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Determinants of physical activity initiation and maintenance among community-dwelling older persons.

BACKGROUND: Understanding determinants of initiation and maintenance of an active lifestyle among older individuals is of great concern to public health because of the increasing evidence that lifestyle may alter the course of frequently occurring chronic diseases. METHOD: Two thousand five hundred seven community-dwelling Medicare beneficiaries age 65 and over were interviewed at three points over 4 years regarding their physical activity, defined as a self-report of walking briskly, gardening, or heavy housework at least three times a week. Extensive data were also collected on health status, health services use, sociodemographics, and, at the final interview, self-mastery, importance of various factors in the decision to be physically active, and interaction with their physician regarding physical activity. Determinants of initiation and maintenance of physical activity were identified using logistic regressions. RESULTS: Forty-one percent maintained an active lifestyle; 12% initiated an active lifestyle; 22% declined to become sedentary; 25% were sedentary at all observation. Predictors of both initiation and maintenance of physical activity were younger age, moderate to excellent health, and the patient's belief that physical activity was important to his/her health. Among the 301 patients who initiated activity, 40% said their physician was a very important influence. CONCLUSIONS: Strengthening the belief of older individuals in the benefits to their health of physical activity holds promise for increasing the proportion of community-dwelling older persons who move from a sedentary lifestyle to a more physically active lifestyle and for maintaining such activity.

Aged↗

Weight control smoking among sedentary women.

This study examined characteristics associated with weight control smoking among 281 sedentary women enrolled in a smoking cessation trial. A series of regression models were developed to identify predictors of weight control smoking as measured by the Smoking Situations Questionnaire. Predictor variables included demographic variables, dietary intake, weight gain following previous quit attempts, dietary restraint, self-efficacy for weight management, smoking behavior, exercise behavior, negative affect and psychological constructs relevant to smoking cessation, and exercise adoption. In the final predictor model, anticipation of weight gain in the current quit attempt, higher dietary restraint, younger age, greater Fagerstrom scores, greater number of pounds gained in previous quit attempts, and lower levels of self-efficacy to manage weight in negative affect situations were associated with smoking for weight control. Treatment implications for women who smoke for weight control reasons are discussed.

Adult↗

Genetic influences on exercise participation in 37,051 twin pairs from seven countries.

BACKGROUND: A sedentary lifestyle remains a major threat to health in contemporary societies. To get more insight in the relative contribution of genetic and environmental influences on individual differences in exercise participation, twin samples from seven countries participating in the GenomEUtwin project were used. METHODOLOGY: Self-reported data on leisure time exercise behavior from Australia, Denmark, Finland, Norway, The Netherlands, Sweden and United Kingdom were used to create a comparable index of exercise participation in each country (60 minutes weekly at a minimum intensity of four metabolic equivalents). PRINCIPAL FINDINGS: Modest geographical variation in exercise participation was revealed in 85,198 subjects, aged 19-40 years. Modeling of monozygotic and dizygotic twin resemblance showed that genetic effects play an important role in explaining individual differences in exercise participation in each country. Shared environmental effects played no role except for Norwegian males. Heritability of exercise participation in males and females was similar and ranged from 48% to 71% (excluding Norwegian males). CONCLUSIONS: Genetic variation is important in individual exercise behavior and may involve genes influencing the acute mood effects of exercise, high exercise ability, high weight loss ability, and personality. This collaborative study suggests that attempts to find genes influencing exercise participation can pool exercise data across multiple countries and different instruments.

Adult↗

[The potential of central obesity anthropometric indicators as diagnostic tools].

