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Obesity among children attending elementary public schools in São Paulo, Brazil: a case--control study.

OBJECTIVES: To describe obesity among students of public schools in São Paulo and to identify risk factors for this nutritional and physical activity disorder. DESIGN: Case-control study of obese and non-obese schoolchildren to study risk factors for obesity. SETTING: Anthropometric survey including 2519 children attending eight elementary public schools in São Paulo, Brazil. SUBJECTS: Schoolchildren aged 7-10 years, of whom 223 were obese (cases; weight-for-height greater than or equal to two standard deviations (>or=2SD) above the median of the National Center for Health Statistics (NCHS) reference population) and 223 were eutrophic (controls; weight-for-height +/-1SD from NCHS median). MEASUREMENTS: Parents or guardians of the 446 cases and controls were interviewed about the children's eating behaviours and habits. RESULTS: The prevalence of obesity (weight-for-height >or=2SD) in the surveyed population was 10.5%. A logistic regression model fitted to the case-control dataset showed that obesity was positively associated with the following factors: birth weight >or=3500 g (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.21-2.78), child's appetite at meals (OR 3.81, 95% CI 2.49-5.83), watching television for 4 h per day or longer (OR 2.07, 95% CI 1.32-3.24), mother's schooling >4 years (OR 1.85, 95% CI 1.25-2.75) and parents' body mass index >or=30 kg x m(-2) (OR 2.50, 95% CI 1.43-4.37). CONCLUSIONS: The explanatory multivariate model points to preventive measures that would encourage knowledge of the children and their guardians in relation to a balanced diet and a less sedentary lifestyle, such as reducing television viewing. Schoolchildren with a birth weight of 3500 g or more or whose parents are obese should receive special attention in the prevention of obesity.

Anthropometry↗

Sedentary older women's limited experience with exercise.

The aim of this study was to examine sedentary older women's experiences with exercise. Interview-administered questionnaires and physical measures assessed exercise history variables, health-related quality of life, functional status, depression, perceived vigor, adiposity, and body mass index. Women aged 65 to 97 years (N = 198) participated in the study. Most women reported at least 1 experience with episodic exercise but only 27% had experience with 2 forms of exercise and just 7% had experience with 3 exercise types. Many women began regular continuous exercise during their 5th, 6th, or 7th decades, but stopped exercising after a few years. Correlations between past exercise and potential health outcomes were very modest. These sedentary elderly women had very limited repertoires of experience with episodic exercise. Interventions designed to help women in their 50s, 60s, and 70s maintain the exercise programs may prove particularly valuable.

Aged↗

Modest exercise prevents the progressive disease associated with physical inactivity.

Activity levels continue to decline as technology continues to engineer movement out of our environment. We summarize the findings from Studies Targeting Risk Reduction Interventions through Defined Exercise (STRRIDE) emphasizing the high cost of even short-term continued inactivity in sedentary, overweight, or mildly obese individuals. There seems to be a critical minimal level of physical activity required to maintain metabolic health. A modest amount of exercise seems to prevent metabolic deterioration.

Cardiovascular Diseases↗

A comparison of the behavioural and emotional characteristics of Alzheimer's dementia in individuals with and without Down syndrome.

The behavioural and emotional changes associated with Alzheimer's disease (AD) are compared for individuals with Down syndrome and AD and individuals with AD from the general population (AD-only). The primary caregivers of 30 people with Down syndrome and AD and 30 people with AD-only completed the BEHAVE-AD and the Apathy subscale of the CERAD. As well, behavioural observations at adult day programs were undertaken with selected participants (n = 26). The Down syndrome group experienced fewer delusions and had lower total scores on the BEHAVE-AD, indicating fewer problem behaviours overall. Day program observations suggested that the AD-only group were more likely to be sedentary and observe the activities of others, while the Down syndrome group were more physically active. Improving our understanding of the similarities and differences between these two groups may help facilitate the integration of individuals with Down syndrome into adult day programs for the general population.

Adult↗

[Urolithiasis among flight personnel (author's transl)].

