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Does the Y chromosome make a difference? Gender differences in attempts to change cardiovascular disease risk factors.

PURPOSE: The purpose of this study was to determine if gender differences exist in attempts to change cardiovascular disease (CVD) risk factor behaviors, specifically cigarette smoking, sedentary lifestyle, and overweight, and if the success of these attempted behavior changes also differs by gender in the Pawtucket Heart Health Program (PHHP). METHODS: The risk factors were considered in reference to individuals who needed to change a particular risk factor behavior. Data were gathered from three different sources within the PHHP (the contact card registry of participants and both cross-sectional and cohort household surveys). RESULTS: Women were much more likely than men to participate in PHHP risk factor programs related to smoking, exercise, or weight loss. Women were also more likely than men to self-report making attempts to change these risk factor behaviors. Men self-reported to have a greater percentage of long-term smoking cessation success than women, although men and women had similar success rates related to weight loss and increasing physical activity. Men who reported being at least 20% overweight at baseline achieved significantly greater self-reported weight loss when followed up about 8.5 years later than women who were overweight at baseline. CONCLUSIONS: More research needs to be done to find ways to help women become more successful at modifying CVD risk factor behaviors. In addition, emphasis must be placed on ways to help men initiate and increase the number of attempts they make to change these same risk factor behaviors.

Adult↗

[Prevalence of sedentarism and its associated factors among urban adolescents].

OBJECTIVE: To evaluate the prevalence and determinants of sedentarism among adolescents living in Pelotas, State of Rio Grande do Sul, Brazil. METHODS: A cross-sectional study was carried out in Pelotas, in 2002. An anonymous, self-administered questionnaire was answered by a representative sample of 960 adolescents with ages ranging from 15 to 18 years old. Those who reported that their participation in some kind of physical activity amounted to less than 20 minutes a day with a frequency of less than 3 times a week were considered to have a sedentary lifestyle. Sociodemographic and behavioral variables were evaluated. The chi-squared test was used for comparisons between proportions. The Poisson regression was used for multivariate analysis with robust adjustment for variances. Corrections were made for study design effects. RESULTS: Interviews were held with 960 adolescents. Of these, 39% were classified as having a sedentary lifestyle. The prevalence of sedentarism was higher among girls than among boys (prevalence ratio of 2.45; 95% CI 2.06-2.95). The adolescents from lower social levels had the highest percentage of sedentarism (prevalence ratio of 1.35; 95% CI 1.06-1.72). There was an inverse relationship between the adolescent's and the mother's schooling and sedentarism. After adjusting for confounding factors, there was also a positive association between sedentarism and minor psychiatric disturbances, and in relation to sexual activity. CONCLUSIONS: Higher prevalences of sedentarism are associated with girls, low social class, low levels of schooling and being the child of a mother with a low level of schooling.

Adolescent↗

Revenge of the "sit": how lifestyle impacts neuronal and cognitive health through molecular systems that interface energy metabolism with neuronal plasticity.

Exercise, a behavior that is inherently associated with energy metabolism, impacts the molecular systems important for synaptic plasticity and learning and memory. This implies that a close association must exist between these systems to ensure proper neuronal function. This review emphasizes the ability of exercise and other lifestyle implementations that modulate energy metabolism, such as diet, to impact brain function. Mechanisms believed to interface metabolism and cognition seem to play a critical role with the brain derived neurotrophic factor (BDNF) system. Behaviors concerned with activity and metabolism may have developed simultaneously and interdependently during evolution to determine the influence of exercise and diet on cognition. A look into our evolutionary past indicates that our genome remains unchanged from the times of our hunter-gatherer ancestors, whose active lifestyle predominated throughout almost 100% of humankind's existence. Consequently, the sedentary lifestyle and eating behaviors enabled by the comforts of technologic progress may be reaping "revenge" on the health of both our bodies and brains. In the 21st century we are confronted by the ever-increasing incidence of metabolic disorders in both the adult and child population. The ability of exercise and diet to impact systems that promote cell survival and plasticity may be applicable for combating the deleterious effects of disease and ageing on brain health and cognition.

