John Moore: eighteenth century physician, bearleader and social observer.
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Famous Persons↗
Biomedical subjects
Andrew Steptoe
Publications and source records attributed to Andrew Steptoe.
Sociodemographic, developmental, environmental, and psychological correlates of physical activity and sedentary behavior at age 11 to 12.
BACKGROUND: Low levels of physical activity and high levels of sedentary behavior during adolescence are a cause for concern. Sociodemographic, developmental, environmental, and psychological factors may be relevant, but the correlates of these behaviors may differ. PURPOSE: To investigate the multidimensional correlates of physical activity and sedentary behavior in a large sample of 11- to 12-year-old boys and girls. METHODS: Cross-sectional survey of 2,578 boys and 1,742 girls from 36 schools stratified by socioeconomic background and gender mix of students (84% response rate). Questionnaire assessments and objective measurements of height and weight were obtained. RESULTS: Days of vigorous physical activity and hours of sedentary behaviors over the past week were uncorrelated. Ethnicity, socioeconomic factors, developmental stage, environmental factors, and psychological variables were associated with physical activity and sedentary behavior in univariate analyses. In multiple regression, sedentary behavior was greater in ethnic minority groups, in students from more deprived backgrounds, and in those with conduct problems. Girls who were more advanced developmentally and who reported emotional symptoms also engaged in more sedentary behaviors. Vigorous physical activity was associated with good self-rated health, prosocial psychological characteristics, and (in boys) with low emotional symptoms. CONCLUSIONS: A multidimensional approach to understanding the context of physical activity in early adolescence is needed because factors in several domains are relevant. The correlates of physical activity and sedentary behaviors are distinct in this age group, and there are also important gender differences.
Child↗
Marital-role quality and stress-related psychobiological indicators.
BACKGROUND: The quality of one's marital relationship is gaining recognition as a potential stressor associated with negative health outcomes. PURPOSE: In this study, we estimated the relationship between marital-role quality and three psychobiological stress indicators (self-reported stress, cortisol levels, and ambulatory blood pressure). METHOD: Participants were 105 middle-age adults (67 men, 38 women) who had previously taken part in the Whitehall psychobiology study. Ambulatory monitoring and saliva sampling were carried out over a working day, and marital relationships were assessed with the Marital/Partner Role Quality scales. RESULTS: We found that marital-role concerns (but not marital-role rewards) were related to all three psychobiological stress indicators; results did not vary by gender. Specifically, participants with more marital concerns reported greater stress throughout the day (p=.014), showed an attenuated cortisol increase following waking (p=.042) and a flatter cortisol slope over the day (p=.010), and had elevated ambulatory diastolic blood pressure over the middle of the workday (p=.004), with a similar trend in systolic pressure (p=.069). CONCLUSIONS: The results suggest that in addition to the carryover of work stress into domestic life that has been evident for many years, there are also influences of domestic strain on biological function over the working day and evening. Previous research suggests that a possible mechanism linking troubled marriages to health outcomes is depressed immune functioning. This study suggests a second mechanism-poorer stress-related biological response.
Blood Pressure↗
Socioeconomic position and cardiovascular and neuroendocrine responses following cognitive challenge in old age.
Social disparities in health persist into old age, and differences in psychophysiological responsivity may contribute to this pattern. We assessed whether higher socioeconomic status (SES) is associated with attenuated cardiovascular and neuroendocrine responses elicited by cognitive tasks in old age. We tested 132 community-dwelling men and women aged 65-80 years, divided on the basis of educational attainment into higher and lower SES groups, and compared them with 26 higher educated participants aged 27-42 years. Blood pressure, hemodynamic variables and salivary cortisol were assessed in response to the performance of three cognitive tasks, and then during recovery. Older groups showed smaller heart rate and larger cortisol changes than younger participants. Post-task recovery in heart rate, stroke volume, pre-ejection period, and systolic blood pressure was greatest in the younger group, least in the older/lower education group, and intermediate in the older/higher education group. SES did not influence the increased cortisol responsivity of older participants. The results are consistent with the notion that higher SES protects against age-related changes in cardiovascular response profiles, particularly during recovery.
Adult↗
Acute reduction in secretory immunoglobulin A following smoking cessation.