Urinary calculosis is, according to the different medical statistics, one of the most common diseases among flight personnel. The causes which favour urolithiasis are reviewed in relation with the flight factors themselves and the type of life which these professionals lead. Diet, low intake of fluids, and the loss of water through the skin and lungs, are together with the sedentary nature of the work the most obvious causes as etiological factors. The risks which this pathology supposes for flight personnel and their suitability for flight under these conditions are studied. Likewise, the measures which should be established to prevent this anomaly as far as possible are reviewed.

Adult↗

Ergometer within a whole-body plethysmograph to evaluate performance of guinea pigs under toxic atmospheres.

A guinea pig ergometer was constructed within an enclosure, with inlet and outlet ports for continuous ventilation, designed so that the enclosure would work as a whole-body plethysmograph as well as an inhalation exposure chamber. This system provided continuous measurement of tidal volume, respiratory frequency, oxygen uptake, and carbon dioxide output which enabled an evaluation of performance in terms of distance traveled over time with the animals running at a known speed and constant oxygen uptake. The effects of CO or HCl in running versus sedentary animals were investigated using this apparatus. For CO, exercise increased the rapidity of the onset of incapacitation as would be predicted by the increase in metabolic rate. HCl produced a more severe incapacitating effect in exercising animals that was out of proportion with the increase in minute volume induced by exercise.

Air Pollutants↗

Predictors of weight change in men: results from the Health Professionals Follow-up Study.

OBJECTIVE: Since the prevalence of adult obesity is increasing in the United States, we examined the effect of changing common habits (exercise, TV viewing, smoking and eating habits) on four year change in body weight. DESIGN: A prospective cohort study of US male health professionals with follow-up from 1988-1992. Participants were 19478 men aged 40-75 in 1986, who were free of cancer, coronary heart disease, stroke and diabetes. METHODS: Multiple regression was used to determine the association between four year change in body weight (from 1988-1992) and common habits, after adjusting for baseline age, hypertension and hypercholesterolemia. RESULTS: For middle aged men, vigorous activity was associated with weight reduction and TV/VCR viewing and eating between meals with weight gain. Quitting smoking and a history of voluntary weight loss prior to the study period were consistently related to weight increase. Recently being on a diet was more strongly associated with weight loss among older men. Over the four year follow-up period, middle-aged men who increased their exercise, decreased TV viewing and stopped eating between meals, lost an average weight of -1.4 kg (95% confidence interval (CI) -1.6 - -1.1 kg), compared to a weight gain of 1.4 kg among the overall population. The prevalence of obesity among middle-aged men was lowest among those who maintained a relatively high level of vigorous physical activity, compared to those who were relatively sedentary. CONCLUSION: These data suggest that improvement in the mix of health habits, particularly increasing vigorous activity, as well as decreasing TV use and changing eating habits, results in weight maintenance or a modest weight loss over four years.

Adult↗

Exercise affects energy metabolism and neural plasticity-related proteins in the hippocampus as revealed by proteomic analysis.

Studies were conducted to evaluate the effect of a brief voluntary exercise period on the expression pattern and post-translational modification of multiple protein classes in the rat hippocampus using proteomics. An analysis of 80 protein spots of relative high abundance on two-dimensional gels revealed that approximately 90% of the proteins identified were associated with energy metabolism and synaptic plasticity. Exercise up-regulated proteins involved in four aspects of energy metabolism, i.e. glycolysis, ATP synthesis, ATP transduction and glutamate turnover. Specifically, we found increases in fructose-bisphosphate aldolase C, phosphoglycerate kinase 1, mitochondrial ATP synthase, ubiquitous mitochondrial creatine kinase and glutamate dehydrogenase 1. Exercise also up-regulated specific synaptic-plasticity-related proteins, the cytoskeletal protein alpha-internexin and molecular chaperones (chaperonin-containing TCP-1, neuronal protein 22, heat shock 60-kDa protein 1 and heat shock protein 8). Western blot was used to confirm the direction and magnitude of change in ubiquitous mitochondrial creatine kinase, an enzyme essential for transducing mitochondrial-derived ATP to sites of high-energy demand such as the synapse. Protein phosphorylation visualized by Pro-Q Diamond fluorescent staining showed that neurofilament light polypeptide, glial fibrillary acidic protein, heat shock protein 8 and transcriptional activator protein pur-alpha were more intensely phosphorylated with exercise as compared with sedentary control levels. Our results, together with the fact that most of the proteins that we found to be up-regulated have been implicated in cognitive function, support a mechanism by which exercise uses processes of energy metabolism and synaptic plasticity to promote brain health.