OBJECTIVE: It has been suggested that the indicators of centralized obesity, namely by waist-to-hip circumference ratio (WHR) and waistline measure (WM), express different metabolic disorders. Thus, a study was conducted in order to verify the diagnostic potential of the relationship between these two measures and social, behavioral, and biological determinants of centralized obesity. METHODS: Two hierarchical multiple regression models were applied to a 1,042 subject sample from the city of São Paulo, southeastern Brazil, in order to evaluate relationships between indicators and determinants for centralized obesity. Clinical, biochemical/laboratory, and behavioral surveys were carried out using standardized questionnaires. Evaluation included blood pressure, anthropometric measurements, and waistline and hip measures. RESULTS: WHR was significantly associated with low stature and strongly related to socioeconomic level; this was not the case with WM. Both WHR and WM were strongly associated with age, sex, and sedentary lifestyle. Women were at greater risk of centralized obesity then men: OR=5.04 and 7.27 for WHR and WM, respectively. WHR was significantly associated with alterations indicative of metabolic syndrome: hypertension and low levels of HDL-cholesterol. WM was significantly associated with hypertension alone. Both indicators were strongly associated with the concomitant presence of two or more alterations related to metabolic syndrome. Unlike WHR, WC was associated with hypercholesterolemia. CONCLUSIONS: WHR was more closely associated with socioeconomic factors, former risk of malnutrition, and alterations indicative of metabolic syndrome than WM, which was more closely associated with risk factors for cardiovascular and arteriosclerotic diseases.

Analysis of Variance↗

Reliability and validity of measures from the Behavioral Risk Factor Surveillance System (BRFSS).

OBJECTIVES: To assess the reliability and validity of measures on the BRFSS, to assist users in evaluating the quality of BRFSS data, and to identify areas for further research. METHODS: Review and summary of reliability and validity studies of measures on the BRFSS and studies of measures that were the same or similar to those on the BRFSS from other surveys. RESULTS: Measures determined to be of high reliability and high validity were current smoker, blood pressure screening, height, weight, and BMI, and several demographic characteristics. Measures of both moderate reliability and validity included when last mammography was received, clinical breast exam, sedentary lifestyle, intense leisure-time physical activity, and fruit and vegetable consumption. Few measures were of low validity and only one measure was determined to be of low reliability. Several other measures were of high or moderate reliability or validity, but not both. The reliability or validity could not be determined for some measures, primarily due to lack of research. CONCLUSIONS: Most questions on the core BRFSS instrument were at least moderately reliable and valid, and many were highly reliable and valid. Additional research is needed for some measures.

Adult↗

Efficacy of an individualized, motivationally-tailored physical activity intervention.

This study compared the efficacy of two low-cost interventions for physical activity adoption. Sedentary (N = 194) adults recruited through newspaper advertisements were randomized to receive either a motivationally-matched, individually-tailored intervention (IT) or a standard self-help intervention (ST). Assessments and interventions were delivered by repeated mailings at baseline, one, three, and six months. Participants were assessed regarding current physical activity behavior, motivational readiness to adopt regular physical activity, and psychological constructs associated with physical activity participation (e.g. self-efficacy, decisional balance). Repeated measures analyses of variance (ANOVAs) revealed significant increases in physical activity participation between baseline and six months for both groups with a significantly greater increase among IT participants. The IT group outperformed the ST group on all primary outcome measures: (a) minutes of physical activity per week, (b) reaching Centers for Disease Control and American College of Sports Medicine (CDC/ACSM) recommended minimum physical activity criteria, and (c) achieving the Action stage of motivational readiness for physical activity adoption. Both groups showed significant improvement between baseline and six months on the psychological constructs associated with physical activity adoption (e.g. self-efficacy), with no significant differences observed between the treatment groups. Utilizing computer expert systems and self-help manuals to provide individually-tailored, motivationally-matched interventions appears to be an effective, low-cost approach for enhancing physical activity participation in the community.

Adult↗

Coupling effect of locomotor activity on the rat's circadian system.

Exercise is recognized to affect circadian rhythmicity in a variety of ways. It masks the expression of other behavioral and physiological rhythms, entrains the master pacemaker, and influences the free-running period of other rhythms. In this paper we study the influence of exercise on the organization of the timing system by analyzing the effect of voluntary locomotor activity on the circadian feeding behavior of rats subjected to different lighting conditions. The availability of wheel running prevented loss of feeding circadian rhythmicity under constant bright light (LL) but did not elicit any circadian pattern in rats showing a previous arrhythmic pattern. Under dim red light (DR), the rhythm was more pronounced in exercising than in sedentary rats, while wheel-running availability accelerated the emergence of circadian rhythmicity in arrhythmic animals that were moved from LL to DR. These results can be explained by the existence of a positive feedback loop between physical exercise and its pacemaker and also suggest that exercise changes the functioning of the circadian system to facilitate the emergence of circadian rhythms in previously arrhythmic animals.