Smokers report an increase in upper respiratory infections in the early phase of stopping smoking. One possible cause is a depletion in secretory immunoglobulin A (S-IgA) which has been observed in one study. The present study sought to establish this finding in smokers using nicotine patches. Ninety-two smokers, trying to stop smoking, were assessed whilst smoking and for up to six weeks of abstinence. All smokers were prescribed 15 mg 16-h nicotine patches. Among abstinent smokers, changes in S-IgA and saliva volume were assessed. During the preliminary analyses, we observed that for the pre-smoking cessation measure a longer time since the last cigarette was significantly related to lower S-IgA levels (P = 0.006). Consequently, the main analysis, of changes in S-IgA from pre-cessation to post-cessation, was confined to those who had smoked within 0.5-1.5 h of the pre-cessation measure (n = 51). There was a significant decline in S-IgA, relative to pre-smoking abstinence levels, following abstinence of one day (P = 0.027), but levels returned to pre-abstinence values after one week. There was no evidence of any significant changes in saliva volume following smoking cessation, relative to pre-cessation levels. Users of 15 mg patches are likely to experience a decline in S-IgA levels on the first day of smoking cessation, independent of saliva volumes, and this decline in S-IgA is likely to occur acutely, within the first few hours of smoking abstinence. This acute drop in S-IgA appears to stem from a factor other than depletion of nicotine from the body. The observed decrease in S-IgA may help to explain the increased susceptibility of smokers to upper respiratory tract infections in the immediate post-cessation period.
Administration, Cutaneous↗
Leisure-time physical activity in university students from 23 countries: associations with health beliefs, risk awareness, and national economic development.
BACKGROUND: Physical inactivity has been linked with chronic disease and obesity in most western populations. However, prevalence of inactivity, health beliefs, and knowledge of the risks of inactivity have rarely been assessed across a wide range of developed and developing countries. METHODS: A cross-sectional survey was carried out with 19,298 university students from 23 countries varying in culture and level of economic development. Data concerning leisure-time physical activity, health beliefs, and health knowledge were collected. RESULTS: The prevalence of inactivity in leisure time varied with cultural and economic developmental factors, averaging 23% (North-Western Europe and the United States), 30% (Central and Eastern Europe), 39% (Mediterranean), 42% (Pacific Asian), and 44% (developing countries). The likelihood of leisure-time physical activity was positively associated with the strength of beliefs in the health benefits of activity and with national economic development (per capita gross domestic product). Knowledge about activity and health was disappointing, with only 40-60% being aware that physical activity was relevant to risk of heart disease. CONCLUSIONS: Leisure-time physical activity is below recommended levels in a substantial proportion of students, and is related to cultural factors and stage of national economic development. The relationship between health beliefs and behavior is robust across cultures, but health knowledge remains deficient.
Adult↗
Mild acute inflammatory stimulation induces transient negative mood.
OBJECTIVE: This study aims to assess the mood changes induced by mild acute inflammatory stimulation (typhoid vaccination). METHODS: Using a double blind study design, 26 healthy volunteers underwent baseline assessments of mood, financial strain and work stress and were randomised to injection of Salmonella typhi vaccine or placebo injection. Mood, symptoms and body temperature was assessed by a modified version of the Profile of Mood States at 1, 2, 3, 4, 6 and 8 h post injection. RESULTS: Typhoid vaccination induces no increases in physical symptoms or temperature. Mood improved over the day in the placebo but not in the vaccine condition. Negative changes in mood following injection were correlated with chronic stress (financial strain) in the vaccination condition (r=-.65, P<.025). CONCLUSION: A mild acute inflammatory stimulus induces transient negative mood, and responses were modulated by chronic stress. Implications for depressed mood in physical illness are discussed.
Acute Disease↗
Work stress, socioeconomic status and neuroendocrine activation over the working day.
