There is a lack of meta-analyses focusing on low-intensity endurance training (LIT), including considerations of the lowest effective intensity across different outcomes. This systematic review and meta-analysis examined the effects of LIT on aerobic fitness and cardiometabolic health. Randomized controlled trials involving healthy adults aged 18-65 were included if the training intervention was ≥ 3 weeks, intensity was exclusively below the first lactate/ventilatory threshold (VT1), or ≤ 60% heart rate reserve, or maximum oxygen uptake (VO2max), or ≤ 75% maximum heart rate. Outcome variables were VO2max, VT1, systolic and diastolic blood pressure, plasma/serum low-density, high-density, and total cholesterol, triglycerides, and glucose. Effect sizes (ES) were calculated according to Hedge's g. The subgroup analyses (Q-test) examined the effects of training and background characteristics on outcomes. A total of 50 studies with 824 participants in the intervention groups were included. LIT had a large effect on relative VO2max (ES = 0.94, p < 0.001, I2 = 0.73) and a moderate effect (ES = 0.74, p = 0.003, I2 = 0.57) on VT1 compared with the control group. Small but significant effects (|ES| = 0.29-0.44, p < 0.05, I2 = 0.39-0.79) were observed for other variables, excluding glucose. According to the subgroup analysis, exercise intensity was associated with the adaptations only in VO2max (p = 0.02). LIT improved aerobic fitness and cardiometabolic health, but effects on fitness were more pronounced. Although higher exercise intensity was associated with greater adaptations in VO2max, no minimum intensity for adaptations was detected for most outcomes. Notable heterogeneity in responses was observed, which likely reflects both methodological differences (e.g., intensity prescription) between studies and uncertainty regarding the response magnitude. Trial Registration: The review protocol was registered at PROSPERO (CRD42023469528).

OBJECTIVES:This study examined whether children and adolescents meet the guideline of 60 min of daily moderate-to-vigorous physical activity by analyzing the proportion of active days on school and non-school days. DESIGN:Cross-sectional study. METHODS:Data from three Finnish school-aged physical activity studies (n = 3,221; ages 7-15 years) were analyzed. Participants wore hip accelerometers for seven consecutive days and completed questionnaires. Moderate-to-vigorous physical activity was derived from accelerometer data using mean amplitude deviation in 6-second epochs, further processed with 1-10-minute exponential moving averages. A day met guidelines if it included at least 60 minutes of moderate-to-vigorous physical activity, based on data from the accelerometer, questionnaire or both. RESULTS:Overall, the mean number of days meeting the recommendation was 5.3 (standard deviation 2.1) days per week according to the questionnaire, and 6.3 (1.2) days with 6-second epochs, 5.3 (1.8) days with the 1-minute exponential moving average, and 4.2 (2.1) days with the 10-minute exponential moving average according to the accelerometer. From 1st to 9th grades, boys' proportion of active days decreased from 96% to 64% on school days and from 92% to 40% on non-school days using the 1-minute exponential moving average. Similarly, girls' proportion of active days dropped from 95% to 53% on school days and from 81% to 30% on non-school days. CONCLUSIONS:The proportion of active days approach captures day-to-day variation in physical activity. The closest agreement between questionnaire and accelerometer estimates was observed when using a 1-minute exponential moving average.

Background Lower hemoglobin (Hb) levels within the normal range have been associated with favorable metabolic traits in cross-sectional studies. This study investigated whether changes in Hb levels correlated with changes in physiological and cardiometabolic parameters during a six-month behavioral intervention in individuals with metabolic syndrome.Methods The six-month randomized controlled trial aimed to reduce sedentary behavior in adults with metabolic syndrome (n = 64). Key measurements included fasting blood samples, insulin sensitivity during a hyperinsulinemic-euglycemic clamp, insulin-stimulated liver glucose uptake, liver fat content (LFC), indirect calorimetry, cardiorespiratory fitness, and cardiac function. Correlations between changes in these variables and changes in Hb levels at baseline, three, and six months were examined.Results Cross-sectionally, higher Hb levels correlated with lower insulin sensitivity (r=-0.35, p = 0.005), higher resting O2 consumption (r = 0.41, p < 0.001), higher resting energy expenditure (r = 0.49, p < 0.001), higher LFC (r = 0.40, p = 0.011), and greater left ventricular wall thickness (r = 0.42, p = 0.001). The intervention did not significantly impact Hb levels, and changes in Hb levels did not correlate with most cardiometabolic changes. However, reduced Hb levels correlated with reduced fasting blood glucose (r = 0.29, p = 0.032), improved insulin sensitivity (r = -0.26, p = 0.045), and increased cardiorespiratory fitness (r = -0.29, p = 0.033).Conclusions Changes in Hb levels did not consistently correlate with changes in cardiometabolic markers during the intervention. However, reductions in Hb levels may relate to improved insulin sensitivity and fitness. Along cross-sectional correlations, this may be clinically relevant for individuals with metabolic syndrome. Further studies are merited to clarify the role of Hb levels in this high-risk group.

