BackgroundData are sparse regarding the impacts of habitual physical activity (PA) and sedentary behavior on cardiovascular (CV) risk in older adults with mobility limitations.Methods and ResultsThis study examined the baseline, cross‐sectional association between CV risk and objectively measured PA among participants in the Lifestyle Interventions and Independence for Elders (LIFE) study. The relationship between accelerometry measures and predicted 10‐year Hard Coronary Heart Disease (HCHD) risk was modeled by using linear regression, stratified according to CVD history. Participants (n=1170, 79±5 years) spent 642±111 min/day in sedentary behavior (ie, <100 accelerometry counts/min). They also spent 138±43 min/day engaging in PA registering 100 to 499 accelerometry counts/min and 54±37 min/day engaging in PA ≥500 counts/min. Each minute per day spent being sedentary was associated with increased HCHD risk among both those with (0.04%, 95% CI 0.02% to 0.05%) and those without (0.03%, 95% CI 0.02% to 0.03%) CVD. The time spent engaging in activities 100 to 499 as well as ≥500 counts/min was associated with decreased risk among both those with and without CVD (P<0.05). The mean number of counts per minute of daily PA was not significantly associated with HCHD risk in any model (P>0.05). However, a significant interaction was observed between sex and count frequency (P=0.036) for those without CVD, as counts per minute was related to HCHD risk in women (β=−0.94, −1.48 to −0.41; P<0.001) but not in men (β=−0.14, −0.59 to 0.88; P=0.704).ConclusionsDaily time spent being sedentary is positively associated with predicted 10‐year HCHD risk among mobility‐limited older adults. Duration, but not intensity (ie, mean counts/min), of daily PA is inversely associated with HCHD risk score in this population—although the association for intensity may be sex specific among persons without CVD.Clinical Trial RegistrationURL: www.clinicaltrials.gov Unique identifier: NCT01072500

BackgroundData are sparse regarding the value of physical activity (PA) surveillance among older adults—particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study.Methods and ResultsCardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home‐based activity data were collected by hip‐worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84–0.96; P=0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65–0.89 [P=0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow‐up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85–0.96 [P=0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63–0.90 [P=0.002]) were significantly associated with lower cardiovascular event rates.ConclusionsObjective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500.

Background Obesity within the USA is a public health crisis. Nutrition counselling in primary care is an effective yet underutilized intervention because of both health care professional (HCP) barriers and patient barriers. Objective The purpose of this study was to: (i) identify HCP and patient perceptions, needs and barriers surrounding nutrition counselling, (ii) develop nutrition resources for HCPs and patients and (iii) assess utility of the approach. Methods Paper surveys were completed by 48 HCPs (response rate: 63.2%) and 185 patients in five family medicine clinics. Based on results, nutrition resources were developed and integrated into the electronic medical record. To assess utility, paper surveys were completed by 25 HCPs (response rate: 32.9%) after 4 weeks. Results were presented as descriptive statistics. Results Both HCPs and patients indicated that nutrition counselling is necessary to improve dietary behaviours, but barriers prevented HCPs from providing counselling and patients from improving dietary behaviours. HCPs indicated that improved patient handouts (74.5%), community nutrition classes (72.3%) and community cooking classes (63.8%) could enhance nutrition counselling. Patients identified that coupons and discounts (45.5%), sample meal plans and recipes (44.3%) and websites for recipes, grocery guides, and cooking videos (35.9%) would help them to consume a healthy diet. Patient education handouts, patient resource guides and HCP education were created. Following receipt, most HCPs (85%) indicated that the resources enhanced their nutrition counselling. Conclusions HCP and patient barriers to nutrition counselling are multiple and varied. Design and implementation of an approach tailored to stakeholders’ needs have potential to improve nutrition counselling in primary care.