Socioeconomic status (SES) differences in cardiovascular and metabolic disease risk may be mediated in part by differential activation of neuroendocrine pathways. We have previously found that salivary cortisol levels over the working day are greater in lower than higher SES men, but that cortisol output is greater in higher than lower SES women. This study investigated the role of work stress in generating these patterns, analysing cortisol output in relation to job demands and job control. Participants were 97 men and 84 woman from the Whitehall II cohort, London, UK, recruited from higher and lower grades of employment. Saliva samples were obtained on waking and 30 min later to assess the cortisol waking responses, and at two hourly intervals over a typical working day. Cortisol responses to waking were positively associated with high job demands, but this effect was attenuated by higher SES. In women but not men, cortisol levels over the remainder of the day were elevated in lower SES participants who experienced high job demands, but depressed in lower status women who reported low job demands. Job control did not influence cortisol responses to waking, but in men cortisol levels over the remainder of the day were inversely related to job control. These cortisol differences were independent of age, smoking status and time of waking up. Subjectively, the most stress was reported by higher SES individuals who experienced low job control. We conclude that work stress and SES are related differently to cortisol responses to waking and cortisol output over the day. Job control may partly mediate SES differences in cortisol in men, while job demands are more relevant for women. Analyses of psychobiological pathways must take account of variations in exposure to chronic stressors as well as differences in responsivity to stressors.
Adaptation, Psychological↗
Differences in cortisol awakening response on work days and weekends in women and men from the Whitehall II cohort.
It is thought that the salivary cortisol awakening response can serve as a reliable marker of hypothalamic-pituitary-adrenocortical activity. Response magnitude might be influenced by stress, but results of studies on work-related stress have been inconclusive. Non-compliance with the sampling schedule is a potential confounding factor that has rarely been controlled. The objective of the study was to determine whether the cortisol awakening response is greater on a work day than on a weekend day, and whether responses vary with gender and socioeconomic position. Compliance was controlled by excluding participants who reported a delay of more than 10 min between waking up and taking the first saliva sample. Data were collected from 196 men and women aged 47 to 59 years drawn from the Whitehall II cohort of British civil servants, with free salivary cortisol sampled immediately after waking up and 30 min later on 2 days. Data on stress, perceived control and happiness over the remainder of the day, and on sleep quality, time of waking, and health behaviour were also obtained. The awakening response was lower in non-compliant participants than in compliant ones, so non-compliant participants were excluded from further analyses. Salivary cortisol levels on waking did not differ by gender or socioeconomic position, or between work and weekend days. However, the cortisol awakening response (defined as the difference between waking and 30 min later) was greater on work than weekend days (mean increases 10.5 and 3.7 nmol/l, P < 0.001). On the work day, women showed larger increases than men (P = 0.011), but there were no gender differences on the weekend day. Across both days, lower socioeconomic position was associated with a larger cortisol awakening response (P = 0.014). Time of waking up was not related to the cortisol awakening response on either day. Participants rated themselves as more stressed, less in control, and less happy over the remainder of the work than weekend day. These results indicate that the cortisol awakening response occurs on both work and non-work days, but that anticipation of the working day is associated with an enhanced response. Cortisol output over the early part of the day may be particularly sensitive to the influence of chronic stress and its anticipation, especially in women.
Biomarkers↗
Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and women.
Loneliness is a psychological experience related to social isolation and perceived lack of companionship, and may be relevant to health risk. The revised UCLA loneliness scale was completed by 240 working men and women aged 47-59 years, and related to affective state and neuroendocrine, cardiovascular, and inflammatory responses. Loneliness scores were not associated with gender, age or socioeconomic position, but were lower in married than single or divorced participants, and were positively related to social isolation, low emotional support, ratings of depression, hopelessness and low self-esteem, and to reported sleep problems. Diastolic blood pressure reactions to acute mental stress were positively correlated with loneliness in women but not men, independently of age, socioeconomic status, smoking, body mass and marital status (p = 0.014). Lonely individuals also displayed significantly greater fibrinogen (p = 0.038) and natural killer cell responses (p = 0.042) to stress, independently of covariates. The cortisol response over the first 30 min following waking was positively associated with loneliness after adjusting for waking cortisol value, sex, socioeconomic status, smoking, time of waking, and body mass (p = 0.046). We conclude that loneliness is a psychological experience with potentially adverse effects on biological stress processes that may be relevant to health.
Adult↗
Psychological and social predictors of changes in fruit and vegetable consumption over 12 months following behavioral and nutrition education counseling.