OBJECTIVES:This study applied a robust predictive machine learning framework to a comprehensive set of individual background data to detect variables that are predictive of extremely low and high amounts of moderate to vigorous physical activity (MVPA). The main aim was to detect predictive variables, and as a secondary aim, the model accuracy was also assessed. Additionally, the analysis framework is presented for further use in physical activity research. METHODS:Comprehensive data on health, physical functioning, education, work, and the living environment, represented by 130 variables, from 1536 participants aged from 20 to 69 years were used for analysis. The 2.5th and 97.5th quantiles of MVPA were chosen to represent the extreme physical behaviors in the population. Random forest classifiers were trained separately to predict the low and high MVPA groups. Results were confirmed and predictive variables detected with permutation tests and the Wilcoxon signed-rank test, Bonferroni-corrected for P < .05. RESULTS:Nine significant predictors were found for the extremely low MVPA and 6 for the extremely high MVPA. These variables were related to the individual's mobility function, living environment, and occupation. The areas under the receiver operating characteristic curve were 0.73 and 0.59 for the participants with extremely low and high amounts of MVPA, respectively. CONCLUSIONS:Several significant predictive variables for extremely low and high MVPA were discovered that may help characterize factors associated with PA behavior at the population level. However, it is not possible to accurately identify physically highly inactive or highly active individuals only from comprehensive background data.

Background: Physical activity (PA) has an important role in the prevention and treatment of type 2 diabetes (T2D). Interventions with mobile-based technology (mobile health [mHealth]) seem promising in PA promotion, but their behavioral framework is often vague, and the implementation is seldom reported. Objective: This paper examines perceived behavior change needs and implementation of an mHealth approach in increasing nonexercise PA in patients with T2D. Methods: A 3-arm mHealth intervention was conducted in primary care. Information on perceived behavior change needs was collected with a modified capability, opportunity, motivation-behavior (COM-B) questionnaire before the intervention from a separate sample of patients with T2D (n=25) and at the intervention baseline (n=119). Implementation evaluation focused on the fidelity and acceptability of the main arm of the intervention (n=39), which included 24-hour accelerometer use, a smartphone app with personal feedback, a PA leaflet, a YouTube video on walking, and individual counseling with 3 face-to-face sessions and 4 telephone contacts. Data on fidelity were accumulated during the intervention through counseling cards and cloud computing. Data on acceptability were collected with a questionnaire at the end of the intervention (Likert scale from 1 to 5). Data analysis was mainly descriptive. Results: The participants' responses revealed 3 items in capability and 2 in motivation, which stood out as perceived behavior change needs. Moreover, the main intervention arm showed good fidelity (eg, face-to-face sessions: 112/117, 96% and telephone contacts completed: 145/156, 93%; mean weekly accelerometer use 54%; ranging from 80% to 17% during the intervention) and acceptability (mean score ranging from 3.8 to 4.8), although some challenges were also experienced, especially in cloud-computed feedback and accelerometer-app use. Conclusions: The findings on behavior change needs call for additional research since no comparable studies were found. In addition, the explanatory value of the COM-B model and the psychometric properties of the COM-B questionnaire deserve further attention. The main intervention arm seemed applicable to clinical practice. However, the challenges discovered underscore the importance of pretesting technology-based approaches in patients with T2D. Trial Registration: ClinicalTrials.gov NCT04587414; https://clinicaltrials.gov/study/NCT04587414

