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PubMed1999

Recreational physical activity and the risk of cholecystectomy in women.

BACKGROUND: Physical activity may be an important determinant of the risk of gallstone disease in women, both independently and as a result of its role in maintaining body weight. METHODS: We prospectively studied recreational physical activity (such as jogging, running, and bicycling) and sedentary behavior (such as spending hours watching television) in relation to the risk of cholecystectomy, a surrogate for symptomatic cholelithiasis, in a cohort of 60,290 women who were 40 to 65 years of age in 1986 and had no history of gallstone disease. As part of the Nurses' Health Study, the women reported on questionnaires mailed to them every two years both their activity level and whether they had undergone cholecystectomy. During a 10-year follow-up period (1986 to 1996), 3257 cases of cholecystectomy were documented. RESULTS: Recreational physical activity was inversely related to the risk of cholecystectomy. The multivariate relative risk for women in the highest as compared with the lowest quintile of physical activity was 0.69 (95 percent confidence interval, 0.61 to 0.78). In contrast, sedentary behavior was independently related to an increased risk of cholecystectomy. As compared with women who spent less than 6 hours per week sitting while at work or driving, women who spent 41 to 60 hours per week sitting had a multivariate relative risk of 1.42 (95 percent confidence interval, 1.06 to 1.89), and women who spent more than 60 hours per week sitting while at work or driving had a multivariate relative risk of 2.32 (95 percent confidence interval, 1.26 to 4.26). These associations persisted after we controlled for body weight and weight change. CONCLUSIONS: In women, recreational physical activity is associated with a decreased risk of cholecystectomy. The association is independent of other risk factors for gallstone disease, such as obesity and recent weight loss.

Adult↗

PubMed2003

Sedentary lifestyle and risk of obesity and type 2 diabetes.

Obesity and type 2 diabetes have reached epidemic proportions in the United States. It is well-established that increasing physical activity plays an important role in reducing risk of obesity and diabetes. Few studies, however, have examined the association between sedentary behaviors such as prolonged television (TV) watching and obesity and diabetes. Using data from a large prospective cohort study, the Health Professionals' Follow-up Study, we have demonstrated that increasing TV watching is strongly associated with obesity and weight gain, independent of diet and exercise. Also, prolonged TV watching is associated with a significantly increased risk of type 2 diabetes. Men who watched TV more than 40 h per week had a nearly threefold increase in the risk of type 2 diabetes compared with those who spent less than 1 h per week watching TV. The increased risk was not entirely explained by the decreased physical activity and unhealthy eating patterns associated with TV watching. Thus, public health campaigns to reduce the risk of obesity and type 2 diabetes should promote not only increasing exercise levels but also decreasing sedentary behaviors, especially prolonged TV watching.

Diabetes Mellitus, Type 2↗

PubMed2001

Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men.

BACKGROUND: Television (TV) watching, a major sedentary behavior in the United States, has been associated with obesity. We hypothesized that prolonged TV watching may increase risk for type 2 diabetes. METHODS: In 1986, 37 918 men aged 40 to 75 years and free of diabetes, cardiovascular disease, and cancer completed a detailed physical activity questionnaire. Starting from 1988, participants reported their average weekly time spent watching TV on biennial questionnaires. RESULTS: A total of 1058 cases of type 2 diabetes were diagnosed during 10 years (347 040 person-years) of follow-up. After adjustment for age, smoking, alcohol use, and other covariates, the relative risks (RRs) for type 2 diabetes across increasing quintiles of metabolic equivalent hours (MET-hours) per week were 1.00, 0.78, 0.65, 0.58, and 0.51 (P for trend, <.001). Time spent watching TV was significantly associated with higher risk for diabetes. After adjustment for age, smoking, physical activity levels, and other covariates, the RRs of diabetes across categories of average hours spent watching TV per week (0-1, 2-10, 11-20, 21-40, and >40) were 1.00, 1.66, 1.64, 2.16, and 2.87, respectively (P for trend, <.001). This association was somewhat attenuated after adjustment for body mass index, but a significant positive gradient persisted (RR comparing extreme categories, 2.31; P for trend,.01). CONCLUSIONS: Increasing physical activity is associated with a significant reduction in risk for diabetes, whereas a sedentary lifestyle indicated by prolonged TV watching is directly related to risk. Our findings suggest the importance of reducing sedentary behavior in the prevention of type 2 diabetes.

