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Physical activity in children/teens with epilepsy compared with that in their siblings without epilepsy.

PURPOSE: To determine (a) whether children and teens with epilepsy participate in less physical activity and have higher body mass index (BMI) percentiles for age than do their siblings without epilepsy; and (b) what epilepsy-specific factors limit their participation. METHODS: Patients 5-17 years, with a >or=3 month history of epilepsy, a development quotient >or=80, no major motor or sensory impairments, and at least one sibling without epilepsy in a similar age range, were identified from the Neurology Clinic database or at the time of clinic visit. Parents completed a questionnaire regarding sedentary activities and group, individual, and total sports activities. Children aged 11-15 years also completed the physical activity portion of the Health Behavior in School Aged Children questionnaire. Clinic charts were reviewed for seizure type, etiology, frequency, duration of epilepsy, and number of antiepileptic drugs (AEDs) ever taken. RESULTS: Teens with epilepsy participated in fewer group and total sports activities than did controls and were more likely to be potentially overweight or overweight. Receiving three or more AEDs in the past showed a significant negative correlation with sports participation. Although a trend was noted for those with higher seizure frequency to be less active, no other epilepsy-specific factors or prior seizures or seizure-related injury during a sports event correlated with participation in physical activity. CONCLUSIONS: Programs that promote exercise in adolescents with epilepsy should be encouraged to improve their physical, psychological, and social well-being.

Adolescent↗

Sensory acceptability of meat and dairy products and dietary fat in male collegiate swimmers.

This study was undertaken to determine whether high-level training alters food choice behavior with regard to meat and dairy products because of their high fat content. Twenty male collegiate swimmers were compared to 20 male sedentary students for dietary fat intake, nutrition knowledge, and liking of meat and dairy products. There was no significant difference between the two groups for restraint, energy intake, dietary fat intake, and energy derived from fat. Nutrition knowledge, energy derived from saturated fat, and cholesterol intake, however, were significantly higher in the athletes. The two groups did not differ in their hedonic ratings of flavor or in their overall degree of liking of the meat and dairy products, and the athletes actually liked the appearance and texture of the products significantly more than did the sedentary students. This study shows that the sensory appeal of fat-containing animal products is not affected in male swimmers by a high level of exercise.

Adult↗

Applying a stepped-care approach to the treatment of obesity.

OBJECTIVE: In a stepped-care (SC) approach to treatment, more intensive interventions are implemented when less intensive interventions prove to be insufficient. It was hypothesized that a behavioral weight loss program with SC (BWLP+SC) would evidence superior treatment outcomes when compared with a BWLP without SC (BWLP). METHODS: Forty-four obese, sedentary adults were randomly assigned to a BWLP+SC [i.e., problem-solving therapy (PST)] or a BWLP. RESULTS: Participants in the BWLP+SC lost significantly more weight and body fat, reported greater physical activity and greater improvements in diet, and were more likely to achieve their within-treatment weight loss goals than BWLP participants. Participants in the BWLP+SC who received PST (BWLP+SC [PST]) also evidenced superior treatment outcomes including superior weight loss maintenance (through 12 months posttreatment) compared with BWLP participants matched on SC eligibility [BWLP (SC matched)]. CONCLUSION: BWLP+SC may improve treatment outcomes and participant motivation to achieve preestablished weight loss goals.

Attitude to Health↗

Declining rates of physical activity in the United States: what are the contributors?

This review describes current patterns and long-term trends (up to 50 years when possible) related to (a) physical activity, (b) employment and occupation, (c) travel behavior, (d) land use, and (e) related behaviors (e.g., television watching). On the basis of available data, the following trends were observed according to type of physical activity: relatively stable or slightly increasing levels of leisure-time physical activity, declining work-related activity, declining transportation activity, declining activity in the home, and increasing sedentary activity. These result in an overall trend of declining total physical activity. Large differences were noted in the rates of walking for transportation across metropolitan statistical areas. A strong linear increase existed in vehicle miles traveled per person over the past half century, coupled with a strong and consistent trend toward Americans living in suburbs. Although it is difficult to precisely quantify owing to the lack of long-term data, it is apparent that a combination of changes to the built environment and increases in the proportion of the population engaging in sedentary activities put the majority of the American population at high risk of physical inactivity.

