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PubMed1993

Metabolic and behavioral covariates of high-density lipoprotein cholesterol and triglyceride concentrations in postmenopausal women.

OBJECTIVE: To determine predictors of high-density lipoprotein cholesterol (HDL) and triglyceride (TG) concentrations in postmenopausal women. DESIGN: Cross-sectional study. SETTING: Clinical research facility. PARTICIPANTS: One hundred twenty-seven healthy, relatively sedentary, postmenopausal women not on estrogen replacement, mean age 57 years. MEASUREMENTS: Alcohol intake, cigarette smoking, aerobic fitness (VO2max), body mass index (BMI), percent body fat, waist-hip ratio, lipids and lipoproteins, fasting plasma glucose (FPG), and insulin (FPI) concentrations. RESULTS: In univariate analyses, HDL was significantly (P < 0.05) inversely related to BMI, waist-hip ratio, smoking, FPG, and FPI, and directly related to VO2max and alcohol intake. Triglycerides were related directly to BMI, waist-hip ratio, percent body fat, FPG, and FPI, and inversely to VO2max. In stepwise multiple regressions, BMI, waist-hip ratio, alcohol, smoking, and FPG were significantly associated with HDL (R2 for the model = 0.43). Addition of TG to these models reduced relations of BMI and waist-hip ratio, but not the other variables, to insignificance. For triglycerides, waist-hip ratio, alcohol, smoking, FPG, and FPI were significant predictors (R2 = 0.33). VO2max and percent body fat did not contribute to any model. CONCLUSIONS: Obesity, abdominal obesity, smoking, alcohol intake, and measures of carbohydrate metabolism predict HDL and triglyceride concentrations in postmenopausal women.

Alcohol Drinking↗

PubMed2006

The association between information and communication technology exposure and physical activity, musculoskeletal and visual symptoms and socio-economic status in 5-year-olds.

BACKGROUND: Increasing use of computers by children has raised concerns over the potential impact on their cognitive, social, educational, visual and physical development. Despite this concern, there are no large-scale studies relating the use of computers to specific health indicators in children as they reach school age. METHODS: A cross-sectional analysis of 1600 5-year-old Western Australian children participating in a longitudinal cohort study was conducted to ascertain their computer use, other activities (watching television and videos, playing electronic games, reading and looking at books, drawing on paper and moderate to vigorous physical activity), and specific health indicators. RESULTS: More than half (56%) of the children used computers each week. Computer use was significantly related to TV viewing (OR 1.97 weekday) and electronic game use (console games OR 2.48 weekday, 1.81 weekend; hand-held games OR 1.88 weekend) and negatively associated with vigorous physical activity on weekends (OR 0.72). Computer use was also significantly related to socio-economic indicators such as the mother being older (40+ years, OR 1.70 weekend, 1.73 weekday), tertiary educated (OR 1.63 weekend) and studying (OR 1.52 weekend, 1.41 weekday). Almost 1% children were reported to have complained of tired or sore muscles, and 2.2% had complained of tired or sore eyes, after watching television or using a computer. CONCLUSION: A substantial proportion of 5-year-old Western Australian children are using computers. Computer use was related to other sedentary activities and less vigorous activity. While musculoskeletal and vision problems are not widespread, their presence and the sedentary nature of computer use is of public health concern.

Child Behavior↗

PubMed1983

A comparison of populations self-selected and randomly selected for coronary risk factor screening.

Levels of coronary risk factors in 3,090 adults who sought screening over a 2-year period in Perth, Western Australia, were compared with those in 722 subjects who were selected at random to attend the screening center. Self-referred (SR) subjects were less likely than random-sample (RS) subjects to have suffered from, or be on treatment for, heart disease, hypertension, gout, or diabetes but were more likely to have a family history of premature heart disease. They were less likely to be current smokers and overweight (women only) but more likely to be sedentary at work and have higher mean serum cholesterol levels. SR also had more knowledge about coronary heart disease (CHD) and its causes and were more likely to believe that this knowledge had influenced their behavior, but were less likely than RS to be satisfied with their knowledge level. Smokers among SR were more likely to express a wish to give up smoking than smokers in the RS. These findings are consistent with previous observations. The differences, although statistically significant, were generally small and did not clearly favor one group with respect to total risk of CHD. Therefore the effectiveness of risk factor modification following screening should not be greatly affected by self-selection for screening. Effectiveness may be greater in self-selected subjects because of their apparently greater motivation toward risk factor change.

