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PubMed2006

Dose-response relation between physical activity and sick leave.

OBJECTIVE: To investigate the dose-response relation between moderate and vigorous physical activity and sick leave in a working population. METHODS: Data were used from three large Dutch databases: two continuous, cross sectional surveys among a representative sample of the Dutch population and one prospective cohort study. A distinction was made between duration, frequency and intensity of physical activity. The outcome measure was the number of days of sick leave. Analyses of variance were used to compare sick leave (in days) for workers with different amounts of physical activity, in particular workers meeting the physical activity recommendations v those who did not. Linear and logistic regression analyses were used to obtain effect estimates in the prospective cohort study, with the generalised estimating equation (GEE) method. RESULTS: No relation was found between moderate physical activity and sick leave. In two databases, workers meeting the recommendation of vigorous physical activity (active at a vigorous level for at least three times a week) had significantly less sick leave: more than one day over two months and more than four days over a year. The duration of vigorous physical activity was not associated with sick leave. CONCLUSION: Physical activity at a vigorous intensity level for at least three times a week, as in the CDC/ACSM recommendation, has a positive effect on sick leave.

Adult↗
PubMed1993

Lifelong exercise and stroke.

OBJECTIVES: To examine the potential of lifelong patterns of increased physical activity to prevent stroke. DESIGN: Case-control study. SETTING: 11 general practices in west Birmingham. SUBJECTS: 125 men and women who had just had their first stroke and were aged 35-74 and 198 controls frequency matched for age and sex recruited over 24 months during 1988-90. Exclusion criteria were a previous history of stroke, mitral valvular heart disease combined with atrial fibrillation, primary or metastatic cerebral neoplasm, or coagulation disorder or myeloproliferative disease. MAIN OUTCOME MEASURES: Odds ratios for stroke related to lifetime history of exercise after 15 years of age. RESULTS: A history of vigorous exercise during the ages 15-25 appeared to protect from stroke: odds ratio adjusted for age and sex 0.33 (95% confidence interval 0.2 to 0.6). This effect was independent of other potential risk factors. Increasing years of participation in vigorous exercise between the ages of 15 and 55 produced an increasing protection from stroke (p < 0.001). In the 65 cases and 169 controls who were free of cardiac ischaemia, peripheral vascular disease, and poor health recent vigorous exercise and walking were protective against stroke: odds ratios of 0.41 (0.2 to 1.0) for recent vigorous exercise and 0.30 (0.1 to 0.7) for recent walking. CONCLUSIONS: Appreciable protection from stroke in later life is conferred by vigorous exercise in early adulthood. This increased level of physical activity should, if possible, be continued lifelong.

Adult↗
PubMed2004

Interactive effects of habitual physical activity and calcium intake on bone density in boys and girls.

The purpose of this study was to assess the interactive effects of habitual physical activity (total and vigorous intensity) and calcium intake on bone mineral content (BMC) in prepubertal boys and girls. Seventy-six children, aged 8-11 yr, wore accelerometers for up to 7 days to assess activity. Calcium intake was estimated by a 4-day weighted food diary. BMC and areal density (bone mineral density) were measured at the total body, proximal femur, and femoral neck by using dual-energy X-ray absorptiometry. Moderated regression analyses were used to assess the contributions of physical activity (total and vigorous) and calcium intake to BMC, residualized for bone area and body mass. Interactive effects of vigorous activity (> or =6 metabolic equivalents) and calcium intake were found at the total body in boys (b = 2.90 x 10(-3)) and in girls (b = 6.58 x 10(-3)) and at the proximal femur (b = 9.87 x 10(-5)) and femoral neck (b = 2.29 x 10(-5); where b is the regression coefficient from final equation) in boys only; residualized BMC was high only if both vigorous activity and calcium intake were high. There were no interactive effects of total activity and calcium intake. This study provides evidence for synergistic action of habitual vigorous activity and calcium intake on bone mass in children. Recommendations for optimizing bone mass should reflect this synergism.

Activities of Daily Living↗
PubMed2006

Children's television viewing and objectively measured physical activity: associations with family circumstance.

