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PubMed1991

Nutrition and health patterns in midlife women.

The middle years for women present many challenges and opportunities. The changes of life--physical, psychosocial, developmental, and environmental--can be rewarding, positive experiences. At the same time, as women enter the middle years, they may face a number of health problems. Preparation for health maintenance, illness prevention, and coping with problems as they occur can prevent many of the potential health alterations through life style changes. Even when these health problems are unpreventable, modification of behaviors and habits may ameliorate some of their consequences. The nurse is the logical person to educate and counsel women on how to lower their risks for midlife health problems. An overview of the health status of women at midlife is presented, including current life expectancy, mortality, and morbidity data. Risk factors and risk assessment specific to diseases prevalent in midlife and older women are reviewed, with emphasis on nutrition and obesity. Nursing strategies for reducing the risk factors (obesity, hypercholesterolemia, and sedentary life style) related to many of the health concerns of midlife women are presented.

Exercise↗

PubMed1998

The relationship between modifiable health risks and health care expenditures. An analysis of the multi-employer HERO health risk and cost database.

This investigation estimates the impact of ten modifiable health risk behaviors and measures and their impact on health care expenditures, controlling for other measured risk and demographic factors. Retrospective two-stage multivariate analyses, including logistic and linear regression models, were used to follow up 46,026 employees from six large health care purchasers for up to 3 years after they completed an initial health risk appraisal. These participants contributed 113,963 person-years of experience. Results show that employees at high risk for poor health outcomes had significantly higher expenditures than did subjects at lower risk in seven of ten risk categories: those who reported themselves as depressed (70% higher expenditures), at high stress (46%), with high blood glucose levels (35%), at extremely high or low body weight (21%), former (20%) and current (14%) tobacco users, with high blood pressure (12%), and with sedentary lifestyle (10%). These same risk factors were found to be associated with a higher likelihood of having extremely high (outlier) expenditures. Employees with multiple risk profiles for specific disease outcomes had higher expenditures than did those without these profiles for the following diseases: heart disease (228% higher expenditures), psychosocial problems (147%), and stroke (85%). Compared with prior studies, the results provide more precise estimates of the incremental medical expenditures associated with common modifiable risk factors after we controlled for multiple risk conditions and demographic confounders. The authors conclude that common modifiable health risks are associated with short-term increases in the likelihood of incurring health expenditures and in the magnitude of those expenditures.

Adolescent↗

PubMed2003

Personal, social, and environmental correlates of physical activity in urban African-American women.

BACKGROUND: African-American women are at risk of chronic diseases for which regular physical activity can provide benefits. This group, however, remains predominantly sedentary. Little research has been undertaken to elucidate the multiple factors that influence their physical activity levels. This study was designed to determine associations among personal, social environmental, and physical environmental factors with physical activity level in urban African-American women. METHODS: The Women and Physical Activity Survey, an interviewer-administered survey consisting of demographic, personal, and social and physical environmental factors, was given to 234 African-American women living in Baltimore, Maryland. Physical activity level was determined from the Behavioral Risk Factor Surveillance System survey. Women were divided into three groups: meeting current recommendations for moderate or vigorous physical activity, insufficiently active, and inactive. Comparisons were made between the group of women that met recommendations versus women who did not, and women who reported any activity versus women who were inactive. RESULTS: Twenty-one percent (48) of women met recommendations for physical activity, 61% (143) were insufficiently active, and 18% (43) were inactive. Women who had a partner or who had no children were less likely to engage in some physical activity. Inactive women were more likely than women who participated in some physical activity to know people who exercised. Women who belonged to community groups were more likely to be inactive than women who met current recommendations for physical activity. Women with fewer social roles were more likely to meet current recommendations. Physical environment factors were not associated with physical activity level. CONCLUSIONS: Further exploration is needed to determine how personal and social environmental and physical environmental factors relate to physical activity in African-American women.

Adult↗

PubMed1999

Providing sedentary adults with choices for meeting their walking goals.