Aging↗

[Eating habits among employees of a state-owned bank: food consumption profile].

In order to investigate the health conditions of current employees in a government-owned bank in the State of Rio de Janeiro, we performed a cross-sectional study in two departments where systematic sampling was applied. Among the health conditions, we focused on the employees' eating habit profile using a questionnaire on frequency of food group consumption analyzed through a summary measure (eating score). Although the majority of the study population display good eating habits, the results confirmed a major difference between genders. Some 60% of men had scores higher than the population mean (51.2), as compared to only 45% of women. In addition, we observed that men, and particularly younger men, consumed more foodstuffs that were rich in saturated fat, salt, and sugar as compared to women. The findings indicate that quality of one's diet along with changes in other habits and behaviors (like smoking and sedentary life style) should be part of programs to promote health in the workplace, with a view towards controlling cardiovascular and other diseases.

Adult↗

Physical activity among breast cancer survivors: regular exercisers vs participants in a physical activity intervention.

BACKGROUND: Secondary prevention is of great importance in the cancer survivor population, given the substantial medical risks survivors face. Consequently, researchers have begun developing interventions that target behavioral risk factors, such as sedentary lifestyle, among survivors. This study represents a novel approach for evaluating the efficacy of a physical activity intervention for breast cancer survivors. METHODS: Repeated measures analyses were used to compare a group of previously sedentary breast cancer survivors offered a physical activity intervention (n=43) with a group of regularly active survivors (n=40). These two groups were compared on select behavioral and psychosocial measures associated with physical activity. RESULTS: Results indicated significant time x group effects on the following: behavioral processes of change, minutes of moderate-intensity activity/week, and time to complete the one-mile walk test (a measure of fitness). There was also a borderline significant interaction for self-efficacy. Contrasts indicated that, for each interaction, previously sedentary and regularly active survivors differed at baseline, but were not significantly different postintervention. CONCLUSIONS: Thus, after completing a 12-week physical activity intervention, previously sedentary breast cancer survivors became similar to regularly active survivors on select behavioral and psychosocial measures associated with physical activity.

Adult↗

Expectancy-value constructs and expectancy violation as predictors of exercise adherence in previously sedentary women.

This prospective study examined effects of expectancy of exercise benefits, value of benefits, expectancy violation, and self-efficacy (SE) on exercise behavior and study dropout in sedentary women (n=86). SE predicted exercise for study completers but did not predict study dropout. After 6 and 12 weeks, participants evidenced expectancy violations, particularly for fitness and weight. Initial value, expectancy, and Expectancy X Value did not predict exercise for study completers, but dropouts had higher initial positive expectancies than did completers. Expectancy violations produced in Weeks 1-6 did not predict exercise in Weeks 7-12 in study completers, but dropouts in Weeks 7-12 had higher expectancy violations for weight in Weeks 1-6 than did completers. Follow-up revealed that study dropouts stopped exercising. Identifying individuals with high initial expectancies and expectancy violations may improve health behavior intervention and research.

Adolescent↗

Circulating insulin-like growth factor I mediates the protective effects of physical exercise against brain insults of different etiology and anatomy.

