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PubMed2006

A longitudinal study of the relationship between health behavior risk factors and dependence in activities of daily living.

OBJECTIVES: The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. METHODS: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non-Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. RESULTS: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. CONCLUSIONS: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.

Activities of Daily Living↗

PubMed1999

Stage of regular exercise and health-related quality of life.

BACKGROUND: Research on cognitive factors and motivational readiness for exercise is important for increasing our understanding of behavior change among those with sedentary lifestyles. This study examines stage of change for regular exercise and self-perceived quality of life. METHODS: Data are from 1,387 respondents to a random digit dial survey of health behaviors. Stage of change is assessed with a single item, and individuals are classified with respect to intention and exercise behavior. Quality of life is assessed with the SF-36, a multidimensional measure of health-related quality of life. RESULTS: Exercise stage is associated with self-perceived quality of life. The three areas most strongly related were physical functioning, general health perceptions, and vitality. Physical functioning scores were lowest in precontemplation and highest in maintenance. Vitality and mental health scales were related to exercise behavior, but not to intention. CONCLUSIONS: Cognitions about self-perceived quality of life vary across the stages of change, with those who are least prepared to adopt regular exercise reporting the lowest levels of quality of life. These findings suggest that cognitive-motivational messages designed to emphasize quality of life benefits associated with exercise may be useful intervention strategies for people who are less motivationally ready to change.

Adult↗

PubMed2003

Diagnosed diabetes and ethnic disparities in adverse health behaviors of American women.

Despite higher rates of some high-risk lifestyle factors in non-Hispanic black women compared to non-Hispanic white women, no data exist examining the role of diagnosed diseases. Having diabetes diagnosed might motivate women and their providers to work together to lower the women's levels of behavioral risk factors. The purpose of this study was to determine the association between diagnosed diabetes and adverse health behaviors, including smoking, alcohol consumption, and sedentary lifestyle in non-Hispanic white (n=270) and non-Hispanic black (n=149) women with type 2 diabetes. Diagnosed diabetes was defined as answering "yes" to the Third US National Health and Nutrition Examination Survey question: "Have you ever been told by a doctor that you have diabetes or sugar diabetes?" Logistic regression analyses were used to determine the association of diagnosed diabetes with the adverse health behaviors. In this study, non-Hispanic black diabetic women had higher prevalences of smoking, sedentary lifestyle, and lower rates of diagnosed diabetes compared with non-Hispanic white women (P<0.01). Relative to non-Hispanic diabetic white, non-Hispanic diabetic black was associated respectively with 25% and 58% increased odds of smoking and sedentary lifestyle, adjusting for diagnosed diabetes and other confounding variables. Approximately 15% of alcohol consumption and 13% excess sedentary lifestyle in non-Hispanic diabetic blacks were associated with their increased rates of diagnosed diabetes relative to non-Hispanic diabetic whites. These excesses in adverse health behaviors, however, were within what can be explained by chance variation. There were non-significant trends toward less smoking and more sedentary lifestyle. Thus, diabetic women with a diagnosis generally had a worse behavioral risk profile than those without a diagnosis even after controlling multiple confounders. This shows the need for physicians to educate their diabetic patients regarding benefits of exercise and smoking avoidance.

Black or African American↗

PubMedDate not supplied

Impact of a worksite behavioral skills intervention.

Sixty-four male and female sedentary employees were randomly assigned to an intervention group or control group to determine the effects of behavioral skill training on adoption and maintenance of exercise. Both received a 9-month membership at a local fitness facility. The control group received a 12-week semistructured course, which included a facility orientation and three meetings with a personal trainer. The intervention group received a 12-week behavioral skills course and were encouraged to participate in a 12-week semistructured exercise course followed by a 3-month problem-solving support intervention. Both groups improved their daily energy expenditure, the amount of moderate and vigorous activity they performed, and their strength and flexibility. The study sample was too small to show substantial differences between the intervention and control group. Changes in mediator variables were mixed.

Adult↗

PubMedDate not supplied

Is the intention to quit smoking influenced by other heart-healthy lifestyle habits in 30- to 60-year-old men?

