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Biomedical subjects

K J Stewart

Publications and source records attributed to K J Stewart.

62 records · Page 4Linked to original sources
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Fatigue and quality of life outcomes of exercise during cancer treatment.

PURPOSE: Despite the recognition of fatigue as a common and distressing symptom during cancer treatment, there are few evidence-based interventions available to manage such fatigue. The purpose of this multi-institutional pilot study was to explore the effects of a home-based moderate walking exercise intervention on fatigue, physical functioning, emotional distress, and quality of life (QOL) during breast cancer treatment. DESCRIPTION OF STUDY: Fifty-two women were recruited from five university hospital outpatient departments for this pilot study with an experimental design. Subjects were randomly assigned to the walking program or to usual care during adjuvant chemotherapy or radiation therapy for breast cancer. Symptoms, physical functioning, and QOL were measured at baseline, midtreatment, and at the end of treatment. RESULTS: Women who exercised at least 90 minutes per week on 3 or more days reported significantly less fatigue and emotional distress as well as higher functional ability and QOL than women who were less active during treatment. CLINICAL IMPLICATIONS: A home-based walking exercise program is a potentially effective, low-cost, and safe intervention to manage fatigue and to improve QOL during adjuvant chemotherapy or radiation therapy for breast cancer. This health-promoting self-care activity needs further testing in large randomized clinical trials.

Activities of Daily Living↗
PubMedDate not supplied

Physical fitness, physical activity, and fatness in relation to blood pressure and lipids in preadolescent children. Results from the FRESH Study.

PURPOSE: The cross-sectional gender patterns of fitness, activity, and fatness were examined in relation to blood pressure and lipids in 9- to 10-year-old children. METHODS: Subjects were fourth graders (26 boys and 27 girls) participating in FRESH, a school-based heart health program. The main variables of interest were fitness determined on a treadmill, habitual physical activity by self-report, fatness by skinfolds and body mass index, blood pressure, and lipoprotein lipids. RESULTS: Physical fitness and activity were higher in boys, whereas fatness and triglycerides were higher in girls. Systolic blood pressure correlated positively with fatness in girls, and there was a trend for this relationship in boys. In boys, total LDL cholesterol correlated positively with fatness and negatively with fitness. By multivariate analysis, fitness was the primary correlate of total and LDL cholesterol. In girls, fitness correlated positively with total and LDL cholesterol. This finding was opposite in boys. Fatness correlated negatively with HDL cholesterol in boys. CONCLUSION: Boys are more fit and active and less fat than girls. Fatness in young children already shows a relationship with heart disease risk factors. In boys, fitness shows a favorable relation to lipids. These data along with other studies suggest that more consistent relationships among fitness, activity, fatness, blood pressure, and lipids are likely to emerge as children approach adolescence. The findings also underscore the complexity of defining these relationships in young children.

Blood Pressure↗
PubMedDate not supplied

Safety and efficacy of weight training soon after acute myocardial infarction.

BACKGROUND: To determine if weight training used during cardiac rehabilitation as soon as 4 weeks after myocardial infarction (MI) is safe, and if weight training combined with aerobic exercise improves aerobic fitness and muscle strength more than aerobic exercise alone. METHODS: Twenty-three men within 6 weeks of an acute MI and without exercise-induced ischemia, complex arrhythmias, anterior Q wave MI, or ejection fraction < 40% were randomly assigned to combined weight and cycle training versus cycle training for 10 weeks. The main measures were change in maximal oxygen uptake (VO2max), muscle strength, resting left ventricular (LV) wall segment motion and early diastolic filling by resting echocardiograms, exercise ECG, heart rate, and blood pressure responses [corrected]. RESULTS: VO2max increased 14% (P < 0.01) and cycle time increased 10% (P < 0.01) in the combined training group. The 8% increases in VO2max (P = 0.15) and cycle time (P = 0.08) in the cycling group were not significant. Arm and leg strength increased (P < 0.01) in each group. However, the change was greater for the combined training group--31% versus 16% (P < 0.03) for leg strength and 20% versus 10% (P < 0.001) for arm strength. There were no changes for either group in resting hemodynamics, body weight and composition, LV wall segment motion, LV fractional shortening, and early diastolic function, and no adverse clinical events or exercise-related complications. CONCLUSIONS: Combined training soon after MI improved aerobic and muscle fitness more than cycling alone, and was performed without complication.

Bicycling↗
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Dietary fat and cholesterol intake in young children compared with recommended levels.

