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Exercise induces behavioral recovery and attenuates neurochemical deficits in rodent models of Parkinson's disease.

Exercise is thought to improve motor function and emotional well-being in patients with Parkinson's disease (PD). However, it is not clear if the improvements are due to neurochemical alterations within the affected nigrostriatal region or result from a more general effect of exercise on affect and motivation. In this study we show that motorized treadmill running improves the neurochemical and behavioral outcomes in two rodent models of PD: the unilateral 6-hydroxydopamine (6-OHDA) rat model and bilateral 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) model in aged C57bl mice. Exposure to the dopamine (DA) toxins 6-OHDA or MPTP resulted in permanent behavioral and neurochemical loss. In contrast, when lesioned animals were exposed to treadmill activity two times a day for the first 10 days post-lesion they displayed no behavioral deficits across testing days and had significant sparing of striatal DA, its metabolites, tyrosine hydroxylase, vesicular monoamine transporter, and DA transporter levels compared to lesion sedentary animals. These results demonstrate that exercise following nigrostriatal damage ameliorates related motor symptoms and neurochemical deficits in rodent models of PD.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗

Lifelong physical activity patterns of sedentary Mexican American women.

Increasing physical activity, especially for high-risk groups, is a national priority; yet little is known about the lifelong patterns of physical activity of older Mexican American women. This article describes Mexican American women's current sedentary status by reviewing their physical activity history. Interventions aimed at promoting health in older adults require an understanding of the impact of prior experiences on current health behaviors. Thus, in-depth semistructured interviews were conducted with 71 Mexican American women (aged 50 years or older) recruited from local churches and senior centers. Household, occupational, and leisure activities from age 15 years to present time were reviewed. A lifelong pattern of low occupational and leisure activity and low to moderate household activity were found, with sedentary occupations and no leisure activities predominating. Most believed that current household, occupational and leisure activities provide enough physical activity, thus influencing participation in exercise programs or activities. Attempts to increase physical activity for this group need to begin by teaching them age-appropriate and culturally acceptable physical activities.

Aged↗

Enhanced sexual behavior in exercising men.

The effects of 9 months of aerobic exercise on aerobic work capacity (physical fitness), coronary heart disease risk factors, and sexuality were studied in 78 sedentary but healthy men (mean age, 48 years). The men exercised in supervised groups 60 min per day, 3.5 days per week on average. Peak sustained exercise intensity was targeted at 75-80% of maximum aerobic working capacity. A control group of 17 men (mean age, 44 years) participated in organized walking at a moderate pace 60 min per day, 4.1 days per week on average. Each subject maintained a daily diary of exercise, diet, smoking, and sexuality during the first and last months of the program. Beneficial effects of chronic, vigorous exercise on fitness and coronary heart disease risk factors were obtained in close agreement with prior studies. Analysis of diary entries revealed significantly greater sexuality enhancements in the exercise group (frequency of various intimate activities, reliability of adequate functioning during sex, percentage of satisfying orgasms, etc.). Moreover, the degree of sexuality enhancement among exercisers was correlated with the degree of their individual improvement in fitness.

Anxiety↗

Control of food intake in the obese.

Food intake (eating) is a form of behavior that is subject to conscious control. In practice, many obese and weight-gaining individuals claim that their eating is out of (their) control. Mechanistic models describe the interplay of biological and environmental forces that control food intake. However, because human food intake is characterized by individuals intervening to adjust their own patterns of behavior, food intake should reflect interactions among biology, environment, and attempted self-imposed control of behavior. In general, humans display a system of weight regulation that is asymmetrical--a reduction in body weight is strongly defended but weight gain is not. The body seems to tolerate a positive energy balance. There is no mechanism that can detect a positive energy balance per se or that can implement a sufficiently strong correction to behavior to maintain body weight in an environment that promotes consumption. The evolutionary process has favored biological traits associated with preferences for high energy density (sweet and/or fatty) energy-yielding foods. The control of food intake in obese or weight-gaining individuals may display various risk factors that favor an increase in energy. These include the preference for high energy-dense over low energy-dense foods, weak postprandial inhibitory signaling, strong hunger traits associated with low leptin levels after weight loss, and the consumption of fatty foods. In addition, many individuals (up to 47% of some samples) display binge eating patterns, whereas approximately 16% show either night eating or nocturnal eating. Because energy expenditure is only loosely coupled to energy intake, sedentariness does not down-regulate food intake.

