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PubMed2006

A comparison of health behaviours in lonely and non-lonely populations.

Loneliness can be defined as perceived social isolation and appears to be a relatively common experience in adults. It carries a significant health risk and has been associated with heart disease, depression and poor recovery after coronary heart surgery. The mechanisms that link loneliness and morbidity are unclear but one of the mechanisms may be through poor health beliefs and behaviours. The aims of this cross-sectional survey of 1289 adults were to investigate differences in health behaviours (smoking, overweight, BMI, sedentary, attitudes towards physical activity) in lonely and non-lonely groups. Lonely individuals were more likely to be smokers and more likely to be overweight - obese. The lonely group had higher body mass index scores controlling for age, annual income, gender, employment and marital status. Logistic regression revealed no differences in sedentary lifestyles. Lonely individuals were significantly less likely to believe it was desirable for them to lose weight by walking for recreation, leisure or transportation. The findings provide support for an association between health behaviours, loneliness and excess morbidity reported in previous studies.

Adult↗
PubMed1995

Decline in maximal oxygen uptake on work performance in rats during the developmental phase.

Development-related changes in maximal oxygen uptake (VO2max) and work performance were examined in young sedentary rats 4-11 weeks after birth during exercise. The running speed to elicit VO2max increased from 4 to 8 weeks of age, whereas the exercise VO2max declined progressively. Therefore, the work performance during the developmental phase, when rapid growth occurs, seems to be little related to the decline in the relative VO2 max.

Aging↗
PubMed2005

Approaches to increase physical activity: reviewing the evidence for exercise-referral schemes.

OBJECTIVE: To review current evidence of effectiveness for exercise-referral schemes. METHODS: Studies were identified from MEDLINE 1966-2002, EMBASE 1980-2002 and CINHAL 1982-2002 and bibliographies of relevant papers. INCLUSION CRITERIA: Interventions providing access to exercise activities and/or facilities, experimental or quasi-experimental studies, studies with a control group, interventions based in a primary care setting, and interventions including an exercise component with measures of physical activity levels. CONCLUSIONS: Exercise-referral schemes appear to increase physical activity levels in certain populations, namely individuals who are not sedentary but already slightly active, older adults and those who are overweight (but not obese). However, increases in the level of physical activity may not be sustained over time. Further studies are required to assess effectiveness in a range of populations and for different activities, and to find strategies to increase long-term adherence.

Evidence-Based Medicine↗
PubMed2004

Exercise training during rehabilitation of patients with COPD: a current perspective.

Patients with chronic obstructive pulmonary disease (COPD) suffer frequently from physiologic and psychological impairments, such as dyspnea, peripheral muscle weakness, exercise intolerance, decreased health-related quality of life (HRQOL) and emotional distress. Rehabilitation programmes have shown to result in significant changes in perceived dyspnea and fatigue, utilisation of healthcare resources, exercise performance and HRQOL. Exercise training, which consists of whole-body exercise training and local resistance training, is the cornerstone of these programmes. Regrettably, the positive effects of respiratory rehabilitation deteriorate over time, especially after short programmes. Hence, attention should be given to the aftercare of these patients to prevent them to revert again to a sedentary lifestyle. On empirical basis three possibilities seem to be clinically feasible: (1) continuous outpatient exercise training; (2) exercise training in a home-based or community-based setting; or (3) exercise training sessions in a group of asthma and COPD patients.

Aftercare↗
PubMed2004

The public health usefulness of the exercise recreation and sport survey (ERASS) surveillance system.

BACKGROUND: There is a public health need to monitor habitual participation in physical activity (PA). This report evaluates the usefulness of routine sport and recreation sector collected 'Exercise Recreation and Sport Survey (ERASS)' data from a public health perspective. METHODS: The ERASS telephone surveys collected information about participation in any PA undertaken for exercise, recreation or sport and the frequency of participation during the previous 12 months from a random sample of 3,400 Australians (aged > or = 15) each quarter. Activities were categorised as Health Enhancing Physical Activities (HEPA) if the activity was of sufficient intensity (METs > or = 3.5). 'Sufficiently active' people reported HEPA > or = 5 days/week and the sedentary group reported HEPA < 0.5 day/week. The total person-days of PA were calculated and main PA types that contributed to HEPA were highlighted. RESULTS: In 2001, walking accounted for 58% of all HEPA person-days. For females walking (66%), swimming (5.7%) and gym (4.7%) combined accounted for 75% of HEPA days while for males, walking (50%), cycling (8.1%), football (6.2%), jegging (5.6%) and swimming (4.5%) were main contributors. The mean days walked was 2.20 days/week (95% CI; 2.16-2.25) while all other HEPA combined totalled 1.56 days/week (95% CI; 1.52-1.60). Over 12-month period 15.8% of Australians were defined as sedentary and 31% were 'sufficiently active' including 16.8% who reported frequent walking (> or = 5 days/week). CONCLUSION: ERASS could supplement informational gaps in current PA surveillance. It provides estimates of long-term PA behavioural habits and informs policy makers about the types of activities that contribute to population health.