Animals↗

Panoramic dental radiography: an aid in detecting individuals prone to stroke.

Stroke (cerebrovascular accident, CVA) is the third leading cause of death and an important cause of hospital admission and long-term disability in England and Wales. Atherosclerotic lesions at the bifurcation of the common carotid artery are the most common cause of stroke. On occasion, these lesions are partially calcified and visible on a conventional panoramic dental radiograph. The atheroma may appear either as a nodular radiopaque mass or as two radiopaque vertical lines within the soft tissues of the neck at the level of the lower margin of the third cervical vertebra (C3). These opacities are separate and distinct from the hyoid bone and variably appear above or below it. Dentists should scrupulously review the panoramic radiographs of all individuals over the age 55 with medical histories (hypertension, diabetes mellitus, hypercholesterolaemia, coronary artery disease) and behaviours (smoking, alcohol abuse, dietary indiscretion, overweight, sedentary life-style) known to be associated with atherosclerosis and stroke.

Aged↗

Evaluation of relapse prevention and reinforcement interventions to promote exercise adherence in sedentary females.

An experimental design was employed to assess the effectiveness of a relapse prevention program, a reinforcement program, and an exercise-only control group in increasing exercise program adherence and short-term maintenance in 120 previously sedentary female university employees. The subjects participated in an 18-week exercise program composed of stretching, calisthenics, and aerobic dance. Attendance during the first half of the program was significantly higher for subjects in the relapse prevention group than for those in the control group. A nonsignificant trend in this direction emerged during the second half of the program and at 2-month follow-up. For all treatment groups, attrition (attendance at less than two thirds of the exercise sessions) was substantial, averaging 72% at the end of the 18-week program. These findings indicate that relapse prevention and reinforcement programs may not assist previously sedentary females in long-term adherence to an exercise program.

Adaptation, Psychological↗

Outcome expectations that motivate physical activity among world senior games participants.

This study validates a questionnaire which examines the role of selected outcome expectations from physical activity on motivating regular physical activity among a group of older adults. Data were obtained from a cross-sectional survey of 675 participants in the 2002 World Senior Games. Factor analysis identified four clusters among 14 outcome expectation items, which were labeled Recreation and Social, Physical Health, Mental Health, and Self-image. The percentage agreeing that the selected items motivated physical activity were calculated and ranked from 1 (high) to 14 (low). The average ranking in each of the four factors was 4.7 for Recreation and Social, 5.8 for Physical Health, 10.5 for Self-image, and 11.7 for Mental Health. The ranks of items did not significantly differ across categories of sex, age, marital status, education, smoking, alcohol drinking, and disease history. However, the ranking did significantly differ between individuals who considered themselves to be physically active versus sedentary. Physically active individuals were most likely to agree that recreational enjoyment or fun motivated physical activity, whereas sedentary individuals were most likely to agree that improving the quality of life motivated physical activity.

Adult↗

Predictors of pregnancy-associated change in physical activity in a rural white population.

OBJECTIVE: The objective of this study was to examine the relationship of sociodemographic and psychosocial characteristics and exercise prior to pregnancy to change in physical activity (PA) during pregnancy. METHODS: This study was part of the Bassett Mothers' Health Project (BMHP), a prospective cohort study of women who enrolled for prenatal care in the Bassett Healthcare system between November 7, 1994, and November 15, 1996. Six hundred twenty-two women met the eligibility criteria and were enrolled in the study. Sociodemographic and psychosocial characteristics and exercise behavior were assessed prenatally using the medical record and an anonymous mailed questionnaire. Staged linear regression analysis was used to predict change in physical activity with the psychosocial and sociodemographic characteristics as the independent variables and prepregnancy exercise frequency as a control variable. RESULTS: Women who were older, more educated, and had higher household incomes were more likely to exercise prior to pregnancy (p < .05). Change in PA after becoming pregnant was associated with prepregnancy exercise frequency (p < .001). Women who exercised frequently moderated their activity, while sedentary women maintained or increased their PA after becoming pregnant. Exercise self-efficacy (the belief in one's ability to exercise regularly) and body mass index (BMI) were positive predictors of change in PA (p < .05), while prepregnancy exercise frequency remained significant as a control variable. CONCLUSION: Interventions that aim to help women maintain or increase their PA during the perinatal period should be designed to increase exercise self-efficacy.