Adult↗

PubMed2004

Barriers and motivations to exercise in older adults.

Although exercise is an established component in the management of many chronic diseases associated with aging, activity levels tend to progressively decline with increasing age. Given the growing proportion of older adults, these suboptimal levels of physical activity represent an increasing public health problem. The predicators of adherence elucidated in younger adults are unreliable in elderly populations. Age-specific barriers and motivators unique to this cohort are relevant and must be acknowledged. The identification of reliable predictors of exercise adherence will allow healthcare providers to effectively intervene and change patterns of physical activity in sedentary elderly. In particular, because older patients respect their physician's advice and have regular contact with their family doctor, physicians can play a key and pivotal role in the initiation and maintenance of exercise behavior among the older population.

Aged↗

PubMed2003

Pricing effects on food choices.

Individual dietary choices are primarily influenced by such considerations as taste, cost, convenience and nutritional value of foods. The current obesity epidemic has been linked to excessive consumption of added sugars and fat, as well as to sedentary lifestyles. Fat and sugar provide dietary energy at very low cost. Food pricing and marketing practices are therefore an essential component of the eating environment. Recent studies have applied economic theories to changing dietary behavior. Price reduction strategies promote the choice of targeted foods by lowering their cost relative to alternative food choices. Two community-based intervention studies used price reductions to promote the increased purchase of targeted foods. The first study examined lower prices and point-of-purchase promotion on sales of lower fat vending machine snacks in 12 work sites and 12 secondary schools. Price reductions of 10%, 25% and 50% on lower fat snacks resulted in an increase in sales of 9%, 39% and 93%, respectively, compared with usual price conditions. The second study examined the impact of a 50% price reduction on fresh fruit and baby carrots in two secondary school cafeterias. Compared with usual price conditions, price reductions resulted in a four-fold increase in fresh fruit sales and a two-fold increase in baby carrot sales. Both studies demonstrate that price reductions are an effective strategy to increase the purchase of more healthful foods in community-based settings such as work sites and schools. Results were generalizable across various food types and populations. Reducing prices on healthful foods is a public health strategy that should be implemented through policy initiatives and industry collaborations.

Costs and Cost Analysis↗

PubMed1996

Lumped-parameter tissue temperature-blood perfusion model of a cold-stressed fingertip.

A lumped-parameter model of a fingertip is presented. The semispherical model includes the effects of heat storage, heat exchange with the environment, and heat transport by blood perfusion. The thermal insulation on the surface of the fingertip is represented by the overall heat transfer coefficient that is calculated by common engineering formulas. The model is solved analytically for the simple case of constant blood perfusion rate. The general case of variable blood perfusion rates is solved by an Euler finite difference technique. At this stage, the model does not include active control mechanisms of blood perfusion. Thus the effects of cold-induced vasodilatation have to be superimposed and are modeled by symmetrical triangular waveforms because these were found to best depict the behavior of fingers exposed to cold environments. Results of this model were compared with experimental data obtained in two separate studies. One included 60-min infrared thermograms of the dorsal surface of bare hands of sedentary subjects horizontally suspended on a fish net in a 0 degree C environment. Another study, on gloved finger temperatures, involved 0 and -6.7 degrees C environments. Fingertip (nail bed) temperatures of both these studies were compared with model predictions. Blood perfusion rates were assumed and adjusted within physiologically reasonable limits. Comparison of measured and computed temperature records showed very good conformity in both cases studied.

Body Temperature Regulation↗

PubMed2002

School transportation modes--Georgia, 2000.