The aim of this study was to analyze whether the intention to quit smoking was associated with other lifestyle habits healthy for the heart, namely a low-fat diet and regular exercise, using variables suggested by the theory of planned behavior. Self-administered postal questionnaires were sent to 3,200 men 30 to 60 years of age residing in Laval, Quebec. With a response rate of 70.9%, 671 respondents (29.6%) were smokers. A significant proportion (43%) had all three risk behaviors--smoking, a high-fat diet, and sedentariness, and 42% had two--smoking and one of the other behaviors. The remaining had a single risk behavior, namely smoking. Regression analysis suggested that a healthy diet and exercise had no significant influence on the intention to quit smoking. However, men who had a stronger intention to quit smoking than others had a more favorable attitude toward the behavior, a stronger perception of approval in achieving it on the part of important referents, stronger perceived behavioral control, and were among those who smoked fewer cigarettes per day, but had made more attempts to quit. These results can assist in designing better heart-health intervention programs for this high-risk population.

Adult↗

PubMed2006

Health care provider advice for African American adults not meeting health behavior recommendations.

INTRODUCTION: Poor dietary habits and sedentary lifestyle contribute to excessive morbidity and mortality. Healthy People 2010 goals are for 85% of physicians to counsel their patients about physical activity and for 75% of physician office visits made by patients with cardiovascular disease, diabetes, or dyslipidemia to include dietary counseling. The purpose of this study was to 1) determine the rate of participant-reported health care provider advice for healthy lifestyle changes among African Americans who do not meet recommendations for physical activity, fruit and vegetable consumption, and healthy weight; 2) examine correlates of provider advice; and 3) assess the association between provider advice and stage of readiness for change for each of these health behaviors. METHODS: Data for this study were collected as part of a statewide faith-based physical activity program for African Americans. A stratified random sample of 20 African Methodist Episcopal churches in South Carolina was selected to participate in a telephone survey of members aged 18 years and older. The telephone survey, conducted over a 5-month period, asked participants a series of questions about sociodemographics, health status, physical activity, and nutrition. Analyses for moderate to vigorous physical activity, fruit and vegetable consumption, and weight loss were conducted separately. For each of these behaviors, logistic regression analyses were performed to examine the independent association of sex, age, body mass index, education, number of diagnosed diseases, perceived health, and stage of change with health care provider advice for health behaviors. RESULTS: A total of 572 church members (407 women, 165 men; mean age, 53.9 years; range, 18-102 years) completed the survey. Overall, participant-reported provider advice for lifestyle changes was 47.0% for physical activity, 38.7% for fruit and vegetable consumption, and 39.7% for weight. A greater number of diagnosed diseases and higher body mass index were independently associated with receiving advice to increase physical activity. A more advanced stage of change and a greater number of diagnosed diseases were independently associated with receiving advice for fruit and vegetable consumption. Body mass index, stage of change, and poorer perceived health were independently associated with receiving advice about weight. CONCLUSION: Health care provider advice appears to be based predominantly on comorbidities. Because of the preventive benefit of physical activity, fruit and vegetable consumption, and healthy weight, all health care providers are urged to increase counseling for all patients not meeting health behavior recommendations.

Adolescent↗

PubMed2003

Worksite intervention model for facilitating changes in physical activity, fitness, and psychological parameters.

The purpose was to examine the effectiveness of a physical activity intervention which combined behavior-change strategies with a variety of physical activities for 30 sedentary adults in a 12-wk. intervention that included behavior-change strategy sessions and supervised physical activity. Before and after the intervention, psychological and physiological variables were measured. Statistically significant changes right after the intervention included (1) an increase in physical activity participation, (2) an increase in muscular endurance, flexibility, and predicted VO2 max, and (3) a decrease in the number of barriers to physical activity. Changes in physical self-perception, a psychological variable often linked to increased physical activity, were not statistically significant, but effect sizes were large. The use of behavior-change strategies in conjunction with a variety of physical activities may be useful in improving physical and psychological well-being in previously sedentary adults. Stability of change requires study.

Adaptation, Psychological↗

PubMed1999

Alexithymia and health behaviors in healthy male volunteers.