Physical exercise ameliorates age-related neuronal loss and is currently recommended as a therapeutical aid in several neurodegenerative diseases. However, evidence is still lacking to firmly establish whether exercise constitutes a practical neuroprotective strategy. We now show that exercise provides a remarkable protection against brain insults of different etiology and anatomy. Laboratory rodents were submitted to treadmill running (1 km/d) either before or after neurotoxin insult of the hippocampus (domoic acid) or the brainstem (3-acetylpyridine) or along progression of inherited neurodegeneration affecting the cerebellum (Purkinje cell degeneration). In all cases, animals show recovery of behavioral performance compared with sedentary ones, i.e., intact spatial memory in hippocampal-injured mice, and normal or near to normal motor coordination in brainstem- and cerebellum-damaged animals. Furthermore, exercise blocked neuronal impairment or loss in all types of injuries. Because circulating insulin-like growth factor I (IGF-I), a potent neurotrophic hormone, mediates many of the effects of exercise on the brain, we determined whether neuroprotection by exercise is mediated by IGF-I. Indeed, subcutaneous administration of a blocking anti-IGF-I antibody to exercising animals to inhibit exercise-induced brain uptake of IGF-I abrogates the protective effects of exercise in all types of lesions; antibody-treated animals showed sedentary-like brain damage. These results indicate that exercise prevents and protects from brain damage through increased uptake of circulating IGF-I by the brain. The practice of physical exercise is thus strongly recommended as a preventive measure against neuronal demise. These findings also support the use of IGF-I as a therapeutical aid in brain diseases coursing with either acute or progressive neuronal death.

Animals↗

Prevalence of high-risk behaviors and obesity among low-income patients attending primary care clinics in Louisiana.

This study examined the prevalence of the most prominent high-risk behaviors that contribute to mortality in the United States (i.e., sedentary lifestyle, cigarette smoking, and high dietary fat intake) and obesity among low-income patients attending primary care clinics in Louisiana. The sample consisted of 1,132 patients attending primary care clinics that were randomly selected and administered a demographic questionnaire, the 1994 Behavioral Risk Factor Surveillance System, and the Eating Patterns Questionnaire. Participants consisted predominantly of African-American (67.7%), uninsured (73.3%), low-income, middle-aged females. Prevalence of high-risk behaviors included sedentary lifestyle (47.1%), cigarette smoking (26.2%), and high dietary fat intake (61.3%). Prevalence of obesity was 63.5%. In conclusion, low-income patients attending primary care clinics in Louisiana display a high frequency of important high-risk behaviors that contribute to mortality in this country. Obesity is also extremely prevalent in this population. Clinical implications and directions for future studies are discussed.

Adult↗

[Management of behavioral risk factors for cardiovascular disease (CVD)].

Changes in many patterns of individual risk behaviors (unhealthy diet, smoking, sedentary lifestyle) are necessary in a large majority of patients with established CVD or at high risk of CVD. Make healthy food choices. Energy intake must be adjusted to maintain ideal body weight. Eating from each major food group will ensure dietary balance. The consumption of fruits and vegetables, whole grain cereals and bread, low fat dairy products, fish and lean meat should be encouraged. Oily fish and omega-3-fatty acids are specially recommended. Saturated and trans fatty acids should be replaced with MUFA's or PUFA's of vegetable and seafood origins. Totalfat intake should account for no more than 30% of energy intake, and intake of saturated fats should not exceed a third of total fat intake. The intake of cholesterol should be less than 300 mg/day. Stop smoking tobacco. All smokers should be professionally encouraged to permanently stop smoking all forms of tobacco. Increase physical activity. A lack of regular physical activity may contribute to the early onset and progression of Cardiovascular Disease. Regular physical activity and the maintenance of physical fitness is beneficial in all age groups and should be promoted as an integral part of cardiovascular prevention. Healthy people should be advised to choose enjoyable activities, which fit into their daily routine, preferably 30-40 min, 4-5 times weekly at Borg 13 or at 60-75% of the average maximum heart rate. For patients with established CVD, advice must be based on a comprehensive clinical judgement including the results of an exercise test.

Cardiovascular Diseases↗

Barriers to physical activity: qualitative data on caregiver-daughter perceptions and practices.