Adolescent↗

Cardiovascular disease risk factors and menopausal status in midlife women from the former Soviet Union.

The purpose of this cross-sectional analysis is to examine modifiable CVD risk factors in relation to menopausal status, age, and length of residence in the U.S. of midlife women from the former Soviet Union. The analysis includes baseline data for 193 women, aged 40-70, who lived in the U.S. fewer than 8 years and were enrolled in an ongoing four-year study of post-immigration health and behavior change. Data collection was conducted in women's homes or other community locations. The presence of seven health risk indicators (obesity, dyslipidemia, high blood pressure, diabetes mellitus, sedentary lifestyle, smoking, and excessive alcohol use) was assessed. In addition, Framingham 10 year risk scores for heart disease, and the presence of metabolic syndrome, were calculated using recent National Cholesterol Education Program (ATP-III) guidelines. Consistent with the age distribution, 60% of the women were postmenopausal. Four risk indicators (obesity, dyslipidemia, high blood pressure, and sedentary lifestyle) were identified as significant areas of concern. Although the Framingham risk scores did not seem excessively high, almost 25% of the women had metabolic syndrome. Older and postmenopausal women had significantly higher scores on all risk estimates. When age and menopausal status were held constant, menopausal status remained an independent contributor for the number of CVD risk indicators. Issues specific to this group of women because of their pre- and post-migration lifestyles are discussed in relation to their CVD risk status.

Adult↗

Effects of exercise training on vasomotor reactivity of porcine coronary arteries.

The purpose of this study was to determine whether exercise training induces changes in the contractile behavior of proximal coronary arteries. Female Yucatan miniature swine were either exercise trained (ET) on a motor-driven treadmill or allowed to remain sedentary (SED) for 16-22 wk. Responses to vasoactive compounds were evaluated in vitro using coronary arterial rings (approximately 2 mm diam) isolated from ET and SED pigs. Each ring was stretched to the apex of the length-active tension relationship. Concentration-response relationships for isometric contractions evoked with KCl (5-100 mM), prostaglandin F2 alpha (PGF2 alpha; 10(-8)-3 x 10(-5) M), acetylcholine (ACh; 10(-9)-10(-4) M), and endothelin (10(-10)-10(-7) M) were similar in arteries from SED and ET pigs. In contrast, arteries from the ET group developed 50-60% less maximal tension in response to norepinephrine (NE; 10(-6)-10(-4) M) than did controls. Vasodilator responses of rings precontracted with either KCl or PGF2 alpha were evaluated with adenosine (ADO; 10(-9)-10(-4) M), isoproterenol (10(-9)-10(-4) M), forskolin (10(-9)-10(-4) M), and sodium nitroprusside (NP; 10(-10)-10(-4) M). Vasodilator responses were similar in SED and ET groups for all agents except ADO and NP; arteries from ET pigs were more sensitive to ADO and less sensitive to NP. The ET-induced alterations in vasomotor responses to NE and ADO appear to be due to changes in vascular smooth muscle because they were still present after removal of endothelium. We conclude that chronic exercise training in pigs induces selective alterations in NE and ADO receptor-second messenger coupling and/or postreceptor-related events in epicardial coronary vascular smooth muscle.

Animals↗

Effects of exercise on longevity of rats.

It has been postulated that life span is inversely related to energy expenditure. If this is correct, regularly performed exercise could accelerate the aging process. In two early studies, exercise shortened the life span of rats; the results of these studies have been cited as evidence for the concept that an increase in energy expenditure accelerates aging. However, subsequent studies have not confirmed this finding. Instead, the weight of evidence now indicates that rats that exercise regularly have a longer average life span than sedentary, ad libitum-fed controls. Freely eating sedentary rats become obese, indicating that their food intake is in excess of their energy requirements. Available evidence seems compatible with the interpretation that exercise results in improved survival in rats by countering deleterious effects of a sedentary life combined with overeating.

Aging↗

Freewheel running prevents learned helplessness/behavioral depression: role of dorsal raphe serotonergic neurons.

