Purpose: Obesity and depression are major, inter-related health concerns for men, yet most men with these conditions are reluctant to seek help. Gender-tailored lifestyle programs have shown potential to improve men’s physical and mental health, but none have included specific mental health strategies or targeted men experiencing mental illness. This study investigated whether an eHealth weight loss program with integrated mental health support could improve the weight and mood of men with overweight/obesity and depression.

Methods: Overall, 125 men (mean weight=103.8 kg (SD 15.8), age=48.3 years (SD 11.7)) were recruited for a 6-month RCT. All men were overweight/obese (BMI >25kg/m²) and experiencing mild (55%) or moderate-to-severe (45%) depression according to the validated Patient Health Questionnaire (PHQ-9). Men were randomised into i) the SHED-IT: Recharge group (n=62), or ii) a wait-list control (n=63). The 3-month eHealth program was adapted from the evidence-based SHED-IT program, but the content was tailored for men with depression and supplemented with interactive online modules featuring cognitive behavioural techniques targeting mental health (e.g., cognitive reframing). The primary outcomes were weight and depressive symptoms (PHQ-9). Secondary outcomes including MVPA, sleep quality, and risky alcohol consumption were measured with validated scales. Men were assessed at baseline (September 2019) and 3 months (December 2019, primary endpoint), and will be followed up at 6 months (March 2020).

Results: Intention-to-treat linear mixed models identified medium-sized treatment effects at post-test for weight (adjusted mean difference -2.6 kg, 95%CI -4.3,-0.8, d=0.5) and depressive symptoms (adjusted mean difference -2.5 units, 95%CI -4.4,-0.7, d=0.5). Significant (p<0.05) intervention effects were also observed for MVPA (d=0.4), sleep quality (d=0.4), and risky alcohol consumption (d=0.5). On a scale of 1-Poor to 5-Excellent, the mean (SD) program rating was 4.4 (0.7).

Conclusions: Among men with depression, a gender-tailored, eHealth program that combined behavioural weight loss advice with specific mental health support generated significant, short-term improvements in weight loss and mood. These effects are particularly meaningful given men are traditionally hard to engage in weight loss and mental health research. The program was also completely self-directed, which greatly increases its potential for dissemination, particularly to men in regional and remote areas.

Purpose: Workplaces are often stressful and competitive environments with and in some cases where sitting options are the only options during working hours. Epidemiological studies have shown that prolonged sitting is associated with morbidity and mortality due to cardiovascular diseases as well as all-cause mortality. Energy expenditure at work can be achieved by periodically interrupting sitting through changing in posture, standing, or brief bouts of walking. This study aims to determine the long‑term effects of using height-adjustable standing desks on health, wellbeing and productivity.

Methods: Mixed-methods, quasi-experimental study was conducted with 32 University employees aged 48 ± 9 years (n = 20 experimental, n = 12 control) in Auckland, New Zealand. Time spent sitting, standing and stepping was monitored with the ActivPAL3TM inclinometer for seven days. The Health at Work Questionnaire assessed perceptions of productivity, health and wellbeing. Semi-structured interviews were conducted and coded, and themes extracted using thematic network analysis.

Results: There were no statistically significant differences between the two groups in sitting, standing and stepping time and step count. Significant differences were found in the number of transitions but an unexpected direction. The SITTING group transitioned from sitting to standing on average 59 ± 16 times (p = 0.036, overall) and 34 ± 15 times (p = 0.023, office hours) compared to the STANDING group, who transitioned 46 ± 14 (overall) and 22 ± 9 (office hours). The STANDING group had a significantly (p = 0.002) lower heart rate (64 ± 6 beats/min) compared to the SITTING group (73 ± 8 beats per minute). The SITTING group evaluated themselves as performing better at work compared to others (p=0.05). Analysis of qualitative data showed the following dominant themes: i) The height‑adjustable desks allowed for different needs to be met and provided options for use and ii) There were barriers and facilitators of the use of height-adjustable desks relating to physical health, work, internal administrative processes, and information for use.

Conclusion: Height-adjustable desks may have some effect on total steps and health long term. A larger sample is needed to substantiate these results.

Background

Type 2 diabetes mellitus (T2DM) is emerging as a major public health challenge in Nepal. Increasing physical inactivity, rising overweight and obesity levels, changing dietary patterns along with economic transition, industrialisation, rural-to-urban migration and urbanisation are creating environments conducive for developing T2DM. Understanding the pathways between physical activity and social position to T2DM is crucial for designing effective prevention programs.

Methods

This study analysed cross-sectional data from 1977 Nepalese adults aged 40-69 years from the 2013 WHO STEPwise approach to surveillance survey. Participants’ fasting blood glucose level was used to ascertain their diabetes status. Structural equation modelling, with adjustment for the complex sampling design, was conducted to identify the regression pathways between physical activity, social position, anthropometric and metabolic variables and T2DM.