The association between alexithymia and maladaptive health behaviors was evaluated in 118 young, healthy men, aged 18-45 years. Subjects completed the Toronto Alexithymia Scale (TAS-26), and a health behaviors questionnaire, measuring alcohol and drug use, sedentary lifestyle, poor nutritional consumption, and risky sexual practices. In forced hierarchical regression analyses, the association between alexithymia and health behaviors was evaluated after adjusting for age, body mass index, social support, ambivalence over expression of emotion, and the expression of emotion. Results indicated that: (1) the TAS-26 and difficulty identifying feelings was associated with poor nutritional consumption; (2) difficulty identifying feelings was associated with greater alcohol and drug use; and (3) difficulty communicating feelings was associated with a more sedentary lifestyle. There was no association between risky sexual practices and alexithymia. These results suggest that, in young men, difficulties with identifying emotions and communicating emotions are associated with maladaptive nutritional habits, a sedentary lifestyle, and substance abuse, even after adjusting for other psychosocial and demographic variables. Such maladaptive health behaviors may help explain the association between alexithymia and premature mortality.

Adult↗

PubMed2003

Sleeping problems and health behaviors as mediators between organizational justice and health.

The aim of this longitudinal cohort study was to investigate whether sleeping problems and health behaviors (smoking, alcohol consumption, and sedentary lifestyle) mediate the association between organizational justice and employee health. Health indicators were minor psychiatric morbidity, as assessed by the General Health Questionnaire (U. Werneke, D. P. Goldberg, I. Yalcin, & B. T. Ustun, 2000), and poor self-rated health status. The results of logistic regression analysis of data for 416 male and 3,357 female hospital employees working during the 1998-2000 period in 10 Finnish hospitals suggest that sleeping problems are one of the underlying factors causing the adverse health effects of low organizational justice at work. No support for a mediating role of health behaviors between low organizational justice and health problems was obtained.

Adolescent↗

PubMed2002

Antioxidant gene expression in active and sedentary house mice (Mus domesticus) selected for high voluntary wheel-running behavior.

We present liver mRNA levels of the two antioxidant enzymes catalase (CAT) and Mn-superoxide dismutase (SOD2) in four treatment groups of house mice assayed by RNase protection at 20 months of age. These groups were mice from four replicate selection and four replicate control lines from the sixteenth generation of selective breeding for high voluntary wheel running, housed with or without running wheels from age 3 weeks through 20 months. Exercising control females had induced CAT expression; SOD2 exhibited a similar pattern in females from two of the four control lines. Exercising male mice had induced CAT expression, but not SOD2 expression, irrespective of genetic background. We discuss these results with respect to both evolutionary (genetic) and training (exercise-induced) adaptations and explore predictions of these results in relation to the oxidative-damage theory of senescence.

Aging↗

PubMed2006

Patterns and correlates of physical activity and nutrition behaviors in adolescents.

BACKGROUND: Knowledge of the prevalence, clustering, and correlates of multiple adolescent health behaviors can inform the design of health promotion interventions. METHODS: A cross-sectional design was used to assess 878 adolescents aged 11 to 15 years (53.6% girls, 58% non-Hispanic white) recruited in primary care clinics in 2001-2002. Adolescent physical activity (assessed with accelerometers), television viewing time (reported), percent calories from fat, and servings of fruits and vegetables (assessed with multiple 24-hour recalls) were dichotomized into meeting or not meeting national guidelines. Parent health behaviors were assessed with self-reported measures. Analyses were conducted in 2006. RESULTS: Fifty-five percent of adolescents did not meet the physical activity guideline, and 30% exceeded 2 hours daily of television viewing time, with boys more active and less sedentary than girls (p <0.01). The majority of the adolescents did not meet dietary guidelines. Nearly 80% had multiple risk behaviors and only 2% met all four guidelines. The number of risk behaviors was associated with being older and being at risk for overweight or being overweight, for boys and girls (p <0.05). Two parent health behaviors-history of smoking and failure to meet the fruits and vegetables guideline-were significantly associated with a higher number of risk behaviors for girls (p <0.05). CONCLUSIONS: Eight of ten adolescents in this sample failed to meet guidelines for two or more diet, physical activity, and sedentary risk behaviors. Some parent health behaviors, along with the adolescent's weight status and age, were associated with a higher number of adolescent health risk behaviors.

