Calf circumference was positively correlated with appendicular skeletal muscle mass and skeletal muscle index, and could be used as a surrogate marker of muscle mass for diagnosing sarcopenia. The suggested cut-off values of calf circumference for predicting low muscle mass are <34 cm in men and <33 cm in women.

Abstract-Habitual moderate-to-vigorous-intensity physical activity attenuates arterial stiffening. However, it is unclear whether light physical activity also attenuates arterial stiffening. It is also unclear whether light physical activity has the same effects in fit and unfit individuals. This cross-sectional study was performed to determine the relationships between amount of light physical activity determined with a triaxial accelerometer and arterial stiffness. A total of 538 healthy men and women participated in this study. Subjects in each age category were divided into either high-light or low-light physical activity groups based on daily time spent in light physical activity. Arterial stiffness was measured by carotid-femoral pulse wave velocity. Two-way ANOVA indicated a significant interaction between age and time spent in light physical activity in determining carotid-femoral pulse wave velocity (PϽ0.05). In the older group, carotid femoral pulse wave velocity was higher in the low-light physical activity level group than in the high-light physical activity level group (945Ϯ19 versus 882Ϯ16 cm/s; PϽ0.01). The difference remained significant after normalizing carotid-femoral pulse wave velocity for amounts of moderate and vigorous physical activity. The carotid-femoral pulse wave velocity (rϭϪ0.47; PϽ0.01) was correlated with daily time spent in light physical activity in older unfit subjects. No relationship was observed in older fit subjects. These results suggested that longer time spent in light physical activity is associated with attenuation of arterial stiffening, especially in unfit older people. (Hypertension. 2010;56:540-546.)

Background Self-monitoring using certain types of pedometers and accelerometers has been reported to be effective for promoting and maintaining physical activity (PA). However, the validity of estimating the level of PA or PA energy expenditure (PAEE) for general consumers using wearable devices has not been sufficiently established. Objective We examined the validity of 12 wearable devices for determining PAEE during 1 standardized day in a metabolic chamber and 15 free-living days using the doubly labeled water (DLW) method. Methods A total of 19 healthy adults aged 21 to 50 years (9 men and 10 women) participated in this study. They followed a standardized PA protocol in a metabolic chamber for an entire day while simultaneously wearing 12 wearable devices: 5 devices on the waist, 5 on the wrist, and 2 placed in the pocket. In addition, they spent their daily lives wearing 12 wearable devices under free-living conditions while being subjected to the DLW method for 15 days. The PAEE criterion was calculated by subtracting the basal metabolic rate measured by the metabolic chamber and 0.1×total energy expenditure (TEE) from TEE. The TEE was obtained by the metabolic chamber and DLW methods. The PAEE values of wearable devices were also extracted or calculated from each mobile phone app or website. The Dunnett test and Pearson and Spearman correlation coefficients were used to examine the variables estimated by wearable devices. Results On the standardized day, the PAEE estimated using the metabolic chamber (PAEEcha) was 528.8±149.4 kcal/day. The PAEEs of all devices except the TANITA AM-160 (513.8±135.0 kcal/day; P>.05), SUZUKEN Lifecorder EX (519.3±89.3 kcal/day; P>.05), and Panasonic Actimarker (545.9±141.7 kcal/day; P>.05) were significantly different from the PAEEcha. None of the devices was correlated with PAEEcha according to both Pearson (r=−.13 to .37) and Spearman (ρ=−.25 to .46) correlation tests. During the 15 free-living days, the PAEE estimated by DLW (PAEEdlw) was 728.0±162.7 kcal/day. PAEE values of all devices except the Omron Active style Pro (716.2±159.0 kcal/day; P>.05) and Omron CaloriScan (707.5±172.7 kcal/day; P>.05) were significantly underestimated. Only 2 devices, the Omron Active style Pro (r=.46; P=.045) and Panasonic Actimarker (r=.48; P=.04), had significant positive correlations with PAEEdlw according to Pearson tests. In addition, 3 devices, the TANITA AM-160 (ρ=.50; P=.03), Omron CaloriScan (ρ=.48; P=.04), and Omron Active style Pro (ρ=.48; P=.04), could be ranked in PAEEdlw. Conclusions Most wearable devices do not provide comparable PAEE estimates when using gold standard methods during 1 standardized day or 15 free-living days. Continuous development and evaluations of these wearable devices are needed for better estimations of PAEE.

AVGs could represent an interesting spare physical activity for postpartum women. In the present study, these games promoted physical activity, induced a reduction of energy intake, and subsequently minimized weight retention.