Adult↗

PubMed1995

Physical activity, body weight, and adiposity: an epidemiologic perspective.

Overweight is a common problem in the United States, especially among minority women and persons of lower socioeconomic status and lower educational attainment. Moreover, the prevalence of reported inactivity may be highest in these same population subgroups. Both overweight and sedentary behavior are important risk factors for chronic disease morbidity and mortality; however, there is encouraging evidence that moderate to higher levels of physical activity may provide protection from certain chronic diseases, even among persons with established risk factors. Several methodological issues preclude the ability to determine accurately the impact of physical activity on body weight and adiposity. These issues include (a) a low prevalence of higher-intensity physical activity in the general population, (b) measurement error with regard to self-reported activity, especially that of lower-intensity, (c) inappropriate time frame of the physical activity assessment, (d) effect modification by age and gender, and (e) failure to adjust for important statistical confounders. Despite these methodological issues, the inverse association between physical activity and weight has been reported in several cross-sectional epidemiologic studies, which consistently report lower body weight, or more favorable distribution of body fat, with higher categorical levels of self-reported physical activity. Directionality of the physical activity and weight relation cannot be determined from these studies, however, and the few longitudinal epidemiologic studies that have assessed the influence of physical activity on the risk of weight gain report inconclusive results. This is possibly because a one-time assessment of physical activity if not adequate in describing the contribution of habitual physical activity on long-term weight maintenance. Therefore, longitudinal population-based studies with multiple assessments of physical activity over long follow-up periods are necessary to determine this relationship. In any case, the evidence suggests that persons concerned with overweight, or especially the prevention of overweight and obesity, should increase their physical activity. Sociodemographic characteristics such as age, gender, educational level, and weight are associated with physical activity patterns and choices. Therefore, these characteristics should be considered by professionals when implementing physical activity interventions for weight control. Walking is accessible to all segments of the U.S. population. Because walking is convenient, low cost, and safe, and can result in weight loss if done regularly for durations of at least 20-30 min, its relative merits should be stressed in weight reduction and maintenance programs. Furthermore, to reduce the morbidity and mortality associated with overweight, obesity, and sedentary behavior, priority for intervention programs should be directed at persons in the most vulnerable sectors of the population.

Adipose Tissue↗

PubMed2000

Adolescent cigarette smoking: health-related behavior or normative transgression?

Relations among measures of adolescent behavior were examined to determine whether cigarette smoking fits into a structure of problem behaviors-behaviors that involve normative transgression-or a structure of health-related behaviors, or both. In an ethnically and socioeconomically diverse sample of 1782 male and female high school adolescents, four first-order problem behavior latent variables-sexual intercourse experience, alcohol abuse, illicit drug use, and delinquency-were established and together were shown to reflect a second-order latent variable of problem behavior. Four first-order latent variables of health-related behaviors-unhealthy dietary habits, sedentary behavior, unsafe behavior, and poor dental hygiene-were also established and together were shown to reflect a second-order latent variable of health-compromising behavior. The structure of relations among those latent variables was modeled. Cigarette smoking had a significant and substantial loading only on the problem-behavior latent variable; its loading on the health-compromising behavior latent variable was essentially zero. Adolescent cigarette smoking relates strongly and directly to problem behaviors and only indirectly, if at all, to health-compromising behaviors. Interventions to prevent or reduce adolescent smoking should attend more to factors that influence problem behaviors.

Adolescent↗

PubMed2004

Prevention and treatment of overweight in children and adolescents.

Overweight in childhood and adolescence is an important public health issue because of its rapidly increasing prevalence and associated adverse medical and social consequences. Recent studies have estimated that 15 percent of children in the United States are at risk for overweight, and an additional 15 percent are overweight. Important predictors of overweight include age, sex, race/ethnicity, and parental weight status. Generally, school-based prevention programs are not successful in reducing the prevalence of obesity. Treatment interventions include behavioral therapy, reduction in sedentary behavior, and nutrition and physical activity education. These interventions are moderately successful but may not be generalized to the primary care setting. Family physicians should focus on identifying at-risk and overweight children and adolescents at an early stage and educating families about the health consequences of being overweight. Interventions should be tailored to the patient and involve the entire family.