Appetite Regulation↗

The association between fruit and vegetable intake and chronic disease risk factors.

Understanding the associations between fruit and vegetable intake and other health behaviors is important for properly interpreting the rapidly growing number of studies that link low intakes of fruits and vegetables to the risk of cancer and cardiovascular disease. To examine the association between fruit and vegetable intake and behavioral risk factors for chronic diseases, we analyzed data from a population-based behavioral risk factor survey. Data were collected in 1990 from 21,892 adults in 16 states by a random-digit-dial telephone survey. Respondents answered questions about behaviors related to chronic disease risk, including their frequency of intake of fruits and vegetables, using a six-item questionnaire. Consumption of fruits and vegetables was lowest among those who also reported that they were sedentary, heavy smokers, heavy drinkers, or had never had their blood cholesterol checked. Because fruit and vegetable intake covaries with several other chronic disease risk factors, it is important to account for possible confounding between fruit and vegetable intake and other behaviors in etiologic studies of the risk of cancer and cardiovascular disease.

Adolescent↗

Physical activity levels of adolescents with congenital heart disease.

Regular physical activity prevents chronic disease and moderate to vigorous participation provides additional health benefits. Therefore, adolescents with congenital heart disease risk developing latent diseases due to real or perceived physical activity restrictions. Habitual physical activity levels, psychological determinants and advice received were examined by postal survey of 434 West Australian adolescents aged 12-18 years with congenital heart disease. Survey results (n = 153) were compared with published normative adolescent data. Total activity was classified as vigorous, adequate or inadequate according to metabolic equivalents, reported frequency and duration. Comparable numbers of respondents and healthy peers were active (winter 62% vs 74%; and summer 73% vs 82% respectively, p = 0.27). However, significantly fewer male respondents were classified as vigorously active compared with healthy peers, in both winter (48% vs 67%, p < 0.02), and summer (48% vs 69%, p = 0.04). Similar, but non-significant, trends were found when comparing female respondents with healthy peers and for mild versus severe disease groups. Self-efficacy ratings did not explain differences in physical activity intensity. Congenital heart disease may impact on the intensity of physical activity undertaken by affected adolescents thus denying additional health benefits. Physiotherapists could facilitate these adolescents to achieve more moderate to vigorous physical activity, to offset adult sedentary behaviour.

Adolescent↗

Economic costs of obesity and inactivity.

PURPOSE: The purpose of this paper is to assess the economic costs of inactivity (including those attributable to obesity). These costs represent one summary of the public health impact of increasingly sedentary populations in countries with established market economies. Components of the costs of illness include direct costs resulting from treatment of morbidity and indirect costs caused by lost productivity (work days lost) and forgone earnings caused by premature mortality. METHODS: We searched the Medline database for studies reporting the economic costs of obesity or inactivity, or cost of illness. From the identified references those relating to obesity or conditions attributable to obesity were reviewed. Chronic conditions related to inactivity include coronary heart disease (CHD), hypertension, Type II diabetes, colon cancer, depression and anxiety, osteoporotic hip fractures, and also obesity. Increasing adiposity, or obesity, is itself a direct cause of Type II diabetes, hypertension, CHD, gallbladder disease, osteoarthritis and cancer of the breast, colon, and endometrium. The most up-to-date estimates were extracted. To estimate the proportion of disease that could be prevented by eliminating inactivity or obesity we calculated the population-attributable risk percent. Prevalence based cost of illness for the U.S. is in 1995 dollars. RESULTS: The direct costs of lack of physical activity, defined conservatively as absence of leisure-time physical activity, are approximately 24 billion dollars or 2.4% of the U.S. health care expenditures. Direct costs for obesity defined as body mass index greater than 30, in 1995 dollars, total 70 billion dollars. These costs are independent of those resulting from lack of activity. CONCLUSION: Overall, the direct costs of inactivity and obesity account for some 9.4% of the national health care expenditures in the United States. Inactivity, with its wide range of health consequences, represents a major avoidable contribution to the costs of illness in the United States and other countries with modern lifestyles that have replaced physical labor with sedentary occupations and motorized transportation.