Current approaches to prescribing exercise intensity might not standardize physiological strain across individuals, potentially affecting training outcomes. Whether exercise guidelines applying a 1:2 duration ratio between moderate (MOD) and vigorous (VIG) activities equalize physiological strain is unclear. This exploratory study compared physiological strain and its variance across two intensities and three prescription methods. Thirteen habitually active males performed an incremental treadmill test as well as 40-min MOD and 20-min VIG sessions prescribed by: (1) absolute metabolic equivalents (ABS), (2) relative maximal oxygen uptake (VO2max) (REL), and (3) lactate thresholds (LT). Physiological strain was estimated using excess post-exercise oxygen consumption, individualized training impulse, post-exercise heart rate variability (HRV), blood lactate, and session rating of perceived exertion (sRPE). Except for sRPE, estimated physiological strain was greater during VIG than MOD (p < 0.05) across all prescription methods. A general linear mixed model estimated that equivalent strain for most outcomes would have required MOD > 55

Introduction This study investigated population level changes in body weight and waist circumference before, during, and after the COVID-19 pandemic among young Finnish men with the average age of 20 years. Methods This retrospective study used data collected by the Finnish Defence Forces on body weight and waist circumference from 212,109 young men, with mean age of 20.0±1.1 years, commencing their compulsory military service between 2014 and 2023 (on average 21,211 individuals annually). Mean values, their confidence intervals (CI), proportion of overweight and obese individuals, and deciles were determined for each study year. Interrupted time-series analysis was used to compare trends before (2014-2020) and after (2021-2023) the onset of COVID-19. Moreover, we fitted linear and quadratic regression prediction models to the observed data to predict the development of body weight or waist circumference for the years 2024-2034. Results In year 2021, mean body weight was 0.72 kg (95% CI 0.35 to 1.09, p<0.001) and mean waist circumference 0.39 cm greater (95% CI 0.27 to 0.51, p<0.001) than the pre-pandemic level according to the interrupted time-series analysis. The values measured after the pandemic remained at this higher level. The proportion of abdominally overweight and obese individuals was greater after the pandemic (+1.72 percentage points for overweight, 95% CI 1.29 to 2.15, p<0.001 and +0.69 percentage points for obesity, 95% CI 0.23 to 1.15, p=0.003). Based on predictive models, the mean body weight and waist circumference of young Finnish men are likely to be greater over the next decade. Conclusion After the COVID-19 pandemic, the mean waist circumference, body weight, and proportion of young men with overweight or obesity were significantly greater compared with the values measured before the pandemic. The increasing prevalence of obesity and overweight are significant public health challenges and may contribute to a greater burden of non-communicable diseases in the future.

Objectives Declining physical fitness, rising obesity and mental and behavioural diagnoses are growing public health issues in young adults. This study aimed to examine the associations between cardiorespiratory and muscular fitness and waist circumference with mental and behavioural diagnoses in a large, population-based sample of young men.Methods We performed a retrospective cohort analysis using data from the Finnish Defence Forces. Cardiorespiratory fitness (12 min running test), muscular fitness (muscular fitness index combining push-ups, sit-ups and standing long jump) and waist circumference were measured at the beginning of compulsory military service. These data were linked with physician-diagnosed mental and behavioural diagnoses (International Classification of Diseases, 10th Revision F-diagnoses) in individuals who interrupted their service. The sample consisted of 156 202 men (mean age 19.7 years), representing over two-thirds of the national male age cohort.Results In total, 4034 men interrupted service due to mental and behavioural diagnoses. These individuals had lower levels of cardiorespiratory fitness (2250±390 m vs 2410±380 m, p<0.001) and muscular fitness index scores (10.4±2.5 vs 11.2±2.7, p<0.001) than those who completed their military service. After adjusting for age, body mass index and year of the service, lower cardiorespiratory fitness (OR 0.88, 95% CI 0.88 to 0.89) and muscular fitness (OR 0.88, 95% CI 0.86 to 0.89) remained significantly associated with service interruption. Greater waist circumference showed no general association, except in cases of hyperkinetic disorders.Conclusions Among young men, lower levels of cardiorespiratory and muscular fitness are universally associated with mental and behavioural diagnoses during military service. Co-occurrence between physical fitness and mental and behavioural diagnoses suggests that good physical fitness may be an important component of overall mental health in this population.