Moderate physical activity (e.g., walking or bicycling) offers substantial health benefits. Physical activity is especially important for young persons not only because of its immediate benefits but also because participation in healthy behaviors early in life might lead to healthier lifestyles in adulthood. Persons aged > 2 years should engage in > or = 30 minutes of moderately intense physical activity on all or most days of the week. However, sedentary after-school activities (e.g., watching television or using computers), decreased participation in physical education, and fewer students walking or riding their bicycles to school might contribute to the high rate of childhood obesity. Walking to school provides a convenient opportunity for children to be physically active. To examine modes of transportation to school for Georgia children, the Georgia Division of Public Health analyzed data from the Georgia Asthma Survey conducted during May-August 2000. This report summarizes the results of that analysis, which indicate that < 19% of Georgia school-aged children who live < or = 1 mile from school walk to school the majority of days of the week. Statewide surveillance data of school transportation modes should be collected to monitor prevalence of walking to school.

Adolescent↗

PubMed1996

Adenylyl cyclase system is affected differently by endurance physical training in heart and adipose tissue.

Adaptive changes in the beta-adrenergic adenylyl cyclase (AC) system in response to endurance training were studied in heart and adipose tissue. Training was performed by making male Wistar rats run on a motor-driven treadmill. The changes following exercise training were opposite in the two tissue studied. The density of beta-adrenergic receptors in left ventricular membranes of trained rats showed a marked decrease. Comparison of AC activities in cardiac membranes prepared from trained and sedentary rats revealed a depressing effect of endurance training on: 1. the beta-adrenergic stimulatory pathway and the inhibition of AC via receptor; 2. the Gs component and the Gs-adenylyl cyclase coupling, as shown by the response of adenylyl cyclase to GppNHp and NaF; and 3. the enzyme catalytic activity in the presence of Mn2+ or forskolin. The levels of Gsalpha subunits in the left ventricle, as measured in terms of ADP-ribosylated and immunologically reactive proteins, were decreased by endurance exercise, whereas immunodetectable levels of Gialpha2 increased in the membranes of trained myocardium. In contrast to the diminished sensitivity that characterizes the behavior of the cardiac beta-adrenergic-AC system, endurance physical training increased sensitivity of this signal transduction system in adipose tissue. Thus, the density of beta-ARs as well as AC activity and the beta-adrenergic stimulatory pathway were increased in adipose membranes of trained rats compared with the corresponding sedentary controls. In addition, the levels of Gsalpha subunits were higher in the adipose plasma membranes of trained rats. However, immunodetectable levels of Gi1alpha and Gi3alpha increased with training, whereas the amount of Gi2alpha decreased in membranes of trained rats. In conclusion, the present study shows that chronic exercise is associated with a tissue-specific adaptation of the beta-adrenergic AC system.

Adenylyl Cyclases↗

PubMed2006

Health behaviors among women of reproductive age with and without a history of gestational diabetes mellitus.

OBJECTIVE: To estimate the prevalence of several health-related behaviors among women of reproductive age with and without a history of gestational diabetes mellitus (hGDM). RESEARCH DESIGN AND METHODS: We performed a cross-sectional study using the 2001-2003 Behavioral Risk Factor Surveillance System, a national population-based random sample telephone survey. Participants were 177,420 women aged 18-44 years with and without self-reported hGDM. Outcome measures included meeting physical activity and fruit and vegetable guidelines, sedentary activity level, and current smoking. RESULTS: Approximately 3% (n = 4,718) of women aged 18-44 years reported physician-diagnosed hGDM. Women with hGDM had higher BMIs, were significantly older, were less often educated or employed, and were more often Hispanic or African American, married, and living with children. Women with hGDM reported worse self-rated health than women without hGDM. In unadjusted and multivariate adjusted comparisons, there were no significant differences in levels of physical activity, fruit and vegetable consumption, or smoking among women with and without hGDM. However, women with hGDM who lived with children were significantly less likely to meet fruit and vegetable consumption guidelines (odds ratio 0.78 [95% CI 0.63-0.97]; P < 0.05) and more likely to smoke (1.21 [1.01-1.47]; P < 0.05) than their counterparts without hGDM. CONCLUSIONS: Despite their elevated risk for future diabetes, women with hGDM who lived with children were less likely to meet fruit and vegetable consumption guidelines and more likely to smoke than women with children who did not have hGDM.