Adolescent↗

PubMed1997

Personality factors differentially predict exercise behavior in men and women.

Personality assessed with the Minnesota Multiphasic Personality Inventory (MMPI) in college was used to predict exercise behavior measured at midlife in 3,630 men and 796 women enrolled in the University of North Carolina Alumni Heart Study. Logistic regression models were fitted for each of the MMPI clinical scales to test the predictive effect of personality, gender, and their interaction on adult exercise behavior. Lower depression, social introversion, and psychopathic deviance scores were associated with increased probability of exercising in midlife for both men and women. Furthermore, better psychological health (indexed by lower hypochondriases and psychasthenia) in college was generally predictive of increased exercise for men, whereas higher scores on these same factors predicted midlife exercise for women. There were two other patterns of gender interactions: (a) for men, lower scores on hysteria and schizophrenia scales were associated with increased probability of exercising at midlife, whereas these factors were unrelated to exercise for women and (b) for women, lower ego strength and higher college scores on paranoia and mania were associated with exercise behavior at midlife. These data suggest that early adulthood personality predictors of exercise behavior at midlife are both gender-neutral and gender-specific; that is, where no gender differences exist, healthier personality traits predict exercise at midlife, and when gender differences do occur, healthier college patterns of personality predict exercise behavior for men and sedentary behavior for women.

Adolescent↗

PubMed2026

Changes in hemoglobin levels and cardiometabolic health in adults with metabolic syndrome - a secondary outcome analysis of a six-month randomized controlled trial.

BACKGROUND: Lower hemoglobin (Hb) levels within the normal range have been associated with favorable metabolic traits in cross-sectional studies. This study investigated whether changes in Hb levels correlated with changes in physiological and cardiometabolic parameters during a six-month behavioral intervention in individuals with metabolic syndrome. METHODS: The six-month randomized controlled trial aimed to reduce sedentary behavior in adults with metabolic syndrome (n = 64). Key measurements included fasting blood samples, insulin sensitivity during a hyperinsulinemic-euglycemic clamp, insulin-stimulated liver glucose uptake, liver fat content (LFC), indirect calorimetry, cardiorespiratory fitness, and cardiac function. Correlations between changes in these variables and changes in Hb levels at baseline, three, and six months were examined. RESULTS: Cross-sectionally, higher Hb levels correlated with lower insulin sensitivity (r=-0.35, p = 0.005), higher resting O2 consumption (r = 0.41, p < 0.001), higher resting energy expenditure (r = 0.49, p < 0.001), higher LFC (r = 0.40, p = 0.011), and greater left ventricular wall thickness (r = 0.42, p = 0.001). The intervention did not significantly impact Hb levels, and changes in Hb levels did not correlate with most cardiometabolic changes. However, reduced Hb levels correlated with reduced fasting blood glucose (r = 0.29, p = 0.032), improved insulin sensitivity (r = -0.26, p = 0.045), and increased cardiorespiratory fitness (r = -0.29, p = 0.033). CONCLUSIONS: Changes in Hb levels did not consistently correlate with changes in cardiometabolic markers during the intervention. However, reductions in Hb levels may relate to improved insulin sensitivity and fitness. Along cross-sectional correlations, this may be clinically relevant for individuals with metabolic syndrome. Further studies are merited to clarify the role of Hb levels in this high-risk group.

Humans↗

PubMed1996

Physical and sedentary activity in school children grades 5-8: the Bogalusa Heart Study.

Physical and sedentary activity in children and adolescents has immediate health benefits and can also set a pattern that carries over into adulthood, resulting in long-term health benefits. Activity levels in a free-living biracial sample of children and adolescents, ages 9-15 yr (N = 995), were examined using a 24-h recall instrument, the Self-Administered Physical Activity Checklist. Selected sedentary activities (television watching and video-/computergame playing) were also assessed. Overall, boys were more physically active than girls and engaged in more heavy physical activity, while girls reported a larger percentage of time spent in light and moderate physical activities. Gender and, to a lesser extent, ethnic differences were seen in the types of activities reported. Although most physical activity occurred after school, children who reported no physical education class during school had less physical activity overall. There was a decrease in moderate physical activity with increasing grade levels in school and an increase in sedentary behavior. Black children reported more sedentary activity than white children, and girls reported more than boys. Although this 24-h recall method has limitations, it allows characterization of the activity of groups of children and provides useful data for policy recommendations.

