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PubMed2003

Breakfast skipping and health-compromising behaviors in adolescents and adults.

OBJECTIVE: To investigate which sociodemographic factors and behaviors are associated with breakfast skipping in adolescents and adults. DESIGN: Five birth cohorts of adolescent twins and their parents received an extensive behavioral and medical self-report questionnaire that also assessed breakfast-eating frequency. SETTING: Finland, 1991-1995. SUBJECTS: A population sample of 16-y-old girls and boys (n=5448) and their parents (n=4660). RESULTS: Parental breakfast eating was the statistically most significant factor associated with adolescent breakfast eating. Smoking, infrequent exercise, a low education level at 16, female sex, frequent alcohol use, behavioral disinhibition, and high body mass index (BMI) were significantly associated with adolescent breakfast skipping. In adults, smoking, infrequent exercise, low education level, male sex, higher BMI, and more frequent alcohol use were associated with breakfast skipping. In the adult sample, older individuals had breakfast more often than younger ones. Both adults and adolescents who frequently skipped breakfast were much more likely to exercise very little compared to those who skipped breakfast infrequently. Breakfast skipping was associated with low family socioeconomic status in adults and adolescent boys, but not in girls. Breakfast skipping clustered moderately with smoking, alcohol use, and sedentary lifestyle in both adults and adolescents. CONCLUSIONS: Breakfast skipping is associated with health-compromising behaviors in adults and adolescents. Individuals and families who skip breakfast may benefit from preventive efforts that also address risk behaviors other than eating patterns. SPONSORSHIP: National Institute of Alcohol Abuse and Alcoholism (AA08315), Academy of Finland (44069), European Union Fifth Framework Program (QLRT-1999-00916), Yrjö Jahnsson Foundation, and Jalmari and Rauha Ahokas Foundation.

Adolescent↗
PubMed2005

The efficacy of moderate-intensity exercise as an aid for smoking cessation in women: a randomized controlled trial.

Evidence suggests that vigorous-intensity exercise interventions may be effective for smoking cessation among women; however, few studies have examined the efficacy of a moderate-intensity exercise program. The present study examined the efficacy of moderate-intensity exercise for smoking cessation among female smokers. Healthy, sedentary female smokers (N = 217) were randomly assigned to an 8-week cognitive-behavioral smoking cessation program plus moderate-intensity exercise (CBT+EX) or to the same cessation program plus equal contact (CBT). A subsample received nicotine replacement therapy. Results indicated that the CBT+EX and CBT groups were equally likely to attain smoking cessation at the end of treatment, as measured by cotinine-verified 7-day point-prevalence abstinence (20.2% for CBT+EX vs. 18.5% for CBT). The CBT+EX group was more likely to report smoking cessation, as measured by 7-day point prevalence at the 3-month follow-up (11.9% vs. 4.6%, p<.05), compared with the CBT group. No group differences were found at 12 months by either 7-day point prevalence (7.3% for CBT+EX vs. 8.3% for CBT) or continuous abstinence (0.9% for CBT+EX vs. 0.9% for CBT). Additionally, among participants in the CBT+EX group, those with higher adherence to the exercise prescription were significantly more likely to achieve smoking cessation at the end of treatment than were participants reporting lower adherence to exercise. Our findings indicate that the empirical support for moderate-intensity exercise as an adjunctive treatment to CBT for smoking cessation may be limited. Perhaps future studies could compare moderate- vs. vigorous-intensity physical activity to test their relative efficacy.

Adult↗
PubMed2005

Behavioral versus genetic correlates of lipoproteins and adiposity in identical twins discordant for exercise.

