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The role of efficacy cognitions in the prediction of exercise behavior in middle-aged adults.

The present study adopted a social cognitive framework to examine the role played by perceptions of personal efficacy in adherence to exercise behavior in sedentary middle-aged adults. Subjects were followed for 5 months in order to study the process of exercise as it moved through the adoption to maintenance stage of the behavior. Participation rates paralleled those reported elsewhere in the literature. Path analytic techniques examined the role over time of efficacy, perceptual, and behavioral indicators of frequency and intensity of exercise. Self-efficacy cognitions were shown to predict adoption of exercise behavior but previous behavior proved to be the strongest predictor of subsequent exercise participation. Results are discussed in terms of examining process versus static design models in exercise and physical activity research. Implications for future research and health promotion are suggested.

Aging↗

Joint association of sedentary behaviour and physical activity with cardiovascular disease: a systematic review and meta-analysis.

This systematic review and meta-analysis of cohort studies aimed to synthesize existing evidence on the joint association of physical activity (PA) and sedentary behaviour (SB) with cardiovascular disease (CVD) risk among adults. We searched PubMed, EMBASE, and Cochrane for English studies published between January 2010 and February 2025 that examined the joint association of PA and SB (fatal and non-fatal) CVD among adults and pooled their results through meta-analyses using study-level data. Using findings from 17 studies, the pooled effect size for the lowest PA + highest SB group was 1.78 (95% CI: 1.59-2.00), suggesting increased risk for CVD compared with the reference group (i.e. highest PA + lowest SB). Compared with the same reference group, we found an increased risk for CVD in the lowest PA + lowest SB (HR = 1.25, 95% CI: 1.12-1.40) and the highest PA + highest SB (HR = 1.16, 95% CI: 1.06-1.27) groups. Subgroup analyses according to domains or types of PA and SB exposure, outcome measures, and exposure measurement method revealed a similar pattern. In conclusion, individuals with the lowest PA combined with the highest SB may experience an increased risk for CVD events compared with those with the highest PA and lowest SB. There was also an increased risk for individuals with a combination of either low PA + low SB and high PA + high SB, albeit to a lesser extent. Although substantial study-level heterogeneity exists, the results highlight the potential value of considering both behaviours jointly in relation to CVD risk.

Humans↗

Preventable smoking and exercise-related hospital admissions. A model based on the NHEFS.

BACKGROUND: The NHANES I Epidemiologic Follow-Up Study (NHEFS), a longitudinal study of a representative sample of U.S. adults, makes it possible for the first time to develop a simulation model relating hospital admissions to baseline clinical risk factors for the general adult population. The model is presented here and used to project the impact on hospital admissions of changes in smoking behavior and sedentary lifestyle. METHODS: Three kinds of projections were calculated for the cohort of adults aged 45 to 74 at baseline: projections of hospital admissions in the absence of the risk factor; projections that reflect a 10-year lag between behavior change and full health benefit; and projections that reflect both lag and incomplete adherence to behavior change. For incomplete adherence we assumed that only 10% of the at-risk population changed their behavior. RESULTS: Tests of the simulation model showed that it agreed with a Cox analysis of the hospital data and accurately projected observed hospital admissions over the study period. The projections showed that eliminating smoking would reduce annual rates of all-cause hospitalization among older adults by 8.9% 20 years after baseline. Eliminating inactivity would reduce them 4.6%. Introducing a lag of 10 years between behavior modification and full benefit delayed the impact on hospitalization rates but the effect at 20 years was the same. When only 10% of the population at risk stopped smoking or became physically active, a percentage that reflects the effectiveness of current interventions, annual hospitalization rates at 20 years fell by 0.9% and 0.5%, respectively. CONCLUSIONS: Substantial reductions in hospital admissions can be achieved by interventions to prevent smoking, help smokers quit, or encourage inactive persons to become active. Improving adherence can markedly improve the impact on hospitalizations. The costs of these efforts would be rewarded not only by better health, but by lower expenditures for hospitalization.

Age Distribution↗

Preliminary outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type 2 diabetes.