Purpose: Loyalty to behaviour can be defined as a consistent preference for a specific way of acting, maintained over time. Physical activity (PA) and inactivity behaviours established in childhood and adolescence may persist in adulthood and affect health throughout the life cycle. The purpose of the present study is to monitor behavioural loyalty among children and adolescents. Methods: Data were collected from three Finnish School-Age Physical Activity studies (2016, 2018, and 2022) involving 4,631 students in 1st, 3rd, 5th, 7th, and 9th grades, aged 7–15 years. Participants wore hip-worn accelerometers for seven consecutive days. Moderate-to-vigorous physical activity (MVPA) was analysed using the mean amplitude deviation, smoothed with a 1 minute exponential moving average. Each school or non-school day was classified as active if it included at least 60 minutes of MVPA, and inactive otherwise. The analysis was done in two independent categories, loyalty to physical activity (LtPA) and loyalty to physical inactivity (LtPI). The day was classified as LtPA if an active day was followed by another active day and as LtPI if an inactive day was followed by another inactive day. Active-inactive and inactive-active pairs are not reported here. Results: On school days, LtPA showed a decreasing pattern with an increasing grade. The proportion of days classified as LtPA was 97%, 94%, 92%, 79%, and 70% for grades from 1st to 9th. A similar downwards pattern was observed on non-school days, although the proportions were lower: 88%, 79%, 70%, 62%, and 49%. In contrast, LtPI increased with an increasing grade level. On school days, the proportion of days LtPI were 21%, 26%, 24%, 46%, and 51%. The proportions were higher on non-school days with values of 41%, 43%, 56%, 63%, and 76%. Conclusion: On school days, there is a large drop in LtPA and a corresponding increase in LtPI between 5th and 7th grade. On non-school days, the harmful trend was observed across all grade levels. These findings suggest that PA promotion efforts during school days should be especially targeted at 7th grade students. On non-school days, the PA promotion should begin already for 1st grade students.

Purpose: Physical activity (PA) is associated with perceived health and fitness, but associations of broader concept of physical behaviour and relative intensities of PA have been studied less. This study analysed how daily physical behaviour – in terms of lying, reclining, sitting, and standing, both absolute and relative individual intensities of PA, number of steps, and peak 1-min metabolic equivalents (MET) – is associated with perceived health and fitness. Methods: The study is based on combined data from two cross-sectional population-based FINFIT studies that measured physical behaviour by a triaxial hip-worn accelerometer (UKK RM42) among 20–69-year-old adults. Lying, reclining, sitting, and standing during waking hours were analysed by the APE-algorithm and PA by the MAD-algorithm. The range for absolute light PA (LPA) was 1.5–2.9 METs. The cut point for absolute moderate PA (MPA) was ≥3 METs and for vigorous PA (VPA) ≥6 METs. The cut point for relative LPA was <40% of oxygen consumption reserve (V̇O2R), for relative MPA ≥40% and <60% of V̇O2R, and for relative VPA ≥60% of V̇O2R. Multivariate multiple regression and receiver operator characteristics (ROC) analysis were used as statistical methods. Results: Participants (n = 3,915, mean age 50.5, standard deviation 13.1 years, 62% women) used the accelerometer for at least four days, 24 h/day. Most participants perceived their health (87%) and fitness (92%) as at least good. Less lying and reclining were associated with better health while less standing, absolute and relative LPA and VPA, absolute MPA, and fewer steps and lower peak 1-min MET were related to poorer health. The highest area under the ROC curve (AUC) values for good perceived health were found to peak 1-min MET (AUC = 0.676) and absolute VPA (AUC = 0.650). The associations with perceived fitness were similar, but stronger. The AUC values for good fitness were highest for steps (AUC = 0.716) and peak 1-min MET (AUC = 0.715). Relative MPA and VPA indicated low AUC values for both health and fitness. Conclusion: Higher volume of daily PA, regardless of absolute intensity and higher relative LPA, was associated with good perceived health and fitness. Lying and reclining had the opposite association compared to those of PA.

Background: Physical functioning is traditionally assessed and presented as self-reported measures, which have shown either improvement or stability during the last decades at population level. On the other hand, objectively measured, performance-based measures of physical functioning have indicated increased body weight and decreased physical fitness. Therefore, there is a need for objective, measured total physical functioning index (MePFIX). Methods: The MePFIX was developed from the data of 5238 working-aged adults (60% women) who took part in the FINFIT studies from years 2017 and 2021. The outcomes of measured body composition, cardiorespiratory fitness, muscular fitness, physical activity, stationary behavior, and time in bed were used to create the MePFIX. Results: The best performing index contained the fol-lowing measures: waist circumference, estimated maximal oxygen consumption, modified push-up, mean of daily 1-minute metabolic equivalent, high-movement time in bed, lying and reclining during waking hours >20-min bouts, standing, daily step count, moderate-to-vigorous physical activity in absolute terms, and light physical activity relative to fitness. Conclusions: The developed MePFIX is based on population-based data, containing measured outcomes of body composition, cardiorespiratory fitness, muscular fitness, physical activity, sedentary behavior and time in bed. The index could serve as an objective indicator of physical functioning among the target population. The MePFIX can be used as a figure of merit of measured physical functioning for research community and policy makers both at cross-sectional and at longitudinal analyses.