Serotonin (5-HT) neurons in the dorsal raphe nucleus (DRN) are implicated in mediating learned helplessness (LH) behaviors, such as poor escape responding and expression of exaggerated conditioned fear, induced by acute exposure to uncontrollable stress. DRN 5-HT neurons are hyperactive during uncontrollable stress, resulting in desensitization of 5-HT type 1A (5-HT1A) inhibitory autoreceptors in the DRN. 5-HT1A autoreceptor downregulation is thought to induce transient sensitization of DRN 5-HT neurons, resulting in excessive 5-HT activity in brain areas that control the expression of learned helplessness behaviors. Habitual physical activity has antidepressant/anxiolytic properties and results in dramatic alterations in physiological stress responses, but the neurochemical mediators of these effects are unknown. The current study determined the effects of 6 weeks of voluntary freewheel running on LH behaviors, uncontrollable stress-induced activity of DRN 5-HT neurons, and basal expression of DRN 5-HT1A autoreceptor mRNA. Freewheel running prevented the shuttle box escape deficit and the exaggerated conditioned fear that is induced by uncontrollable tail shock in sedentary rats. Furthermore, double c-Fos/5-HT immunohistochemistry revealed that physical activity attenuated tail shock-induced activity of 5-HT neurons in the rostral-mid DRN. Six weeks of freewheel running also resulted in a basal increase in 5-HT1A inhibitory autoreceptor mRNA in the rostral-mid DRN. Results suggest that freewheel running prevents behavioral depression/LH and attenuates DRN 5-HT neural activity during uncontrollable stress. An increase in 5-HT1A inhibitory autoreceptor expression may contribute to the attenuation of DRN 5-HT activity and the prevention of LH in physically active rats.

Animals↗

Physical activity, exercise, and sedentary activity: relationship to the causes and treatment of obesity.

Lack of physical activity is a known determinant of obesity. Unfortunately, children become less and less active as they reach and progress through adolescence. This behavior leads to detrimental effects on body composition and other components of health-related physical fitness. Various types of exercise and activities have different effects on fitness, body composition, and metabolic state. For a physician to recommend activities or sports and exercise type, he or she should examine and discuss the patients fitness and physique goals to maintain their enthusiasm and promote lifelong physical activity benefits.

Adolescent↗

Ambulatory monitoring of physical activity and symptoms in fibromyalgia and chronic fatigue syndrome.

OBJECTIVE: Fibromyalgia (FM) and chronic fatigue syndrome (CFS) are associated with substantial physical disability. Determinants of self-reported physical disability are poorly understood. This investigation uses objective ambulatory activity monitoring to compare patients with FM and/or CFS with controls, and examines associations of ambulatory activity levels with both physical function and symptoms during activities of daily life. METHODS: Patients with FM and/or CFS (n = 38, mean +/- SD age 41.5 +/- 8.2 years, 74% women) completed a 5-day program of ambulatory monitoring of physical activity and symptoms (pain, fatigue, and distress) and results were compared with those in age-matched controls (n = 27, mean +/- SD age 38.0 +/- 8.6 years, 44% women). Activity levels were assessed continuously, ambulatory symptoms were determined using electronically time-stamped recordings at 5 time points during each day, and physical function was measured with the 36-item Short Form health survey at the end of the 5-day monitoring period. RESULTS: Patients had significantly lower peak activity levels than controls (mean +/- SEM 8,654 +/- 527 versus 12,913 +/- 1,462 units; P = 0.003) and spent less time in high-level activities when compared with controls (P = 0.001). In contrast, patients had similar average activity levels as those of controls (mean +/- SEM 1,525 +/- 63 versus 1,602 +/- 89; P = 0.47). Among patients, low activity levels were associated with worse self-reported physical function over the preceding month. Activity levels were inversely related to concurrent ambulatory pain (P = 0.031) and fatigue (P < 0.001). Pain and fatigue were associated with reduced subsequent ambulatory activity levels, whereas activity levels were not predictive of subsequent symptoms. CONCLUSION: Patients with FM and/or CFS engaged in less high-intensity physical activities than that recorded for sedentary control subjects. This reduced peak activity was correlated with measures of poor physical function. The observed associations may be relevant to the design of behavioral activation programs, because activity levels appear to be contingent on, rather than predictive of, symptoms.

