
RESULTS
Of the 5,820 Korean adults, 66.0% did not meet any of the guidelines. Among demographic factors, sex, age, marital status, income, education level, occupation, and employment status were associated with meeting the PA guidelines. Chronic disease prevalence, weight, waist circumference, body mass index, diastolic blood pressure, glucose, high-density lipoprotein and triglyceride levels, hand-grip strength, resting heart rate, and family history of chronic disease in the medical and fitness variables; frequency of drinking and eating breakfast, total calorie, water, protein, and fat intake in the lifestyle variables; and perceived stress, depression, suicidal thoughts, and quality of life in the psychological variables were associated with meeting PA guidelines.
CONCLUSIONS
Most Korean adults participate in insufficient PA. Moreover, individuals who are socially underprivileged, have low-income or poor physical and mental health conditions participated in relatively less PA. Our findings suggest that government and individual efforts are required to increase PA and resolve health inequality in Korean adults.
Summary
Korean summary
2017년 국민건강영양조사 자료를 분석한 결과, 한국 성인들의 신체활동 실천율은 매우 낮았으며, 특히, 사회적 약자나 저소득층, 신체적, 정신적 건강 위험요인이 높은 사람들에게 더 낮게 나타났다. 신체활동은 건강증진을 위한 가장 경제적이며 효율적인 방법으로써, 신체활동 참여를 늘리고 건강불평등을 해소하기 위한 정부, 의료기관, 교육기관은 물론 국민 개개인의 신체활동에 대한 인식개선과 적극적인 노력이 필요하다.

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Decomposing Gender Disparity in Total Physical Activity among Iranian Adults
Ebrahim Rahimi, Seyed Saeed Hashemi-Nazari, Koorosh Etemad, Hamid Soori
Epidemiol Health. 2017;39:e2017044.   Published online October 16, 2017
DOI: https://doi.org/10.4178/epih.e2017044
  • 12,230 View
  • 200 Download
  • 5 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
While gender differences in physical activity (PA) have been reported, their origin is not well understood. The present study aimed to identify factors contributing to this disparity.
METHODS
This was a population-based cross-sectional study based on the 2011 surveillance of risk factors of non-communicable diseases that was conducted among Iranian adults. Multi-staged sampling was performed to obtain the required study sample. The primary outcome was gender differences in the prevalence of sufficient physical activity (SPA). Total physical activity (TPA) was calculated as metabolic equivalents (MET) per minute during a typical week, as recommended by the World Health Organization. On this basis, achieving 600 MET-min/wk or more was defined as SPA. The nonlinear Blinder-Oaxaca decomposition technique was used to explain the disparity.
RESULTS
The predicted gap was 19.50%. About one-third of the gap was due to differences in the level of observable covariates. Among them, work status contributed the most (29.61%). A substantial portion of the gap remained unexplained by such differences, of which about 40.41% was related to unobservable variables. The differential effects of standard of living, ethnicity, and smoking status made the largest contribution, accounting for 37.36, 35.47, and 28.50%, respectively.
CONCLUSIONS
Interventions to reduce the gender gap in PA should focus on increasing TPA among housewives and women with chronic diseases, as well as those with a higher standard of living. In addition, it is essential to explore the impact of ethnicity and smoking status on women’s TPA in order to promote health.
Summary

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    Frontiers in Public Health.2021;[Epub]     CrossRef
  • Health-Related Quality of Life and Physical Activity in a Community Setting
    Marta Gil-Lacruz, Ana Isabel Gil-Lacruz, Paola Domingo-Torrecilla, Miguel Angel Cañete-Lairla
    International Journal of Environmental Research and Public Health.2021; 18(14): 7301.     CrossRef
  • A detailed explanation and graphical representation of the Blinder-Oaxaca decomposition method with its application in health inequalities
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The association between physical activity and atrial fibrillation applying the Heaviside function in survival analysis: the Multi-Ethnic Study of Atherosclerosis
Yaser Mokhayeri, Seyed Saeed Hashemi-Nazari, Mohammad Ali Mansournia, Hamid Soori, Soheila Khodakarim
Epidemiol Health. 2017;39:e2017024.   Published online June 18, 2017
DOI: https://doi.org/10.4178/epih.e2017024
  • 13,173 View
  • 203 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Although the effect of physical activity (PA) on the incidence of atrial fibrillation (AF) has been studied, contradictory results have been reported. Such discrepancies may reflect the different effects of various types of PA upon AF, as well as gender interactions. Therefore, we aimed to evaluate the associations of PA types (total, moderate/vigorous, and intentional), as well as walking pace, with AF risk in men and women.
METHODS
Using the Multi-Ethnic Study of Atherosclerosis Typical Week Physical Activity Survey, 3 PA measures and walking pace were calculated among 6,487 men and women aged 45-84 years. The incidence of AF over approximately 11 years of followup was ascertained. The association of each PA measure and walking pace with AF incidence was estimated using multivariable Cox proportional hazard models. An extended Cox model with Heaviside functions (hv) of time was used to estimate the effects of time-varying covariates.
RESULTS
During 11 years of follow-up (49,557 person-years), 242 new AF cases occurred. The incidence rate of AF was 48.83 per 10,000 person-years. The proportional hazard (PH) assumption for total PA among women was not met; hence, we used the hv to calculate the hazard ratio. Total PA in women in the hv2 analysis was negatively associated with AF in all 3 models, although for hv1 no significant association was observed. The PH assumption for walking pace among men was not met, and none of the hv showed a statistically significant association between walking pace and AF in men.
CONCLUSIONS
These results suggest that PA is inversely associated with AF in women.
Summary

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    Asma Kazemi, Sepideh Soltani, Dagfinn Aune, Elham Hosseini, Zeinab Mokhtari, Zahra Hassanzadeh, Ahmad Jayedi, Francisco Pitanga, Masoumeh Akhlaghi
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