BACKGROUND: The contribution of family circumstance to physical activity and television viewing has not been widely investigated in pre-adolescents, and available information is inconsistent. This study examines whether television viewing and objectively measured physical activity vary by different indicators of family circumstance. METHODS: Data from the 2001 Children's Leisure Activity Study and the 2002/3 Health, Eating and Play Study, involving Australian children in Grades Prep (mean age 6y) and 5-6 (mean age 11y), were combined. Children wore accelerometers for six consecutive 24 hour periods. Average min/day in low-intensity activity (1.0-1.9 METs) and moderate-to-vigorous-intensity activity (>or=3 METs) were calculated. Parents reported children's television viewing and family circumstance. Linear regression analyses were conducted separately for young girls, young boys, older girls and older boys. RESULTS: Complete data were available for 2458 children. Parental education and, to a lesser extent, employment level were inversely associated with television viewing. Children in single-parent families, those whose fathers were not in paid employment, and those without siblings tended to spend more time in low-intensity activity than their peers. Children with siblings spent more time in moderate-to-vigorous-intensity activity; associations were stronger for girls. Maternal education was positively associated with moderate-to-vigorous-intensity activity for younger children. Maternal employment was positively associated with moderate-to-vigorous-intensity activity for older children. Multivariable models did not demonstrate a cumulative explanatory effect. CONCLUSION: Individual measures of family circumstance were differentially associated with television, low-intensity activity and moderate-to-vigorous-intensity activity and associations were often not consistent across age-by-gender groups. Interventions may need to be tailored accordingly.

Journal Article↗
PubMed2003

Validity of a modified CHAMPS physical activity questionnaire among African-Americans.

PURPOSE: Valid methods for assessing physical activity (PA) patterns are essential for accurate evaluation of intervention programs and population surveillance. Numerous self-report PA instruments have been validated in white adults; however, few studies have reported validity in African-Americans. METHODS: Data are from the Healthy Body/Healthy Spirit Trial, a study to increase fruit and vegetable intake and physical activity among adults in 17 black churches. Participants completed a modified version of the CHAMPS activity recall as well as components of the Yale Physical Activity Survey and the Paffenberger Activity Questionnaire. The modified CHAMPS was scored to yield four indices: moderate to vigorous physical activities (MET value > or = 3.0), vigorous activities (MET value > or = 5.0), "Sports and Recreational Activities," and all activities. Estimated V(O2) maximum was obtained by submaximal treadmill test in 138 participants, 109 females and 29 males. RESULTS: With the exception of moderate to vigorous activities, the modified CHAMPS indices were significantly correlated with estimated maximum VO(2). Highest correlations were observed for the index of vigorous and sports-related activities, 0.19 and 0.32, respectively. Activity measures were generally uncorrelated with blood pressure, body mass index, or total cholesterol. For the CHAMPS indices, correlations with VO(2max) and other physiologic variables were generally higher for males than females as well as those with income < 30,000 US Dollars and for those participants who did not complete college. CONCLUSION: Responses from the modified CHAMPS were moderately correlated with estimated VO(2max), with higher correlations for vigorous activity and recreational sports indices. The instrument may be useful for assessing physical activity among African-Americans. Stronger correlations for individuals with lower income and educational attainment was an unexpected finding that merits further examination.

Adult↗
PubMed2004

Youth recall and TriTrac accelerometer estimates of physical activity levels.