Absenteeism↗

Tackling the obesity pandemic: a call for sedentary behaviour research.

An emerging threat to public health is seen in the dramatic rise in obesity status of Canadians, especially among young people. In addressing the possible factors responsible for these dramatic increases, this paper outlines the importance of understanding sedentariness as an important health behaviour, distinct from physical activity, and identifying the modifiable determinants of sedentary behaviours.

Adolescent↗

Behavioral risk factors in breast cancer: can risk be modified?

The International Agency for Research on Cancer estimates that 25% of breast cancer cases worldwide are due to overweight/obesity and a sedentary lifestyle. The preponderance of epidemiologic studies indicates that women who engage in 3-4 hours per week of moderate to vigorous levels of exercise have a 30%-40% lower risk for breast cancer than sedentary women. Women who are overweight or obese have a 50%-250% greater risk for postmenopausal breast cancer. Alcohol use, even at moderate levels (two drinks per day) increases risk for both premenopausal and postmenopausal breast cancer. Certain dietary patterns, such as high fat, low vegetables/fruits, low fiber, and high simple carbohydrates, may increase risk, but definitive data are lacking. These lifestyle factors are likely associated with breast cancer etiology through hormonal mechanisms. The worldwide trends of increasing overweight and obesity and decreasing physical activity may lead to an increasing incidence of breast cancer unless other means of risk reduction counteract these effects. Thus, adoption of lifestyle changes by individuals and populations may have a large impact on the future incidence of this disease.

Attitude to Health↗

Pediatric obesity epidemic: treatment options.

The increasing prevalence of overweight youth in the United States and the associated increase in medical comorbidities has created a growing need for effective weight-management interventions. The recommended treatment for an overweight child to achieve a more healthful weight uses four primary behavioral strategies: (a) reduce energy intake while maintaining optimal nutrient intake to protect growth and development, (b) increase energy expenditure by promoting more physical movement and less sedentary activity, (c) actively engage parents and primary caretakers as agents of change, and (d) facilitate a supportive family environment. Although this approach has the most empirical support, the impact on the pediatric obesity epidemic has been limited, particularly for adolescents with more severe obesity and for African-American, Native-American, and Hispanic children. This has prompted efforts to adapt strategies that have been effective in adult weight management for use in pediatric behavioral intervention programs. These include using motivational interviewing to increase readiness for health behavior changes, modifying the carbohydrate content of children's diets, using culturally appropriate messages and materials, improving cultural competency of health care providers, and using computer-based strategies. Randomized, controlled clinical trials are needed to test the safety and efficacy of these approaches before they can be recommended for clinical practice. Pharmacotherapy and bariatric surgery are more aggressive and historically adult interventions with greater risk that are being considered for severely obese adolescents who have serious obesity-related medical complications and who have failed other more conventional methods.

Behavior Therapy↗

Increasing exercise among blue-collar employees: the tailoring of worksite programs to meet specific needs.

Despite increasing interest in worksite exercise programs, little attention has been focused on the blue-collar segment of the workforce. Because of their low participation in traditional exercise classes and programs, blue-collar workers at a university were targeted for an exercise program tailored specifically to their preferences and needs. Thirty-eight sedentary males employed in operations and maintenance shops on the university campus were evaluated with regard to their current exercise behavior, other health habits, and their preferred types of physical activity programs. A pre- and postprogram submaximal exercise test, weight, and blood pressure measurements were also completed on-site. Twenty-two men (23% of the total blue-collar population) subsequently participated in a 16-week exercise program using an on-site parcourse, and incorporating such motivational strategies as public monitoring, intershop competition, and activity-based incentives. Participation rates were substantially higher than those recorded for previous worksite exercise classes. Participants showed increases in fitness levels (P less than 0.0001) and decreases in weight (P less than 0.05) compared with nonparticipants. Suggestions concerning recruitment of such individuals into low-cost exercise programs and subsequent participation maintenance are discussed.