Adolescent↗
PubMed2006

Assessing preschool children's physical activity: the Observational System for Recording Physical Activity in children-preschool version.

In this paper we present initial information concerning a new direct observation system-the Observational System for Recording Physical Activity in Children-Preschool Version. The system will allow researchers to record young children's physical activity levels while also coding the topography of their physical activity, as well as detailed indoor and outdoor social and nonsocial contextual information. With respect to interobserver agreement (IOA), the kappa and category-by-category agreement mean of those obtained for the three illustrative preschools were generally above .80. Hence, our IOA data indicated that trained observers in the three preschools frequently agreed on the eight observational categories and accompanying codes. The results for preschoolers' level of physical activity indicated they spent the majority of observational intervals in sedentary activity (i.e., more than 80% intervals) and were observed in moderate to vigorous physical activity much less frequently (i.e., 5% or fewer intervals). For the 15 indoor and 12 outdoor activity contexts, variability across both the activity contexts and the three preschools were evident. Nevertheless, three classroom contexts-transition, snacks, and naptime--accounted for the greatest porportion of coded activity contexts for the children. In the three preschools, 4 of 17 physical activity types--sit and squat, lie down, stand, and walk--accounted for the topography of much of children's physical activity behavior Systematic observation of more representative preschool samples might better inform our present understanding of young children's physical activity in community preschool programs.

Child, Preschool↗
PubMed2006

Health behaviors in breast cancer survivors experiencing bone loss.

PURPOSE: To describe the baseline healthy lifestyle behaviors (dietary, calcium, vitamin D, caffeine and alcohol intake, smoking history, and physical activity) of postmenopausal breast cancer survivors (BCS); and to identify any relationship of healthy lifestyle behaviors with bone mineral density (BMD) at the forearm, total hip and spine, L1-L4. DATA SOURCES: Self-reported responses to a demographic and health status questionnaire, to a 3-day Diet Record, and to the 7-Day Physical Activity Questionnaire-Adapted provided data for the lifestyle behaviors. Baseline BMD (g/cm(2)) was determined with dual-energy x-ray absorptiometry (DEXA). Height, weight, and body mass index (BMI) were also measured in each of the 249 postmenopausal BCS. CONCLUSIONS: There was an imbalance between consumed kilocalories and expenditure of energy. The majority of BCS were overweight or obese. They consumed less fruit and vegetable servings than recommended by the new 2005 U.S. Department of Agriculture's dietary guidelines, less dairy products, below average recommended grains and fiber, less protein and carbohydrate intake, and a slightly higher fat gram intake. Approximately, 43% did not take any supplemental calcium, with 46% taking less than 1000 mg a day. Likewise, 52.59% consumed less than 400 IU of vitamin D with both supplemental and dietary intake. This group of BCS consumed below accepted levels of caffeine and alcohol. Only 18 BCS continued to smoke. This group spent an average of 10.36 h in light (sedentary) activities on a daily basis. There were significant negative relationships with bone mass (g/cm(2)) at the total hip and daily intake of caffeine/mg and daily grams of alcohol. Weight and BMI both demonstrated a significant relationship with bone mass (g/cm(2)) at the total hip, spine L1-L4, and the forearm. IMPLICATIONS FOR PRACTICE: The healthcare provider must incorporate appropriate teaching strategies, intensive counseling, and coaching, along with a support mechanism, to enable BCS to understand the importance of a healthy diet, calcium, and vitamin D supplement, and a regular strength/weight program that will be integrated into their daily lifestyle. Early DEXA screens should be part of the protocol with BCS, and there is a particular need for forearm DEXA screens to be included in the treatment protocol for BCS.

Absorptiometry, Photon↗
PubMed2005

Childhood obesity. Treatment options.