The First Step Program uses simple and inexpensive pedometers to incrementally increase walking behaviors in sedentary individuals with type 2 diabetes. The pilot sample consisted of nine individuals (six women, three men; group mean age 53+/-6; group mean body mass index=32.9+/-3.4kg/m(2)). A timed self-paced walk while wearing the pedometer allowed for the conversion of changes in pedometer steps per day to time in minutes per day. There was an immediate and dramatic increase in walking behavior (an average of 34.3min of walking a day) that was sustained even 2 months post-intervention and after withdrawal of contact (an average of 22.6min of walking a day). Improvements in other outcomes (systolic blood pressure and waist girth) support a valid change in behavior. Although preliminary, these results warrant further investigation of such approaches.

Analysis of Variance↗

Causal effects of sedentary behaviours on the risk of migraine: A univariable and multivariable Mendelian randomization study.

BACKGROUND: Migraine is a common and burdensome neurological disorder. The causal relationship between sedentary behaviours (SBs) and migraine remains instinct. We aimed to evaluate the roles of SBs including watching TV, using computer and driving in the risk of migraine. METHODS: We conducted a univariable and multivariable Mendelian randomization (MR) study based on summary datasets of large genome-wide association studies. The inverse variance weighted method was utilized as the primary analytical tool. Cochran's Q, MR-Egger intercept test, MR pleiotropy residual sum and outlier and leave-one-out were conducted as sensitivity analysis. Additionally, we performed a meta-analysis to combine the causal estimates. RESULTS: In the discovery analysis, we identified causal associations between time spent watching TV and an increased risk of migraine (p&#x2009;=&#x2009;0.015) and migraine without aura (MO) (p&#x2009;=&#x2009;0.002). Such causalities with increasing risk of migraine (p&#x2009;=&#x2009;0.005), and MO (p&#x2009;=&#x2009;0.006) were further verified using summary datasets from another study in the replication analysis. There was no significant causal association found between time spent using computer, driving and migraine or its two subtypes. The meta-analysis and multivariable MR analysis also strongly supported the causal relationships between time spent watching TV and an increased risk of migraine (p&#x2009;=&#x2009;0.0003 and p&#x2009;=&#x2009;0.034), as well as MO (p&#x2009;<&#x2009;0.0001 and p&#x2009;=&#x2009;0.0004), respectively. These findings were robust under all sensitivity analysis. CONCLUSIONS: Our study suggested that time spent watching TV may be causally associated with an increased risk of migraine, particularly MO. Large-scale and well-designed cohort studies may be warranted for further validation. SIGNIFICANCE STATEMENT: This study represents the first attempt to investigate whether a causal relationship exists between SBs and migraine. Utilizing MR analysis helps mitigate reverse causation bias and confounding factors commonly encountered in observational cohorts, thereby enhancing the robustness of derived causal associations. Our MR analysis revealed that time spent watching TV may serve as a potential risk factor for migraine, particularly MO.

Humans↗

Insufficiently active Australian college students: perceived personal, social, and environmental influences.

BACKGROUND: A sustainable pattern of participation in physical activity is important in the maintenance of health and prevention of disease. College students are in transition from an active youth to a more sedentary adult behavior pattern. METHODS: We assessed self-reported physical activity and other characteristics in a sample of 2,729 male and female students (median age was 20 years) recruited from representative courses and year levels at four Australian College campuses. They were categorized as sufficiently or insufficiently active, using estimates of energy expenditure (kcal/week) derived from self-reported physical activity. Personal factors (self-efficacy, job status, enjoyment), social factors (social support from family/friends), and environmental factors (awareness of facilities, gym membership) were also assessed. RESULTS: Forty-seven percent of females and 32% of males were insufficiently active. For females, the significant independent predictors of being insufficiently active were lower social support from family and friends, lower enjoyment of activity, and not working. For males, predictors were lower social support from family and friends, lower enjoyment of activity, and being older. CONCLUSIONS: Factors associated with physical activity participation (particularly social support from family and friends) can inform physical activity strategies directed at young adults in the college setting.

Adolescent↗

[Health-risks associated with Western diet and sedentariness: the obesity epidemia].

We describe the magnitude and trends of obesity in Spain and of its main determinants, associated both with the increase in energy intake and the reduction of energy expenditure. Such determinants include factors from the individual subjects and from their environment. We also present the main features of the strategy for the Nutrition, Physical Activity, and the Prevention of Obesity, fostered by the Ministry of Health, as well as plans and activities carried out by the Regional Governments, to control this health disorder. We conclude that effective and sustained implementation of these activities is badly needed. It should be made along with the monitoring of obesity and its determinants in the general population. Research in this field should also be strengthened because social determinants of obesity are not known in depth, and the effectiveness of many of the interventions proposed by the national and regional initiatives is not well established yet. Moreover, in the next future, the effectiveness of intervention models applied to control the smoking epidemic must be assessed to examine its usefulness in the control of obesity. An example of this type of interventions is the limitation of the publicity of nutrient-poor and energy-dense foods addressed to children.

