Associations of weather and air pollution with objective physical activity and sedentary time before and after bariatric surgery: a secondary analysis of a prospective cohort study

Purpose--Identifying factors that influence moderate-to-vigorous intensity physical activity (MVPA) and sedentary time (ST) in metabolic and bariatric surgery (MBS) patients is necessary to inform the development of interventions. Weather/environmental factors may be especially important considering rapid climate change and the vulnerability of people with obesity to heat and pollution. Our study aimed to examine the associations of weather (maximal, average and Wet Bulb Globe Temperatures), and air pollution indices (air quality index [AQI]) with daily physical activity (PA) of both light (LPA) and MVPA and ST before and after MBS. Materials and methods--Participants (n=77) wore an accelerometer at pre- and 3, 6, and 12-months post-MBS to assess LPA/MVPA/ST (min/d). These data were combined with participants’ local (Boston, MA or Providence, RI, USA) daily weather and AQI data (extracted from federal weather and environmental websites). Results--Multilevel generalized additive models showed inverted U-shaped associations between weather indices and MVPA (R2≥.63, p<.001), with a marked reduction in MVPA for daily maximal temperatures ≥20°C. Sensitivity analysis showed a less marked decrease of MVPA (min/d) during higher temperatures after versus before MBS. Both MVPA before and after MBS (R2=0.64, p<.001) and ST before MBS (R2=0.395; p≤.05) were negatively impacted by higher AQI levels. Conclusion--This study is the first to show that weather and air pollution indices, even in locations with good AQI and moderate temperatures, are related to variability in activity behaviors, particularly MVPA, during pre- and post-MBS. Weather/environmental conditions should be considered in MVPA prescription/strategies for adults who have undergone MBS.