Adult↗

[Cardiovascular risk factors in adolescents: biological and behavioral indicators].

OBJECTIVE: To provide descriptive information and investigate to what extent behavioral risk factors for cardiovascular diseases are associated with biological risk factors in the young population. METHODS: The sample included 452 adolescents (246 girls and 206 boys) between 15 and 18 years of age selected in a high school in the city of Londrina, Paraná. Risk factors of a behavioral nature were analyzed as regards insufficient physical activity, excessive intake of fat and cholesterol and smoking. As biological risk factor indicators we used overweight, high arterial pressure levels, and adverse concentration of serum lipids and lipoproteins. RESULTS: Approximately 20% of the girls and 16% of the boys presented at least one biological risk factor for development of cardiovascular diseases. Overweight was significantly associated with excessive intake of fats, while elevated arterial pressure was related to sedentary lifestyle and smoking. Excessive intake of fat and cholesterol indicated increased risk of undesirable concentrations of serum lipids and lipoproteins. The risk associated with altered blood pressure and serum lipids and lipoprotein was increased two-fold in smokers when compared with nonsmokers. CONCLUSION: The results reinforce the need for interventions targeted at the adoption of a healthy lifestyle, including the regular practice of physical exercise, appropriate dietary patterns, and abstention from smoking as of an early age.

Adolescent↗

The effect of endurance exercise on the morphology of muscle attachment sites.

The morphology of muscle attachment sites, or entheses, has long been assumed to directly reflect in vivo muscle activity. The purpose of this study is to examine whether variations in muscle activity that are within normal physiological limits are reflected in variations in external attachment site morphology. This study tests the hypothesis that increased muscle activity (magnitude, number and frequency of loading cycles) results in the hypertrophy of muscle attachment sites. The attachment sites of six limb muscles and one muscle of mastication (control) in mature female sheep were measured and compared in exercised (weighted treadmill running for 1 h per day for 90 days) and sedentary control animals. Attachment site surface morphology was assessed by quantifying the size (3D surface area) and complexity (fractal dimension parallel and perpendicular to soft tissue attachment) of the surfaces. The results of this study demonstrate no effect of the exercise treatment used in this experiment on any measure of enthesis morphology. Potential explanations for the lack of exercise response include the mature age of the animals, inappropriate stimulus type for inducing morphological change, or failure to surpass a hypothetical threshold of load for inducing morphological change. However, further tests also demonstrate no relationship between muscle size and either attachment site size or complexity in sedentary control animals. The results of this study indicate that the attachment site morphological parameters measured in this study do not reflect muscle size or activity. In spite of decades of assumption otherwise, there appears to be no direct causal relationship between muscle size or activity and attachment site morphology, and reconstructions of behavior based on these features should be viewed with caution.

Aging↗

Coronary artery disease in women: assessment, diagnosis, intervention, and strategies for life style change.

Coronary heart disease is reaching epidemic proportions in women. With increased longevity, more women are living many years beyond menopause, the time when heart disease peaks in women. For midlife women, it is important to determine a personal profile of unmodifiable (family history, age, and race) and modifiable risk factors. The goal for every woman must be to control coronary risk factors such as smoking, hyperlipidemia, diabetes, sedentary life style/weight control and stress, which have been proven to be amenable to modification strategies. Many women also may consider hormonal replacement but must be counseled to make informed choices concerning the benefits and risks. Finally, as nurses and as leaders in the health care of women, we must model heart healthy behaviors to encourage each other and to increase our effectiveness with the clients we serve.

Coronary Disease↗

Relations between children's playground and classroom behaviour.

