All three grants were developed to address key research gaps outlined in the latest Physical Activity Guidelines for Americans, each leveraging an existing multi-center National Heart, Lung and Blood Institute cohort study including the Coronary Artery Risk Development in Young Adults (CARDIA), the Jackson Heart Study (JHS), and the Multi-Ethnic Study of Atherosclerosis (MESA).
The CARDIA Activity and Heart Failure Study (CARDIA ACT-HF) is sponsored by the National Heart, Lung, and Blood Institute and includes UAB as one of four Field and Coordinating Centers. The CARDIA Study examines the association of physical activity and related behaviors, including sedentary behavior, during early adulthood and midlife with the onset and progression of heart failure risk. Heart failure burden is rapidly growing in the United States. due to the aging population, and is particularly prevalent in Black men and women. While prior research has shown that exercise reduces the lifetime risk of clinical heart failure, this evidence is based on reported accounts of exercise that do not take into account time spent in sedentary behaviors and lower intensity physical activity. This research is also focused on later stages of heart failure when related symptoms make it difficult to be physically active.
To address these research gaps, Dr. Gabriel will include measures of accelerometry, cardiorespiratory fitness, and heart failure biomarkers into the CARDIA Year 35 follow-up exam to identify novel behavioral targets including the potential health benefits of lower intensity physical activity, alone or in combination with higher intensity exercise, and health consequences of prolonged sedentary time on heart failure risk and progression across the early adult to midlife transition. Gabriel will also examine if these associations vary by biological sex and race. The CARDIA Activity and Heart Failure Study began in August 2020 and will continue through July 2024.
The second two R01s, sponsored by the National Institute on Aging, focus on the role of the 24-hour movement cycle, including physical activity, sedentary behavior, and sleep to optimize cognitive resilience to Alzheimer’s Disease and Related Dementias (ADRD) and include the JHS 24-Hour Activity Cycle Study (Jackson 24H-ACT; September 2020 to May 2024) and MESA 24-Hour Activity Study (MESA 24H-ACT; May 2021 to April 2025). The Jackson 24H-ACT is led by Dr. Gabriel and Dr. Priya Palta, PhD, MHS, Assistant Professor of Medical Sciences and Epidemiology at the Columbia University Medical Center and the MESA 24H-ACT is lead by Drs. Gabriel and Palta with Dr. Keith Diaz, PhD, Assistant Professor of Behavioral Medicine at the Columbia University Medical Center.
ADRD is an emerging public health epidemic due to the rapidly aging population, with important disparities in ADRD onset and burden existing in Black and Hispanic men and women. While exercise and adequate sleep have been shown to promote resilience to adverse cognitive outcomes, most studies consider these behaviors separately. This approach is problematic given that exercise and sleep are interrelated, as together, these two behaviors define a 24-hour period. Further, no studies have considered time spent in sedentary or lower intensity physical activity behaviors, which are also part of a 24-hour period. To address these research gaps, Dr. Gabriel and colleagues will leverage the JHS Cohort consisting of Black men and women, and the MESA cohort, a multi-ethnic sample. This approach will include measures of accelerometry and sleep actigraphy into the JHS Exam 4 and MESA Exam 7 to construct 24 hour compositions to evaluate associations with several brain outcomes, including cognitive performance, brain MRI, and prevalent mild cognitive impairment and dementia.
“While substantial evidence has accumulated over several decades about the importance of a physically active lifestyle, most U.S. men and women do not meet current recommendations with important disparities shown by biological sex, race/ethnicity, and age,” said Dr. Kelley Gabriel. “I’m excited the opportunity to leverage these studies to address several key research gaps outlined by the 2018 Physical Activity Guidelines Advisory Committee, including novel behavioral targets to attenuate the rapidly progressing public health burden of heart failure and ADRD.”
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