Animals↗

Primary prevention of acute coronary events through the adoption of a Mediterranean-style diet.

We evaluated the role of a Mediterranean-style diet in preventing acute coronary syndromes (ACS). Data from CARDIO2000, a multi-centre retrospective case-control study investigating the association between ACS and demographic, nutritional, lifestyle and medical risk factors were used. We studied 661 patients hospitalized for a first ACS event and 661 matched controls without clinical suspicion of cardiovascular disease. The Mediterranean diet significantly reduced (by 16%) the risk of developing ACS. The association remained significant in the presence of hypertension, hypercholesterolaemia, sedentary lifestyle, diabetes mellitus or a combination of two of these cardiovascular risk factors. Our findings illustrate the importance of the Mediterranean diet in the primary prevention of acute coronary events.

Acute Disease↗

Approach to treatment of the patient with metabolic syndrome: lifestyle therapy.

The National Cholesterol Education Program's Adult Treatment Panel III definition of the metabolic syndrome identifies those at high risk for diabetes mellitus and/or a cardiac event by clustering a number of easily measured clinical findings, including abdominal obesity, elevated plasma levels of triglycerides, low plasma levels of high-density lipoprotein cholesterol, elevated fasting blood glucose, and elevated blood pressure. The presence of > or = 3 of these 5 risk factors justifies a diagnosis of the metabolic syndrome. This article focuses on root causes of the syndrome (atherogenic diet, sedentary lifestyle, and overweight/obesity) and highlights recent studies that demonstrate the effectiveness of therapeutic lifestyle changes in improving or preventing the components of the metabolic syndrome. We offer a practical approach with a focus that embraces not only patients, but also physicians and healthcare professionals as well as the larger healthcare system.

Diet, Atherogenic↗

Child overweight in France and its relationship with physical activity, sedentary behaviour and socioeconomic status.

OBJECTIVE: (1) To assess the prevalence of childhood overweight (OW) and obesity in France; (2) to examine how physical activity and sedentary behaviour are involved in the association between socioeconomic status (SES) and OW, while taking into account total energy intake. DESIGN AND SUBJECTS: Representative sample of French children aged 3-14 years (n=1016) taken from the 1998-1999 cross-sectional French INCA (Enquête Individuelle et Nationale sur les Consommations Alimentaires) food consumption survey. MEASUREMENTS: Weight and height, leisure-time physical activity (LTPA), sedentary behaviour (TV viewing and video-game use), and SES were reported by parents or children by answering questionnaires; total energy intake was assessed using a 7-day food record. RESULTS: In total, 15.2% (95% CI: 13.0-17.6) of the children are OW (including obese), according to the IOTF (International Obesity Task Force) definition. OW is inversely associated with SES in children over 6 years of age. LTPA is negatively correlated to OW among the 3 to 5-year-old children only, whereas sedentary behaviour is positively related to OW in childhood and adolescence. From 6 years old on, SES is inversely associated with sedentary behaviour, which consequently may partly mediate the relationship between SES and OW. CONCLUSION: This study confirms the association between SES, sedentary behaviour and childhood OW in France. It was performed before the launching of the French Program of Nutrition and Health (PNNS) in 2001 and will be repeated in 2006. This will contribute to monitoring both childhood OW and its main determinants at the population scale.

Adolescent↗

Epidemiological measures of participation in community health promotion projects.