Adolescent↗

PubMedDate not supplied

Type A behavior pattern and alcohol intake in middle-aged men.

Eighty-one sedentary but healthy, middle-aged men were studied. Type A behavior pattern (TABP) was determined by "structured interview", and dietary intake was assessed by alcohol questionnaire and 3-day diet record. Type A men reported drinking approximately twice as much alcohol as their non-Type A counterparts (mean +/- SD: 21.7 +/- 18.2 vs. 9.4 +/- 9.1 g of ethanol per day; p = 0.0003), and a strong, positive association between TABP and alcohol intake was found. The TABP-alcohol relationship was not confounded by concomitant differences in income level or years of formal education, and remained highly significant in subsequent analyses of nonsmokers alone. Type As and non-Type As did not differ significantly in their consumption of any other nutrient measured. The association between TABP and alcohol intake may have confounded conclusions from previous studies that focused on one or the other as a risk factor for coronary heart disease.

Adult↗

PubMed1998

Stages of exercise behavior change at two time periods following coronary artery bypass graft surgery.

A sedentary lifestyle is the most prevalent coronary heart disease risk factor in the United States. It is a challenge for healthcare providers to promote the adoption and maintenance of regular exercise as a lifestyle change in sedentary individuals. For this effort to be effective, research on exercise behavior and the processes that promote the desired behavior is needed. Using the Transtheoretical Model of Change (TMC), this study was aimed at describing and comparing short- and long-term regular exercise behavior and the change processes used in the different stages, with subjects after coronary artery bypass graft (CABG) surgery. Questionnaires were sent to 253 patients aged 60 years and older at 4 to 6 months and 22 to 26 months after CABG surgery. The study findings indicate that 67% of the subjects had become long-term regular exercisers. However, there were more subjects who had begun exercise shortly after the surgery than at the 2-year point. The data suggest that health promotion efforts may be more cost-effective and efficient if focused on educating the smaller percentage of post-CABG surgery patients in the pre-regular-exercise stages. In addition, relapse prevention may be needed to maintain exercise adherence. This study also demonstrates that exercise behavior can be easily categorized into stages with the use of four questions. However, an instrument to evaluate the processes of exercise behavior change needs to be developed specifically for the older population.

Aged↗

PubMed2006

Learned helplessness is independent of levels of brain-derived neurotrophic factor in the hippocampus.

Reduced levels of brain-derived neurotrophic factor (BDNF) in the hippocampus have been implicated in human affective disorders and behavioral stress responses. The current studies examined the role of BDNF in the behavioral consequences of inescapable stress, or learned helplessness. Inescapable stress decreased BDNF mRNA and protein in the hippocampus of sedentary rats. Rats allowed voluntary access to running wheels for either 3 or 6 weeks prior to exposure to stress were protected against stress-induced reductions of hippocampal BDNF protein. The observed prevention of stress-induced deceases in BDNF, however, occurred in a time course inconsistent with the prevention of learned helplessness by wheel running, which is evident following 6 weeks, but not 3 weeks, of wheel running. BDNF suppression in physically active rats was produced by administering a single injection of the selective serotonin reuptake inhibitor fluoxetine (10 mg/kg) just prior to stress. Despite reduced levels of hippocampal BDNF mRNA following stress, physically active rats given the combination of fluoxetine and stress remained resistant against learned helplessness. Sedentary rats given both fluoxetine and stress still demonstrated typical learned helplessness behaviors. Fluoxetine by itself reduced BDNF mRNA in sedentary rats only, but did not affect freezing or escape learning 24 h later. Finally, bilateral injections of BDNF (1 mug) into the dentate gyrus prior to stress prevented stress-induced reductions of hippocampal BDNF but did not prevent learned helplessness in sedentary rats. These data indicate that learned helplessness behaviors are independent of the presence or absence of hippocampal BDNF because blocking inescapable stress-induced BDNF suppression does not always prevent learned helplessness, and learned helplessness does not always occur in the presence of reduced BDNF. Results also suggest that the prevention of stress-induced hippocampal BDNF suppression is not necessary for the protective effect of wheel running against learned helplessness.

Animals↗

PubMed1996

The effect of socioeconomic status on chronic disease risk behaviors among US adolescents.

