ObjeCtives To examine the suitability of age specific limits for alcohol consumption and to explore the association between alcohol consumption and mortality in different age groups.

Physical activity (PA) is a cornerstone of disease prevention and treatment. There is, however, a considerable disparity between public health policy, clinical guidelines and the delivery of physical activity promotion within the National Health Service in the UK. If this is to be addressed in the battle against non-communicable diseases, it is vital that tomorrow's doctors understand the basic science and health benefits of physical activity. The aim of this study was to assess the provision of physical activity teaching content in the curricula of all medical schools in the UK. Our results, with responses from all UK medical schools, uncovered some alarming findings, showing that there is widespread omission of basic teaching elements, such as the Chief Medical Officer recommendations and guidance on physical activity. There is an urgent need for physical activity teaching to have dedicated time at medical schools, to equip tomorrow's doctors with the basic knowledge, confidence and skills to promote physical activity and follow numerous clinical guidelines that support physical activity promotion.

ObjectiveThere is increasing interest in the association between sedentary behaviour and mental health, although most studies have relied solely on self-reported measures, thus making results prone to various biases. The aim was to compare associations between objectively assessed and self-reported sedentary time with mental health in adults.SettingCommunity dwelling population sample drawn from the 2008 Health Survey for England.Participants11 658 (self-report analysis) and 1947 (objective data) men and women.Primary outcomeThe 12-item General Health Questionnaire was administered to assess psychological distress. Sedentary and physical activity (exposure) was objectively measured using accelerometers (Actigraph GT1M) worn around the waist during waking hours for seven consecutive days.ResultsThe highest tertile of objective sedentary time was associated with higher risk of psychological distress (multivariate adjusted OR=1.74, 95% CI 1.07 to 2.83), as was the highest tertile of self-reported total sitting time (OR=1.34, 95% CI 1.15 to 1.56). Self-reported, but not objective, moderate-to-vigorous physical activity was associated with lower risk of psychological distress. Only objective light-intensity activity was associated with lower risk of psychological distress.ConclusionsSedentary time is associated with adverse mental health.

BackgroundMatrix-metalloproteinases (MMPs) are proteolytic enzymes that can degrade the extra cellular matrix and drive tissue remodelling, key processes in the pathogenesis of COPD. The development of small airway disease has been identified as a critical mechanism in the early development of airflow obstruction but the contribution of MMPs in human disease is poorly characterised.

Eosinophilic inflammation in chronic obstructive pulmonary disease (COPD) predicts response to treatment, especially corticosteroids. We studied the nature of eosinophilic inflammation in COPD prospectively to examine the stability of this phenotype and its dynamics across exacerbations, and its associations with clinical phenotype, exacerbations and infection.127 patients aged 40–85 years with moderate to very severe COPD underwent repeated blood and sputum sampling at stable visits and within 72 h of exacerbation for 1 year.Blood eosinophils ≥2% was prevalent at baseline, and predicted both predominantly raised stable-state eosinophils across the year (area under the curve 0.841, 95% CI 0.755–0.928) and increased risk of eosinophilic inflammation at exacerbation (OR 9.16; p<0.001). Eosinophils ≥2% at exacerbation and eosinophil predominance at stable visits were associated with a lower risk of bacterial presence at exacerbation (OR 0.49; p=0.049 and OR 0.25; p=0.065, respectively). Bacterial infection at exacerbation was highly seasonal (winter versus summer OR 4.74; p=0.011) in predominantly eosinophilic patients.Eosinophilic inflammation is a common and stable phenotype in COPD. Blood eosinophil counts in the stable state can predict the nature of inflammation at future exacerbations, which when combined with an understanding of seasonal variation provides the basis for the development of new treatment paradigms for this important condition.