BACKGROUND: This study was designed to test different ways of meeting the new ACSM/CDC recommendations for physical activity stating that all Americans at least 2 years of age should obtain 30 minutes of moderate intensity activity on most days of the week. METHODS: Thirty-two sedentary 18- to 55-year-old adults were randomly assigned to three groups of brisk walking/6 days per week: 30 continuous minutes, three 10-minute bouts, and 30 minutes in any combination of bouts as long as each bout was at least 5 minutes. Aerobic fitness, blood pressure, body composition, and physical activity were assessed at baseline, at end of program (16 weeks), and at follow-up (32 weeks). RESULTS: All groups significantly (P </= 0.05) improved their aerobic fitness and systolic blood pressure and increased their physical activity at the end of the program. At follow-up all groups maintained these changes, while additionally reducing their percentage body fat and diastolic blood pressure. CONCLUSION: These findings demonstrate that a walking prescription of 30 minutes per day on most days of the week with the choice to walk in as little as 5 minute bouts can improve cardiovascular health and body composition, as well as help sedentary people maintain those improvements over time. This is supported by all participants indicating that "making walking part of my lifestyle" was the most important factor in maintaining their walking habits.

Adolescent↗

PubMedDate not supplied

Coronary artery disease in South Asians: an emerging risk group.

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide and was responsible for 7.2 million deaths in 2003. Various studies have pointed out that South Asians have a higher prevalence of CAD as compared with other ethnicities. South Asians may have a genetic predisposition to CAD; however, environmental, nutritional, and lifestyle factors may also be responsible. South Asians have a much higher prevalence of metabolic syndrome, diabetes, insulin resistance (and resultant hyperinsulinemia), central obesity, dyslipidemias (lower high-density lipoprotein, increased lipoprotein[a], higher triglyceride levels), increased thrombotic tendency (increased plasminogen activator inhibitor-1 and decreased tissue plasminogen activator levels), decreased levels of physical activity, and low birth weights ("fetal origins hypothesis"). In addition, the dietary indiscretions and sedentary lifestyle practiced by most South Asians puts them at a higher risk. A multidisciplinary approach involving the population at risk, healthcare personnel, and the government is required to diminish the incidence. Educational programs regarding the genetic predisposition as well as risk factors for CAD, physical activity, and dietary modifications need to be encouraged. There is a need for implementation of newer guidelines as well as a lower threshold for initiating therapeutic interventions in this population. Mass media should be involved to bring about behavioral changes, and these changes should be reinforced at the physician's level.

Age of Onset↗

PubMed2005

Epidemiology of leisure-time physical activity in socio-demographic, lifestyle and psychological characteristics of men and women in Greece: the ATTICA Study.

BACKGROUND: We aimed to evaluate the prevalence, frequency and type of leisure-time physical activity (LTPA) among adults in Greece, as well as its relationship with socio-demographic, lifestyle and clinical characteristics of these people. METHODS: From May 2001 to December 2002 we randomly enrolled 1514 men and 1528 women, without any evidence of cardiovascular or any other chronic disease. The sampling was stratified by the age-gender distribution of (census 2001) of the greater area of Athens. Weekly energy expenditure assessed by considering frequency, duration (in minutes) and intensity of sports related physical activity during a usual week. RESULTS: 53% of men and 48% of women were classified as physically active. Men were more likely to be active as compared to women (p < 0.05), while the lowest activity rates were observed in 40 to 49 years old participants (p < 0.01). Physically active people had higher occupation skills, were more likely to live in rural areas, to be unmarried, non smokers and they were devoted to a healthier dietary pattern, as compared to sedentary, irrespective of age and sex (all p < 0.05). In addition, the cumulative risk factors score of obesity, hypertension, hypercholesterolemia and diabetes, was inversely associated with activity status (p < 0.001). Finally, physically active men and women were less likely to report depressive symptoms (p < 0.01), after various adjustments were made. CONCLUSION: Half of the studied population reported physically inactive, indicating that sedentary lifestyle becomes a serious epidemic in Greece. High occupation skills, non-smoking, devotion to a healthier dietary pattern and a better cardiovascular risk factors profile were some of the determinants of physically active people.