The prevalence of child and adolescent overweight and obesity is rapidly increasing and is associated with morbidity, both medical and psychosocial. Obesity is unlikely to resolve spontaneously. It is important that health professionals can assess obesity and initiate an action plan. The evidence base for what works best in the management of child and adolescent overweight and obesity is limited. It is uncertain whether protocols from clinical research trials can be translated into primary care. Dietary change, with an emphasis on lower fat intake and smaller portion size, should be commenced. There should be an increase in physical activity and a decrease in sedentary behaviours, combined with behavioural change and parental involvement. These are the elements of a lifestyle intervention. In the severely obese adolescent with obesity-related co-morbidity, the use of very low-energy diets and anti-obesity agents could be considered. Bariatric surgery may be indicated in carefully selected, older, severely obese adolescents.

Adolescent↗
PubMed2006

Promoting physical activity and exercise in older adults.

Although the benefits of increased physical activity and exercise are universally recognized, many older persons remain sedentary, and relatively few achieve recommended levels of activity. Effective interventions to reverse the lack of physical activity in older adults are clearly needed. By understanding correlates of inactivity and appreciating those factors that contribute to a sedentary lifestyle, appropriate strategies can be employed to help order patients reap the benefits of increased physical activity and exercise. In this article, we offer to the reader a brief overview of the field as well as our own thoughts on how clinicians might help individual patients at a more practical level.

Aged↗
PubMed2006

Physical activity, diet and gene-environment interactions in relation to body mass index and waist circumference: the Swedish young male twins study.

OBJECTIVE: The aim of the present study was to examine the relationships between genetic susceptibility to obesity, physical activity (PA), dietary fibre, sugar and fat intakes and 4-year changes in body mass index (BMI) and attained waist circumference (WC) in a cohort of 287 monozygotic and 189 dizygotic young adult male twin pairs. Increased knowledge about interactions between genes and environment may provide insight into why some individuals are more prone to obesity than others. DESIGN: Information about PA, BMI, dietary habits, WC and potential confounders was collected by questionnaire in 1998 and 2002. The cohort data were analysed by mixed linear models. RESULTS: Twins with low PA attained larger WC than twins with high PA (difference 2.5 cm; 95% confidence interval (CI) 1.3, 3.6). The twins with the lowest fibre intake were found to have attained the highest WC and to have increased most in BMI (difference between highest and lowest fibre intakes: 1.6 cm, 95% CI 0.4, 2.9 and 0.45 kg m(-2), 95% CI 0.15, 0.76, respectively). Furthermore, our results suggested the presence of interactions so that twins with genetic susceptibility to obesity were more prone to have larger WC if sedentary than twins without genetic susceptibility. CONCLUSION: PA and a diet rich in fibre may be protective against weight gain among younger adult men. An interaction between PA, genes and attained WC is a novel finding which needs confirmation by other studies.

Adult↗
PubMed2006

Weekly changes in basal metabolic rate with eight weeks of overfeeding.

OBJECTIVE: The contribution of basal metabolic rate (BMR) to weight gain susceptibility has long been debated. We wanted to examine whether BMR changes in a linear fashion with overfeeding. Our hypothesis was that BMR does not increase linearly with 1000-kcal/d overfeeding in lean healthy subjects over 8 weeks. The null hypothesis states that BMR increases linearly with 1000-kcal/d overfeeding in lean healthy subjects. RESEARCH METHODS AND PROCEDURES: Initially, 16 lean healthy sedentary subjects completed 2 weeks of weight maintenance feeding at the General Clinical Research Center. The subjects were then overfed by 1000 kcal/d over 8 weeks. BMR was measured under standard conditions each week using indirect calorimetry. RESULTS: Baseline BMR was 1693 +/- 154.5 kcal/d. BMR increased from 1711 +/- 201.3 kcal/d at week 1 of overfeeding to 1781 +/- 171.65 kcal/d at the second week of overfeeding (p = 0.05). BMR fell during the third week of overfeeding to 1729 +/- 179.5 kcal/d (p = 0.05). After 5 weeks of overfeeding, BMR reached a plateau. Thereafter, there was no further change. Comparison of BMR with weeks of overfeeding was significantly different compared with the linear model (p < 0.05). DISCUSSION: Increases in BMR in lean sedentary healthy subjects with 1000-kcal/d overfeeding are not linear over 8 weeks. There seems to be a short-term increase in BMR in the first 2 weeks of overfeeding that is not representative of longer-term changes.

Adiposity↗
PubMedDate not supplied

Focus on insulin resistance in type 2 diabetes: therapeutic implications.