Results

The overall prevalence of T2DM was 7% with almost double the burden among urban residents (13%). The prevalence was greater among males (9.8%) compared to females (5.5%). After adjusting for the effects of age, sex and place of residence, standardised path coefficients indicated that social position (0.380), waist circumference (0.204), triglycerides (0.087) and hypertension (0.152) had a statisticallysignificant direct effect on T2DM. We also found a positive direct effect of social position on body mass index (0.638), waist circumference (0.134), triglycerides (0.208) and total cholesterol (0.189) and a negative effect on physical activity (-0.303). Physical activity had a negative direct effect on waist circumference (-0.068), total cholesterol (-0.070) and hypertension (-0.064) and an indirect effect on T2DM mediated by waist circumference (-0.014).

Conclusion

Among Nepalese adults, the higher social position has a significant direct effect on T2DM, while both physical activity and higher social position have significant indirect effects. In addition to having its own direct effect on T2DM, waist circumference was an important mediating variable of the indirect effects of social position and physical activity on T2DM. Policies and programs to address T2DM in Nepal should address the factors contributing to unhealthy weight status, particularly among those of higher social position.

Purpose: Overall 7.3 million immigrants living in Australia. There is very diminutive information available for the prevalence of chronic diseases and risk factors about immigrants in the Australian setup. The first aim of this study was to measure and compare the prevalence of risk factors and chronic diseases in the immigrant and Australian born population. The second aim was to examine the trajectoriesof these diseases and risk factors over a period of nine years.

Methods: This study used data from five waves (2007, 2009, 2011, 2013 and 2016) of a longitudinal survey of 11,035 (40-to 65-y-old; 55% female at baseline) residents in Brisbane, Australia. Disease burden was assessed using major chronic conditions of cancer, diabetes, coronary heart diseases, emphysema, and asthma. The major modifiable risk factors were excessive weight (BMI ≥ 25), insufficient physical activity (PA<600 MET-min per week), and cigarette smoking. The participants were divided into three groups: Australian born, immigrants from high-income countries (HIC), and immigrants from low-middle-income countries (LMIC).

Results/findings: There was an increase in the prevalence of cancer, diabetes and heart diseases during nine years, whereas emphysema and asthma showed a slight decline in some waves. The rates of cancer were consistently higher among participants born in Australia (8.1% in 2007 to 27.7% in 2016) and HIC immigrants (6.1 to 22.7%) than those from LMICs (2.9% to 8.0%). The prevalence of diabetes at each time point was higher in LMIC immigrants (9.6% in 2016) than Australian born (7.4%) and HIC immigrants (7.6%). The proportion of current smokers was lower in LMIC immigrants (12.2% to 6.4%) than the Australian born (16.5% to 7.4%) and HIC immigrants (14.9% to 7.2%). Insufficient physical activity was consistently higher among LMIC immigrants (44.9% in 2016) than their Australian born counterparts (41.3%) and HIC immigrants (38.3%).

Conclusions: This study provides information about levels of chronic diseases and risk factors in immigrants and Australian born adults. Further research is needed to understand the disparities of chronic diseases and risk factors in the Australian population's groups.

Keywords:immigrants, chronic disease, risk factors, Australia.

Purpose: Green space is theoretically a valuable resource for physical activity and has the potential to contribute to improving mental well-being. The aims of this study were: (1) to determine the evidence for the associations between green space and adolescents’ mental well -being (and quality of this evidence), and (2) to develop a structural equation model for investigating links between green space and adolescent mental well-being taking into account the potential mediating role of physical activity in this relationship.

Methods: A systematic literature search was conducted in June 2019. Articles were eligible if they were experimental or observational studies (e.g., randomized controlled trial, intervention, cross-sectional, or longitudinal design) exploring the association between green space and adolescents' mental well-being.  Exploratory structural equation modeling (SEM) analyses were undertaken using Mplus to explore the direct effects of green space on adolescent mental well-being and its indirect effects through mediating variables.

Results: Fifteen studies met the inclusion criteria and were assessed for quality and strength of the evidence. The majority of papers found weak to moderate associations between green space and mental well-being indicators in adolescents. Three papers indicated that physical activity may have a mediating pathway between changes in green space and benefit outcomes. Based on the results of the systematic review, a structural equation model was developed and tested to analyze the causal mechanisms among green space, physical activity, and adolescents mental well-being.

Conclusions: Green space is positively related to mental well-being in adolescents. The mediating pathway of physical activity on the relationship between green space and mental well-being is an area requiring further investigation. Further research is needed to provide more consistent evidence on the mechanisms of how green space might promote mental well-being among young people.