Adult↗

PubMed2006

Muscle dissatisfaction in young adult men.

BACKGROUND: Appearance concerns are of increasing importance in young men's lives. We investigated whether muscle dissatisfaction is associated with psychological symptoms, dietary supplement or anabolic steroid use, or physical activity in young men. METHODS: As a part of a questionnaire assessment of health-related behaviors in the population-based FinnTwin16 study, we assessed factors associated with muscle dissatisfaction in 1245 men aged 22-27 using logistic regression models. RESULTS: Of men, 30% experienced high muscle dissatisfaction, while 12% used supplements/steroids. Of highly muscle-dissatisfied men, 21.5% used supplements/steroids. Mean body mass index, waist circumference, or leisure aerobic activity index did not differ between individuals with high/low muscle dissatisfaction. Muscle dissatisfaction was significantly associated with a psychological and psychosomatic problems, alcohol and drug use, lower height satisfaction, sedentary lifestyle, poor subjective physical fitness, and lower life satisfaction. CONCLUSION: Muscle dissatisfaction and supplement/steroid use are relatively common, and are associated with psychological distress and markers of sedentary lifestyle.

Journal Article↗

PubMed1987

Cardiovascular risk in parents of children with elevated blood pressure. "Heart Smart"--family health promotion.

The Heart Smart Family Health Promotion identified elementary-school-age children with elevated blood pressure (BP), based on sex-, race-, height-specific 90th percentiles, and ponderal index (wt/ht3), based on sex-, race-, and age-specific 90th percentiles (norms developed in the Bogalusa Heart Study). These children and their parents were recruited into a behavioral program aimed at reducing cardiovascular (CV) risk factors for both children and parents and preventing "tracking" of children's elevated risk factors into adulthood. Cardiovascular screening consisted of BP, anthropometric evaluation, serum lipids, and 24-hour urinalysis. Self-reported assessments were personal and family medical history, eating, exercise, smoking, and alcohol behaviors. Both child and parent subjects were predominantly black and female. Data were stable over two baseline measurements and indicated CV risk factor abnormalities in one or both of the parents selected: 67% of the black parents and 25% of the white parents were hypertensive; 91% had positive familial CV history; 41% had total cholesterol greater than or equal to 220 mg/dl; 50% had LDL-C levels greater than or equal to 140 mg/dl; 74% were overweight; 44% were smokers; and 91% were completely sedentary. Using percentile grids to identify children with elevated BP also identifies families with hypertension and associated risk factors.

Adolescent↗

PubMed1999

Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial.