Adolescent↗

PubMed2002

Effects of moderate-intensity exercise on physiological, behavioral, and emotional responses to family caregiving: a randomized controlled trial.

BACKGROUND: The study objective was to determine the health and quality-of-life effects of moderate-intensity exercise among older women family caregivers. METHODS: This 12-month randomized controlled trial involved a volunteer sample of 100 women aged 49 to 82 years who were sedentary, free of cardiovascular disease, and caring for a relative with dementia. Participants were randomized to 12 months of home-based, telephone-supervised, moderate-intensity exercise training or to an attention-control (nutrition education) program. Exercise consisted of four 30- to 40-minute endurance exercise sessions (brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate. Main outcomes were stress-induced cardiovascular reactivity levels, rated sleep quality, and reported psychological distress. RESULTS: Compared with nutrition participants (NU), exercise participants (EX) showed significant improvements in the following: total energy expenditure (baseline and post-test means [SD] for EX = 1.4 [1.9] and 2.2 [2.2] kcal/kg/day; for NU = 1.2 [1.7] and 1.2 [1.6] kcal/kg/day; p <.02); stress-induced blood pressure reactivity (baseline and post-test systolic blood pressure reactivity values for EX = 21.6 [12.3] and 12.4 [11.2] mm Hg; for NU = 17.9 [10.2] and 17.7 [13.8] mm Hg; p <.024); and sleep quality (p <.05). NU showed significant improvements in percentages of total calories from fats and saturated fats relative to EX (p values <.01). Both groups reported improvements in psychological distress. Conclusions. Family caregivers can benefit from initiating a regular moderate-intensity exercise program in terms of reductions in stress-induced cardiovascular reactivity and improvements in rated sleep quality.

Athletic Injuries↗

PubMed1993

Self-efficacy and the maintenance of exercise participation in older adults.

The role played by exercise self-efficacy in the maintenance of exercise participation of previously sedentary middle-aged adults 4 months after the termination of a formal exercise program is reported. Correlational and multiple regression analyses examined the influence of self-efficacy, physiological (aerobic capacity, sex, body composition), and behavioral (past exercise frequency and intensity) parameters in the maintenance of exercise participation. Self-efficacy significantly predicted exercise behavior at follow-up when controlling for biological and behavioral influences. Aerobic capacity, exercise efficacy, and exercise behavior in combination were significantly related to current energy expenditure in aerobic physical activity. The discussion focuses on the need to examine the impact of different correlates of exercise behavior at different stages of the exercise process.

Aged↗

PubMed1997

Reasons for not exercising and exercise intentions: a study of middle-aged sedentary adults.

The aims of this study were to assess why people do not participate in exercise and physical activity, and what might lead them to become active. More specifically, we focused on the hindrances to entering the phase of transition from a sedentary to a more active lifestyle by analysing the reasons 265 middle-aged Belgian adults gave for their inactivity. Their justifications were examined in relation to the conditions which they say would be needed for them to become more involved in regular physical activity. Factor analysis revealed that the reasons for inactivity referred to the adults' self-concept, to cognitive cost-benefit based processes and to negative emotions associated with exercise. The conditions reported to be necessary to begin exercising referred to a perceived decrease in health and to the appropriateness of the exercise offered. Discriminant analysis showed that 'never-exercisers' differed from 'ex-exercisers', and that within the subgroup of 'ex-exercisers' the long-term drop-outs differed from the recent drop-outs. Cluster analysis revealed three types of sedentary adults: the unconcerned, the opposed and the approachable.

Adult↗

PubMedDate not supplied

Randomized trial of a "talking computer" to improve adults' eating habits.