This study assessed psychological and social factors predicting 12-month changes in fruit and vegetable consumption achieved by 271 men and women from a low-income population randomized to brief behavioral and nutrition education counseling. Greater increases in fruit and vegetable intake were achieved in the behavioral than in the nutrition education condition (1.49 vs. 0.87 portions per day, p=.021). Increases were predicted by baseline social support for dietary change but not by baseline psychological measures. However, short-term (8-week) changes in dietary self-efficacy, encouragement, anticipated regret, perceived benefits, and knowledge of recommended intake predicted 12-month changes in fruit and vegetable consumption independently of gender, age, ethnicity, income, and baseline intake. These factors accounted for 51% of the superiority of behavioral counseling over nutrition education.
Adolescent↗
Quality of life and self-rated health in relation to changes in fruit and vegetable intake and in plasma vitamins C and E in a randomised trial of behavioural and nutritional education counselling.
We have carried out a randomised trial comparing brief behavioural counselling with nutritional education counselling to increase fruit and vegetable consumption and associated biomarkers in adults from a low-income neighbourhood. The objective of the present analysis was to assess the impact of interventions on quality of life and health status, and associations between changes in fruit and vegetable consumption, plasma vitamins C and E, and quality of life. Behavioural counselling and nutritional education counselling were carried out in 271 adults in two 15 min sessions in a primary-care setting. Physical and mental health status (medical outcome study short form 36) and self-rated health were assessed at baseline, 8 weeks and 12 months, and analysed on an intention-to-treat basis. Both groups reported increased fruit and vegetable consumption; plasma vitamin E and beta-carotene also increased, with significantly greater changes in consumption and plasma beta-carotene in the behavioural counselling condition. Physical and mental health status, and the proportion of participants in good self-rated health, increased in both groups to a similar extent. Individual differences in improvements in physical health status and self-rated health were correlated with increases in fruit and vegetable intake and in plasma vitamins C and E, independently of age, gender, ethnicity, financial status, smoking, BMI and use of vitamin supplements. We conclude that participation in the present study was associated with improved health-related quality of life. Increases in fruit and vegetable intake and plasma vitamin levels may stimulate beneficial changes in physical health status in socio-economically deprived adults.
Adult↗
The influence of low job control on ambulatory blood pressure and perceived stress over the working day in men and women from the Whitehall II cohort.
OBJECTIVE: Work stress contributes to risk of coronary heart disease and hypertension. This study tested the influence of job control on ambulatory blood pressure, and ratings of perceived stress and happiness in men and women systematically sampled by socio-economic status from the Whitehall II epidemiological cohort. PARTICIPANTS: A total of 227 men and women aged 47-59 years sampled from higher, intermediate and lower employment grades. OUTCOME MEASURES: Ambulatory blood pressure and ratings of stress, perceived control and happiness. METHODS: Participants completed standard measures of job demands and job control, and undertook ambulatory monitoring with measures of blood pressure and subjective state every 20 min from early in the working day until going to bed. RESULTS: Systolic and diastolic blood pressure were greater in participants reporting low rather than high job control (means 125.7/81.5 versus 122.4/78.6 mmHg, P < 0.05), independently of gender, employment grade, body mass index, age, smoking status, and physical activity. Differences persisted into the evening after work. Job demands and job strain (high demand/low control) were not associated with blood pressure. Participants reporting low job control experienced stress more frequently over the working day than did those with high job control. Higher socio-economic status participants and women were more stressed by low job control than were men and people of lower socio-economic status. CONCLUSIONS: Job control plays an important role in modulating cardiovascular and affective responses over the working day, and these responses may contribute to increased cardiovascular disease risk.
Blood Pressure↗
Stress reduction and blood pressure control in hypertension: a role for transcendental meditation?
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Blood Pressure↗
Size at birth and cardiovascular responses to psychological stressors: evidence for prenatal programming in women.