Adolescent↗

[Analysis on the association of physical activity with metabolic syndrome in a population-based study of Japanese-Brazilians].

Sedentary behavior-related diseases can be prevented by lifestyle changes. Part of the cardiovascular benefits of physical activity (PA) may be due to low-grade inflammation. This study describes the PA of a population of Japanese and analyses its association with metabolic syndrome (MS) adjusted a number of variables. This was based on a database previously created following a population-based study of Japanese-Brazilians. 1,330 subjects aged > or = 30 years, of both sexes, living in Bauru, were included and they were submitted to interviews, being obtained sociodemographic, health, physical activity and dietary data, as well as clinical and laboratory data. Physical activity assessment focused on activities during work and leisure times. Diagnosis of MS was based on an adaptation of NCEP criteria for Asians. Non-conditional logistic regression had MS as the dependent variable. Men (46.1%) and women showed similar mean ages (57.0 +/- 12.8 and 56.9 +/- 12.2 years, respectively). A slight preponderance of females was observed. Men had a higher level of education and more frequently were smokers (p< 0.001); their mean values of BMI, waist and blood pressure (p< 0.001) were higher than the womens. For both sexes, the majority referred light and moderate activities (81.2% of men and 86.6% of women). As far as work time is concerned, 87.8% of men classified their effort as light or moderate versus 96.1% of women. Distribution by PA levels showed that women were always less active than men (p= 0.01). Stratifying by the presence of MS, men and women with MS were significantly older and showed greater anthropometric values. Considering the walking duration for work, there was a tendency of shorter periods among those with MS (p< 0.078). As expected, subjects with MS showed significantly higher levels of blood pressure, plasma glucose, lipids and HOMA-IR when compared to those without MS. HDL levels were lower in the MS group, being significant for the female sex. The mean values of CRP were higher in subjects with MS. In logistic regression, age, BMI, HOMA-IR and CRP were shown to be independently associated with MS, but not parameters used to measure physical activity. Our findings do not allow to state that physical inactivity is associated with MS in a Japanese-Brazilian population. High frequencies of physical inactivity should have contributed to the negative findings concerning protective effects of physical activity. The association of MS and serum CRP favors the hypothesis that a low-grade inflammatory state may participate in this syndrome.

Adipose Tissue↗

The effect among older persons of a general preventive visit on three health behaviors: smoking, excessive alcohol drinking, and sedentary lifestyle. The Medicare Preventive Services Research Team.

BACKGROUND: The U.S. Congress mandated evaluations, initiated in 1989, to determine whether extending Medicare benefits to include preventive services would improve health status, reduce costs of care, and improve health risk behaviors of beneficiaries. METHODS: The Johns Hopkins Medicare Preventive Services Demonstration was a randomized trial in which Medicare beneficiaries were assigned either to an intervention group that was offered yearly preventive visits for 2 years and optional counseling visits to their primary care provider or to a control group that received usual care. This report describes the effect of the intervention over a period of 2 years on smoking, problem alcohol use, and sedentary lifestyle. RESULTS: Differences were observed between the intervention and control groups in the extent to which changes occurred in smoking and problem alcohol use, but none of the differences was statistically significant. The proportion of smokers who quit was higher in the intervention group than in the control group (24.2 vs 17.9%, P = 0.09). However, a higher proportion of problem drinkers in the control group improved (67.1 vs 57.0%, P = 0.183). There was virtually no difference between the intervention and the control groups in the proportion with improvement in sedentary lifestyle. CONCLUSIONS: This study demonstrates the difficulty of bringing about health behavior change in older patients in the course of a yearly preventive visit for 2 years with their primary care physician when the visit encompasses screening and immunizations, as well as health behavior counseling directed by the physician. Further study is required to determine whether a more intense program of counseling for health behavior change among older persons by their primary care providers would be effective.

Aged↗

The effect of physician advice on exercise behavior.