BACKGROUND: The paper is concerned with the use of epidemiological methods to measure the rates at which different strata of a defined population participate in community health promotion projects. The specific aim was to estimate the incidence rates of participation in projects sponsored by the Western Australian Health Promotion Foundation (Healthway), separately for sociodemographic and health-related behavioural subgroups. METHODS: Data were drawn from Healthway sponsorship projects in 1992. Each sport, arts and racing project was associated with promotion of a health message and creation of a health promoting environment. The study used a two-stage sampling design. Thirteen of 57 large sponsorship projects and 30 of 129 small projects were selected. In the second stage, respondents were randomly surveyed from among project participants. A total of 4060 respondents aged > or = 10 years was sampled from the 43 selected projects. Population-based incident participants were estimated and were related to person-years at risk. RESULTS: The total participation rate was 4.01 per person-year. The rate was very high at ages 10-14 years and thereafter declined with increasing age. Compared with the least socially disadvantaged 25% of population, the participation rate fell by around one-third in the medium and high disadvantage groups, but exceeded the baseline by a ratio of 1.85 (95% confidence interval: 1.57-2.18) in the most disadvantaged 10% of population. The effect was most pronounced at ages 10-19 years. Participation was higher in those who smoked, drank alcohol unsafely, reported sunburn and reported low consumption of fruit and vegetables. However, participation was reduced in people who were sedentary. CONCLUSIONS: Epidemiological methods can be used to evaluate the distribution of participation of a population in community health promotion projects. The Western Australian Health Promotion Foundation has been successful in reaching disadvantaged youth.

Adolescent↗

Perceptions of neighborhood characteristics and leisure-time physical inactivity--Austin/Travis County, Texas, 2004.

Regular physical activity improves quality of life and reduces risk for coronary heart disease, colon cancer, hypertension, diabetes, and overall mortality. Physical activity also has been associated with reduced symptoms of depression and greater independence. A sedentary lifestyle is associated with obesity. However, despite the health benefits of physical activity, 23.1% of adults in the United States report they do not engage in any leisure-time physical activity. Neighborhood environment (e.g., sidewalks and street lighting), perceived trustworthiness of neighbors, and perceptions of neighborhood safety all have been associated with levels of physical activity. During 2004, to assess the association between these factors and leisure-time physical inactivity in eastern Travis County, Texas, the local health department collected and analyzed data by using the methodology of the Behavioral Risk Factor Surveillance System (BRFSS). This report describes the results of that analysis, which indicated that persons who perceived their neighborhoods as less than extremely safe were more than twice as likely to have no leisure-time physical activity, and those who perceived their neighborhoods as not at all safe were nearly three times as likely to have no leisure-time physical activity. Public health agencies promoting physical activity in neighborhoods should consider how residents perceive their safety and design programs that specifically address those safety concerns.

Adult↗

Multiple exposure to activity anorexia in rats: effects on eating, weight loss, and wheel running.

Animals were given five cycles of an activity anorexia (AA) procedure in order to determine the effect of additional experience on eating, running, and weight loss. Female Sprague-Dawley rats were given a 1h meal and allowed access to a running wheel for the remainder of each day. Upon reaching 75% of free-feeding body weight, each animal was denied wheel access and given ad libitum food until it regained the lost weight. Then, food was again restricted and wheel access provided. Sedentary control animals were placed on the restricted feeding schedule for the median number of days experimental animals required to reach weight loss criterion. Experimental animals showed adaptation by increasing food consumption and decreasing the rate of weight loss despite an increase in running across cycles. Additionally, the distribution of running shifted gradually so that during the later cycles, much of the running occurred in the hours just before feeding. The results support the hypothesis that running interferes with adaptation to the restricted feeding schedule and also that the marked increase in anticipatory behavior during the later cycles is primarily responsible for the maintenance of AA.

Journal Article↗

[Sedentarity--sedentary lifestyle and physical activity].

Physical inactivity is the most important planetary reason for non-transmissible mortality. Technical developments have allowed a sedentary lifestyle. This causes health problems such as insulin resistance, atherosclerosis, heart failure and obesity. In addition, disturbances of bones and muscles as well as dementia of the Alzheimer type are associated with sedentarity. Assessing this risk factor and attempting to increase physical activity should be a very important part of any general practitioner's measures.

Cardiovascular Diseases↗

Gender, age, socio-demographic and lifestyle factors associated with major dietary patterns in the Spanish Project SUN (Seguimiento Universidad de Navarra).

