Background: Physical activity (PA) is vital for physical and mental health, but many college students fail to meet recommended levels. Artificial intelligence (AI)-powered gamification interventions through mobile app have the potential to improve PA levels among Chinese college students. Objective: This study aimed to assess the feasibility and usability of an AI-powered gamification intervention. Methods: A quasi-experimental study spanning 2 months was conducted on a sample of college students aged 18 to 25 years old from 18 universities in Beijing. PA data were recorded using the ShouTi Fitness app, and participant engagement was evaluated through surveys. User satisfaction was gauged through the System Usability Scale, while the intervention’s feasibility was assessed through Spearman rank correlation analysis, Mann-Whitney tests, and additional descriptive analyses. Results: As of July 2023, we enrolled 456 college students. In total, 18,073 PA sessions were recorded, with men completing 8068 sessions and women completing 10,055 sessions. The average PA intensity was 7 metabolic equivalent of energy (MET)s per session. Most participants preferred afternoon sessions and favored short-duration sessions, with men averaging 66 seconds per session and women 42 seconds. The System Usability Scale score for the intervention based on app is 65.2. Users responded positively to the integration of AI and gamification elements, including personalized recommendations, action recognition, smart grouping, dynamic management, collaborative, and competition. Specifically, 341 users (75%) found the AI features very interesting, 365 (80%) were motivated by the gamification elements, 364 (80%) reported that the intervention supported their fitness goals, and 365 (80%) considered the intervention reliable. A significant positive correlation was observed between the duration of individual PA and intervention duration for men (ρ=0.510, P<.001), although the correlation was weaker for women (ρ=0.258, P=.046). However, the frequency of PA declined after 35 days. Conclusions: This study provides pioneering evidence of the feasibility and usability of the AI-powered gamification intervention. While adherence was successfully demonstrated, further studies or interventions are needed to directly assess the impact on PA levels and focus on optimizing long-term adherence strategies and evaluating health outcomes.

Although the impact of physical exercise on blood lipids is well documented, less information is available regarding the effect of traditional Chinese exercises (TCEs), and it is unclear what the best TCE treatment for dyslipidemia in middle-aged and elderly individuals is. The aim of this study was to systematically assess the effects of TCEs (Taijiquan, TJQ; Wuqinxi, WQX; Baduanjin, BDJ; Liuzijue, LZJ; Yijinjing, YJJ; Dawu, DW) on blood lipids in middle-aged and elderly individuals. Chinese and English databases were searched, including PubMed, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP, and Web of Science. A total of 42 randomized controlled trials (RCTs) including 2977 subjects were analyzed. Outcome indicators include total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triacylglyceride (TAG), and high-density lipoprotein cholesterol (HDL-C). Summary mean differences (MD) were calculated using pairwise and network meta-analysis with a random-effects model. The results of this study showed that compared to non-exercise intervention (NEI), all six kinds of TCE treatment had some kind of influence on blood lipid indicators, among which WQX and TJQ could improve all four blood lipid indicators, whereas BDJ was effective on three indicators but not on TC. The results of cumulative probability ranking showed that WQX (84.9%, 73.8%, 63.4%, 63.1% to TC, TAG, HDL-C, LDL-C, respectively) was at the top spot being the best intervention, followed by BDJ (55.6%, 83.7%, 68.4%, 56.1%) and TJQ (73.7%, 47.6%, 63.1%, 54.1%). The network meta-analysis of RCTs demonstrates that WQX may be the best TCE treatment for dyslipidemia in middle-aged and elderly individuals.

Background: The viewpoints of previous studies on the correlation between exercise and cellular lipid peroxidation are contradictory from many perspectives and lack evidence for elder individuals. A new systematic review with network meta-analysis is necessary and will have significant practical value to provide high-quality evidence in the development of exercise protocols and an evidence-based guide for antioxidant supplementation for the elderly.Aims: To identify the cellular lipid peroxidation induced by different types of exercise, with or without antioxidant supplementation, in elderly individuals.Methods: Randomized controlled trials that recruited elderly participants and reported cellular lipid peroxidation indicators and were published in peer-reviewed journals in English were searched by a Boolean logic search strategy and screened in the databases PubMed, Medline, Embase, and Web of Science. The outcome measures were the biomarkers of oxidative stress in cell lipids in urine and blood, namely F2-isoprostanes, hydrogen peroxide (LOOH, PEROX, or LIPOX), malondialdehyde (MDA), and thiobarbituric acid reactive substances (TBARS).Result: 7 trials were included. A combination program of aerobic exercise (AE), low-intensity resistance training (LIRT), and a placebo intake (Placebo) and a combination program of aerobic exercise, low-intensity resistance training, and antioxidant supplementation (S) had the most and sub-most potential to dampen cellular lipid peroxidation (AE + LIRT + Placebo: 0.31 in Rank 1 and 0.2 in Rank 2; AE + LIRT + S: 0.19 in Rank 1 and 0.20 in Rank 2); A placebo intake (Placebo) and a blank intervention without exercise (NE) had the most and sub-most potential to induce an enhancement of cellular lipid peroxidation (Placebo: 0.51 in Rank 9 and 0.16 in Rank 8; NE: 0.16 in Rank 9 and 0.28 in Rank 8). All included studies had an unclear risk of selecting reporting. There were no high confidence ratings in all the direct and indirect comparisons, 4 comparisons in the direct evidence structure and 7 comparisons in the indirect evidence structure had moderate confidence.Conclusion: A combined protocol consisting of aerobic exercise and low-intensity resistance training is recommended to dampen cellular lipid peroxidation. Extra antioxidant supplementation might be unnecessary if an elderly individual has enough aerobic and resistance exercise.Systematic Review Registration: CRD42022367430