PURPOSE: To examine significance of missing data and describe physical activity patterns using recall and accelerometer measures among youth in a nonlaboratory setting. METHODS: Fifty-four middle-school students wore TriTrac-R3D monitors (TTM) and completed an interviewer-prompted 24-h recall during two, 5-d monitoring sessions. We coded 2860 30-min recall intervals to a standard MET compendium. Complete TTM data were gathered for 43 students. Ordinal multinomial models tested for bias in TTM estimates of activity levels due to: 1) exclusion of subjects with incomplete TTM data, and 2) exclusion of intervals within days due to missing TTM data. RESULTS: Students with complete monitor data had an average 12.5 +/- 0.9 monitored hours per day over 5.5 +/- 2.1 d. Compared with students with incomplete monitoring data, they reported similar proportions of recall 30-min intervals at sedentary (68% vs 69%), light (14% vs 15%), moderate (11% vs 10%), and vigorous (7% vs 6%) intensity levels (P = 0.63). The proportion of recall intervals (within days) with and without simultaneous monitoring data did not differ by activity intensity (P = 0.64) across sedentary (69% vs 67%), light (14% vs 12%), moderate (11% vs 10%), and vigorous (6% vs 9%) categories. Recalls overestimated percent time per day in moderate and vigorous activity relative to TTM (22.8% vs 8.9%, P < 0.0001). Boys reported higher percent of time than girls in vigorous activity (10.9% vs 3.9%, P < 0.05). Girls reported more time than boys (9.5% vs 6.4%, P < 0.05) in light activities. No significant sex differences were observed using TTM. CONCLUSIONS: Missing TTM data did not bias estimates of activity levels. Self-reported activity measures overestimated moderate and vigorous activity relative to the TTM and varied by sex.

Adolescent↗
PubMed2005

An adult physical activity scoring scheme: its evaluation and application.

PURPOSE: The purpose of this paper was to describe the development and evaluation of an adult physical activity (PA) scoring scheme (SS). METHODS: SS was based on the 2000 METs compendium and PA guidance. Scoring credit was assigned to moderate (3-6 METs) or vigorous (>6 METs) activities using a 100-point scale. A point designator for evaluation (80.01-100, good; 51.00-80, needs improvement; and <51, poor) was based on guidance to perform 30 min of moderate activity > or = 5 d x wk(-1) or 20 min of vigorous activity > or = 3 d x wk(-1). Activities were scored individually and summed for a final score. PA information was from the Behavioral Risk Surveillance Survey, 2000. Weighted data were analyzed using SAS. Sensitivity and specificity methods were used to evaluate the SS. Fifty-six PA met intensity criteria and were examined for frequency and duration. RESULTS: Study included adults > or = 18 yr (N = 173,980). 71.4% of the men and 67.2% of the women reported moderate or vigorous activity, but only 13.1% of the men and 12.8% of the women received a good score. 48.9% of the men and 41% of the women needed improvement and 9.4% of the men and 13.4% of the women had a poor score. The sensitivity of identifying inactivity was 94 and 95% for inactive men and women, respectively; 92% for identifying both men and women needing improvement; and 79% for men and 90% for women with a poor score. The specificity of getting a good score was 57 and 60% for active men and women, respectively. CONCLUSION: SS appropriately assigns scoring credit to moderate and vigorous activities. However, assumptions made for mixed moderate and vigorous activities may misclassify active individuals.

Adult↗
PubMed2006

International Physical Activity Questionnaire: Validity against fitness.

PURPOSE: This study was conducted to criterion-validate the short format of International Physical Activity Questionnaire (IPAQ) against health-related fitness. METHODS: Participants included 951 men, aged 21-43 yr. VO2max by ergometer was used to measure cardiorespiratory fitness. Muscular fitness tests included the number of sit-ups, push-ups, and squats performed during 60 s. Physical activity was assessed from IPAQ by categories for health (health-enhancing physical activity (HEPA)) and by calculating total and vigorous MET-hours per week. The participants were classified in five groups of almost equal size by the IPAQ outcomes. Moreover, the frequency of vigorous activity was assessed by one precoded question (single-item question on leisure-time vigorous physical activity (SIVAQ)). RESULTS: The mean fitness improved from the first through the fourth IPAQ group. VO2max in the most active IPAQ group, however, was lower than in the fourth group (P < 0.05), both with HEPA categories and vigorous METs as the outcome. In contrast, the weekly frequency of vigorous physical activity showed a positive association with fitness through all six categories. The 65 sedentary (according to SIVAQ) and unfit individuals who belonged to the highest 20% (by IPAQ total METs) were older (30.6 +/- 5.1 vs 28.9 +/- 3.8, P = 0.02), more obese (waist 93 +/- 12 vs 89 +/- 10 cm), more often current smokers (59.4 vs 42.0%; P = 0.03), and less educated (<12 yr of education 70.8 vs 52.0%; P = 0.02), compared with the others in the highest IPAQ group. CONCLUSIONS: Almost 10% of young men had poor fitness and apparently low physical activity, but they reported very high physical activity by IPAQ. An evident need therefore exists to develop IPAQ further to solve the apparent overreporting by a considerable proportion of sedentary individuals.