Background: Interventional studies on sedentary behaviour (SB) and cardiac health are missing. Therefore, this study investigates the effects of reducing SB on cardiac structure and function in inactive and sedentary adults with metabolic syndrome. Methods: In this randomized controlled trial, the intervention group (n = 33) aimed at reducing SB by 1 h/d for 6 months. The control group (n = 31) continued their SB and physical activity (PA) as usual. All participants wore accelerometers throughout the study. Echocardiography was performed at rest and during incremental exercise tests before and after the intervention. Results: No intervention effects were observed in any echocardiographic variables between the randomized groups. However, when participants were regrouped into a less sedentary (mean SB reduction 60 min/d) or a continuously sedentary group, based on their actual measured behaviour change, left ventricular (LV) mass index and end-diastolic diameter decreased more in the less sedentary than in the continuously sedentary group (group x time P = 0.045 and 0.020, respectively). Moreover, LV global longitudinal strain during exercise improved in the less sedentary group compared to the continuously sedentary group. Among all participants, the change in light PA was correlated inversely with the change in LV mass index (r = -0.32, P = 0.026), and the change in standing time was correlated with the change in the early diastolic flow velocity / lateral mitral annular velocity (E/e') ratio (r = 0.28, P = 0.048). Conclusions: A 6-month intervention aimed at reducing SB did not affect cardiac structure or function. However, in participants with successful SB reduction and increased light PA regardless of original randomization, LV mass index may have decreased, and LV function during exercise may have improved. Clinical Trial Registration: NCT03101228.

Knee osteoarthritis (KOA) is considered a whole-joint disease that is amenable to prevention and treatment in the early stages. Exercise is among the core treatment recommendations for KOA and it has been suggested that optimal exercise regimens should improve aerobic capacity and knee extensor strength. Subchondral bone and articular cartilage are functionally paired, and information on the responses of these tissues to exercise may help in the development of efficacious and feasible exercise regimens that can potentially improve bone and cartilage properties. This article describes a clinical trial investigating the effects of a multicomponent exercise regimen on the subchondral bone and articular cartilage of the knee joint in postmenopausal women with mild KOA. A minimum of 90 postmenopausal women between the ages of 55 and 75 meeting the inclusion criteria will be recruited. After an initial assessment, the participants will be randomly assigned to two groups. The intervention group will participate in a progressive multicomponent exercise regimen, including step aerobics and resistance training alternating every 2 weeks, for 50 min three times a week for 8 months. The reference group will be conducting home exercise program representing standard rehabilitative management for KOA patients. The primary outcome measures of this trial are the 8-month changes in the biochemical composition of the knee articular cartilage measured by the T1r and T2 relaxation times from quantitative magnetic resonance imaging and subchondral bone sclerosis, density and structure as measured via cone beam computed tomography. Measurements will be performed at baseline, after the 8-month intervention period, and at 12 months of maintenance. This RCT investigates the effectiveness of a multicomponent exercise regimen on the subchondral bone and cartilage of the knee joint and the potential interaction between these tissues. The information gained will improve our understanding of the effects of exercise on subchondral bone and the biochemical properties of articular cartilage and improve the prescription of multicomponent exercise regimens in the management of mild KOA. ClinicalTrials.gov NCT06173193. Retrospectively registered before completion of the recruitment on 31 October 2023, https://www.clinicaltrials.gov/study/NCT06173193 .