BACKGROUND: Lipoprotein and weight differences between vigorously active and sedentary monozygotic (MZ) twins were used to (1) estimate the effects of training while controlling for genotype and (2) estimate genetic concordance (ie, similarity) in the presence of divergent lifestyles. METHODS AND RESULTS: Thirty-five pairs of MZ twins (25 male, 10 female) were recruited nationally who were discordant for vigorous exercise (running distances differed by > or =40 km in male and > or =32 km in female twins). The active twins ran an average (mean+/-SD) of 63.0+/-20.4 km/wk, whereas the mostly sedentary twins averaged 7.0+/-13.5 km/wk. The active twins had significantly lower body mass index (difference+/-SE, -2.12+/-0.57 kg/m2, P=0.0007) and significantly higher HDL cholesterol (0.14+/-0.04 mmol/L, P=0.004), HDL2 (2.71+/-1.04 U, P=0.01), and apolipoprotein (apo) A-I (0.10+/-0.03 g/L, P=0.004). Despite the difference in lifestyle, when adjusted for sex, the correlations between the discordant MZ twin pairs were significant (P<0.01) for HDL cholesterol (r=0.69), apoA-I (r=0.58), and HDL2 (r=0.67). There was no significant MZ twin correlation for body mass index (r=0.17). None of the active twins having an overweight twin were themselves overweight. CONCLUSIONS: Behavior (vigorous exercise) may reduce genetic influences on body mass index. In contrast, genetics (or shared environment) substantially influences HDL cholesterol and HDL subclasses, even in the presence of extreme behavioral differences. There may be greater individual control over moderate degrees of obesity, whereas low HDL cholesterol may be largely predetermined and less effectively treated by vigorous exercise.

Adiposity↗
PubMedDate not supplied

Reduction in cardiovascular disease risk factors: 6-month results from Project Active.

BACKGROUND: Project Active is a randomized clinical trial that compares a lifestyle physical activity intervention with a traditional structured exercise intervention. The purpose of this paper is to report 6-month results of these interventions on cardiovascular disease (CVD) risk factors among healthy, sedentary, middle-aged men and women, and to examine the psychological strategies used in each group (Lifestyle and Structured) to reach the level of physical activity recommended by the Centers for Disease Control and Prevention (CDC) and American College of Sports Medicine (ACSM) and to achieve changes in these CVD risk factors. METHODS: A total of 116 initially sedentary men (mean +/- SD self-reported physical activity, 33.2 +/- 1.4 kcal.kg-1.day-1) and 119 women (32.9 +/- 1.0 kcal.kg-1.day-1), ages 35-60 years (46.0 +/- 6.7 years) were randomly assigned to a 6-month lifestyle physical activity counseling intervention or a 6-month gymnasium-based structured program. At baseline and 6 months, changes in lipid and lipoprotein-cholesterol concentrations, blood pressure, and body composition and cognitive and behavioral measures of change were assessed. One-way analyses of variance with covariate adjustment were used to test for between-group differences in CVD risk factors. Associations between achieving the CDC/ACSM criterion and changes in cognitive and behavioral measures were assessed with multiple logistic regression models. RESULTS: After 6 months of intervention, 78% of Lifestyle participants and 85% of Structured participants were meeting or exceeding the CDC/ACSM recommendation of accumulating 30 min or more of moderate-intensity physical activity on most, preferably all, days of the week. This was verified by a significant increase in cardiorespiratory fitness in both groups. The adjusted mean increase in maximal METs (VO2peak divided by 3.5 ml.kg-1.min-1) between treadmill tests was 0.4 kcal.kg-1.hr-1 (P < 0.001) for Lifestyle and 1.1 kcal.kg-1.hr-1 (P < 0.001) for Structured. There was a significant difference between intervention groups for this outcome. Both groups had significant reductions in total cholesterol, total cholesterol/HDL-C ratio, diastolic blood pressure, and percentage of body fat. There were no significant between-group differences in changes in these outcomes. Adjusted mean changes in total cholesterol, systolic blood pressure, and percentage of body fat in Lifestyle [in Structured] participants were -0.2 [-0.3] mmol.L-1, -3.2[-1.8] mm Hg, and -1.4 [-1.7] %, respectively. There were significant associations between achieving the CDC/ACSM physical activity criterion and greater use of the cognitive and behavioral strategies of change. Both groups changed self-efficacy and many of the behavioral measures, but there were no significant differences between intervention groups. CONCLUSIONS: These results demonstrate that lifestyle physical activity counseling is as effective as structured exercise programs in increasing physical activity and improving CVD risk factors after 6 months among initially sedentary men and women. Furthermore, specific cognitive and behavioral counseling strategies were increased significantly as a result of the intervention. These strategies are effective and could be used in a wide variety of settings.