Adult↗

Timber rattlesnakes (Crotalus horridus) use chemical cues to select ambush sites.

Chemicals left by organisms moving through the environment are used by other organisms to mediate interspecific interactions. Most studies of chemical eavesdropping focus on prey responding to chemical cues from predators, despite the fact that chemical cues are frequently used by predators as a source of information about prey. Crotalus horridus uses a foraging strategy that is widespread among sedentary predators: the snake chooses a site where it is likely to encounter prey and remains immobile for many hours. I investigated this ambush hunting behavior in captive-raised timber rattlesnakes and provide evidence that sit-and-wait predators may discriminate among prey chemical cues, even when they have no prior experience with the prey. Snakes explored chemical cues with chemosensory behaviors, and more frequently adopted a stereotyped ambush foraging posture toward chemical cues from prey sympatric with their population of origin than either allopatric prey or sympatric nonprey species that are eaten by other viperids. These results support the notion that intra- and interspecific variation in diet may be mediated proximally by innate recognition of cues from particular prey items. This system also describes a bioassay that may be used in the isolation and identification of prey-derived kairomones. Studies such as this can be used to determine more realistic parameters for models of predator-prey interaction and foraging behavior that involve secretive, less active predators.

Animals↗

A prospective analysis of the relationship between walking and mood in sedentary ethnic minority women.

Walking for exercise is becoming widely recognized for bestowing health benefits. This study examined the association of walking for exercise and mood in sedentary, ethnic minority women over a five-month period. Ethnic minority women (N = 102) participated in a randomized, controlled trial of a 7-week behaviorally based telephone and mail intervention that promoted the adoption of walking for exercise compared to a non-behavioral minimal intervention. At 2-month post-test and 5-month follow-up, participants reported significant decreases in depressive mood and increases in vigor. Increase in walking over the course of the study was associated with change in vigor. Limited evidence was found to support a relationship between walking for exercise and mood improvement in ethnic-minority women.

Adult↗

Coronary Artery Risk Detection in Appalachian Communities (CARDIAC): preliminary findings.

West Virginia's mortality and morbidity from cardiovascular disease (CVD) is among the highest in the developed world. Appalachia, and West Virginia in particular, could reduce the high prevalence of premature coronary heart disease (CHD) by addressing modifiable independent risk factors such as poor nutrition, sedentary lifestyle, and tobacco use. School-based health promotion programs have been shown to be an effective means of influencing student and parental health behavior. The pilot phase of the Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) project substantiated an alarmingly high incidence of CVD risk factors among 347 fifth grade children from three rural counties, and was also an effective means of identifying parents at risk of developing CHD. Utilization of the innovative Rural Health Education Partnerships (WVRHEP), coupled with a health conscious public school system, offers a unique opportunity to establish the first statewide cardiovascular disease community intervention project in the nation.

Blood Pressure Determination↗

Energy expenditure, physical activity, and obesity in children.

Although there are physiologic and genetic influences on the various components of energy metabolism and body weight regulation, and a major portion of individual differences in body weight can be explained by genetic differences, it seems unlikely that the increased global prevalence of obesity has been driven by a dramatic change in the gene pool. It is more likely and more reasonable that acute changes in behavior and environment have contributed to the rapid increase in obesity and that genetic factors may be important in the deferring individual susceptibilities to these changes. The most striking behavioral changes that have occurred have been an increased reliance on high-fat and energy-dense "fast foods," with larger portion sizes, coupled with an ever-increasing sedentary lifestyle. The more sedentary lifestyle is caused by an increased reliance on technology and labor-saving devices, which has reduced the need for physical exertion for everyday activities. Examples of energy-saving devices that have resulted in a secular decline in physical activity include: Increased use of automated transport rather than walking or biking Central heating and use of automated equipment, such as washing machines, in the household. Reduction in physical activity in the workplace because of computers, automated equipment, and electronic mail. Increased use of television and computers for entertainment and leisure activities. Use of elevators and escalators rather than stairs. Increased concern for crime, which has reduced the likelihood of outdoor playing. Poor urban planning that does not provide adequate biking paths or even sidewalks in some communities. Thus, the increasing prevalence, numerous health risks, and astounding economic costs of obesity clearly justify widespread efforts toward prevention efforts. These prevention efforts should begin in childhood because the behaviors are learned and continue through the lifetime.