Type 2 diabetes is extremely common and increasing in the United States. The pathophysiology of type 2 diabetes is a combination of increased insulin resistance and inadequate secretion. The main risk factors for diabetes are family history, obesity, sedentary lifestyle, ethnic background, age, and a history of gestational diabetes. Diet and exercise, the cornerstones of diabetes management, will improve insulin sensitivity and indirectly augment insulin secretion. Until recently, the only pharmacological approaches to diabetes were sulfonylureas and insulin, which either augment insulin secretion or replace insulin, thus acting only on the insulin side of the equation. Recently, a series of new drugs have become available that are capable of decreasing hepatic glucose output (metformin), slowing postprandial glucose absorption (acarbose), and improving peripheral insulin sensitivity (troglitazone). With these drugs, either alone or in combination, and behavioral therapies, it is now feasible to achieve good to outstanding glycemic control in most individuals with type 2 diabetes.

Combined Modality Therapy↗
PubMed2000

Effects of voluntary activity and genetic selection on muscle metabolic capacities in house mice Mus domesticus.

Selective breeding is an important tool in behavioral genetics and evolutionary physiology, but it has rarely been applied to the study of exercise physiology. We are using artificial selection for increased wheel-running behavior to study the correlated evolution of locomotor activity and physiological determinants of exercise capacity in house mice. We studied enzyme activities and their response to voluntary wheel running in mixed hindlimb muscles of mice from generation 14, at which time individuals from selected lines ran more than twice as many revolutions per day as those from control (unselected) lines. Beginning at weaning and for 8 wk, we housed mice from each of four replicate selected lines and four replicate control lines with access to wheels that were free to rotate (wheel-access group) or locked (sedentary group). Among sedentary animals, mice from selected lines did not exhibit a general increase in aerobic capacities: no mitochondrial [except pyruvate dehydrogenase (PDH)] or glycolytic enzyme activity was significantly (P < 0.05) higher than in control mice. Sedentary mice from the selected lines exhibited a trend for higher muscle aerobic capacities, as indicated by higher levels of mitochondrial (cytochrome-c oxidase, carnitine palmitoyltransferase, citrate synthase, and PDH) and glycolytic (hexokinase and phosphofructokinase) enzymes, with concomitant lower anaerobic capacities, as indicated by lactate dehydrogenase (especially in male mice). Consistent with previous studies of endurance training in rats via voluntary wheel running or forced treadmill exercise, cytochrome-c oxidase, citrate synthase, and carnitine palmitoyltransferase activity increased in the wheel-access groups for both genders; hexokinase also increased in both genders. Some enzymes showed gender-specific responses: PDH and lactate dehydrogenase increased in wheel-access male but not female mice, and glycogen phosphorylase decreased in female but not in male mice. Two-way analysis of covariance revealed significant interactions between line type and activity group; for several enzymes, activities showed greater changes in mice from selected lines, presumably because such mice ran more revolutions per day and at greater velocities. Thus genetic selection for increased voluntary wheel running did not reduce the capability of muscle aerobic capacity to respond to training.

Animals↗
PubMed1990

Leisure time exercise and lipid and lipoprotein levels in an older population.

Plasma lipid and lipoprotein levels were measured in 1,019 men and 1,273 women, aged 50 to 89, who were classified according to whether they reported participation in regular strenuous exercise. In men and women, strenuous exercisers had significantly (P less than .01) higher age-adjusted high-density lipoprotein (HDL) cholesterol levels than nonstrenuous exercisers, and male strenuous exercisers also had lower plasma triglyceride levels. Adjusting for differences in cigarette smoking, alcohol consumption, or obesity did not alter these results. A subgroup of 498 consecutive men and 615 consecutive women that completed a more detailed exercise questionnaire were classified into categories of light, moderate, heavy, or no exercise. In men, age-adjusted HDL cholesterol levels were higher and triglyceride levels lower with higher exercise-intensity categories (P for trend less than .001). In the heavy exercise category, HDL cholesterol levels were 15% higher and plasma triglyceride levels were 41% lower than in the sedentary group. In women, HDL cholesterol levels were significantly higher and triglyceride levels lower at the more moderate levels of exercise. In both genders results among exercise-intensity groups did not change after adjusting for age, cigarette smoking, and alcohol consumption. In men, adjusting for obesity did not significantly alter the intergroup differences, whereas in women adjusting for body mass index or waist-to-hip ratio reduced differences in HDL cholesterol levels between exercising and sedentary participants to nonsignificance. We conclude that exercise levels attainable by older adults may significantly improve HDL cholesterol levels and could theoretically reduce the risk of ischemic heart disease.

Aged↗
PubMed2004

Stages of change for physical activity in a community sample of adolescents.