Adult↗
PubMed1975

Heart rate in fetuses and neonates in normal conditions and with mild depression.

The continuous recording of fetal and neonatal heart rate gives reliable information on the condition of the fetus and neonate. In the present study the results obtained in vigorous and mildly depressed newborns, by the continuous recording of fetal heart rate during labor and of neonatal heart rate during 90 minutes after birth, are presented. Twenty three pregnant women were studied during labor, as well as their newborns. They fulfilled the following conditions: --Mothers without known complications and good prenatal care. --Term pregnancies with single fetuses in vertex presentation with birthweight normal for age. --All labors started, progressed and delivered spontanously withoug signs of fetal distress. No drugs were given to the mother during labor or to the neonate. The umbilical cord was clamped immediately after birth. Seventeen neonates were vigorous at 1 and 5 minutes (Apgar score 7 or higher). Six neonates were slightly depressed at the first minute but all of them recovered at 5 minutes. Both groups are studied separately. Figure 1 shows the average values of BFHR and NHR corresponding to 17 vigorous newborns (Apgar scores 7-10 at the first and fifth minutes of life). No major variations were found in the average values of BFHR in the time period studied. No statistically significant differences were found in the BFHR of the same fetus at 60, 30 and 8 minutes before delivery (Fig. 2). A decrease in BFHR occurred during the 6 minutes preceding birth (fig. 1). After birth the average values of NHR were higher than the fetal ones (Fig. 1). This post-natal increase in heart rate (32 beats/min) is statistically significant when BFHR values 30 minutes before delivery are compared with NHR values recorded 10 minutes after birth (Fig. 3). After this initial increase, NHR starts a gradual fall, lasting about 50 minutes and then becomes stable at a level similar to that of fetal heart rate (Fig. 1). Figure 1 shows that puncture of the heel causes an increase in NHR. The difference between NHR before and after the puncture is significant (Fig. 6). The heart rate of 6 newborns which were slightly depressed at the first minute of life (Apgar score 4-6) but vigorous at the fifth minute, are not significantly different from those of the vigorous group of 17 neonates (Fig.7). The cases chosen for this study have been carefully selected with the aim of establishing the "normal" pattern of fetal and neonatal heart rate. We concluded that in normal term labors BFHR remains stable from 90 until 10 minutes before delivery; there is a tendency to fall during the last 6 minutes preceeding birth. Immediately after birth, neonatal heart rate rises significantly, then falls gradually and becomes stabilized 50 minutes after delivery, at levels similar to those of BFHR.

Adolescent↗
PubMed1979

HCS, estriol and oxytocinase in maternal serum and neonatal condition in high risk pregnancies.

In order to find a reliable index of fetal wellbeing, maternal estriol, hCS and oxytocinase levels were related with condition of the neonate. Fifty six high risk pregnancies were studied. Estriol and hCS were determined by specific radioimmunoassay and oxytocinase with a colorimetric method. The condition of the newborn was evaluated by the APGAR score. Neonates were divided into two groups, depressed (APGAR score 0-6) and vigorous (APGAR score 7-10). When the mean birthweights of both groups were statistically different, maternal estriol levels were corrected to avoid the influencing factor of newborn weight. Mean maternal estriol level corresponding to vigorous newborns was 46.73 ng/ml. This value was statistically higher than that corresponding to the group of depressed newborns, which was 26.25 ng/ml (Fig. 1). The mean birthweight of depressed infants (2,382.75 g) was statistically lower than that of the vigorous group (3,044.75 g). The corrected mean maternal estriol values of vigorous neonates (45.44 ng/ml) was different from that of depressed ones (25.14 ng/ml) (Fig. 2). When patients were divided according to maternal diseases (diabetes, vascular pathology, Rh sensitization) serum estriol levels of the mother were statistically different according to the Apgar score of the newborns. There was no significant difference between serum hCS and oxytocinase levels of mothers with depressed and vigorous newborns. Discarding fetal weight as an influencing factor in maternal hormone level, our results indicate the suitability of maternal serum estriol determinations to predict condition of the newborns in high risk pregnancies.