Activities of Daily Living↗

PubMed2024

Leisure television watching exerts a causal effect on gastroesophageal reflux disease: evidence from a two-step mendelian randomization study.

BACKGROUND: Previous studies have shown that physical activity (PA) and leisure sedentary behaviors (LSB, including leisure television watching) are linked to gastroesophageal reflux disease (GERD). However, the associations between PA/LSB and GERD remain controversial. In this study, we aimed to reveal whether these associations reflect causal relationships and reveal the potential mechanisms of these relationships using bidirectional and two-step Mendelian randomization (MR) analyses. METHODS: We obtained genome-wide association study (GWAS) summary statistics for PA/LSB, four common risk factors (including cigarettes smoked per day, alcoholic drinks per week, triglycerides, total cholesterol) and GERD from published GWASs. A bidirectional MR analysis was performed to identify causal relationships between PA/LSB and GERD. Then, a series of sensitivity analyses were performed to verify the robustness of the results. Finally, a mediation analysis via two-step MR was conducted to investigate any effects explained by common risk factors in these relationships. RESULTS: Genetically predicted per 1-SD increase in leisure time television watching significantly increased the risk of GERD in the bidirectional MR analysis (OR = 1.33; 95% CI: 1.14-1.56; P = 2.71 × 10- 4). Sensitivity analyses successfully verified the robustness of the causal relationship. Further mediation analysis showed that this effect was partly mediated by increasing cigarettes smoked per day, with mediated proportions of 18.37% (95% CI: 11.94-39.79%). CONCLUSION: Our findings revealed a causal relationship between leisure television watching and an increased risk of GERD, notably, the causal effect was partially mediated by cigarettes smoked per day. These findings may inform prevention and management strategies directed toward GERD.

Humans↗

PubMed2026

Plasma Proteomic Signatures of Physical Activity Provide Insights into Biological Impacts and its Protective Role against Dementia.

PURPOSE: Physical activity (PA) and sedentary behavior (SB) are associated with many diseases, including Alzheimer disease and all-cause dementia. However, the specific biological mechanisms through which PA protects against disease are not entirely understood. This study aims to address this gap, with a specific focus on all-cause dementia. METHODS: We first assessed the conventional observational associations of three self-reported and three device-based PA/SB measures with circulating levels of 2911 plasma proteins measured in the UK Biobank ( nmax = 39,160) and assessed functional enrichment of identified proteins. We then used bidirectional Mendelian randomization to further evaluate the evidence for causal relationships of PA/SB with protein levels. Finally, we performed mediation analyses to identify proteins that may mediate the relationship of PA with incident all-cause dementia. RESULTS: Our findings revealed 41 proteins consistently associated with all PA measures and 1027 proteins associated with at least one PA measure. Both conventional observational and Mendelian randomization study designs converged on proteins that appear to increase as a result of PA, including integrins such as ITGAV and ITGAM, as well as MXRA8, CLEC4A, CLEC4M, LPL, and ADGRG2; and on proteins that appear to decrease as a result of PA such as LEP, INHBC, CLMP, PTGDS, ADM, OGN, and PI3; and on proteins that are more responsive to high-intensity PA, such as CA14, CA6, CA4, KIT, and ANGPT2. Functional enrichment analyses revealed processes such as cell-matrix adhesion, integrin-mediated signaling, and collagen binding. Finally, GDF15, ITGAV, ITGAM, ITGA11, HPGDS, GFAP, ADM, AHNAK, and DPP4 were among 21 unique proteins found to mediate the relationship of PA with all-cause dementia, implicating processes such as synaptic plasticity, neurogenesis, and inflammation. CONCLUSIONS: Our results provide insights into how PA affects biological processes and protects against dementia, and provide avenues for future research into the health-promoting effects of PA.

Humans↗

PubMed2001

Relationships of physical activity with dietary behaviors among adults.