OBJECTIVE: To ascertain the major dietary patterns in the cohort 'SUN' and to assess the association of several sociodemographic (including age and gender) and lifestyle variables with the adherence to these dietary patterns. DESIGN: This study is a cross-sectional analysis of 3847 subjects (1587 men and 2260 women) belonging to a prospective cohort study based on self-reported questionnaires. A factor analysis based on 30 predefined food groups was conducted to ascertain the major dietary patterns in the cohort. Multiple regression models were fitted to assess the relationship between several sociodemographic and lifestyle variables and the adherence to these dietary patterns (measured using two scores with observed values ranging from -3.2 to +4.6 for the Western pattern and -3.1 to +5.5 for the Mediterranean pattern). RESULTS: Two major dietary patterns were found. The first pattern was labelled as a 'Western' dietary pattern and the other as a 'Spanish-Mediterranean' dietary pattern. Younger subjects were more likely to follow a 'Western' dietary pattern; the coefficient representing the change for every 10 y increase in age was b=-0.24 (P<0.001) for men and b=-0.12 (P<0.001) for women. More physically active subjects were less likely to follow a 'Western' dietary pattern and more likely to follow a 'Spanish-Mediterranean' dietary pattern. CONCLUSIONS: An association between a higher level of physical activity during leisure time and adherence to a 'Spanish-Mediterranean' diet was apparent. However, the profile of being a young, sedentary and single male was identified as the most likely to exhibit a departure from the traditional 'Spanish-Mediterranean' diet and follow a 'Western' dietary pattern.

Adult↗

Effects of usual nutrient intake and vitamin D status on markers of bone turnover in Swiss adolescents.

OBJECTIVE: To evaluate the effects of nutrient intake and vitamin D status on markers of type I collagen formation and degradation in adolescent boys and girls. DESIGN: Cross-sectional study. SETTING: Canton of Vaud, West Switzerland. SUBJECTS: A total of 92 boys and 104 girls, aged 11-16 y. Data were collected on height, weight, pubertal status (self-assessment of Tanner stage), nutrient intake (3-day dietary record) and fasting serum concentration of 25-hydroxyvitamin D (25OHD), and markers of collagen formation (P1NP) and degradation (serum C-terminal telopeptides: S-CTX). RESULTS: Tanner stage was a significant determinant of P1NP in boys and girls and S-CTX in girls. Of the nutrients examined, only the ratio of calcium to phosphorus (Ca/P) was positively associated with P1NP in boys, after adjustment for pubertal status. 25OHD decreased significantly at each Tanner stage in boys. Overall, 15% of boys and 17% of girls were identified as being vitamin D insufficient (serum 25OHD <30 nmol/l), with the highest proportion of insufficiency at Tanner stage 4-5 (29%) in boys and at Tanner stage 3 (24%) in girls. A significant association was not found between 25OHD and either bone turnover marker, nor was 25OHD insufficiency associated with higher concentrations of the bone turnover markers. CONCLUSIONS: The marked effects of puberty on bone metabolism may have obscured any possible effects of diet and vitamin D status on markers of bone metabolism. The mechanistic basis for the positive association between dietary Ca/P ratio and P1NP in boys is not clear and may be attributable to a higher Ca intake per se, a critical balance between Ca and P intake or higher dairy product consumption. A higher incidence of vitamin D insufficiency in older adolescents may reflect a more sedentary lifestyle or increased utilisation of 25OHD, and suggests that further research is needed to define their requirements. SPONSORSHIP: Nestec Ltd and The Swiss Foundation for Research in Osteoporosis.

Adolescent↗

Medical implications of obesity. Losing pounds, gaining years.

Through thousands of years of starvation and poor nutrition, the human body has become adept at storing scarce nutrients. Today, in the United States and Canada particularly, the combination of sedentary habits and excessive intake of calories is imposing a dual burden on a physiologic system that is ill-equipped to handle it. Unable to rid itself of calories, the body's only defense is to store them all. The end result is obesity, with all its deleterious effects on health and longevity.

Appetite Depressants↗