Aminopeptidases↗
PubMed1991

The effects of crossfostering pigs on survival and growth.

Data from 254 crossfostered pigs and 753 noncrossfostered pigs of Duroc and Landrace first-parity litters were used to assess the phenotypic effects of crossfostering on baby pigs. Differences between crossfostered and noncrossfostered pigs in the recipient litter were analyzed. Phenotypic correlations were calculated for selected individual pig traits (n = 1007, combined foster and nonfoster data). Birth weight was correlated positively with improved birth vigor (r = .40; P less than .01), survival to 21 d (r = .34; P less than .01) and weight at 21 d (r = .37; P less than .01). Improved birth vigor was correlated positively with pig survival to 21 d (r = .70; P less than .01) and to weaning (r = .66; P less than .01). These correlations indicate that baby pig size and strength are related and that these two characteristics influence survival and performance. Pigs that were not crossfostered (adjusted for birth vigor) had a 4.8% (P less than .10) higher rate of survival to 21 d and a 6.8% (P less than .05) higher rate of survival to weaning (42 d). However, crossfostered pigs had greater birth vigor (P less than .01). Unadjusted for vigor, crossfostered pigs had an 11.3% (P less than .01) higher rate of survival to 21 d and an 8.6% (P less than .05) higher rate of survival to weaning than noncrossfostered pigs. These results indicate that when average-strength pigs were crossfostered, livability was reduced. However, crossfostered pigs that were stronger than average had greater livability than pigs that were not crossfostered.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Husbandry↗
PubMed1991

Physical activity and hypertension: an epidemiological view.

We examined patterns of physical activity and other characteristics that might deter hypertension or delay all-cause mortality among university alumni, 1962-1985. Collegiate sports play did not alter hypertension incidence, nor did contemporary walking, stair-climbing, or light sports play among 5463 University of Pennsylvania alumni, 739 of whom developed hypertension. But vigorous sports play reduced hypertension incidence; and overweight, gain in weight, history of parental hypertension, or any combination of these, increased it. Among 819 hypertensive Pennsylvania alumni (138 died during follow-up), vigorous sports play had minimal influence on mortality; but freedom from overweight and cigarette smoking deferred death. Among 16,936 Harvard College alumni, of whom 2614 died during follow-up, lack of vigorous sports play, or presence of hypertension, cigarette smoking, and overweight increased risk of premature mortality, heightened by any combination of these adverse characteristics. Overall, we found an inverse relationship between vigorous sports participation and hypertension risk but a direct relationship between risk and weight-for-height, weight gain, or parental hypertension. With regard to all-cause mortality, cigarette smoking and hypertension were most hazardous for the individual; smoking and lack of vigorous recreational play were most hazardous for the alumnus population as a whole.

Adult↗
PubMed2005

Prevalence of physical activity levels by ethnicity among adults in Hawaii, BRFSS 2001.

BACKGROUND: Few studies have examined the differences in physical activity levels between subgroups of Asian or Pacific Islanders living in the United States. This study compared levels of physical activity for three subgroups of Asian or Pacific Islanders residing in Hawaii. METHODS: Data on Native Hawaiian/Part Native Hawaiian (N=585), Filipino (N=548), Japanese (N=871), and White (N=1728) adults were obtained from the Hawaii 2001 Behavioral Risk Factor Surveillance System (BRFSS), which contained more detailed questions on ethnicity than are collected by most states. Six physical activity categories were compared: inactive, insufficient (some activity but less than recommended activity), moderate activity (> or = 30 minutes of moderate activity > or = 5 days a week), vigorous activity (> or = 20 minutes of vigorous activity > or = 3 days a week), recommended activity (meeting either moderate or vigorous activity requirements), and a recently suggested target of > or = 60 minutes of moderate activity 7 days a week or > or = 20 minutes of vigorous activity > or = 4 days a week. RESULTS: Among Asians or Pacific Islanders, Native Hawaiians/Part Native Hawaiians were most active (38.9% moderate and 23.9% vigorous), followed by Japanese (32.1%, 20.4%) and Filipinos (31.8%, 18.6%). Whites were more active than any of these three subgroups (47.2%, 35.4%). CONCLUSIONS: Differences in physical activity levels between subgroups of Asians or Pacific Islanders in Hawaii suggests that aggregated data for all subgroups obscures important information about disparities in activity levels. State efforts to reduce disparities in activity levels should take into account differences between Asian or Pacific Islander subgroups.