In this within-subjects design field experiment children's behaviour in the playground was charted as a function of gender and time in the classroom immediately preceding playtime. Playground behaviour was also related to post-recess classroom behaviour. Twenty-three 9-year-old children were observed for 14 weeks. Classroom behaviour (i.e., task relevant behaviour on standardised seat work immediately before and after playtime) and playground behaviour (i.e., social and non-social exercise and sedentary behaviour) were observed. Time in classroom before playtime was manipulated so that there was a shorter and a longer confinement period. Results indicated that children were less attentive to seat work as a function of time and that longer confinement resulted in more exercise for boys and more social sedentary behaviour for girls. Social behaviour at playtime and post-playtime attention to seat work were significantly related. Results are discussed in terms of Novelty Theory.

Attention↗

[Influence of the working posture on the flow-volume curve: an advanced identification of the "wave speed theory"].

The flow-volume (F-V) curves and routine ventilatory functions were performed with "point-measured method" on 473 healthy workers. 224 engaged in heavy work; 248 engaged in moderately heavy work and were compared with normal sedentary subjects. In workers who had heavy load, the flows at high lung volumes were reduced after 40 years of age, and the flows at low lung volumes were increased after 30 years both in males and females. There was a tendency of increase with age. In workers who had moderately heavy load, only the increase of flow at low lung volumes in individual age group was noticed. The same ventilatory functions were repeatedly measured on 7 healthy sedentary subjects who mimicked the working posture by bending forward. The same results were obtained with reduced flows at high lung volumes and increased flows at low lung volumes, and were also consistent with those of farmers measured previously. This fact suggested that the wave speed theory can also be applicable to the ventilatory behavior of the workers with forward bending of neck and trunk during heavily loaded working.

Adult↗

[Consumption of bread and its substitutes].

Over the years, the consumption of bread has dropped considerably. A consumer survey of 3 109 people of all ages undertaken in several regions in France has revealed different criteria of variation enabling us to understand better the way in which this drop has taken place. The consumption of various foodstuffs replacing bread such as "biscottes" and"croissants" has also been noticed. In 1972, the average consumption of bread was 166 grams per person per day, but this is subjected to considerable variations. The sample reveals 9 p. 100 non-consumers, but 30 p. 100 men and 8 p. 100 women eat more than 250 grams per day. The drop in the consumption of bread is generally linked with an increase in sedentary life. This marked restriction in glucids contained in cereals can have important effects on health as it upsets the balance of the energy intake.

Bread↗

Lymphocyte apoptosis in ovariectomized mice given progesterone and voluntary exercise.

BACKGROUND: At menopause, many women begin both exercise programs and hormone replacement therapy (HRT). Although the effects of estrogen on exercise behavior and immune functions have been well characterized, less is known about the behavioral and immunological consequences of progesterone (P) administration. The purpose of the present study was to describe the effect of P on running behavior and on lymphoid tissue cell viability and apoptosis in ovariectomized female mice. METHODS: Adult female B6D2F1 mice were ovariectomized, allowed to recover for 1 week and implanted subcutaneously with 25 mg progesterone (n=42) or placebo pellet (n=42). Within hormone treatment, mice were randomized to running wheels or no running wheel conditions. After 21 days of wheel running and hormone exposure, mice were sacrificed for measurements of body weight, tissue weights, and thymocyte and splenocyte apoptosis, necrosis and viability with annexin-V FITC and propidium iodide by flow cytometry. RESULTS: P treated mice were heavier than placebo controls at sacrifice (p<0.001). Irrespective of hormone condition, mice increased the volume of spontaneous activity over time (p<0.001). Within the thymus, there were no differences by hormone or running condition on percent apoptosis, necrosis and viability. In the spleen, P marginally increased percent apoptosis (p<0.05) and reduced percent viability (p<0.001). Serum levels of P were higher in the hormone replaced mice compared with placebo mice (p<0.001) and in running compared with sedentary mice (p<0.01). CONCLUSIONS: P replacement in ovariectomized mice does not alter running volume relative to placebo animals. P alone was associated with a small increase in splenocyte apoptosis. The clinical relevance for postmenopausal women of lymphocyte viability changes needs to be determined.

Animals↗