CONTEXT: Even though the strong association between physical inactivity and ill health is well documented, 60% of the population is inadequately active or completely inactive. Traditional methods of prescribing exercise have not proven effective for increasing and maintaining a program of regular physical activity. OBJECTIVE: To compare the 24-month intervention effects of a lifestyle physical activity program with traditional structured exercise on improving physical activity, cardiorespiratory fitness, and cardiovascular disease risk factors. DESIGN: Randomized clinical trial conducted from August 1, 1993, through July 31, 1997. PARTICIPANTS: Sedentary men (n = 116) and women (n = 119) with self-reported physical activity of less than 36 and 34 kcal/kg per day, respectively. INTERVENTIONS: Six months of intensive and 18 months of maintenance intervention on either a lifestyle physical activity or a traditional structured exercise program. MAIN OUTCOME MEASURES: Primary outcomes were physical activity assessed by the 7-Day Physical Activity Recall and peak oxygen consumption (VO2peak) by a maximal exercise treadmill test. Secondary outcomes were plasma lipid and lipoprotein cholesterol concentrations, blood pressure, and body composition. All measures were obtained at baseline and at 6 and 24 months. RESULTS: Both the lifestyle and structured activity groups had significant and comparable improvements in physical activity and cardiorespiratory fitness from baseline to 24 months. Adjusted mean changes (95% confidence intervals [CIs]) were 0.84 (95% CI, 0.42-1.25 kcal/kg per day; P<.001) and 0.69 (95% CI, 0.25-1.12 kcal/kg day; P = .002) for activity, and 0.77 (95% CI, 0.18-1.36 mL/kg per minute; P = .01) and 1.34 (95% CI, 0.72-1.96 mL/kg per minute; P<.001) for VO2peak for the lifestyle and structured activity groups, respectively. There were significant and comparable reductions in systolic blood pressure (-3.63 [95% CI, -5.54 to -1.72 mm Hg; P<.001] and -3.26 [95% CI, -5.26 to -1.25 mm Hg; P = .002]) and diastolic blood pressure (-5.38 [95% CI, -6.90 to -3.86 mm Hg; P<.001] and -5.14 [95% CI, -6.73 to -3.54 mm Hg; P<.001) for the lifestyle and structured activity groups, respectively. Neither group significantly changed their weight (-0.05 [95% CI, -1.05 to 0.96 kg; P = .93] and 0.69 [95% CI, -0.37 to 1.74 kg; P = .20]), but each group significantly reduced their percentage of body fat (-2.39% [95% CI, -2.92% to -1.85%; P<.001] and -1.85% [95% CI, -2.41 % to -1.28%; P<.001]) in the lifestyle and structured activity groups, respectively. CONCLUSIONS: In previously sedentary healthy adults, a lifestyle physical activity intervention is as effective as a structured exercise program in improving physical activity, cardiorespiratory fitness, and blood pressure.

Adult↗

PubMed2000

Body-weight regulation: causes of obesity.

The aetiology and treatment of obesity have been fraught with disappointment for researchers, because the mechanisms that control fuel homeostasis and adiposity are incompletely understood. It is assumed that regulatory processes match the dietary fuel supply with energy requirements in order to maintain a stable body mass and adiposity. In this context several theories have been proposed to explain the laws of thermodynamics describing the conservation and transformation of energy in living organisms. In the light of new evidence it can now be hypothesized that the control of body weight and composition depends on an axis with three interrelated and self-controlled components: (1) food intake; (2) nutrient turnover and thermogenesis; (3) body fat stores. Complex feedback mechanisms underlie all these components. The major factors involved in obesity seem to be dietary and physical activity habits. These factors are affected by susceptibility genes that in turn may influence energy expenditure, fuel metabolism, muscle fibre function and appetite or food preferences. However, the increasing rates of obesity cannot be explained exclusively by changes in the gene pool, although genetic variants that were previously 'silent' are now being triggered by the high availability of energy- and fat-dense foods, and by the increasingly sedentary lifestyle of modern societies. The study of factors such as genetics and lifestyle implicated in weight gain and obesity is crucial for predictions about the future impact of the global epidemic of obesity, and provides a unique opportunity for the implementation of preventive action.

Body Weight↗

PubMed2003

[Benefits of physical activity and harms of inactivity].

Epidemiological research has consistently shown that physical activity decreases the risk of coronary heart disease, hypertension and stroke. The finding that a low level of physical activity is a major determinant of the growing epidemics of obesity is also firm and consistent. The direct association existing between a sedentary lifestyle and the incidence of diabetes mellitus is solid and of great importance for public health. Additional benefits from a a physically active lifestyle are a reduction in the incidence and prevalence of osteoporosis, lower risk of falls and fractures in the elderly, and a lower risk of anxiety and depression. Although evidence is less consistent, low levels of physical activity have been related to a higher risk of colon, breast and lung cancer. Some preliminary evidence relates physical activity with a lower risk of dementia. During the last three decades a huge amount of epidemiological research has led to uniform conclusions about the benefits of a physically active lifestyle. In spite of this fact, the prevalence of sedentary lifestyles is rising. Therefore, health promotion interventions are urgently needed to reach the objective of engaging in regular and moderate physical activity for at least 30 minutes per day in most, preferably all, days of the week.

Cardiovascular Diseases↗

PubMed1990

Age-related differences in cardiovascular reactions to mental stress tests in women.