Adolescent↗
PubMed1998

A prospective study of physical activity and prostate cancer in male health professionals.

Because the role of exercise in prostate cancer is unclear, we examined the relationship between leisure time physical activity and risk of prostate cancer in the Health Professionals Follow-up Study, a prospective cohort study of male health professionals in the United States. In 1986, 47,542 men 40-75 years of age and free of cancer responded to a mailed questionnaire that included an assessment of physical activity. The reported average time per week spent on each of a variety of nonoccupational activities was multiplied by its typical energy expenditure requirements expressed in metabolic equivalents (METs) and summed to yield a total weekly MET-hour score. We also examined MET-hours from all vigorous activities, defined as those requiring energy expenditures of six or more METs, and nonvigorous activities. From 1986 until January 31, 1994, we identified 1362 incident cases of total prostate cancer (excluding stage A1), 419 advanced (extraprostatic) cases, and 200 metastatic cases. No relationship with total or advanced prostate cancer was evident for total, vigorous, and nonvigorous physical activity. For metastatic prostate cancer, we also found no linear trends for these activities, but did observe a significantly lower risk in the highest category of vigorous activity (multivariate relative risk = 0.46; 95% confidence interval = 0.24-0.89 for > 25 versus 0 MET-hours), controlling for age, vasectomy, history of diabetes, height, smoking, and dietary factors. This highest category included 15% of the population and reflects at least 3 h/week of participation in vigorous activities. Differences in disease surveillance according to activity level could not account for our findings. The results from this cohort indicate that physical activity is unlikely to influence the incidence of total prostate cancer appreciably; however, the suggestion of a lower risk of metastatic prostate cancer in men engaging in high levels of vigorous activities warrants further study.

Adult↗
PubMed2006

A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus.

BACKGROUND: Although gestational diabetes mellitus (GDM) has been associated with substantial adverse health outcomes for both mothers and offspring, few modifiable risk factors for GDM have been identified. METHODS: We conducted a prospective cohort study among women in the Nurses' Health Study II to assess whether the amount, type, and intensity of pregravid physical activity and sedentary behaviors are associated with GDM risk. The analysis included 21,765 women who reported at least 1 singleton pregnancy between 1990 and 1998. Physical activity and sedentary behaviors were assessed through validated questionnaire. RESULTS: We documented 1428 incident GDM cases. After controlling for body mass index, dietary factors, and other covariates, there was a significant inverse association between vigorous activity and the risk of GDM. The multivariate relative risk (RR) comparing the highest with the lowest quintile of vigorous activity was 0.77 (95% confidence interval [CI], 0.69-0.94) (P = .002 for trend). Among women who did not perform vigorous activity, brisk walking pace was associated with significantly lower GDM risk (RR, 0.66; 95% CI, 0.46-0.95) compared with an easy pace. Women who spent 20 h/wk or more watching television but did not perform vigorous activity had a significantly higher GDM risk than women who spent less than 2 h/wk watching television and were physically active (multivariate RR, 2.30; 95% CI, 1.06-4.97). CONCLUSION: Our prospective study provides strong evidence that regular physical activity before pregnancy is associated with lower GDM risk.

Activities of Daily Living↗
PubMed2003

Frequency and intensity of activity of third-grade children in physical education.