PURPOSE: To assess efficacy of an intervention delivered by an interactive, computer-controlled telephone system to improve individuals' diets. DESIGN: Randomized controlled trial. SETTING: Large multispecialty group practice. SUBJECTS: Two hundred ninety-eight adults who were both sedentary and had suboptimal diet quality. INTERVENTION: Weekly communication for 6 months via a totally automated, computer-based voice system. Among intervention group subjects, the system monitored dietary habits and provided educational feedback, advice, and behavioral counseling. Control group subjects received physical activity promotion counseling. MEASURES: Daily intake of fruits, vegetables, red and processed meats, whole fat dairy foods, and whole grain foods estimated from a food frequency questionnaire. RESULTS: Mean age 45.9 years, 72% women, 45% white, and 45% African-American. Among participants who completed diet assessments, compared with the control group, the intervention raised fruit intake a mean of 1.1 servings per day (95% confidence interval [CI] .4, 1.7). On a 0 to 100 global diet quality score combining all five food groups, intervention participants improved their mean score 9 (95% CI 4, 13) points more than in the control group. The intervention also raised dietary fiber intake 4.0 g/d (95% CI .1, 7.8) and decreased saturated fat, as a proportion of energy intake, by 1.7% (95% CI -2.7, -.7). CONCLUSIONS: This computer-based telecommunications dietary behavior intervention helped improve participants' overall diet.

Adult↗

PubMed2006

Alcohol consumption, physical activity, and chronic disease risk factors: a population-based cross-sectional survey.

BACKGROUND: Whether the association of alcohol consumption and cardiovascular disease is the product of confounding and the degree to which this concern applies to other behaviors are unclear. METHODS: Using the 2003 Behavioral Risk Factor Surveillance System, a population-based telephone survey of adults in the US, we compared chronic disease risk factors between 123,359 abstainers and 126,674 moderate drinkers, defined as intake of < or = 2 drinks per day among men and < or = 1 drink per day among women, using age- and sex- and multivariable-adjusted models. We also compared sedentary and active individuals, defined as moderate physical activity > or = 30 minutes per day for > or = 5 days per week, or vigorous activity for > or = 20 minutes per day on > or = 3 days. RESULTS: Chronic disease risk factors and features of unhealthy lifestyle were generally more prevalent among abstainers than drinkers in age- and sex-adjusted analyses, but these differences were generally attenuated or eliminated by additional adjustment for race and education. For low fruit and vegetable intake, divorced marital status, and absence of a personal physician, adjustment for race and education reversed initially positive age- and sex-adjusted associations with abstention. Comparison of sedentary and active individuals produced similar findings, with generally lower levels of risk factors among more physical active individuals. CONCLUSION: The differences between abstainers and drinkers are attenuated after adjustment for limited sociodemographic features, and sedentary and active individuals share a similar pattern. Although observational studies of both factors may be susceptible to uncontrolled confounding, our results provide no evidence that moderate drinking is unique in this regard. Ultimately, randomized trials of all such lifestyle factors will be needed to answer these questions definitively.

Adult↗

PubMed1994

Enhancing exercise adherence in middle-aged males and females.

BACKGROUND: Perceptions of personal efficacy have been consistently identified as being determinants of exercise adherence in asymptomatic, rehabilitative, younger, and older populations. The present study incorporated a randomized control design in an effort to examine the effects of an efficacy-based intervention in enhancing exercise adherence in a large sample (N = 114) of formerly sedentary middle-aged males and females. METHODS: Subjects randomly assigned to an exercise plus intervention group or an exercise plus attentional control group participated in a 5-month long walking program led by trained personnel. Exercise behavior (frequency, miles walked, duration) were assessed on a continuous basis and self-efficacy was measured at 1, 2, and 4 months. RESULTS: Repeated measures multivariate analyses revealed a significant treatment effect with subjects in the intervention group exercising more frequently, for longer duration, and walking greater distances over the course of the program. Path analysis indicated that the effect of the treatment on adherence was direct rather than through self-efficacy as hypothesized. Self-efficacy was, however, a significant predictor of exercise behavior in the early and middle stages of the exercise program but not during the last month. CONCLUSIONS: An intervention program designed to maximize information pertaining to participants' capabilities appears to have had a reasonable effect on reducing attrition in middle-aged males and females and self-efficacy was a significant predictor of exercise frequency over time. Further research efforts are required to tease out those cognitive factors that might underlie any effects of interventions in exercise adherence.