BACKGROUND: Epidemiological studies have repeatedly shown inverse associations between size at birth and blood pressure in later life. There is some evidence to suggest that exaggerated blood pressure responses to psychological stressors are a forerunner of sustained hypertension. OBJECTIVE: To determine whether individuals who were smaller at birth have greater blood pressure and heart rate responses to psychological stressors. DESIGN: Prospective cohort study. METHODS: A total of 104 men and 79 women (mean age 26.3 years) were recruited from the Adelaide Family Heart Study cohort. Blood pressure was monitored continuously throughout the study using a Portapres and participants undertook a series of three stress tests: Stroop, mirror drawing and public speech. The stress response was defined as the increment from baseline to the mean blood pressure during the three tasks. RESULTS: In women, a 1 kg increase in birthweight was associated with an 8.7 mmHg (95% confidence interval: 3.6-13.8, P = 0.001) reduction in the systolic and a 4.1 mmHg (1.6-6.6, P = 0.002) reduction in the diastolic response to stress. The heart rate response to stress was also inversely related to birthweight. These results remained significant after correction for gestational age and other potential confounding factors. Similar results were found for birth length and head circumference. There were no such relationships in men. CONCLUSIONS: This study provides the first human evidence that cardiovascular responses to psychological stressors may be programmed antenatally and suggests a potential mechanism linking reduced fetal growth with raised blood pressure and cardiovascular disease in later life.
Adult↗
How neighborhoods and physical functioning are related: the roles of neighborhood socioeconomic status, perceived neighborhood strain, and individual health risk factors.
BACKGROUND: Increasing attention is being paid to the impact of neighborhood residence on individual health status. PURPOSE: This study examined pathways through which low neighborhood socioeconomic status (SES) and associated subjective neighborhood characteristics may be associated with self-reported physical functioning. METHODS: A sample of 658 adults responded to a questionnaire survey sent to residents of lower and higher SES neighborhoods. Measures of neighborhood social cohesion and problems were obtained and individual deprivation, social integration, sense of control, and financial strain were assessed with standard measures. Physical functioning was assessed with the MOS 36-item Short Form health survey. RESULTS: Structural equation modeling analyses showed that living in a lower socioeconomic neighborhood was associated with greater perceived neighborhood strain, which, in turn, was associated with poorer physical functioning. Lower neighborhood SES and greater perceived neighborhood strain were associated with poorer physical functioning of individuals through less social integration, less perceived control, and greater financial strain. Individual deprivation was also related to less social integration, less perceived control, and greater financial strain. CONCLUSIONS: Neighborhood SES and associated perceptions of neighborhoods are associated with physical functioning to some extent through the shaping of the social and psychological experiences of individuals living within them.
Adolescent↗
Gender differences in food choice: the contribution of health beliefs and dieting.
BACKGROUND: Gender differences in health behaviors have been reported in many studies but casual mechanisms have been neglected. PURPOSE AND METHODS: This study examines 4 food choice behaviors in a large sample of young adults from 23 countries and tests 2 possible explanatory mechanisms for the gender differences-women's greater likelihood of dieting and women's greater beliefs in the importance of healthy diets. RESULTS: Women were more likely than men to report avoiding high-fat foods, eating fruit and fiber, and limiting salt (to a lesser extent) in almost all of the 23 countries. They were also more likely to be dieting and attached greater importance to healthy eating. Dieting status explained around 22% of fiber choices, and 7% of fruit, but none of the gender difference in salt. Health beliefs explained around 40% of the differences in each of the dietary behaviors and together they explained almost 50%. Gender differences in food choices therefore appear to be partly attributable to women's greater weight control involvement and partly to their stronger beliefs in healthy eating. CONCLUSION: Further research is needed to understand the additional factors that could promote men's participation in simple healthy eating practices.
Adult↗
Depression, perceived control, and life satisfaction in university students from Central-Eastern and Western Europe.
The poor health and psychological well-being of people in the former socialist states of Centeral-Eastern Europe are of serious concern and may be related to low perceived control. We compared depressive symptoms, life satisfaction, and self-rated health in 3,571 male and female university students from 5 Western European countries and 4,793 students from 5 Central-Eastern European countries. Depression scores (short Beck Depression Inventory; Beck & Beck, 1972) were higher in Central-Eastern than Western European samples. The prevalence of low life satisfaction was also greater in Central-Eastern Europeans, but ratings of self-rated health did not differ. Ratings of perceived control were diminished, but sense of mastery and internal health locus of control were higher in Central-Eastern Europe. Depression and low life satisfaction were associated with low perceived control and mastery and with strong beliefs in the influence of chance over health. However, taking these factors into account did not explain the East-West difference in depressive symptoms and low life satisfaction.
Adolescent↗