BACKGROUND AND OBJECTIVE: There is a paucity of prospective evidence examining the links between sedentary time (ST) and cardiometabolic outcomes in youth. We examined the associations between objectively assessed ST and moderate to vigorous physical activity (MVPA) in childhood with cardiometabolic risk in adolescence. METHODS:The study included 4639 children (47% male) aged 11 to 12 years at baseline whose mothers were enrolled in ALSPAC (Avon Longitudinal Study of Parents and Children) during their pregnancy in the early 1990s. A total of 2963 children had valid blood samples at age 15 to 16 years. Associations with baseline ST and MVPA were examined for BMI, waist circumference, body fat mass, lean body mass, systolic and diastolic blood pressure, fasting triglycerides, total cholesterol, low-density lipoprotein and high-density lipoprotein (HDL) cholesterol, glucose, insulin, C-reactive protein, and a clustered standardized cardiometabolic risk score (CMscore).RESULTS: Baseline ST was not associated deleteriously with any cardiometabolic markers. MVPA was beneficially associated with the 3 adiposity indicators, lean body mass, systolic blood pressure, triglycerides, C-reactive protein, insulin, HDL cholesterol, and CMscore; once the models were adjusted for baseline levels of these markers, these associations remained for body fat mass ( CONCLUSIONS: We found no evidence linking ST in late childhood with adverse cardiometabolic outcomes in adolescence. Baseline MVPA was beneficially linked to broad cardiometabolic health in adolescence.WHAT'S KNOWN ON THIS SUBJECT: Evidence on the cardiometabolic consequences of sedentary behavior in youth is inconsistent and mostly relies on cross-sectional studies. Studies with objective measures of sedentary time have found limited evidence of cross-sectional associations with adiposity markers but no other outcomes. WHAT THIS STUDY ADDS:Objectively assessed daily sedentary time was not prospectively associated with cardiometabolic outcomes. Moderate to vigorous physical activity was beneficially associated with body fat mass, insulin, high-density lipoprotein cholesterol, and clustered cardiometabolic score. Dr Stamatakis conceptualized and designed the study, drafted the initial manuscript, and revised the text of the manuscript several times after previous submissions and reviews; Dr Coombs conducted the initial analyses, drafted parts of the methods section, repeated the analyses several times after previous submissions and reviews, and reviewed and revised the manuscript; Dr Tiling drafted parts of the statistical analyses section, contributed to the idea and design, and reviewed and revised the manuscript; Dr Mattocks drafted parts of the physical analyses section and reviewed and revised the manuscript; Dr Cooper acquired the physical activity data and reviewed and revised the manuscript; Dr Hardy contributed to the idea and reviewed and revised the manuscript; Dr Lawlor acquired the biochemical data, contributed to the idea and design, and reviewed and r...

The criterion validity of the 2008 Physical Activity and Sedentary Behavior Assessment Questionnaire (PASBAQ) was examined in a nationally representative sample of 2,175 persons aged ≥16 years in England using accelerometry. Using accelerometer minutes/day greater than or equal to 200 counts as a criterion, Spearman's correlation coefficient (ρ) for PASBAQ-assessed total activity was 0.30 (95% confidence interval (CI): 0.25, 0.35) in women and 0.20 (95% CI: 0.15, 0.26) in men. Correlations between accelerometer counts/minute of wear time and questionnaire-assessed relative energy expenditure (metabolic equivalent-minutes/day) were higher in women (ρ = 0.41, 95% CI: 0.36, 0.46) than in men (ρ = 0.32, 95% CI: 0.26, 0.38). Similar correlations were observed for minutes/day spent in vigorous activity (women: ρ = 0.39, 95% CI: 0.33, 0.46; men: ρ = 0.31, 95% CI: 0.26, 0.36) and moderate-to-vigorous activity (women: ρ = 0.42, 95% CI: 0.36, 0.48; men: ρ = 0.38, 95% CI: 0.32, 0.45). Correlations for time spent being sedentary (<100 counts/minute) were 0.30 (95% CI: 0.24, 0.35) and 0.25 (95% CI: 0.19, 0.30) in women and men, respectively. Sedentary behavior correlations showed no sex difference. The validity of sedentary behavior and total physical activity was higher in older age groups, but validity was higher in younger persons for vigorous-intensity activity. The PASBAQ is a useful and valid instrument for ranking individuals according to levels of physical activity and sedentary behavior.

ObjectivesTo examine the associations between socioeconomic position (SEP) and multidomain self-reported and objectively-assessed sedentary time (ST).DesignCross-sectional.SettingGeneral population households in England.Participants2289 adults aged 16–96 years who participated in the 2008 Health Survey for England.OutcomesAccelerometer-measured ST, and self-reported television time, non-television leisure-time sitting and occupational sitting/standing. We examined multivariable associations between household income, social class, education, area deprivation for each SEP indicator (including a 5-point composite SEP score computed by aggregating individual SEP indicators) and each ST indicator using generalised linear models.ResultsAccelerometry-measured total ST and occupational sitting/standing were positively associated with SEP score and most of its constituent SEP indicators, while television time was negatively associated with SEP score and education level. Area-level deprivation was largely unrelated to ST. Those in the lowest composite SEP group spent 64 (95% CIs 52 to 76) and 72 (48 to 98), fewer minutes/day in total ST and occupational sitting/standing compared to those in the top SEP group, and an additional 48 (35–60) min/day watching television (p<0.001 for linear trend). Stratified analyses showed that these associations between composite SEP score and total ST were evident only among participants who were in employment.ConclusionsOccupational sitting seems to drive the positive association between SEP and total ST. Lower SEP is linked to higher TV viewing times.