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Zusammenfassung Regelmäßige physische Aktivität und Sport sind Grundpfeiler des modernen Typ-1-Diabetes-Managements. In den letzten Jahren verbesserte die Verfügbarkeit von Systemen zur automatisierten Insulinabgabe ([AID] dynamische Insulinabgabe + kontinuierliche Glukosemessung + Dosierungsalgorithmus) die glykämische Einstellung von Menschen mit Typ-1-Diabetes (T1D). Körperliche Aktivität und sportliche Betätigung bieten zusätzliche Gesundheitsvorteile, können jedoch zu Glukosespiegelschwankungen führen, die die derzeitigen AID-Systeme vor verschiedene Herausforderungen stellen. Obwohl klinische Studien und Übersichtsartikel zu AID-Systemen, körperlicher Aktivität und Bewegung veröffentlicht wurden, wird erst im September 2024 beim EASD-Kongress (EASD: European Association for the Study of Diabetes) ein neues Positionspapier zur T1D, AID und Sport veröffentlich werden. In dieser gemeinsamen Stellungnahme der EASD und der ISPAD (International Society for Pediatric and Adolescent Diabetes) werden die vorhandenen Erkenntnisse zu AID-Systemen erörtert und detaillierte Empfehlungen zum Umgang mit körperlicher Aktivität und Sport für Kinder, Jugendliche und Erwachsene mit Typ-1-Diabetes unter Nutzung von AID-Systemen gegeben werden. Somit ist es Ziel dieser Publikation, vorweg Einblicke in die neuen Empfehlungen zu geben und zugleich grundsätzliches Wissen zu physischer Aktivität, Sport und T1D darzustellen. Als Grundmaxime gilt, dass die erläuterten Empfehlungen nur als Erstempfehlungen gelten und weiterführend individualisiert werden müssen.

Sport and physical activity should now be understood as lifelong activity, beginning in childhood, and accessible to participants of all levels of ability. This book offers an overview of some of the core concerns underlying lifelong engagement in sport and physical activity, encompassing every age and phase of engagement. The book explores key models of engagement from around the world, as well as specific areas of research that will help the reader understand this important topic. In adopting a lifespan approach, the book pays particular attention to sport and physical activity during childhood and adolescence as well as transitions into adulthood, the developmental periods when participation in sport and physical activity are most likely to decline. Understanding more about participation during these early years is important for sustaining participation during adulthood. The book also addresses issues relating to sport and physical activity during adulthood, across a range of different populations, while a final section examines sport and physical activity among older adults, an often overlooked, but growing segment of society in this context. Lifelong Engagement in Sport and Physical Activity is important reading for undergraduate and postgraduate students in teacher education, sport and coaching science, and for health promoters, coaches, teachers and relevant bodies and organizations in sport and education. This book is published in partnership with ICSSPE, and is part of the Perspectives series

IntroductionThe incidence of depression is high during the perinatal period. This mood disorder can have a significant impact on the mother, the child and the family.ObjectiveTo examine the effect of an exercise programme during pregnancy on the risk of perinatal depression.MethodsHealthy women who were <16 weeks pregnant were randomly assigned to two different groups. Women in the intervention group participated in a 60 min exercise programme throughout pregnancy, 3 days per week, which was conducted from October 2014 to December 2016. The Center for Epidemiological Studies-Depression Scale was used to measure the risk of depression at the beginning of the study (12–16 weeks), at gestational week 38 and at 6 weeks postpartum.ResultsOne hundred and twenty-four pregnant women were allocated to either the intervention (IG=70) or the control (CG=54) group. No differences were found in the percentage of depressed women at baseline (20% vs 18.5%) (χ2=0.043; p=0.836). A smaller percentage of depressed women were identified in the IG compared with the CG at 38 gestational weeks (18.6% vs 35.6%) (χ2=4.190; p=0.041) and at 6 weeks postpartum (14.5% vs 29.8%) (χ2=3.985; p=0.046) using the per-protocol analysis. No significant differences were found using the intention-to-treat analyses, except in the multiple imputation analysis at week 38 (18.6% vs 34.4%) (χ2=4.085; p=0.049).ConclusionAn exercise programme performed during pregnancy may reduce the prevalence of depression in late pregnancy and postpartum.Trial registration numberNCT02420288; Results.

Objectives. To review the contribution of the Nurses’ Health Studies (NHS and NHS II) in addressing hypotheses regarding risk factors for and consequences of obesity. Methods. Narrative review of the publications of the NHS and NHS II between 1976 and 2016. Results. Long-term NHS research has shown that weight gain and being overweight or obese are important risk factors for type 2 diabetes, cardiovascular diseases, certain types of cancers, and premature death. The cohorts have elucidated the role of dietary and lifestyle factors in obesity, especially sugar-sweetened beverages, poor diet quality, physical inactivity, prolonged screen time, short sleep duration or shift work, and built environment characteristics. Genome-wide association and gene–lifestyle interaction studies have shown that genetic factors predispose individuals to obesity but that such susceptibility can be attenuated by healthy lifestyle choices. This research has contributed to evolving clinical and public health guidelines on the importance of limiting weight gain through healthy dietary and lifestyle behaviors. Conclusions. The NHS cohorts have contributed to our understanding of the risk factors for and consequences of obesity and made a lasting impact on clinical and public health guidelines on obesity prevention.