Tested 84 healthy, sedentary women in the laboratory during performance of difficult and easy problem-solving tasks. They were divided into three age groups: 19 to 32 years, 33 to 43 years, and 44 to 60 years (n = 28 women per group). Baseline systolic blood pressure (SBP) and diastolic blood pressure increased with age, whereas skin conductance level was lower in older women. In addition, initial SBP reactions to tasks were positively related to age, even after controlling for baseline blood pressure, aerobic fitness, and Framingham Type A Scale behavior scores. There were no differences in heart rate (HR) or "additional" HR reactions, so the anticipated decline in cardiac sympathetic response with age was not observed. The mechanisms underlying age-related reactions to mental stress are discussed.

Adult↗

PubMed2005

Effects of retirement on lifestyle in relation to changes in weight and waist circumference in Dutch men: a prospective study.

OBJECTIVE: To study changes in lifestyle in relation to changes in body weight and waist circumference associated with occupational retirement in men. DESIGN: A prospective cohort study with 5 years of follow-up. At baseline and at follow-up, questionnaires were completed and body weight and waist circumference were measured. SETTING: The Doetinchem Cohort Study, consisting of inhabitants of Doetinchem, a town in a rural area of The Netherlands. SUBJECTS: In total 288 healthy men aged 50-65 years at baseline, who either remained employed or retired over follow-up. RESULTS: The effect of retirement on changes in weight and waist circumference was dependent on type of former occupation. Increase in body weight and waist circumference was higher among men who retired from active jobs (0.42 kg year(-1) and 0.77 cm year(-1), respectively) than among men who retired from sedentary jobs (0.08 kg year(-1) and 0.23 cm year(-1), respectively). Weight gain and increase in waist circumference were associated with a decrease in fruit consumption and fibre density of the diet, with an increase in frequency of eating breakfast, and with a decrease in several physical activities, such as household activities, bicycling, walking and doing odd jobs. CONCLUSION: Retirement was associated with an increase in weight and waist circumference among those with former active jobs, but not among those with former sedentary jobs. Retirement may bring opportunities for healthy changes in diet and physical activity, which could be used in health promotion programmes.

Activities of Daily Living↗

PubMed2003

Secular trends in sports: participation and attitudes among adolescents in Sweden from 1974 to 1995.

AIM: To study the secular trend (time changes) in participation in leisure-time sports activities and in attitudes towards sports activities and physical education in a representative sample of Swedish adolescents between 1974 and 1995. METHODS: A questionnaire was distributed to 16-y-old girls and boys (n = 395 in 1974, n = 542 in 1995) to assess participation in leisure-time sports activity, attitudes towards sports activities and attitudes towards physical education at school. Height and weight were measured and body mass index (BMI) was calculated. RESULTS: Compared with 1974, more subjects in 1995 answered that they were engaged in leisure-time sports activities, and that they were members of sports clubs. BMI increased from 1974 to 1995. By 1995, adolescents participated in and had become more interested in individual sports activities, including keep-fit activities (e.g. strength training and aerobics) compared with 1974. A gender difference in the feeling of anxiety towards physical education, with more girls experiencing it, appeared in 1995, but not in 1974. CONCLUSION: Although more adolescents participated in leisure-time sports activity in 1995 than in 1974, the lifestyle of adolescents between sports training sessions may have become more sedentary. This is negative in a health perspective, since the benefits of physical activity on health are largely correlated to the total energy expenditure. However, the increased interest in keep-fit activities is important, since these activities have the potential to be continued into adulthood.

Adolescent↗

PubMed2004

Health contract with sedentary older adults.

PURPOSE: Health educators used health contracts with sedentary older adults for the purpose of increasing exercise or physical activity. DESIGN AND METHODS: Two health educators helped 25 sedentary older adults complete health contracts, and then they conducted follow-up evaluations. The percentage of scheduled exercise sessions successfully completed by older adults was calculated. Participants were asked if each of five components of the health contract-motivation, goal setting, social support, memory techniques, and problem solving-was helpful in achieving their exercise goals. RESULTS: Of the 25 participants, 20 achieved at least 75% of their exercise goals and 15 had a 100% success rate. Most of the older adults reported that several behavioral, social, and cognitive strategies were helpful to them. IMPLICATIONS: This technique may be applied by health educators or clinicians in a variety of settings and can be focused on one of several potential risk factors.