Arthritis is the swelling or tenderness of the joints, and one in four adults within the United States have been diagnosed with some type of it. Arthritis can happen because of genetics and aging, but other factors, such as diet and lifestyle, may contribute to it. This new 5-page publication of the UF/IFAS Food Science and Human Nutrition Department describes the modifiable factors contributing to arthritis and tips to reduce risk for arthritis. It also includes some relevant recipe ideas. Written by Sarah Curl, Jodi Fitzgerald, Danielle Nelson, and Jeanette Andrade.https://edis.ifas.ufl.edu/fs398

Cancer is the #2 cause of death within the United States, where 2 out of every 5 people will be diagnosed with some form of cancer within their lifetime. Forty-five percent of cancer deaths may have been caused by risk that factors that you can change, such as weight, diet, and lifestyle. This new 6-page publication describes the modifiable risk factors for cancer and tips to reduce your risk for cancer. Written by Jodi Fitzgerald, Danielle Nelson, Madison Woodard, and Jeanette Andrade, and published by the UF/IFAS Food Science and Human Nutrition Department. https://edis.ifas.ufl.edu/fs392

Heart disease is the #1 cause of death among men and women within the United States.  Heart disease is an umbrella term for the following heart conditions: Angina Irregular heartbeats Heart attacks Heart failure Stroke This new 8-page publication of the UF/IFAS Food Science and Human Nutrition Department describes the modifiable risk factors for heart disease and tips to reduce one’s risk for heart disease. Written by Elena B. Smith, Jodi Fitzgerald, Danielle Nelson, Madison Woodard, and Jeanette Andrade.https://edis.ifas.ufl.edu/fs426

Type 2 diabetes is a medical condition where you have too much sugar in your blood. According to the Centers for Disease Control, nearly 1 in 10 adults have Type 2 diabetes and 1 in 3 adults have pre-diabetes. This new 14-page publication of the UF/IFAS Food Science and Human Nutrition Department describes the modifiable risk factors for type 2 diabetes and tips to reduce your risk for diabetes. It also includes several example recipes. Written by Elena Torna, Jodi Fitzgerald, Danielle Nelson, Madison Woodard, and Jeanette Andrade.https://edis.ifas.ufl.edu/fs397

Introduction: Objective measurement of daily physical activity (PA) is an important predictor of cardiovascular risk among young- and middle-aged adults. However, data are sparse regarding the value of activity monitoring among older adults [[Unable to Display Character: &#8211;]] particularly among those with mobility limitations. Hypothesis: We hypothesized that objectively-measured daily PA would be associated with the incidence of cardiovascular (CV) events among older adults in the Lifestyle Interventions and Independence for Elders (LIFE) study [[Unable to Display Character: &#8211;]] a Phase 3 randomized clinical trial comparing a structured exercise intervention (median 2.7 years) to health education among mobility-limited older adults. Methods: CV events (myocardial infarction, stroke, cardiovascular death, silent myocardial infarction, angina/symptomatic coronary artery disease, peripheral artery disease, abdominal aortic aneurysm) were adjudicated by medical records review. Free-living activity data were collected by hip-worn accelerometer at baseline and 6, 12, and 24 months post-randomization. Linear regression, adjusted for accelerometer wear time, demographic and cardiovascular disease-related covariates, was used to model the relationship of incident CV events with accelerometry variables (steps/day and minutes/day spent in activity registering ≥ 100 or ≥ 500 counts/minute) at baseline and in a time-dependent fashion. Results: Participants (n = 1618; age 78.9 ± [SD] 5.2 years; 67.2% female) had a cumulative CV event incidence rate of 14.5% (234 events). Event rates did not differ between randomized groups. At baseline, participants registered 2681 ± 1475 steps/day and spent 22.8 ± 8.2% of their time performing activities≥ 100 cts/min and 6.3 ± 4.3% of time in activities ≥ 500 cts/min. At baseline, CV event risk was10% lower for every 500 steps/day (HR: 0.90, 95% CI: 0.84-0.96, p=0.001). Each 30 minutes spent performing activities ≥ 100 cts/min (0.89, CI: 0.83-0.96, p=0.002) and ≥ 500 cts/min (HR = 0.76, CI: 0.65-0.90, p=0.001) was also associated with lower CV event risk. Across all follow-up visits, participants took 2544 ± 1592 steps/day and spent 21.3 ± 8.2% of their time performing activities> 100 cts/min and 5.8± 4.3% of time in activities ≥ 500 cts/min. In time-dependent analyses, both steps/day (HR: 0.92, CI: 0.86-0.97, p=0.004) and duration of activity ≥ 500 counts/min (HR: 0.80, CI: 0.68-0.94, p=0.007) were associated with lower CV event rates. Longitudinal performance of activity ≥ 100 cts/min was not statistically significant (HR: 0.93, CI: 0.87-1.01, p=0.067). Conclusions: Objective measurements of PA collected via accelerometry predicted incident CV events among older adults with limited mobility. These data support the importance of daily PA in this population and suggest that accelerometry may be a useful tool to aid in assessing the risk of CV events.