Baillot Aurélie, Bernard Paquito, Eddine Jmii Nejm, Thomas J Graham, Schumacher Leah M, Papasavas Pavlos K, Vithiananthan Sivamainthan, Jones Daniel, Bond Dale S
Nursing Department, Université du Québec en Outaouais, Gatineau, Québec, Canada.
Institut du savoir de l'hôpital Montfort-recherche, Ottawa, Ontario, Canada.
medRxiv. 2023 Mar 22:2023.03.22.23287589. doi: 10.1101/2023.03.22.23287589.
BACKGROUND--: Most metabolic and bariatric surgery (MBS) patients perform too little moderate-to-vigorous intensity physical activity (MVPA) and too much sedentary time (ST). Identifying factors that influence MVPA and ST in MBS patients is necessary to inform the development of interventions to target these behaviors. Research has focused on individual-level factors and neglected those related to the physical environment (e.g., weather and pollution). These factors may be especially important considering rapid climate change and emerging data that suggest adverse effects of weather and pollution on physical activity are more severe in people with obesity.
OBJECTIVES--: To examine the associations of weather (maximal, average and Wet Bulb Globe Temperatures), and air pollution indices (air quality index [AQI]) with daily physical activity (PA) of both light (LPA) and MVPA and ST before and after MBS.
METHODS--: Participants (n=77) wore an accelerometer at pre- and 3, 6, and 12-months post-MBS to assess LPA/MVPA/ST (min/d). These data were combined with participants' local (Boston, MA or Providence, RI, USA) daily weather and AQI data (extracted from federal weather and environmental websites).
RESULTS--: Multilevel generalized additive models showed inverted U-shaped associations between weather indices and MVPA (R≥.63, p<.001), with a marked reduction in MVPA for daily maximal temperatures ≥20°C. Sensitivity analysis showed a less marked decrease of MVPA (min/d) during higher temperatures after versus before MBS. Both MVPA before and after MBS (R=0.64, p<.001) and ST before MBS (R=0.395; p≤.05) were negatively impacted by higher AQI levels.
DISCUSSION--: This study is the first to show that weather and air pollution indices are related to variability in activity behaviors, particularly MVPA, during pre- and post-MBS. Weather/environmental conditions should be considered in MVPA prescription/strategies for MBS patients, especially in the context of climate change.
大多数代谢和减重手术（MBS）患者进行的中等到高强度身体活动（MVPA）过少，久坐时间（ST）过长。识别影响MBS患者MVPA和ST的因素对于制定针对这些行为的干预措施至关重要。研究主要集中在个体层面的因素，而忽略了与物理环境相关的因素（如天气和污染）。考虑到快速的气候变化以及新出现的数据表明天气和污染对身体活动的不利影响在肥胖人群中更为严重，这些因素可能尤为重要。
研究天气（最高温度、平均温度和湿球黑球温度）以及空气污染指数（空气质量指数[AQI]）与MBS前后的轻度身体活动（LPA）、MVPA和ST的每日身体活动（PA）之间的关联。
参与者（n = 77）在MBS前以及术后3、6和12个月佩戴加速度计，以评估LPA/MVPA/ST（分钟/天）。这些数据与参与者当地（美国马萨诸塞州波士顿或罗德岛州普罗维登斯）的每日天气和AQI数据（从联邦天气和环境网站提取）相结合。
多水平广义相加模型显示天气指数与MVPA之间呈倒U形关联（R≥0.63，p<0.001），当日最高温度≥20°C时MVPA显著降低。敏感性分析显示，与MBS前相比，高温期间MBS后MVPA（分钟/天）的下降不太明显。MBS前后的MVPA（R = 0.64，p<0.001）以及MBS前的ST（R = 0.395；p≤0.05）均受到较高AQI水平的负面影响。
本研究首次表明，天气和空气污染指数与MBS前后的活动行为变化有关，尤其是MVPA。在为MBS患者制定MVPA处方/策略时应考虑天气/环境条件，特别是在气候变化的背景下。