Aged↗

PubMed2000

A review of correlates of physical activity of children and adolescents.

BACKGROUND: Understanding the factors that influence physical activity can aid the design of more effective interventions. Previous reviews of correlates of youth physical activity have produced conflicting results. METHODS: A comprehensive review of correlates of physical activity was conducted, and semiquantitative results were summarized separately for children (ages 3-12) and adolescents (ages 13-18). The 108 studies evaluated 40 variables for children and 48 variables for adolescents. RESULTS: About 60% of all reported associations with physical activity were statistically significant. Variables that were consistently associated with children's physical activity were sex (male), parental overweight status, physical activity preferences, intention to be active, perceived barriers (inverse), previous physical activity, healthy diet, program/facility access, and time spent outdoors. Variables that were consistently associated with adolescents' physical activity were sex (male), ethnicity (white), age (inverse), perceived activity competence, intentions, depression (inverse), previous physical activity, community sports, sensation seeking, sedentary after school and on weekends (inverse), parent support, support from others, sibling physical activity, direct help from parents, and opportunities to exercise. CONCLUSION: These consistently related variables should be confirmed in prospective studies, and interventions to improve the modifiable variables should be developed and evaluated.

Adolescent↗

PubMed2004

[Health among the elderly].

We explore gender, class and geographical inequalities in health of the population aged over 65 years in Spain. We gathered data from the 1997 National Health Survey, 1999 hospital discharge data, 1998 mortality data from vital statistics, and from the 1999 National Survey on Disabilities. Health related behaviors (tobacco and alcohol consumption, eating disorders and physical activity), self-rated health, chronic health problems, functional capacity, and health service utilization are described by gender and social class. Mortality rates among the elderly are compared between the 52 Spanish provinces. Women and members of the lower social classes present worse levels of self-rated health. Tobacco and alcohol consumption are more frequent among men than among women. Physical activity appears correlated to the every-day activities, men and those in the higher classes adopt sedentary habits in a greater proportion. Functional dependency is more frequent among women than among men, showing a clear pattern of inequality. As in other studies, the highest mortality rates were located in the southern part of Spain.

Age Factors↗

PubMed1999

Seeing better at night: life style, eye design and the optimum strategy of spatial and temporal summation.

Animals which need to see well at night generally have eyes with wide pupils. This optical strategy to improve photon capture may be improved neurally by summing the outputs of neighbouring visual channels (spatial summation) or by increasing the length of time a sample of photons is counted by the eye (temporal summation). These summation strategies only come at the cost of spatial and temporal resolution. A simple analytical model is developed to investigate whether the improved photon catch afforded by summation really improves vision in dim light, or whether the losses in resolution actually make vision worse. The model, developed for both vertebrate camera eyes and arthropod compound eyes, calculates the finest spatial detail perceivable by a given eye design at a specified light intensity and image velocity. Visual performance is calculated for the apposition compound eye of the locust, the superposition compound eye of the dung beetle and the camera eye of the nocturnal toad. The results reveal that spatial and temporal summation is extremely beneficial to vision in dim light, especially in small eyes (e.g. compound eyes), which have a restricted ability to collect photons optically. The model predicts that using optimum spatiotemporal summation the locust can extend its vision to light intensities more than 100,000 times dimmer than if it relied on its optics alone. The relative amounts of spatial and temporal summation predicted to be optimal in dim light depend on the image velocity. Animals which are sedentary and rely on seeing small, slow images (such as the toad) are predicted to rely more on temporal summation and less on spatial summation. The opposite strategy is predicted for animals which need to see large, fast images. The predictions of the model agree very well with the known visual behaviours of nocturnal animals.

Animals↗