BACKGROUND: There is little research on household and physical environment barriers to physical activity, particularly in minority populations at high risk for obesity and inactivity. Few studies include data on caregiver and daughter dyads. Formative data were used to develop intervention strategies and pathways for the Girls Rule! obesity prevention intervention, in under-studied high-risk pre-adolescents. METHODS: Participants included 12 African-American girls (mean age 7.8 years) and their 11 primary female caregivers (mean age 41.8 years)--eight mother-daughter dyads and three grandmother-granddaughter dyads--for a total of 51 interviews across 23 participants interviewed from April to October 2000.A qualitative approach was used for 51 semistructured in-depth interviews with 11 dyads (female caregiver and girl), consisting of up to three interviews per respondent (mean=2.4 interviews per respondent). Interviews were transcribed, coded, and systematically analyzed between January 2002 and January 2003 to identify recurrent patterns and themes related to physical activity. RESULTS: Findings indicate clear preference of the girls for sedentary, rather than active, behaviors. Caregivers were unaware of the amount of TV viewed and found positive benefits of TV viewing, including safe supervision of their daughters. Barriers to physical activity include perceived lack of affordable and accessible recreation facilities and low caregiver motivation. Potential intervention strategies identified by respondents include walking for exercise and transportation and several low-cost, favored physical activities, such as hopscotch, jumping rope, and dance. CONCLUSIONS: These findings point toward several physical activity and obesity intervention strategies that can guide obesity prevention efforts.

Adult↗

Attitudes and perceptions of fitness professionals regarding obesity.

The purpose of this study was to assess perceptions of exercise professionals regarding obesity. A three page, 25-item survey was mailed to a random sample of 500 certified Health Fitness Instructors, Exercise Test Technologists, and Exercise Specialists from a certification list provided by the American (College of Sports Medicine (ACSM). The return rate was 66%. Most exercise professionals (74%) supervised or worked directly with obese clients in an exercise/fitness setting. The majority of exercise professionals believed that normal weight is very important to a person's health, that physical activity is very important in the treatment of obesity, that they should be role models by maintaining normal weight, that they are obligated to counsel obese persons concerning the health risks of obesity, that they are very competent to prescribe exercise programs for weight loss, and that counseling obese persons on exercise for weight loss is professionally gratifying. The majority of exercise professionals also believed sedentary lifestyles, poor eating behavior, excessive calorie consumption, and psychological problems play a major role in most obesity. Exercise professionals reported that they received most of their information on weight control from textbooks, college classes, scientific journals, workshops/seminars, and past experience.

Adult↗

The fallacy of epithelial mesenchymal transition in neoplasia.

Epithelial mesenchymal transition has been postulated as a versatile mechanism which facilitates cellular repositioning and redeployment during embryonic development, tissue reconstruction after injury, carcinogenesis, and tumor metastasis. The hypothesis originates from parallels drawn between the morphology and behavior of locomotory and sedentary cells in vitro and in various normal and pathologic processes in vivo. This review analyzes data from several studies on embryonic development, wound healing, and the pathology of human tumors, including work from our own laboratory, to assess the validity of the proposal. It is concluded that there is no convincing evidence for conversion of epithelial cells into mesenchymal cell lineages in vivo and that the biological repertoire of normal and malignant cells is sufficient to account for the events and processes observed, without needing to invoke radical changes in cell identity.

Cell Transformation, Neoplastic↗

Historical diversification of migration patterns in a passerine bird.

Migratory strategies of birds require complex orientation mechanisms, morphological adaptations, and life-history adjustments. From an evolutionary perspective, it is important to know how fast this complex combination of traits can evolve. We analyzed mitochondrial control-region DNA sequences in 241 blackcaps (Sylvia atricapilla) from 12 populations with different migratory behaviors. The sample included sedentary populations in Europe and Atlantic archipelagos and migratory populations with different distances of migration, from regional to intercontinental migrations, and different heading directions (due to a migratory divide in central Europe). There was no genetic structure between migratory and sedentary populations, or among populations from different biogeographic areas (Atlantic islands, the Iberian Peninsula, or the continent), however we found evidence of a genetic structure when comparing populations located on either side of the migratory divide. These findings support an independent evolution of highly divergent migratory strategies in blackcaps, occurring after a postglacial colonization of the continent along western and eastern routes. Accordingly, mismatch-distribution analyses suggested an expansion of blackcaps from a very small population size, and time estimates dated such an expansion during the last postglacial period. However, the populations in Gibraltar, located in a putative Mediterranean refuge, appeared to be independent of these processes, showing evidence of restricted gene flow with other populations and demonstrating insignificant historical changes in effective population size. Our results show that the interruption of gene flow between migratory and sedentary populations is not necessary for the maintenance of such a polymorphism, and that even the most divergent migratory strategies of a bird species are susceptible to evolution in response to historical environmental changes.