BACKGROUND: Physical activity and diet are important influences on health, but few data are available about the relationship between these two factors. The purpose of this study was to examine relationships between physical activity and dietary quality and to identify determinants of the combination of sedentary behavior and suboptimal diet. METHODS: The design of this study was cross-sectional. The setting was a large managed-care organization and the participants were 1,322 racially diverse men and women ages 25-91 years. We categorized subjects' physical activity into vigorous, moderate, and sedentary based on answers to two validated interviewer-administered questions about intensity and duration of specified activities. Dietary assessment was by means of a validated short food frequency questionnaire. We defined suboptimal diet as consuming unhealthful quantities of at least two of the following five food groups: fruits, vegetables, whole grain foods, whole-fat dairy foods, and red and processed meats. RESULTS: Seven hundred fifty-four (57%) subjects were sedentary and 617 (47%) consumed a suboptimal diet. Using multiple linear regression, we found that sedentary individuals consumed smaller amounts of foods and nutrients considered to be healthful, such as fruits and vegetables, fiber, calcium, folate, and vitamins A, C, and E, than more active participants. For nutrients considered to be harmful, such as saturated fat, trans fat, and dietary cholesterol, the association with physical activity was inverse. In multiple logistic regression analyses, the strongest sociodemographic correlates of the joint presence of inactivity and poor diet were less education [odds ratio for 1-year decrease 1.14 (95% confidence interval 1.06, 1.22)], nonwhite race [1.48 (1.05, 2.07)], and nonmarried status [1.49 (1.06, 2.10)]. CONCLUSIONS: Physical activity and diet quality are correlated behaviors. Suboptimal diet and sedentary behavior tend to cluster in individuals who are less educated, not married, and of nonwhite race. Programs that target diet and activity together, informed by their joint determinants, may attain enhanced outcomes.

Adult↗

PubMed2006

Thermal constraints on activity scheduling and habitat choice in baboons.

The importance of thermoregulation as a constraint on behavior has received comparatively little attention in relation to other ecological factors. Despite this, a number of studies suggested that high temperature may represent an important ecological constraint. This paper examines the impact of temperature on activity scheduling in a troop of chacma baboons (Papio hamadryas ursinus) at De Hoop Nature Reserve, South Africa. Once the daily, seasonal, and individual effects were controlled for, the "perceived environmental temperature" (PET), which accounts for the relative contributions of solar radiation, wind speed, and humidity on shade temperature, was a significant constraint on behavior. With high PET, feeding declines, and there is an increase in grooming and particularly resting behavior. Baboons thus engage in more sedentary behaviors as temperature increases, with significantly higher levels of resting and grooming when temperature exceeds the approximate thermal neutral zone for baboons. Seeking shade is an important behavioral response to thermal stress, and PET was a significant determinant of whether an animal was in shade while engaged in either resting or grooming behavior. Furthermore, the proportion of time spent in shade increased across air temperatures that were below, within, and above the thermal neutral zone for baboons. Finally, since resting and grooming are conducted preferentially in certain habitat types, thermoregulatory considerations also impact on patterns of habitat choice and day-journey routes. This suggests that the thermal environment is an ecological variable that should be given greater consideration in future studies of primate behavior.

Animals↗

PubMed2005

Social environmental factors and preteen health-related behaviors.

PURPOSE: To examine associations among risk and protective factors with negative (substance use, delinquent behavior, sedentary recreation, empty calorie consumption, suicidal behavior) and positive behaviors (prosocial recreation, productive behavior, exercise, nutrition behavior, academic achievement, seatbelt use). METHODS: Data were from sixth-grade public school students (n = 133,629) in 2001. Factor analysis produced five risks, five protectors, seven negative and six positive behaviors. Associations were tested among single and cumulative risks and protectors with behaviors (linear, logit regression) and combinations of high and low risks and protectors with behaviors (analysis of variance, Chi-square). RESULTS: Individual and cumulative risks were related to higher and protectors were related to lower negative behaviors. Protectors were associated with higher positive behaviors, with some exceptions. Risks and their sum were associated with lower academic achievement and seatbelt use, but were linked to higher, rather than lower productive behavior. Being bullied or victimized was correlated with higher levels of exercise, good nutrition, and prosocial recreation. The high risk/low protection combination had the highest negative behaviors and low risk/high protection the lowest, but for positive behaviors, high protectors with either high or low risks showed higher positive behaviors. CONCLUSIONS: These findings provide new information about how (a) risks and protectors are associated with negative behaviors besides substance use and delinquency, (b) cumulative protectors, as well as risks, are related to negative and positive behaviors, and (c) combinations of high and low risks and protectors are related to behaviors. The unusual findings for positive behaviors merit further exploration.