Adult↗
PubMed1995

The epidemiology of walking for exercise: implications for promoting activity among sedentary groups.

The relative contribution of walking to overall leisure-time physical activity participation rates was studied among respondents from the 45 states that participated in the 1990 Behavioral Risk Factor Surveillance System (n = 81,557). The percentages of low income, unemployed, and obese persons who engaged in leisure-time physical activity (range = 51.1% to 57.7%) were substantially lower than the percentage among the total adult population (70.3%). In contrast, the prevalence of walking for exercise among these sedentary groups (range = 32.5% to 35.9%) was similar to that among the total population (35.6%). Walking appears to be an acceptable, accessible exercise activity, especially among population subgroups with a low prevalence of leisure-time physical activity.

Adolescent↗
PubMed1998

Physical activity, genetic, and nutritional considerations in childhood weight management.

Almost one-quarter of U.S. children are now obese, a dramatic increase of over 20% in the past decade. It is intriguing that the increase in prevalence has been occurring while overall fat consumption has been declining. Body mass and composition are influenced by genetic factors, but the actual heritability of juvenile obesity is not known. A low physical activity (PA) is characteristic of obese children and adolescents, and it may be one cause of juvenile obesity. There is little evidence, however, that overall energy expenditure is low among the obese. There is a strong association between the prevalence of obesity and the extent of TV viewing. Enhanced PA can reduce body fat and blood pressure and improve lipoprotein profile in obese individuals. Its effect on body composition, however, is slower than with low-calorie diets. The three main dietary approaches are: protein sparing modified fast, balanced hypocaloric diets, and comprehensive behavioral lifestyle programs. To achieve long-standing control of overweight, one should combine changes in eating and activity patterns, using behavior modification techniques. However, the onus is also on society to reduce incentives for a sedentary lifestyle and over-consumption of food. To address the key issues related to childhood weight management, the American College of Sports Medicine convened a Scientific Roundtable in Indianapolis.

Adolescent↗
PubMed2003

Sympathoadrenergic mechanisms in reduced hemodynamic stress responses after exercise.

PURPOSE: This study examines the acute effects of moderate aerobic exercise on 1) hemodynamic and sympathetic activity during behavioral stress and 2) beta-adrenergic receptor responsivity in a biracial sample of 24 sedentary adults. METHODS: Before and after exercise, blood pressure (BP), impedance-derived cardiovascular measures, and plasma norepinephrine (NE) and epinephrine (EPI) were assessed during mental arithmetic and active speech tasks, and beta-adrenergic receptor responsivity was assessed using a standard isoproterenol challenge procedure. RESULTS: After exercise, BP, NE, and EPI responses to stress were reduced (0.0001 < P < 0.08), preejection period (PEP) was elongated (P < 0.0001), and beta(1)- and beta(2)-receptor responsivity (P < 0.02) was enhanced. Approximately 65% of the prepost exercise mean arterial pressure response difference could be accounted for by changes in sympathetic factors, with change in NE and PEP being the single best predictors. CONCLUSIONS: Reduced BP responses to stress after acute exercise are strongly linked to a decrease in sympathetic drive, as evidenced by reduced NE responses and elongation of the PEP. Coincident with this overall dampening of the hemodynamic response to stress, increases in cardiac and vascular beta-adrenergic receptor responsivity occur. These findings may have important implications for future translational studies that seek to articulate the mechanisms through which regular aerobic exercise reduces the risks of hypertensive and coronary heart disease.

Adult↗
PubMed1999

Providing worksite health promotion through university-community partnerships. The South Carolina DOT project.

The occupational health nurse for the South Carolina Department of Transportation (SCDOT) collaborated with the Schools of Nursing within the state universities of South Carolina to coordinate individual health screenings for the employees of SCDOT. Personal Wellness Profiles (PWP) by Wellsource, Inc., were used to perform the health screenings and included family and personal histories, and assessment of blood pressure, vision, height, weight, total and high density lipoprotein cholesterol, and blood glucose levels. In addition, hepatitis and tetanus/diphtheria immunizations and influenza vaccines were provided. Each of the 48 county sites was visited twice during the semester by nursing faculty and nursing and public health students. The first visit was to collect assessment data for screening and provide immunizations. The second visit was to provide individualized analyzed data and health counseling. Of the 5,118 SCDOT employees, 3,141 were screened the first year and 2,315 were screened the second year. Of the original 3,141, only 1,549 elected to participate in the rescreening. Although the average population age was 41, 78.3% were rated at high coronary risk because of high blood pressure, high cholesterol and blood sugar levels, excessive weight and stress levels, and sedentary lifestyles.