AIMS:Obesity is an independent risk factor for chronic kidney disease, and weight loss interventions lead to better kidney outcomes. We aimed to assess whether reducing sedentary behaviour in patients with metabolic syndrome impacts renal glucose uptake rate (GU) during insulin stimulation. MATERIALS AND METHODS:Forty-four participants with metabolic syndrome were randomized to receive either guidance to reduce sedentary behaviour (INT) by 1 h/day during a 6-month intervention or to maintain usual sedentary behaviour (CONT). For this post-hoc analysis, we included all participants with available renal data: 34 participants at baseline and 30 at the end of the intervention. Participants underwent 18F-fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) during a hyperinsulinemic clamp at baseline and at 6 months. Renal [18F]FDG-PET data were analysed using fractional uptake rate (FUR). A correction for the estimated residual amount of [18F]FDG inside the tubuli was applied. Corrected GU was calculated as the product of FUR and glycemia. RESULTS:At the study end, light and moderate-to-vigorous physical activity (PA) were increased and BMI was slightly decreased, with no significant intervention effect. Cortical and medullary GU increased vs baseline, similarly in both groups. At baseline, cortical GU was directly related to the degree of insulin sensitivity and inversely to BMI and circulating FFA levels. Change in renal GU was directly related to change in liver GU, but not to the change in whole-body insulin sensitivity. CONCLUSIONS:In patients with metabolic syndrome, insulin-stimulated renal GU increases concomitantly with a small decrease in body adiposity, independently of changes in whole-body glucose disposal.

ObjectiveTo study the associations between midlife physical activity and later-life mobility limitation and falls in monozygotic and dizygotic twin pairs.MethodsMidlife physical activity data from 1975, 1981, and 1990 questionnaires were drawn from the Older Finnish Twin Cohort. In the third survey, the participants were aged 46-50 years. Mobility limitations (none, some or severe) and falls (no falls, single fall or recurrent falls) were self-reported 2014-2016. Data (n = 641) were analyzed using multinomial logistic regression models.ResultsIn individual-level analysis a low level of physical activity in midlife was associated with severe mobility limitations. In within-twin pair analyses physical activity in midlife was associated with single falls among all pairs.DiscussionLower levels of self-reported physical activity during midlife were associated with severe mobility limitations over two decades later. However, this association was attenuated when controlled for genetic factors.

Metabolic syndrome increases the risk of developing noncommunicable diseases such as metabolic dysfunction-associated steatotic liver disease. The aim was to investigate the effects of sedentary behavior (SB) reduction on liver glucose uptake (LGU), endogenous glucose production (EGP), liver fat content (LFC), and liver enzyme levels [alanine aminotransferase (ALT), aspartate aminotransferase, and γ-glutamyltransferase]. Forty-four sedentary (daily SB time ≥ 10 h), physically inactive middle-aged adults with metabolic syndrome were randomized into intervention (INT; n = 23, 21 completed) and control (CON; n = 21, 19 completed) groups. For 6 mo, INT aimed to limit SB by 1 h/day, whereas CON aimed to maintain usual habits. SB and physical activity (PA) were measured continuously with hip-worn accelerometers. Before and at the end of the intervention, LGU was measured using positron emission tomography during the hyperinsulinemic-euglycemic clamp. EGP was calculated, and LFC was measured by magnetic resonance spectroscopy. INT reduced SB by 51 [95% confidence interval (CI): 22, 78] min/day and increased moderate-to-vigorous physical activity (MVPA) by 22 (95% CI: 12, 33) min/day, with no significant change in CON. Differences in liver health markers between the groups were not significant. However, according to the exploratory analyses among participants who successfully reduced SB, ALT decreased (-1.1 [95% CI: 0.93, 1.36] U/L) compared with the continuously sedentary participants (+0.8 [95% CI: 0.65, 1.05] U/L) (group × time, P = 0.006). To enhance liver health, reducing SB for longer durations and/or increasing the intensity of PA may be necessary. However, successfully reducing SB may lead to better levels of circulating ALT liver enzymes.NEW & NOTEWORTHY Aiming to reduce sedentary behavior (SB) by 1 h/day did not significantly influence liver health markers, suggesting that more substantial reductions or a different approach might be necessary to see improvements. However, achieving the desired behavioral change could lead to improvements in ALT levels. This study is the first to analyze how reducing SB and replacing it with nonguided physical activity impacts liver health in adults with metabolic syndrome, offering insights for future intervention strategies.