BACKGROUND: Although sedentariness, a prevalent lifestyle, is recognized as a significant risk factor for coronary artery disease and other conditions, little is known about the effectiveness of prevention strategies in the primary care setting. This study examines the impact of brief, exercise advice-giving by family physicians. METHODS: During a 2-month baseline period, patients visiting their family physician and who were age 18 or older were queried about their exercise habits and attitudes and whether their physician had discussed exercise. During the following 2-month experimental phase, the same data were gathered, and half the physicians were trained to give brief exercise advice. All patients were followed for 1 month. Changes in exercise duration and frequency were the primary outcome measures. RESULTS: During baseline, a sizable portion of patients were given exercise advice. This was true also of control group patients during the experimental phase, although trained physicians gave advice almost twice as often. A comparison of the patients receiving advice with those not receiving advice revealed significant increases in exercise duration, but not frequency. Patient attitudes were responsive to exercise advice. CONCLUSION: Members of primary care, adult patient population will increase their duration of physical activity in response to physician advice to exercise.

Adult↗

A home-based behavioral intervention to promote walking in sedentary ethnic minority women: project WALK.

A home-based telephone and mail intervention was evaluated for its effectiveness in promoting walking in a sample of sedentary, ethnic minority women. One hundred twenty-five women (ages 23-54) were randomly assigned to behavioral or brief educational interventions. Women in the 8-week behavioral condition received behavior change materials through the mail and 6 structured telephone counseling sessions. Educational condition participants received a single 5-min telephone call and educational information. Both groups reported significantly increased walking at a 2-month posttest (M change = 86 and 81 min per week for behavioral and educational groups, respectively) and 5-month follow-up (M change = 40 and 52 min per week). A 30-month follow-up of 50 participants indicated both groups continued to report more walking than at baseline. The behavioral intervention was not superior to the educational condition at any assessment point. The findings may be explained as (a) both interventions were equally effective, so extensive telephone counseling is unnecessary; (b) changes over time reflected secular trends; or (c) increases in self-reported walking may be due to socially desirable reporting. Other strategies need to be evaluated for promoting walking that are tailored to the needs of ethnic minority women.

Adult↗

Groningen Active Living Model (GALM): stimulating physical activity in sedentary older adults; validation of the behavioral change model.

BACKGROUND: A significant proportion of older adults in The Netherlands do not participate regularly in leisure-time physical activity. The Groningen Active Living Model (GALM) was developed to change this situation for the better. Longitudinal results of the validation of the GALM behavioral change model are presented. METHODS: We obtained data on potentially mediating variables of physical activity behavior change (self-efficacy, social support, perceived fitness, and enjoyment) from 96 participants in a prospective study during the 18 months the GALM strategy lasted. RESULTS: Prospective analyses revealed significant differences in several potentially mediating variables, although some of these differences were contrary to our hypothesis. Discriminant analysis resulted in canonical correlations of 0.50 after 6 months and 0.66 after 18 months of program participation between adherers and nonadherers, respectively; 73.8 and 80.0% of the subjects were classified correctly. CONCLUSIONS: Based on the results, it can be concluded that we partially succeeded in manipulating the potentially mediating variables by means of our GALM strategy. Several mediating variables were identified that reliably discriminated long-term adherers from nonadherers, expanding the generalizability of social cognitive theory-driven variables to a Dutch population.

Aged↗

Factors associated with obesity among workers in a metropolitan waterworks authority.

To examine the relationship of socio-demographic characteristics, psychological factors, knowledge, attitude and behavior towards obesity among Metropolitan Waterworks Authority (MWWA) officers, a cross-sectional study was conducted between July and September, 2004. Two hundred and eighty-eight obese [body mass index (BMI) > or = 25 kg/m2] and 106 non-obese persons, aged 20-60 years, were recruited as study subjects. Data were collected by a self-administered questionnaire, comprised of three parts: socio-demographic; psychological factors (depression and stress); and knowledge, attitude, behavior related to obesity. Univariate analyses and Logistic regression models were used to study the association between obesity and possible risk factors. The results demonstrate significant associations between older age and obesity. Volunteers in the age groups of 40-49 and 50-59 years had a significantly higher risk of being obese than the age group of less than 40 years (adjusted OR = 3.4, 95% Cl = 1.1-11.1 and adjusted OR = 10.4, 95% CI = 3.3-32.7, respectively). Volunteers with unhealthy behaviors were at significantly higher risk than those with healthy behaviors (adjusted OR = 10.3, 95% CI = 2.0-52.4) while persons with moderately healthy behaviors also had increased risk, but to a lesser extent (adjusted OR = 4.5, 95% CI = 1.7-11.4). There were no associations between psychological factors and obesity in this group of volunteers. When we focused on whether they consumed more food when they were stressed, it was found that the obese consumed significantly more food during stress (p-value = 0.003). Watching television, videos, or playing computer continuously for more than 3 hours, were significantly associated with obesity. We conclude that although the obese have a good knowledge and attitude towards obesity, they still practise unhealthy behavior, have a sedentary lifestyle, and over eat when they are stressed. Future research regarding behavioral modification should be implemented at both community and country levels.