Adult↗

Practical and functional consequences of aging.

In the gerontologic and geriatric study of 70-year-old people in Göteborg, Sweden, the first cohort (born 1901/1902) has been followed for 15 years, the second (born 1906/1907) for 9 years, and an intervention study has been added to the third cohort (born 1911/1912). The results have allowed a comparison between age-related changes in joint function and manifestations of aging in other organs and organ systems, e.g. striated muscles, density of the skeleton, certain cardiovascular parameters, as well as changes in body mass and body composition. At age 79, a considerable proportion of the elderly had some restriction of their range of motion in one or several joints (one fifth in knee joints, two thirds in hip joints) compared with younger individuals. In the vast majority of probands, this restriction was rather limited and could be described as a stiffness of the locomotor system that could be due either to the aging process with a decrease in elastic tissue components or to age-related changes in behavior and physical activities. Joint complaints of the lower extremities were more frequent than complaints of the upper extremities. Previous sedentary workers were more disabled in activities of daily living than those whose work had previously been physically strenuous.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Recruitment strategies for black women at risk for noninsulin-dependent diabetes mellitus into exercise protocols: a qualitative assessment.

The literature is devoid of any specific data describing exercise therapy in blacks at risk for diabetes. The increasing and striking prevalence of obesity and diabetes among several indigenous populations demonstrates the unfortunate interplay between genetic predisposition and a "modern" sedentary lifestyle. Any successful intervention to reduce the risk of acquiring or attenuating the severity of diabetes must focus on behavioral, cultural, psychosocial, and social factors that are amenable to change. Thus, the objective of this study is to present qualitative data that can be useful in the recruitment of blacks into exercise protocols that could prove to be beneficial in preventing diabetes. Focus groups were conducted on 57 black women residing in Washington, DC, Columbia, Maryland, and Hartford, Connecticut. Barriers to exercising included lack of child care, lack of transportation, neighborhood constraints, and family. Incentives that would increase black women's ability to participate in an exercise protocols include transportation, child care, and an exercise environment that includes blacks.

Adult↗

Smoking cessation and exercise promotion counseling in psychologists who practice psychotherapy.

PURPOSE: Little is known about health promotion within the context of psychotherapy. The present study assessed a sample of psychologists' attitudes and behavior with their psychotherapy clients regarding smoking cessation and exercise promotion counseling. DESIGN: This is a cross-sectional survey study. SETTING: Surveys were mailed. SUBJECTS: Licensed psychologists (1000) in Massachusetts were randomly selected to receive surveys. Psychologists practicing psychotherapy at least 5 h/wk were invited to participate. Out of 496 responses, 328 completed surveys were analyzed. MEASURES: Two parallel surveys were developed for smoking (N = 154) and exercise (N = 174) assessing health promotion behaviors and attitudes. RESULTS: Approximately 43% of respondents inquire about smoking and 53% inquire about exercise with new clients. Over 45% advise smoking clients to quit and 50% advise sedentary clients to exercise. Over 80% of respondents felt smoking and exercise should be addressed in psychotherapy; however only 41% of smoking and 65% of exercise respondents felt confident in their counseling abilities. Lack of confidence, beliefs about relevance of smoking and exercise to psychological functioning, and beliefs that such personal choices should not be addressed in psychotherapy significantly predicted smoking cessation and exercise promotion behaviors. CONCLUSION: Many respondents are engaging in health promotion with their psychotherapy clients. Exercise promotion is occurring more frequently and is viewed more favorably compared with smoking cessation counseling. Health promotion attitudes are associated with counseling behaviors. Limitations include self-selection bias and small sample size.