BACKGROUND:Obesity and poor physical fitness are essential concerns for public health and disease prevention. Alarmingly, the prevalence of both risk factors is increasing in younger populations. We investigated what is the impact of compulsory military service on waist circumference and cardiorespiratory fitness in large sample of Finnish young men. METHODS:Our study was based on a database from the Finnish Defence Forces, which includes information on 249,279 healthy male conscripts (age 19.1 ± 0.4 years.). We measured the waist circumference, and cardiorespiratory fitness (12-min running test) of conscripts in the beginning and at the end of the service and evaluated how these values differed in individuals with different baseline data. RESULTS:The mean changes in waist circumference and cardiorespiratory fitness were -2.1 cm [95% confidence interval (CI): -2.2 to -1.9] and +62 m (95% CI: 57-68). Conscripts with the largest waist circumference at baseline decreased their value the most and conscripts with the poorest cardiorespiratory fitness at baseline increased their fitness the most. CONCLUSION:Compulsory conscription benefits public health by reducing waist circumference and improving cardiorespiratory fitness of initially obese and unfit young men. Changes, if maintained, are likely to translate into lower morbidity and mortality of chronic illnesses. Interventions containing similar features as military services including increased physical activity, regular sleep and healthy eating habits could be considered in decision making to counteract the growing problem of obesity and poor physical fitness.

Excess sedentary behavior (SB) seems to be harmful for health, whereas the effects of standing can be opposite. The present study aimed at 1) describing different components of SB (lying, reclining, sitting) and standing accumulating from different bout lengths in a population-based sample and 2) analyzing their associations with indicators of cardiometabolic health. The study is based on cross-sectional accelerometer-measured data on 24/7 physical behavior among 20–69-year-old Finns. Outcomes were Framingham score for cardiovascular disease (CVD) risk, serum high (HDL)- and low-density lipoprotein (LDL) and total cholesterol, triglycerides, and waist circumference. Participants (n = 4298) mean age was 51 years (SD=13) and 61 % were female. More lying and reclining, regardless of bout length, were associated with higher CVD-score (p ≤ 0.001), lower HDL-cholesterol (p < 0.001), higher triglycerides (p < 0.001) and larger waist circumference (p < 0.001). Longer sitting time accumulating from <30 min bouts was associated with lower CVD-score (p < 0.001), higher HDL- (p < 0.001), lower LDL- (p = 0.004) and total cholesterol (p = 0.009), lower triglycerides (p < 0.001) and smaller waist circumference (p < 0.001). Longer sitting accumulating from bouts exceeding 20 min was associated with larger waist circumference (p < 0.001) indicating that health associations of sitting may depend on bout length. More standing regardless of bout length was associated with lower CVD-score (≤0.001), higher HDL-cholesterol (p < 0.001), lower triglycerides (p < 0.001) and smaller waist circumference (p < 0.001). These associations were mostly independent of moderate-to-vigorous physical activity. Lying and reclining had negative associations with CVD-score and risk factors while short sitting bouts and standing had positive associations, underpinning the importance of evaluating the different components of stationary behavior separately without combining them to overall SB.

BACKGROUND:This study aimed to examine the adherence to selected health-related fitness (HRF) tests in adults. In addition, we investigated how excluded participants or those who did not attend HRF tests differed in their background characteristics from those who attended. METHODS:Two population study samples comprising 3867 (1594 males) 20─69-year-old participants performing HRF tests, or 1249 (456 males) participants answering only the study questionnaire, were pooled for the analyses. The selected HRF tests were: one-leg stand, neck-shoulder mobility, jump-and-reach, modified push-ups, and 6-min walking test. The exclusion rate was analyzed separately for each test. RESULTS:In total, 14.9% of the participants were excluded from at least one test. Failure to meet the health criteria and unwillingness to perform the test were the most typical reasons for the exclusion. The exclusion rate was highest in the modified push-up test (13.2%), while in all other tests, the rate was less than 5%. Excluded participants were more likely (p < 0.001) older (46-69 years) (OR = 4.59), not meeting physical activity recommendations for endurance (OR = 2.28) and perceiving their health (OR = 3.69) and fitness (OR = 3.26) as poor. Similarly, participants who answered only the questionnaire were more likely (p < 0.01) to perceive their health (OR = 1.56) and fitness (OR = 1.41) as poor and not meeting physical activity recommendations for endurance (OR = 1.48). CONCLUSIONS:The assessed HRF tests were feasible in terms of low exclusion rates. Individuals that were excluded or not participating the tests differed in their background characteristics from those who attended highlighting the importance of feasible testing methods to achieve a representative population sample of participants.