Activities of Daily Living↗

PubMed1999

Health behaviors, social networks, and healthy aging: cross-sectional evidence from the Nurses' Health Study.

Physical function is a significant component of health-related quality of life among older adults. Potential correlates of healthy aging, including health behaviors and social network characteristics, were examined among 56,436 US women aged 55-72 in 1992. Healthy aging was assessed by maintenance of physical function measured by four subscales of the Medical Outcomes Study Short Form (SF)-36 Health Survey: physical functioning; role limitations; freedom from bodily pain; and vitality. Individual health behaviors, defined as current smoking, alcohol consumption, sedentary behavior, and being overweight each contributed to significant decrements in functioning across all age-groups. After controlling for these health behaviors and other confounders (age, race, education, and co-morbid conditions), elements of a woman's social network were significantly correlated with functional status. Strong predictors of high functioning among older women were having close friends and relatives and presence of a confidant. For example, the absence of a confidant was associated with a 4.44 point reduction in physical functioning (95% CI: -7.0, -1.9), and a 5.68 point reduction in vitality (95% CI: -7.9, -3.4). These effects were comparable in magnitude to those observed among heavy smokers, or women in the highest category of body mass index.

Aged↗

PubMed2002

Tailored interventions for multiple risk behaviors.

The prevention and management of chronic disease necessitates the effective treatment of health risk behaviors. Evaluating methods for maximizing change among individuals with a combination of these behaviors is an area of continued research. The University of Michigan's Health Media Research Laboratory, in collaboration with the Henry Ford Health System (HFHS), is testing a computer-based tailored print material intervention and complementary telecounseling intervention among individuals served by the HFHS. Both interventions are informed by theoretical constructs, particularly those derived from the Transtheoretical Framework and the Health Belief Model. Through a randomized, 2x2 factorial trial, we intend to determine effectiveness of the two interventions in achieving behavior change of three health risk behaviors: cigarette smoking, low vegetable consumption and sedentary behavior. Participants with at least two of these behavioral risk factors will receive four treatments over an 18-week intervention period. Follow-up at 3 and 12 months will assess both short- and long-term behavioral effects of the individual and combined treatments against a group receiving generic print materials. Through this research, we intend to develop a better understanding of how the presence of multiple risk behaviors affects the probability of behavior change and to evaluate the joint action of these behaviors.

Adult↗

PubMed2001

Pediatric obesity.

Pediatric obesity can be defined as BMI > 95th percentile for age and sex from large surveys that were carried out in the past. Using these cut points, over 10% of all children and adolescents are obese, and another 10% are overweight (BMI > 85th percentile). Obesity in childhood is associated with many immediate consequences, including orthopedic, neurologic, pulmonary, gastroenterologic, endocrinologic, metabolic, and cardiovascular disorders. Psychosocial and economic problems also are seen in obese adolescents. Long-term consequences of pediatric obesity include risks for cardiovascular disease and death that are independent of adult body weight. The differential diagnosis of pediatric obesity includes many multi-system genetic syndromes and a limited number of endocrine disorders that include abnormalities in the leptin signaling pathway, but most children with excess body weight do not have an established diagnosis. Treatment is best carried out at specialized centers, and usually involves a program of behavioral modification, caloric restriction, increased activity, and decreased sedentary behaviors. Medication for pediatric obesity cannot be recommended at present outside the context of clinical trials. Gastric bypass surgery is effective, but should be considered a last resort for the child with life-threatening complications of obesity.

Body Mass Index↗

PubMed2004

The unique ethics of sports medicine.

The ethical code by which physicians traditionally conduct themselves is based on the relationship between the physician and the patient: both work toward the goal of improving or maintaining health. Constraints on this relationship may be behaviors of patient choice (tobacco use, excessive alcohol use, sedentary behavior, and so on). The athlete-physician relationship is ethically different. Influences such as the physician's employer, the athlete's desire to play with pain and injury, and the economic consequences of playing or not complicate medical decisions. This perspective suggests something different and even unique about the ethics of the sports medicine practitioner. This article explores the differences fostering the ethical tight ropes that sports physicians walk in their sports medicine practices.

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