Attitude of Health Personnel↗

Health disparities among adults with developmental disabilities, adults with other disabilities, and adults not reporting disability in North Carolina.

OBJECTIVES: The purposes of this study were (1) to identify disparities between adults with developmental disabilities and non-disabled adults in health and medical care, and (2) to compare this pattern of disparities to the pattern of disparities between adults with other disabilities and adults without disabilities. METHODS: The authors compared data on health status, health risk behaviors, chronic health conditions, and utilization of medical care across three groups of adults: No Disability, Disability, and Developmental Disability. Data sources were the 2001 North Carolina Behavioral Risk Factor Surveillance System and the North Carolina National Core Indicators survey. RESULTS: Adults with developmental disabilities were more likely to lead sedentary lifestyles and seven times as likely to report inadequate emotional support, compared with adults without disabilities. Adults with disabilities and developmental disabilities were significantly more likely to report being in fair or poor health than adults without disabilities. Similar rates of tobacco use and overweight/obesity were reported. Adults with developmental disabilities had a similar or greater risk of having four of five chronic health conditions compared with non-disabled adults. Significant medical care utilization disparities were found for breast and cervical cancer screening as well as for oral health care. Adults with developmental disabilities presented a unique risk for inadequate emotional support and low utilization of breast and cervical cancer screenings. CONCLUSIONS: Significant disparities in health and medical care utilization were found for adults with developmental disabilities relative to non-disabled adults. The National Core Indicators protocol offers a sound methodology to gather much-needed surveillance information on the health status, health risk behaviors, and medical care utilization of adults with developmental disabilities. Health promotion efforts must be specifically designed for this population.

Adolescent↗

Direct home observations of the prompting of physical activity in sedentary and active Mexican- and Anglo-American children.

Social interactions are important correlates of physical activity in children. Previous studies used global measures; the present study examined the influence of specific social interactions on immediate physical activity in children with data obtained from the Behaviors of Eating and Activity for Child Health: Evaluation System (BEACHES). The study examined parental and peer prompting of physical activity at home among 178 Mexican-American and 113 Anglo-American children at age 4 years and again at age 6.5 years. Most activity prompts came from adults interacting with children when they were sedentary. A reduction in the frequency of prompts from baseline to follow-up occurred in the prompter group (adult or child peer), gender, ethnicity, and preprompted activity level categories. Children's responses to these prompts showed that as they aged, they seemed to rely less on the interpersonal (especially adult) aspects of their environment for cues to be more active.

Adult↗

Leisure-time physical exercise: prevalence, attitudinal correlates, and behavioral correlates among young Europeans from 21 countries.

BACKGROUND: Increasing leisure time physical exercise is a major target of public health programs throughout the developed world, but few international comparisons of exercise habits among people from diverse cultures have been published. The objectives of this study were to assess the prevalence of exercise among young adults from 21 European countries, to analyze associations with health beliefs and risk awareness, and to investigate relationships among exercise, other health-related behaviors, and emotional well-being. METHODS: The European Health and Behaviour Survey, a questionnaire survey of 7,302 male and 9,181 female university students ages 18-30 years from 21 countries, was analyzed. RESULTS: Age-adjusted prevalence of physical exercise in the past 2 weeks averaged 73.2% among men and 68.3% among women, but varied markedly from more than 80% to less than 60% across country samples. Beliefs in the health benefits of exercise were consistently associated with physical exercise, as was desire to lose weight. Awareness of the influence of exercise on heart disease averaged 52% among men and 54% among women, but was not strongly associated with engagement in exercise. Associations among exercise, lack of smoking, and sleep time were observed, but results for alcohol consumption were inconsistent. Social support and depression were independently associated with physical exercise. CONCLUSIONS: Physical exercise levels are highly variable across samples of relatively privileged young Europeans from different countries. Associations with other health behaviors and with emotional well-being suggest that regular physical exercise is consistent with a healthy lifestyle. Links with health beliefs are consistent despite sociocultural differences, but deficient knowledge of the health consequences of a sedentary lifestyle remains a cause for concern.

Adolescent↗