Objective: To explore the effects of breastfeeding during the first four months of life on thinness, overweight, and obesity and to analyze the influential factors in children aged three to six years in eastern China. Methods: This study was designed as a retrospective cohort study, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed. A total of 8053 subjects were included in this secondary analysis of data from the 2015 “Physical Fitness Surveillance data of Jiangsu, China”. The subjects were classified into three groups on the basis of feeding patterns: breastfeeding, mixed feeding, and formula feeding. The International Obesity Task Force (IOTF) definitions of BMI were used to define thinness, overweight, and obesity. Multivariate logistic regression models and subgroup analysis were used to assess the association between feeding patterns and childhood thinness, overweight, obesity, and overweight/obesity, adjusted for potential confounders (sex, age grade, area, region/economy, gestational age, birthweight, childbearing age, mother’s education, and caretaker). Results: The prevalence of breastfeeding was 63.8%, and the prevalence of thinness, overweight, obesity, and overweight/obesity reached 2.7%, 11.2%, 4.7%, and 15.9%, respectively. Breastfeeding participants had a lower risk of overweight and overweight/obesity with adjusted ORs of 0.652 (95% CI: 0.533, 0.797; p < 0.001) and 0.721 (95% CI: 0.602, 0.862; p < 0.001), respectively; however, there was no difference in thinness and obesity (both p > 0.05) compared with formula feeding. There was no statistical difference between mixed and formula feeding, in terms of thinness, overweight, obesity, or overweight/obesity (all p > 0.05). Subgroup analysis showed that breastfeeding for three years, preterm, and a childbearing age of 25–29 years had higher adjusted ORs for thinness, and in 5–6 years, urban areas, southern/developed economy regions, post-mature, childbearing age ≥ 25 years, and other caretakers had higher and invalid breastfeeding-adjusted ORs (all p > 0.05 except overweight in the urban grade) for both overweight and overweight/obesity. Conclusions: Breastfeeding during the first four months was not associated with the thinness of children aged 3–6 years in eastern China, and the protective effect of breastfeeding against overweight or overweight/obesity could be confirmed. However, the effects of breastfeeding on thinness, overweight, and obesity may change or become invalid in some subgroups, suggesting that there may be potential interactions between feeding patterns and influential factors.

Objective: To compare the predictive performance of five handgrip strengths for cardiovascular disease (CVD) risk factors.Methods: A total of 804 Chinese middle-aged community residents' health medical examinations were collected. The absolute handgrip strength was denoted as HGS. HGS/body weight (HGS/BW), HGS/body mass index (HGS/BMI), HGS/lean body mass (HGS/LBM), and HGS/muscle mass (HGS/MM) represented relative handgrip strength (RHGS). To assess predictive performance, receiver operating characteristic (ROC) curves and the area under the curve (AUC) were constructed.Results: HGS was not associated with most CVD risk biomarkers; however, RHGS showed a negative correlation trend after controlling for covariates (sex, age, smoking, and exercise). HGS/BMI and HGS/BW had better AUCs for predicting CVD risk factors than HGS/LBM or HGS/MM. HGS/BMI and HGS/BW can successfully predict all CVD risk factors in men with AUCs 0.55–0.65; similarly, women may effectively predict arteriosclerosis, hyperglycemia, hyperuricemia, and metabolic syndrome with AUCs 0.59–0.64, all p < 0.05. The optimal HGS/BW cut-off points for identifying different CVD risk factors were 0.59–0.61 in men and 0.41–0.45 in women, while the HGS/BMI were 1.75–1.79 in men and 1.11–1.15 in women.Conclusions: Almost all CVD risk biomarkers and CVD risk factors were unrelated to HGS. There is, however, a significant inverse relationship between RHGS and CVD risk factors. HGS/BMI or HGS/BW should be recommended to be the best choice for predicting the risk of CVD risk factors in five expressions of handgrip strength. We also acquired the recommended optimal cut off points of HGS/BMI and HGS/BW for predicting CVD risk factors.

This study aimed to assess the predictive performance and establish optimal cut-off points of blood pressure for identifying arteriosclerosis in eastern Chinese adults. Brachial–ankle pulse wave velocity (baPWV) was utilized to evaluate arteriosclerosis. The predictive performance of blood pressure for arteriosclerosis was determined by the area under the curve (AUC) of receiver operating characteristics; the optimal blood pressure cut-off points were determined by Youden’s index. A logistic regression model was used to acquire the odds ratio (OR) of blood pressure for arteriosclerosis. The AUCs of blood pressure for identifying arteriosclerosis were 0.868 (95%CI: 0.860–0.875) for systolic blood pressure (SBP) and 0.835 (95%CI: 0.827–0.843) for diastolic blood pressure (DBP), both p < 0.01. The AUCs of women were higher than that of men (0.903 vs. 0.819 for SBP; 0.847 vs. 0.806 for DBP; Z test p < 0.05). The AUCs in the 18–39.9-years group were higher than that in the 40–59.9-years and 60–84-years groups (0.894 vs. 0.842 and 0.818 for SBP; 0.889 vs. 0.818 and 0.759 for DBP; Z test p < 0.05). The total optimal cut-off points of blood pressure for predicting arteriosclerosis were 123.5/73.5 mmHg (SBP/DBP) overall; 123.5/73.5 and 126.5/79.5 mmHg for women and men, respectively; and 120.5/73.5, 123.5/76.5, and 126.5/75.5 mmHg for 18–39.9-years, 40–59.9-years, and 60–84-years groups, respectively. Blood pressure indexes had a high predictive performance for identifying arteriosclerosis with the optimal cut-off point of 123.5/73.5 mmHg (SBP/DBP) in eastern Chinese adults. Women or the younger population have a higher predictive performance and lower cut-off points to identify arteriosclerosis.