Animal Migration↗

Cardiovascular and risk factor evaluation of healthy American adults. A statement for physicians by an Ad Hoc Committee appointed by the Steering Committee, American Heart Association.

Cardiovascular disease is the major cause of death in American adults. The chief form of cardiovascular disease is coronary heart disease (CHD). Prevention of CHD depends on the identification of risk factors in asymptomatic individuals. The American Heart Association recommends that all adults be examined periodically for the presence of silent cardiovascular disease and coronary risk factors. The major risk factors for CHD are smoking, high blood pressure, and high blood cholesterol. Additional factors associated with CHD are high blood triglycerides, reduced levels of high-density lipoproteins, diabetes mellitus, obesity, sedentary lifestyle, and certain behavioral characteristics. Available data suggest that the predominance of CHD among Americans can be attributed to these risk factors, and increasing evidence indicates that appropriate modification of these factors will markedly reduce coronary risk. The purpose of this report is to identify the risk factors, indicate their relation to coronary disease, and recommend an approach to their detection in adults during periodic health examinations.

Adult↗

Validating the theoretical structure of the Treatment Self-Regulation Questionnaire (TSRQ) across three different health behaviors.

Nearly 40% of mortality in the United States is linked to social and behavioral factors such as smoking, diet and sedentary lifestyle. Autonomous self-regulation of health-related behaviors is thus an important aspect of human behavior to assess. In 1997, the Behavior Change Consortium (BCC) was formed. Within the BCC, seven health behaviors, 18 theoretical models, five intervention settings and 26 mediating variables were studied across diverse populations. One of the measures included across settings and health behaviors was the Treatment Self-Regulation Questionnaire (TSRQ). The purpose of the present study was to examine the validity of the TSRQ across settings and health behaviors (tobacco, diet and exercise). The TSRQ is composed of subscales assessing different forms of motivation: amotivation, external, introjection, identification and integration. Data were obtained from four different sites and a total of 2731 participants completed the TSRQ. Invariance analyses support the validity of the TSRQ across all four sites and all three health behaviors. Overall, the internal consistency of each subscale was acceptable (most alpha values >0.73). The present study provides further evidence of the validity of the TSRQ and its usefulness as an assessment tool across various settings and for different health behaviors.

Adolescent↗

A transdisciplinary model integrating genetic, physiological, and psychological correlates of voluntary exercise.

OBJECTIVE: Physical inactivity contributes to as many as 250,000 premature deaths per year (R. R. Pate et al., 1995). The authors' objective was to test a transdisciplinary model of the ways in which genetic variants, physiological factors, and psychological factors are thought to influence exercise with 64 healthy, regular exercisers. DESIGN: In a within-subjects design, psychological and physiological responses to exercise were compared with responses to a sedentary activity. MAIN OUTCOME MEASURES: The authors measured affective state, perceived exertion, heart rate, and temperature change in response to moderate exercise versus sedentary activity. They also quantified genotypes on a single nucleotide polymorphism in the brain-derived neurotrophic factor (BDNF) gene. RESULTS AND CONCLUSIONS: The data show a relation between increases in positive affective states and acute exercise behavior, as opposed to a sedentary control. The BDNF gene moderated the effect of exercise on mood, heart rate, and perceived exertion. Physiological factors were, in turn, related to mood response, and mood response was a significant correlate of motivation to exercise in the future and of current exercise behavior. The model has potential as a framework for the basic study of the genetic, physiological, and psychological processes involved with voluntary exercise and as a tool for the applied examination of tailored exercise interventions and their efficacy for different subsets of individuals.

Adolescent↗