Adult↗
PubMedDate not supplied

Using the Behavioral Risk Factor Surveillance System to monitor year 2000 objectives among American Indians.

The Behavioral Risk Factor Surveillance System, a data set based on telephone surveys that have been conducted by States in collaboration with the Centers for Disease Control, has been used to estimate the prevalence of behavioral risk factors for adults in the United States so health objectives can be set and progress towards accomplishing them measured. Data for adult American Indians in this regard have not been available generally. The use of these data to estimate behavioral risk prevalence for American Indians by geographic region was examined and the results compared with those for white Americans. In addition, data from the system were compared with other data sets, including the results of selected surveys in American Indian communities, to explore the validity of the system as a tool for evaluating the behavioral risks of Indians. Behavioral Risk Factor Surveillance System data for the period 1985 to 1988 were used. During this period, the 1,055 American Indian respondents constituted 0.63 percent of those responding under the system and 0.70 percent of the population of the participating States. Separate (sex-specific) behavioral risk prevalence estimates were derived for Indians and whites for four geographic regions--Southwest, Plains, West Coast, and Other States. The system's behavioral risk estimates for the Plains region were compared with available data from behavioral risk surveys done in three American Indian communities in Montana (Blackfeet, Fort Peck, and Great Falls) from 1987 to 1989. The behavioral risk factors compared include use of automobile seatbelts, current smoking, current use of smokeless tobacco, heavy drinking, drinking and driving, overweight, hypertension, and sedentary lifestyle. Although large regional differences in the prevalence of these risk factors were found, the magnitude and direction of the differences are frequently similar among American Indians and whites living in the same geographic regions. The findings from the Behavioral Risk Factor Surveillance System among American Indians are largely consistent within dependently collected data from more resource intensive household surveys, at least when surveys in Montana are compared with system data from the Plains. These data are generally consistent with other epidemiologic studies.When they are used in conjunction with community-specific surveys, the Behavioral Risk Factor Surveillance System data may be useful for monitoring the progress of American Indians towards the Year 2000 national health objectives. The value of the surveillance system for monitoring trends in behavioral risk factors among Indians would be enhanced if States attempted to over sample regions (such as Indian reservations) with a high proportion of Indian residents. It appears that aggressive health promotion and disease prevention efforts will be needed if these objectives are to be achieved.

Adolescent↗
PubMedDate not supplied

Physician advice to reduce chronic disease risk factors.

The U.S. Preventive Services Task Force recommends that physicians advise their patients regarding smoking cessation, weight loss, and physical inactivity. Few studies, however, have assessed the extent to which persons with these risk factors receive advice from their physicians. Using data from the 1990-1991 Missouri Behavioral Risk Factor Surveillance System (BRFSS), a random digit-dialed telephone survey of adults, we identified Missouri residents with one or more of these modifiable risk factors. We examined whether these persons reported being advised by their physicians to modify their behavior(s) within the past year. Of the 2,791 respondents, 764 (26%) smoked, 1,720 (59%) were sedentary, and 686 (23%) were overweight. Five hundred and thirty-five smokers reported having a routine checkup within the past year, but only 224 (42%) reported being advised by their physicians to stop smoking. Of the 1,246 sedentary persons who had a routine checkup within the past year, 192 (15%) reported being told by their physicians to exercise more. Of the 521 overweight respondents who had a routine checkup within the past year, 225 (43%) reported being advised to lose weight. Physician advice for these risk factors was less frequently reported among men, blacks, younger persons, and persons from rural areas. Although most Missouri residents with these modifiable risk factors reported seeing their physicians within the past year, less than half reported that they received advice from their physicians to alter their risk behavior(s). Further efforts are necessary to increase the effectiveness of physician advice for at-risk patients about quitting smoking, losing weight, and increasing physical activity.