Adolescent↗

Exercise in behavioral medicine.

Research on the preventive and rehabilitative applications of exercise and literature on exercise adherence from the past 10 years are briefly reviewed. Although there is now substantial evidence that a low level of physical activity is associated with decreased life expectancy for both men and women and contributes independently to the development of many prevalent chronic diseases, most adults and children lead sedentary lives. Recent intervention studies suggest exercise adherence can be improved in a variety of populations. Researchers in the next decade should continue to elaborate the population- and disease-specific effects of physical activity and exercise and give priority to the problem of exercise adherence, which limits the effectiveness of exercise interventions and remains a significant challenge to behavioral medicine.

Behavior Therapy↗

Estimating changes in daily physical activity levels over time: implication for health interventions from a novel approach.

The aim of this study was to use a novel method to examine and compare physical activity levels in four different groups of men to investigate the impact of modernity on activity levels. Physical activity levels of four different groups of men were measured and compared, using a tri-axial accelerometer (Tracmor). The first group (HA = historically active) were actors in a historical theme park who play the part of Australian settlers 150 years ago, the second were sedentary modern-day office workers (MS = modern sedentary), the third men who had successfully lost weight (SWL) in a modern men's weight loss program and the last, men who were unsuccessful (UWL) in the same program. Men who had successfully lost weight in a weight loss program were active at a level similar to that of men performing activity at a level carried out historically. Both of these groups were in turn significantly more active than modern-day sedentary workers (p < 0.05) and men who had not been successful at losing weight (p < 0.01). A linear regression between weekly average activity levels and the degree of waist size loss showed a significant positive association (r = 0.52, p < 0.01). The data suggest that a higher activity level facilitates the maintenance of long-term weight loss and this level is likely to approximate activity levels in the past. For the prevention and treatment of obesity an increase in physical activity is necessary, because (long-term) weight loss or weight maintenance is unlikely to occur when people are as sedentary as most people are today.

Adult↗

Do interventions to limit sedentary behaviours change behaviour and reduce childhood obesity? A critical review of the literature.

We sought to determine whether interventions that emphasize decreasing sedentary behaviours in children and adolescents result in behaviour change and weight control. A comprehensive literature search was conducted to identify all comparative studies of interventions to reduce sedentary behaviour among children, alone or in combination with other health messages. Two investigators evaluated articles for eligibility and validity. As methods, settings and interventions differ across studies, results were synthesized narratively. Twelve studies met the inclusion criteria and provided relevant data. Six targeted clinic-based populations that were overweight or at risk of overweight, and six were population-based prevention studies. Approaches varied, but all reduced sedentary behaviour and improved weight indices. An emphasis on decreasing sedentary behaviours is an effective intervention to decrease sedentary behaviours and control weight in children and adolescents.

Child↗

Disordered eating attitudes and self-objectification among physically active and sedentary female college students.

The authors' purpose in this study was to examine objectification theory (B. L. Fredrickson & T. A. Roberts, 1997) among physically active (n=115) and sedentary (n=70) women. The women completed the Self-Objectification Questionnaire (Noll & Fredrickson, 1998), the Body Surveillance and Body Shame subscales of the Objectified Body Consciousness Scale (McKinley & Hyde, 1996), the Appearance Anxiety Scale (Dion, Dion, & J. Keelan, 1990), a flow experiences measure (Tiggemann & Slater, 2001), and the Eating Attitudes Test-26 (Garner, Olmsted, Bohr, & Garfinkel, 1982). Self-objectification directly and indirectly (via body shame and appearance anxiety) predicted disordered eating in both groups of women. Physically active women reported more frequent flow experiences than sedentary women. Women high in self-objectification reported higher levels of body surveillance, body shame, appearance anxiety, and self-reported disordered eating attitudes. Body surveillance was related to disordered eating only among women with high self-objectification. Appearance anxiety was negatively associated with flow experiences among sedentary women. Objectification theory provides a useful framework for understanding factors related to disordered eating attitudes among active and sedentary college women.

Adult↗