Attitude to Health↗

PubMed2000

Occasional smoking increases total and cardiovascular mortality among men.

The aim was to study whether occasional smoking increases mortality risk. The mortality of random samples of the Finnish Adult Health Behavior surveys from 1978 to 1991 were followed for 18 years from 1978 to 1995. Poisson models were used to determine the risk of total and cardiovascular mortality. It was found that occasional smokers were less often sedentary and had less often unhealthy diet than other smoking status groups. Occasional smoking among men was significantly related to the risk of both total (age-adjusted relative risk, RR, 1.6, 95% confidence interval, CI, 1.3-2.1) and cardiovascular mortality (age-adjusted RR 1.5, 95% CI 1.0-2.3). Controlling for education, period and chronic morbidity did not change results. Among women no significant associations could be established; when adjusted for age, period, education and morbidity the RR for cardiovascular mortality was 1.4 (95% CI 0.6-3.4) and total mortality 1.0 (95% CI 0.6-1.6). Occasional smoking is associated with increased risk of premature death, at least among men. Although occasional smoking is a less dangerous practice than regular smoking, it is not a safe alternative for daily smoking.

Adolescent↗

PubMed1998

Effects of voluntary activity and genetic selection on aerobic capacity in house mice (Mus domesticus).

An animal model was developed to study effects on components of exercise physiology of both "nature" (10 generations of genetic selection for high voluntary activity on running wheels) and "nurture" (7-8 wk of access or no access to running wheels, beginning at weaning). At the end of the experiment, mice from both wheel-access groups were significantly lighter in body mass than mice from sedentary groups. Within the wheel-access group, a statistically significant, negative relationship existed between activity and final body mass. In measurements of maximum oxygen consumption during forced treadmill exercise (VO2max), mice with wheel access were significantly more cooperative than sedentary mice; however, trial quality was not a significant predictor of individual variation in VO2max. Nested two-way analysis of covariance demonstrated that both genetic selection history and access to wheels had significant positive effects on VO2max. A 12% difference in VO2max existed between wheel-access selected mice, which had the highest mass-corrected VO2max, and sedentary control mice, which had the lowest. The respiratory exchange ratio at VO2max was also significantly lower in the wheel-access group. Our results suggest the existence of a possible genetic correlation between voluntary activity levels (behavior) and aerobic capacity (physiology).

Aerobiosis↗

PubMed1993

Failure of insulin treatment in obese patients with non-insulin-dependent diabetes mellitus.

A number of experts recommend the use of insulin for patients with non-insulin-dependent diabetes mellitus (NIDDM) who fail to respond to diet, exercise, and oral hypoglycemics, even when the patient is morbidly obese. This article describes the use of insulin in two obese patients with NIDDM whose obesity worsened following the institution of insulin therapy. In some cases the risk for increased obesity and its complications following the institution of insulin may offset the potential benefits of insulin therapy itself. There are two main drawbacks associated with insulin therapy in these patients. First, from a medical point of view, insulin has a lipogenic effect and may actually contribute to weight gain, hyperinsulinemia, and increased insulin resistance in obese patients with NIDDM. Second, from a behavioral point of view, the institution of insulin therapy may shift the patient's and physician's focus from the preferred lifestyle adjustments to the numerous details associated with insulin use and monitoring. Since weight gain and sedentary activity are themselves risk factors for coronary artery disease, the benefits of decreased blood glucose levels should be balanced against the risk of increased weight gain in these patients.

Adult↗