Adult↗
PubMed2004

A randomized pilot test of "Moms on the Move": a physical activity intervention for WIC mothers.

BACKGROUND: Sedentary mothers are important to reach with physical activity promotion. PURPOSE: This study pilot tested "Moms on the Move," a Transtheoretical Model (TTM)-derived physical activity (PA) intervention for low-income mothers enrolled in the Women, Infants, and Children (WIC) program. METHOD: Sedentary mothers (N = 44) were randomized to (a). Moms on the Move (PA intervention) or (b). counseling on self-breast examination (control). Pre- and posttest measurement (baseline and 2 weeks after the 8-week interventions) included (a). stage of PA behavior change, (b). PA behavior, (c). selected TTM constructs, and (d). social support. Pre- and postdifference scores, chi-square, and one-way analyses of variance (ANOVAs) were used. RESULTS: The experimental group progressed in stage of change more than control, chi2(1, N = 44) = 20.50, p <.001. The experimental group had greater PA behavior: weekly minutes of PA, F(1, 42) = 46.85, p <.001; daily energy expenditure (EE), F(1, 42) = 23.01, p <.001; and weekly moderate PA EE, F(1, 42) = 32.63, p <.001. Experimental subgroup (n = 11) step counts increased pre-post, t(10) = 6.16, p <.001. An ANOVA showed that the experimental group had greater improvements in all TTM constructs and social support, ps <.001. CONCLUSIONS: WIC mothers are at risk for sedentary living and have not been targeted for PA behavior change using a provider-counseled approach. Although further testing is needed, Moms on the Move appears to be efficacious.

Adult↗
PubMed2002

Impact of weight-cycling history on bone density in obese women.

OBJECTIVE: The purpose of this study was to examine the effect of weight cycling (as defined by the frequency and magnitude of intentional weight loss) on bone mineral density and bone mineral content in obese sedentary women. RESEARCH METHODS AND PROCEDURES: Bone mineral content and density measured by DXA, submaximal physical fitness assessment, nutrient intake, oral contraceptive use, and weight-cycling history were assessed in 195 healthy, overweight sedentary women (age, 21 to 45 years; body mass index, 27 to 40 kg/m(2)) before beginning a behavioral weight-loss intervention. RESULTS: After controlling for body weight, multivitamin use, oral contraceptive/estrogen use, and calcium and magnesium intake, women who had a history of weight cycling did not have significantly lower total-body bone mineral content or density or total femur bone mineral density. In addition, 99% of subjects were above or within one SD of age and gender normative data for total femur bone mineral density. DISCUSSION: It does not seem that a history of weight cycling has an adverse affect on total femur and total-body bone mineral density in overweight sedentary premenopausal women.

Absorptiometry, Photon↗
PubMed2001

Voluntary physical activity prevents stress-induced behavioral depression and anti-KLH antibody suppression.

The current study addressed whether physical activity can buffer stress-induced "behavioral depression" and immunosuppression. Adult, male Sprague-Dawley rats were housed with either a mobile (physically active) or immobile (sedentary) running wheel and exposed to either stress (inescapable tail shock) or no stress (home cage control). Voluntary wheel running began 4 wk before stressor exposure. Immediately before stress, all rats were administered an intraperitoneal injection of keyhole limpet hemocyanin (KLH; 200 microg), and anti-KLH Ig was measured weekly for 4 wk using ELISA. Prior physical activity reduced the stress-induced behavioral depression and prevented the stress-induced suppression of anti-KLH IgM and IgG(2a) antibodies. Anti-KLH IgG(1) was stress insensitive. These data suggest that physical activity can buffer the negative impact of stress on behavior and acquired immune function.

Adjuvants, Immunologic↗
PubMed1998

Relationship of early infant state measures to behavior over the first year of life in the tufted capuchin monkey (Cebus apella).