The aims of the present study were to investigate (1) the proportion of adolescents in each of the stages of change, (2) the differences in psychosocial factors and in physical activity between the stages, and (3) the classification accuracy using several reference criteria. A random sample of 38 schools from the Flemish community in Belgium resulted in a sample of 5931 adolescents (mean age=14.8, range 12-18, 61% females). All adolescents completed a computerized questionnaire assessing demographic variables, physical activity, physical activity determinants and stages of change. Distribution across the stages was: precontemplation, n=684 (11.5%); contemplation, n=948 (16.0%); preparation, n=818 (13.8%); action, n=492 (8.3%); and maintenance, n=2989 (50.4%). Analyses revealed gender and age differences (P<0.001), with girls and older adolescents being more prevalent in the first three stages. Differences between the stages of change were related to higher levels of physical activity of different intensity and within different contexts (P<0.001), together with more favorable psychosocial determinants related to physical activity (P<0.001). No differences between stages were found for sedentary activities. Three subgroups of adolescents were identified based on psychosocial determinants and physical activity levels. About 71% of the adolescents placed themselves in a stage which was in accordance with their self-reported level of physical activity.

Adolescent↗
PubMed2006

Hyperphagia and obesity in OLETF rats lacking CCK-1 receptors.

The brain-gut peptide cholecystokinin (CCK) inhibits food intake following peripheral or site directed central administration. Peripheral exogenous CCK inhibits food intake by reducing the size and duration of a meal. Antagonist studies have demonstrated that the actions of the exogenous peptide mimic those of endogenous CCK. Antagonist administration results in increased meal size and meal duration. The feeding inhibitory actions of CCK are mediated through interactions with CCK-1 receptors. The recent identification of the Otsuka-Long-Evans-Tokushima Fatty (OLETF) rat as a spontaneous CCK-1 receptor knockout model has allowed a more comprehensive evaluation of the feeding actions of CCK. OLETF rats become obese and develop non-insulin dependent diabetes mellitus (NIDDM). Consistent with the absence of CCK-1 receptors, OLETF rats do not respond to exogenous CCK. OLETF rats are hyperphagic and their increased food intake is characterized by a large increase in meal size with a decrease in meal frequency that is not sufficient to compensate for the meal size increase. Deficits in meal size control are evident in OLETF rats as young as 2 days of age. OLETF obesity is secondary to the increased food intake. Pair feeding to amounts consumed by intact control rats normalizes body weight, body fat and elevated insulin and glucose levels. Hypothalamic arcuate nucleus peptide mRNA expression in OLETF rats is appropriate to their obesity and is normalized by pair feeding. In contrast, pair fed and young pre-obese OLETF rats have greatly elevated dorsomedial hypothalamic (DMH) neuropeptide Y (NPY) mRNA expression. Elevated DMH NPY in OLETF rats appears to be a consequence of the absence of CCK-1 receptors. In intact rats NPY and CCK-1 receptors colocalize to neurons within the compact subregion of the DMH and local CCK administration reduces food intake and decreases DMH NPY mRNA expression. We have proposed that the absence of DMH CCK-1 receptors significantly contributes to the OLETF's inability to compensate for their meal size control deficit leading to their overall hyperphagia. Access to a running wheel and the resulting exercise normalizes food intake and body weight in OLETF rats. When given access to running wheels for 6 weeks shortly after weaning, OLETF rats do not gain weight to the same degree as sedentary OLETF rats and do not develop NIDDM. Exercise also prevents elevated levels of DMH NPY mRNA expression, suggesting that exercise exerts an alternative, non-CCK mediated, control on DMH NPY. The OLETF rat is a valuable model for characterizing actions of CCK in energy balance and has provided novel insights into interactions between exercise and food intake.

Animals↗
PubMed1992

Correlates of obesity in young black and white women: the CARDIA Study.

OBJECTIVES: Although differences in obesity between Blacks and Whites are well documented in adult women, less information is available on potential correlates of these differences, especially in young adults. METHODS: The association between behavioral and demographic factors and body size was assessed in 2801 Black and White women aged 18 to 30 years. RESULTS: Black women had significantly higher age-adjusted mean body mass index and subscapular skinfold thickness than did White women. Obesity had different associations with age and education across racial groups. A positive relationship between age and obesity was seen in Black women but not in White women, whereas a negative association between education and body size was noted only in White women. Potential contributing factors to the increased prevalence of obesity in Black women include a more sedentary lifestyle, higher energy intake, earlier menarche, and earlier age at first childbirth. CONCLUSIONS: The difference in obesity across race could not be explained completely by these factors, since within virtually all strata, Black women had higher body mass indexes. Further investigation is needed to develop interventional strategies to prevent or reduce excess levels of obesity in Black women.

Adolescent↗