Adult↗

The value of sedentary alternatives influences child physical activity choice.

The choice to be physically active or sedentary depends in part on the value of the alternatives that are available. The shift from sedentary to active alternatives may be a function of the value of the sedentary alternatives. To evaluate the influence of the value of the sedentary alternatives on the choice to be physically active or sedentary, 30 nonobese 8-12-year-old youth were randomized in groups that provided a choice between 4 active alternatives or 4 sedentary alternatives (Group 1), their least valued sedentary activity (Group 2), or their most valued sedentary activity (Group 3), on computerized and questionnaire versions of a behavioral choice task. The computer task required participants to work for access to the alternatives. The work required to obtain access to the active alternatives remained constant for all choices, while the work required to gain access to the sedentary alternatives progressively increased. Compared to Groups 1 and 3, participants in Group 2 chose to be sedentary less often as they had to make a choice between being physically active or sedentary on the computerized (p < .005) and the questionnaire version (p < .05) of the behavioral choice task, which correlated r = .54, p < .01. These results suggest interventions designed to increase physical activity by reducing access to sedentary behaviors may need to consider the value of the targeted sedentary behavior and the extent to which the sedentary behaviors compete with physical activity.

Activities of Daily Living↗

Ecological correlates of polyphenism and gregarious roosting in the grass yellow butterfly Eurema elathea (Pieridae).

Eurema elathea adults were census weekly (1992-1994) in six night-roosts around a forest fragment on a farm, and in two roosts in the urban area of Uberlândia, Minas Gerais, Brazil. Males were grouped in six phenotypic classes. These were based on a range between having a conspicuous wide black bar at the dorsal forewing inner margin (wet season dark morphs) and the absence of that bar (dry season light morphs). The body mass and wing area of co-occurring morphs were compared: differents morphs showed similar means. The abundance of butterflies and morph frequencies varied in close relation to humidity (rainfall). Individuals were infrequent and monomorphically dark in the wet season while light morphs predominated in dry periods when population peaked. A lower fraction of recaptured individuals and higher recruitment were recorded compared to other night-roosting butterflies. Dispersal potential was similar between the sexes and varied seasonally with a more sedentary population in dry periods. The maximum residence time recorded was 91 days for a female and 84 days for a male. The fraction of individuals that moved from one roosting site to another was similar in both sexes and male morphs, but significantly higher on the farm than in the urban area. Also, a significantly higher fraction (21.3%) of marked butterflies was recaptured in the urban area than on the farm (15.6%), suggesting a behavioral modification for sedentariness in the urban individuals. The selective forces shaping a gregarious roosting habit in E. elathea and other butterflies are discussed and a protocooperational strategy for saving energy is proposed.

Animals↗

Maximal oxygen intake and body composition of female dancers.

Complete paucity of any data regarding the influence of habitual dance on cardiovascular-pulmonary fitness and body composition of female dancers prompted this study in which 12 female dancers and 12 sedentary female students of the same age range participated as subjects. Maximal oxygen intake was determined on the treadmill, body composition was calculated from skinfolds and vital signs were determined besides measurements of height and weight. Dancers had significantly lower weight, lower resting heart rate, and lower diastolic blood pressure. Systolic blood pressure was also lower in dancers but the difference between the means did not reach statistical significance. Maximal oxygen intake was higher in dancers when expressed in relative terms. Dancers had also significantly lower total body fat. In conclusion, it seems tha, dance with all the variations, should be encouraged in schools as a suitable behavioral modifier of sedentary habits and for maintenance of physical fitness and ideal weight.

Adult↗