OBJECTIVE: To examine the relationship between socioeconomic status and risk behaviors for chronic disease among a nationally representative sample of adolescents in the United States. DESIGN: Household survey, the Youth Risk Behavior Survey supplement to the 1992 National Health Interview Survey. SETTING: United States. PARTICIPANTS: Nationally representative sample of 6321 adolescents aged 12 to 17 years. MAIN OUTCOME MEASURES: Standardized prevalence rates and logistic and multiple regression models were used to examine the effect of educational level of the responsible adult and family income on 5 risk behaviors for chronic disease among adolescents--cigarette smoking, sedentary lifestyle, insufficient consumption of fruits and vegetables, excessive consumption of foods high in fat, and episodic heavy drinking of alcohol. RESULTS: Most adolescents (63%) reported 2 or more of the 5 risk behaviors. Controlling for age, sex, race/ethnicity, and school enrollment status of adolescents, as the educational level of the responsible adult increased, cigarette smoking, sedentary lifestyle, and insufficient consumption of fruits and vegetables were less likely among adolescents. Among girls, but not boys, consumption of foods high in fat decreased as education of the responsible adult increased. As family income increased, adolescents were less likely to smoke cigarettes, less likely to be sedentary, and less likely to engage in episodic heavy drinking. CONCLUSION: Among adolescents, risk behaviors for chronic disease are common and inversely related to socioeconomic status. Improved community- and school-based programs to prevent such behaviors among adolescents are needed, especially among socially and economically disadvantaged youth.

Adolescent↗

PubMed2006

Obesity during growth in Switzerland: role of early socio-cultural factors favouring sedentary activities.

Depending upon age, gender and geographical area, 3-20% of the children and young adolescents in Switzerland are overweight and 0-6% obese, using the criteria of the International Obesity Task Force. The most likely explanation for this increasing prevalence of overweight and obesity is a decline in physical activity, and hence diminished energy expenditure that is not matched by a corresponding reduction in energy intake. In this paper, we first review the epidemiological situation in Switzerland regarding the rising prevalence of obesity and the decline in physical activity, and then focus upon the environmental, social and cultural factors that predispose children to sedentary behaviours. Several of these socio-cultural factors and in particular television viewing and poor-parental model, confer early 'learned behaviours' for low physical activity which track throughout growth into adulthood, and which also predispose to the overconsumption of less healthy foods. It is time to focus on preventive strategies directed at curtailing these 'learned behaviours', that we have acquired during the transition from the stone-age to the chip-age, if we want to hold the current pandemic of obesity.

Adolescent↗

PubMed2002

Dietary behavior in relation to socioeconomic characteristics and self-perceived health status.

The purposes of this study were to examine the relationship between dietary behavior and self-perceived health status and to demonstrate the relative significance of people's socioeconomic characteristics in relation to their dietary behavior. Data came from the 1994 Behavioral Risk Factor Surveillance System of South Carolina. Descriptive statistics were performed to provide a profile of the general characteristics of the sample. Multivariate linear regression modeling was used to examine the relative significance of socioeconomic status in relation to dietary behavior and the association between dietary behavior and self-perceived general, physical, and mental health status, controlling for other behavioral risk factors, such as smoking and sedentary lifestyle. Socioeconomically disadvantaged individuals with low income and low educational level were more likely to engage in poor dietary practice than were their counterparts. Dietary behavior was found strongly associated with self-perceived general and mental health status.

Adult↗

PubMedDate not supplied

Behavioral assessment of chronic orofacial pain.

Orofacial pain is usually evaluated and treated from a biomedical perspective. There is no question that the large majority of individuals having acute orofacial pain benefit from timely and appropriate medical intervention. When orofacial pain persists, however, the likelihood that this pain can influence and be influenced by behavioral factors increases. While some individuals are able to adapt and cope with chronic orofacial pain, others develop significant behavioral problems. These problems may include an overly sedentary lifestyle, dependence on habit-forming narcotic medications, or severe depression or anxiety. The hallmark of the behavioral perspective on chronic pain is the insistence that a careful assessment and treatment of such behavioral problems is just as important as appropriate biomedical intervention.(1)

Chronic Disease↗