Major depression, bipolar disorder, and schizophrenia are severe mental illnesses. Despite receiving psychopharmacological and psychosocial treatments, about half of patients develop a chronic course with residual cognitive and negative symptoms and have a high risk for cardiovascular disease and reduced life expectancy. Therefore, add-on innovative treatment approaches are needed to improve outcome. Aerobic exercise interventions have been shown to improve global functioning, cognition, and negative and depressive symptoms in these patients. The basic mechanism of these exercise-related changes has been reported to be improved brain plasticity, e.g., increased volume of disease-related brain regions such as the hippocampus. The optimal type, duration, and frequency of exercise have not yet been determined and need to be addressed in supervised physical exercise studies. Because of the low physical activity levels, lack of drive related to negative and depressive symptoms, and high prevalence of cardiovascular comorbidities in patients with severe mental illness, besides aiming to improve symptoms of mental illness, exercise interventions should also aim to increase cardiorespiratory fitness, which they should comprehensively assess by direct measurements of maximal oxygen uptake. Based on the recommendations for developing cardiorespiratory fitness by the American College of Sports Medicine, 150 min moderate-intensity training per week or vigorous-intensity exercise training for 75 min per week are appropriate. Most studies have had relatively short intervention periods, so future studies should focus on long-term adherence to exercise by implementing motivational strategies supported by telemedicine and by identifying and targeting typical barriers to exercise in this patient population.

Abstract Physical activity is one of the most promising nonpharmacological, noninvasive, and cost-effective methods of health-promotion, yet statistics show that only a small percentage of middle-aged and older adults engage in the recommended amount of regular exercise. This state of affairs is less likely due to a lack of knowledge about the benefits of exercise than to failures of motivation and self-regulatory mechanisms. Many types of intervention programs target exercise in later life, but they typically do not achieve sustained behavior change, and there has been very little increase in the exercise rate in the population over the last decade. The goal of this paper is to consider the use of effective low-cost motivational and behavioral strategies for increasing physical activity, which could have far-reaching benefits at the individual and population levels. We present a multicomponent framework to guide development of behavior change interventions to increase and maintain physical activity among sedentary adults and others at risk for health problems. This involves a personalized approach to motivation and behavior change, which includes social support, goal setting, and positive affect coupled with cognitive restructuring of negative and self-defeating attitudes and misconceptions. These strategies can lead to increases in exercise self-efficacy and control beliefs as well as self- management skills such as self-regulation and action planning, which in turn are expected to lead to long-term increases in activity. These changes in activity frequency and intensity can ultimately lead to improvements in physical and psychological well-being among middle-aged and older adults, including those from underserved, vulnerable populations. Even a modest increase in physical activity can have a significant impact on health and quality of life. Recommendations for future interventions include a focus on ways to achieve personalized approaches, broad outreach, and maintenance of behavior changes.

Objectives. We investigated the underlying mechanisms of the influence of socioeconomic status (SES) on mental health and self-rated health (SRH), and evaluated how these relationships might vary by race/ethnicity, age, and gender. Methods. We analyzed data of 44 921 adults who responded to the 2009 California Health Interview Survey. We used a path analysis to test effects of SES, neighborhood safety, and physical activity on mental health and SRH. Results. Low SES was associated with greater neighborhood safety concerns, which were negatively associated with physical activity, which was then negatively related to mental health and SRH. This model was similar across different racial/ethnic and gender groups, but mean levels in the constructs differed across groups. Conclusions. SES plays an important role in SRH and mental health, and this effect is further nuanced by race/ethnicity and gender. Identifying the psychological (neighborhood safety) and behavioral (physical activity) factors that influence mental health and SRH is critical for tailoring interventions and designing programs that can improve overall health.

Just-in-time adaptive interventions (JITAIs) represent an intervention design that adapts the provision and type of support over time to an individual’s changing status and contexts, intending to deliver the right support on the right occasion. As a novel strategy for delivering mobile health interventions, JITAIs have the potential to improve access to quality care in underserved communities and, thus, alleviate health disparities, a significant public health concern. Valid experimental designs and analysis methods are required to inform the development of JITAIs. Here, we briefly review the cutting-edge design of microrandomized trials (MRTs), covering both the classical MRT design and its outcome-adaptive counterpart. Associated statistical challenges related to the design and analysis of MRTs are also discussed. Two case studies are provided to illustrate the aforementioned concepts and designs throughout the article. We hope our work leads to better design and application of JITAIs, advancing public health research and practice. (Am J Public Health. 2023;113(1):60–69. https://doi.org/10.2105/AJPH.2022.307150 )

Objectives. We evaluated the effects of providing new high-quality, traffic-free routes for walking and cycling on overall levels of walking, cycling, and physical activity. Methods. 1796 adult residents in 3 UK municipalities completed postal questionnaires at baseline (2010) and 1-year follow-up (2011), after the construction of the new infrastructure. 1465 adults completed questionnaires at baseline and 2-year follow-up (2012). Transport network distance from home to infrastructure defined intervention exposure and provided a basis for controlled comparisons. Results. Living nearer the infrastructure did not predict changes in activity levels at 1-year follow-up but did predict increases in activity at 2 years relative to those living farther away (15.3 additional minutes/week walking and cycling per km nearer; 12.5 additional minutes/week of total physical activity). The effects were larger among participants with no car. Conclusions. These new local routes may mainly have displaced walking or cycling trips in the short term but generated new trips in the longer term, particularly among those unable to access more distant destinations by car. These findings support the potential for walking and cycling infrastructure to promote physical activity.