PURPOSE: The National Cholesterol Education Program (1991) recommended that children 2 years of age or more derive less than 30% of their daily energy intake from total fat, less than 10% from saturated fat, up to 10% from polyunsaturated fat, and 10% to 15% from monounsaturated fat, and that they consume less than 300 mg/day of cholesterol. The purpose of this study was to assess whether preadolescent children were following these dietary guidelines in 1994 and to determine the relationship of diet to obesity. METHODS: This cross-sectional study was performed in elementary schools in southeast Baltimore, Maryland. The subjects were 468 children, grades 2 through 5 (mean age, 8.9 +/- 0.8 years). The main outcome measures were a 24-hour diet record, body mass index, and skinfold thickness. RESULTS: Mean percentage of total daily energy (TDE) from fat was 31.1%; saturated fat, 11.0%; monounsaturated fat, 10%; and polyunsaturated fat, 4.9%. Mean dietary cholesterol was 199.1 mg/day. Although the means for total and saturated fat are at recommended levels, the distribution of the dietary responses indicates that 50% of the children exceeded these targets. Twenty-five percent exceeded 35% of TDE derived from fat, and 25% exceeded 13% TDE derived from saturated fat. Fifty percent of children consumed below the desired level of monounsaturated fat, and almost no children consumed the desired 10% of polyunsaturated fat. Although mean dietary cholesterol was at a desired level, 16% of the children consumed more than 300 mg/day and 10% more than 377 mg/day. The negative correlation for sum of skinfold measurements with TDE (r = -0.14; P < 0.05), suggesting that fatter children consume fewer calories than thinner children, was the only correlate among dietary components and obesity. CONCLUSION: A substantial percentage of children in the United States are still not meeting recommended levels for dietary intake of fat and cholesterol. The trend for fatter children to consume fewer daily calories suggests that obesity is not entirely a result of overconsumption.

Age Factors↗
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Exercise, lipids, and obesity in adolescents with parental history of coronary disease.

PURPOSE: The purpose of this study is to determine 1) if adolescents of parents with clinically manifest premature coronary artery disease (CAD) are less physically fit and habitually active, and have less favorable lipid profiles and more obesity than children of nonaffected parents, and 2) if aerobic fitness and activity are related to obesity and lipids in adolescents. SETTING: Patients were identified in the Coronary Care Unit or out-patient clinic. Adolescents were evaluated in the cardiovascular laboratories at the Francis Scott Key Medical Center. DESIGN: Comparisons between groups were tested with ANOVA: Univariate and multivariate regression were used to assess relationships among study variables. SUBJECTS: Thirty-six children of affected parents, ages 12 to 19 years, and 29 comparison subjects participated in the study. MEASURES: Fitness was determined by treadmill testing, fasting blood was analyzed for lipoprotein lipids, habitual physical activity was measured by self-report, and the sum of six skinfolds was used to calculate obesity. RESULTS: Total and LDL cholesterol were higher in girls with a parental history of CAD. The sample size was too small to draw any definitive conclusions about differences, based on parental history in lipids or fitness in the boys, or obesity in both genders. Overall, joggers were more fit and less fat than nonjoggers. Girls playing organized sports were more fit and less fat than nonparticipants. Aerobic fitness correlated negatively with obesity in both genders; fitness was independently associated with HDL cholesterol only in the boys. CONCLUSION: (ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Exercise training combined with antihypertensive drug therapy. Effects on lipids, blood pressure, and left ventricular mass.

We studied exercise training combined with the use of antihypertensive drugs and examined the following questions. (1) Are there additive antihypertensive benefits with exercise and drug therapy combined? (2) Does drug therapy limit exercise-induced lipid improvements? (3) Does exercise that includes weight training and walking/jogging affect the left ventricle? Fifty-two hypertensive men were randomly assigned, double-blind, to diltiazem hydrochloride, sustained release (360 mg daily), propranolol hydrochloride (240 mg daily), or placebo and exercised three times per week for 10 weeks. Baseline blood pressure (145/97 mm Hg) fell after training (131/84 mm Hg) in all groups. Exercise decreased total and low-density lipoprotein cholesterol levels in all groups. Increases in the levels of high-density lipoprotein cholesterol were similar in placebo and diltiazem groups, whereas the propranolol group changed in an opposite direction. In all groups, left ventricular mass increased with training, while diastolic function was unchanged. We conclude that (1) drug therapy provided no additive benefit to the antihypertensive effects of exercise, (2) propranolol limited improvements in high-density lipoprotein cholesterol, and (3) exercise did not adversely affect the left ventricle.

Adolescent↗