BackgroundThis study aimed to examine the relationship between pedometer-assessed daily step count and all-cause mortality in a sample of elderly Japanese people.MethodsParticipants included 419 (228 males and 191 females) physically independent, community-dwelling 71-year-old Japanese people. The number of steps per day was measured by a waist-mounted pedometer for seven consecutive days at baseline. Participants were divided into quartiles based on their average number of steps/day (first quartile, < 4503 steps/day; second quartile, 4503–6110 steps/day; third quartile, 6111–7971 steps/day; fourth quartile, > 7972 steps/day) and were followed up over a mean period of 9.8 years (1999–2010) for mortality.ResultsSeventy-six participants (18.1%) died during the follow-up period. The hazard ratios (adjusted for sex, body mass index, cigarette smoking, alcohol intake, and medication use) for mortality across the quartiles of daily step count (lowest to highest) were 1.00 (reference), 0.81 (95%CI, 0.43–1.54), 1.26 (95%CI, 0.70–2.26), and 0.46 (95%CI, 0.22–0.96) (P for trend = 0.149). Participants in the highest quartile had a significantly lower risk of death compared with participants in the lowest quartile.ConclusionThis study suggested that a high daily step count is associated with a lower risk of all-cause mortality in physically independent Japanese elderly people.

The hope is that the focus on moving to more valuebased payment models will begin to bring in more measures of the effects this has on patient outcomes, which are the most important measure of the effects of changes in the use of health care services. That, along with the focus on comparative effectiveness analysis, which attempts to provide information on the differential clinical effects of using various interventions and treatment agents on different types of patients, should improve the ability to treat patients in a more clinically and cost-effective manner. To say that much remains in the path to accomplishing the objectives associated with value-based payment models is an understatement. However, this analysis suggests that the move to reduce overvalued payments can have differentiated effects, reducing the use of a procedure by physicians and other health care professionals who are not trained to use it while maintaining similar levels of its use by those who are trained in the use of the procedure. The CMS should consider using this strategy for other potentially overvalued services, particularly those that have a high cost, such as the use of proton beam therapy, which is a very expensive intervention with little clinical evidence supporting its use. 4

ObjectiveTo quantify the associations between muscle-strengthening activities and the risk of non-communicable diseases and mortality in adults independent of aerobic activities.DesignSystematic review and meta-analysis of prospective cohort studies.Data sourcesMEDLINE and Embase were searched from inception to June 2021 and the reference lists of all related articles were reviewed.Eligibility criteria for selecting studiesProspective cohort studies that examined the association between muscle-strengthening activities and health outcomes in adults aged ≥18 years without severe health conditions.ResultsSixteen studies met the eligibility criteria. Muscle-strengthening activities were associated with a 10–17% lower risk of all-cause mortality, cardiovascular disease (CVD), total cancer, diabetes and lung cancer. No association was found between muscle-strengthening activities and the risk of some site-specific cancers (colon, kidney, bladder and pancreatic cancers). J-shaped associations with the maximum risk reduction (approximately 10–20%) at approximately 30–60 min/week of muscle-strengthening activities were found for all-cause mortality, CVD and total cancer, whereas an L-shaped association showing a large risk reduction at up to 60 min/week of muscle-strengthening activities was observed for diabetes. Combined muscle-strengthening and aerobic activities (versus none) were associated with a lower risk of all-cause, CVD and total cancer mortality.ConclusionMuscle-strengthening activities were inversely associated with the risk of all-cause mortality and major non-communicable diseases including CVD, total cancer, diabetes and lung cancer; however, the influence of a higher volume of muscle-strengthening activities on all-cause mortality, CVD and total cancer is unclear when considering the observed J-shaped associations.Systematic review registrationPROSPERO CRD42020219808.

BACKGROUND/OBJECTIVES: Little information is available regarding the interactions of sarcopenia and metabolic syndrome (MetS) in the risks of these age-associated diseases in women. The present cross-sectional study was performed to investigate whether the coexistence of sarcopenia and MetS further increases the risks of lifestyle-related diseases in Japanese women. SUBJECTS/METHODS: Healthy Japanese women (n ¼ 533) aged 30-84 participated in this study. MetS was defined as higher body mass index, fasting plasma glucose, systolic or diastolic blood pressure and blood lipid abnormalities. Appendicular muscle mass and bone mineral density (BMD) were measured using dual-energy X-ray absorptiometry. The criterion of low muscle mass and strength defined median skeletal muscle index (appendicular muscle mass/height 2 , kg/m 2 ) and handgrip strength. RESULTS: Two-way ANCOVA with adjustment for age, body fat percentage and whole-body lean tissue mass indicated that sarcopenia and MetS interacted to produce a significant effect on HbA1c, systolic blood pressure, triglycerides and brachial-ankle pulse wave velocity in Japanese women. The systolic blood pressure, triglycerides and brachial-ankle pulse wave velocity were significantly higher in women with coexisting sarcopenia and MetS than in healthy controls or in those with sarcopenia or MetS alone. The HbA1c in the coexisting sarcopenia and MetS group was higher than in healthy controls and sarcopenia subjects. CONCLUSIONS: The coexistence of sarcopenia and MetS further increases the risks of cardiovascular diseases, such as type 2 diabetes mellitus, hypertension, arterial stiffness and hyperlipidemia even adjustment of age and body composition in adult Japanese women.