Data on activity states were collected from 29 group-housed capuchin monkey (Cebus apella) infants for 3 h each week from birth to 11 weeks of age. The amounts of time spent in sleeping/drowsy, alert-quiet, and alert-active states were measured in these subjects. Videotaped observations of these infants were recorded 3 times/week in the home cage over the first year of life and were scored for a number of social and exploratory behaviors. The extent to which early infant activity state scores predicted later behavior in the home cage was examined. Infant state measures correlated significantly with home cage behavior during months 2-6 in that infants that had been more active in early infancy spent more time alone, with other animals, and in exploration and play and less time with mothers than did quieter infants. Early state measures were less successful in predicting home cage scores beyond 8 months of age, whereas differences in behavior attributable to housing variables became more salient in the latter part of the first year. There was also a negative correlation between mother and infant activity in months 2 and 3, in that more sedentary mothers tended to have more active infants.

Aging↗
PubMed1980

Psychosocial and behavioral influences in the pathogenesis of acquired cardiovascular disease.

When taken together, studies relating psychosocial and behavioral factors to cardiovascular disease phenomena provide justification for the conclusion that such factors are importantly involved. We would emphasize the need to study and evaluate the interaction of environmental and biological factors in both laboratory studies of pathogenesis as well as in clinical studies of management. Indeed, upon careful scrutiny, even the accepted "nonbehavioral" risk factors such as hypercholesterolemia, hypertension, cigarette smoking, obesity, and sedentary lifestyles are each composite manifestations rather than single pathogens whose identities are powerfully impregnanted and bolstered by varieties of behavioral and psychosocial underpinnings. In view of the awesome impact of contemporary cardiovascular disease, both in terms of its increasing socioeconomic importance and its biologic devastation, we can not long afford comprehensive public health programs without increased and improved attention to psychosocial and behavioral influences in the pathogenesis of acquired cardiovascular disease.

Animals↗
PubMed2000

Prevalence and co-occurrence of health risk behaviors among high-risk drinkers in a primary care population.

BACKGROUND: Approximately 10% of patients seen in the primary care setting meet criteria for high-risk (HR) drinking. Little data are available about the co-occurrence of other risk behaviors (RBs) in this population. This study examines the co-occurrence of smoking, poor diet, and sedentariness, and several change-related variables, among 479 HR drinkers participating in Project Health, a NIAAA-funded study testing the effectiveness of a provider-delivered intervention to reduce HR drinking. METHOD: Data were collected at study entry via standardized interview and questionnaire. RESULTS: The prevalence of additional RBs among HR drinkers was smoking, 35%; poor diet, 28%; and sedentariness, 44%. In addition to HR drinking, 67% of participants had at least one RB, and 61% reported smoking, sedentariness, or both. Perception of drinking as a problem was generally low (20%), as was intention to change drinking. Seventy-two percent of participants with multiple RBs perceived at least one of these RBs as a problem. Younger, unmarried, less-educated, blue-collar, and non-working participants were more likely to have multiple RBs than white-collar workers. CONCLUSION: Additional RBs are common among HR drinkers and may increase their already elevated health risks. Implications of these findings for interventions integrating multiple RBs into primary care settings are discussed.

Adult↗
PubMed1996

Patterns of tobacco and alcohol use among sedentary, exercising, nonathletic, and athletic youth.

Through a statewide random design, 7,846 9th to 12th grade students in 81 South Carolina public schools were selected to complete the Youth Risk Behavior Survey. Mantel-Haenszel Chi-Square, general linear models, and logistic regression were used to examine the relation between the independent variables of race, gender, and physical activity status with the dependent variables of tobacco and alcohol use while controlling for race, gender, and participation in physical education classes. The six physical activity levels ranged from sedentary nonathletes to athletes participating on two or more sports teams. Highly active athletes drank more frequently than did low-activity nonathletes (p = .002) and sedentary nonathletes (p = .006), and they were more likely to binge drink (p = .004). Athletic groups were less likely to smoke than were the nonathletic groups (p < .0001) with "sedentary nonathletes" the heaviest smokers of all groups. Athletes were more likely to use smokeless tobacco (p < .0001) than nonathletes although this difference disappeared when controlling for gender and race. This research supports other findings about prevalence of smokeless tobacco use among athletic youth. In addition, it reveals that athletic youth are at an increased risk of alcohol use and binge drinking. Possible factors such as the risk-taking tendencies of team sport athletes should be investigated.

Adolescent↗