BACKGROUND: Health recommendations are for preadolescent children to have daily school physical education (PE) classes that engage children in moderate to vigorous physical activity at least 50% of class time. OBJECTIVE: To observe activity of children in PE classes in third grades across 10 different sites. DESIGN: Observational study. SETTING: Six hundred eighty-four elementary schools in 10 sites. SUBJECTS: A total of 814 children (414 boys, 400 girls; mean age, 9.0 years) enrolled in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. METHODS: Each child was observed during 1 scheduled PE class. MAIN OUTCOME MEASURE: The SOFIT (System for Observing Fitness Instruction Time) observation method, a validated, heart rate observation system, yields levels of activity the child is engaged in as well as the lesson context, type of teacher, and location of the PE class. RESULTS: Children averaged 2.1 PE lessons per week, of 33 minutes each. Only 5.9% of children had daily PE. Children accrued 4.8 very active and 11.9 minutes of moderate to vigorous physical activity per PE lesson, 15.0% and 37.0% of lesson time, respectively. Lesson length and number of minutes per week were similar for boys and girls; however, boys spent proportionately more PE time in very active and moderate to vigorous activity. This resulted in boys having a higher energy expenditure rate than girls. CONCLUSION: Children observed in this study received 25 min/wk of moderate to vigorous activity in school PE, falling far short of national recommendations.

Child↗
PubMed2005

Risk factors for functional decline in older adults with arthritis.

OBJECTIVE: Functional limitation is a major factor in medical costs. This study was undertaken to evaluate the prevalence of functional limitation among adults with arthritis and the frequency of functional decline over 2 years, and to investigate factors amenable to public health intervention that predict functional decline. METHODS: Longitudinal data (1998-2000) from a cohort of 5,715 adults ages 65 years or older with arthritis from a national probability sample were analyzed. Function was defined based on ability to perform basic activities of daily living (ADL) tasks and instrumental ADL. Adjusted odds ratios (ORs) from a multiple logistic regression model were used to estimate the associations between functional decline and comorbid conditions, health behaviors, and economic factors. RESULTS: Overall, 19.7% of this cohort had functional limitation at baseline, including 12.9% with ADL limitations. Over the subsequent 2 years, function declined in 13.6% of those at risk. Functional decline was most frequent among women (15.0%) and minorities (18.0% Hispanics, 18.7% African Americans) with arthritis. Lack of regular vigorous physical activity, the most prevalent risk factor (64%), almost doubled the odds of functional decline (adjusted OR 1.9, 95% confidence interval 1.5-2.4) after controlling for all risk factors. It was found that if all subjects engaged in regular vigorous physical activity, the expected functional decline could be reduced as much as 32%. Other significant predictors included older age, cognitive impairment, depressive symptoms, diabetes, physical limitations, no alcohol use, stroke, and vision impairment. CONCLUSION: Lack of regular vigorous physical activity is a potentially modifiable risk factor that could substantially reduce functional decline and associated health care costs. Prevention/intervention programs should include regular vigorous physical activity, weight maintenance, and medical intervention for health needs. (c) 2005, American College of Rheumatology.

Activities of Daily Living↗
PubMed2005

Dietary carbohydrates and breast cancer risk: a prospective study of the roles of overall glycemic index and glycemic load.

We examined breast cancer risk in association with overall glycemic index (GI), glycemic load (GL), and dietary carbohydrate and sugar intake in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study who completed a self-administered food frequency questionnaire between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. During a mean follow-up of 16.6 years, we observed 1,461 incident breast cancer cases. GI, GL, total carbohydrate and total sugar intake were not associated with breast cancer risk in the total cohort. However, there was evidence of effect modification of the association between GI and breast cancer risk by menopausal status (p = 0.01), the hazard ratio for the highest versus the lowest quintile level of GI being 0.78 (95% CI = 0.52-1.16; ptrend = 0.12) in premenopausal women and 1.87 (95% CI = 1.18-2.97; ptrend = 0.01) in postmenopausal women. The associations between GI and GL were not modified by body mass index (BMI) or by vigorous physical activity among pre- or postmenopausal women. Similarly, the associations between GI/GL and risk in postmenopausal women were not modified by BMI, vigorous physical activity, or ever use of hormone replacement therapy (HRT), although the associations were slightly stronger among those who reported no vigorous physical activity (ptrend = 0.02), among those who reported ever using HRT (ptrend = 0.02) and among normal-weight women (BMI < 25 kg/m2; ptrend = 0.03). Our data suggest that consumption of diets with high GI values may be associated with increased risk of breast cancer among postmenopausal women, possibly more so among subgroups defined by participation in vigorous physical activity, ever use of HRT and those who are not overweight.

Blood Glucose↗