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PubMedDate not supplied

Determinants of healthy eating in community-dwelling elderly people.

Among seniors, food choice and related activities are affected by health status, biological changes wrought by aging and functional abilities, which are mediated in the larger arena by familial, social and economic factors. Determinants of healthy eating stem from individual and collective factors. Individual components include age, sex, education, physiological and health issues, psychological attributes, lifestyle practices, and knowledge, attitudes, beliefs and behaviours, in addition to other universal dietary determinants such as income, social status and culture. Collective determinants of healthy eating, such as accessible food labels, an appropriate food shopping environment, the marketing of the "healthy eating" message, adequate social support and provision of effective, community-based meal delivery services have the potential to mediate dietary habits and thus foster healthy eating. However, there is a startling paucity of research in this area, and this is particularly so in Canada. Using search and inclusion criteria and key search strings to guide the research, this article outlines the state of knowledge and research gaps in the area of determinants of healthy eating among Canadian seniors. In conclusion, dietary self-management persists in well, independent seniors without financial constraints, whatever their living arrangements, whereas nutritional risk is high among those in poor health and lacking in resources. Further study is necessary to clarify contributors to healthy eating in order to permit the development and evaluation of programs and services designed to encourage and facilitate healthy eating in older Canadians.

Activities of Daily Living↗
PubMedDate not supplied

[Results of a health education program on smoking for trainee workers].

BACKGROUND: Social costs of smoking behaviour are remarkable. Although smoking is an individual choice, it is strongly influenced by a social contest where it is widespread. OBJECTIVES: To induce young non-smoking apprentices to continue as such and smokers to give up smoking. METHODS: During 1999, a specific health education programme on smoking was carried out for a group of 1083 young apprentices, 531 females and 552 males, who came to the occupational health unit in Venice for a check on work fitness. This programme was part of a larger global programme concerning health hazards prevention where apprentices received various information about health and safety at work. Smoking habits were compared to a control group of 312 females and 458 males after a one year follow-up. RESULTS: The females' chance of giving up smoking was three times higher than controls; while the chance of becoming a smoker was 70% lower. The males' chance of giving up smoking was double; while the chance of becoming a smoker was 60% lower. The health education programme decreased the trend of becoming a smoker in cases and increased non-smoking, especially in females. In females, there was also a significant prevalence who reduced cigarette consumption. CONCLUSIONS: This study demonstrates the effectiveness of health education programmes on smoking directed to young people and stresses the role of public health units in the involvement of the users of such services in prevention programmes. An occupational health service has specific prevention objectives here, since promoting healthy attitudes affects motivation of individual behaviour. This is the reason why initiatives on a single specific prevention objective, like smoking, become significant in every context of people's lives. Such attitudes are a significant resource which people can use to protect themselves from hazards, with a resulting safe, aware and active behaviour as regards occupational risks.

Adolescent↗
PubMed2006

Promoting female condoms in HIV voluntary counselling and testing centres in Kenya.

Promotion of male condoms and voluntary counselling and testing for HIV (VCT) have been cornerstones of Kenya's fight against the HIV epidemic. This paper argues that there is an urgent need to promote the female condom in Kenya through VCT centres, which are rapidly being scaled-up across the country and are reaching increasingly large numbers of people. Training of counsellors using a vaginal demonstration model is needed, as well an adequate supply of free female condoms. In a study in five VCT centres, however, counsellors reported that most people they counselled believed female condoms were "not as good" as male condoms. In fact, many clients had little or no knowledge or experience of female condoms. Counsellors' knowledge too was largely based on hearsay; most felt constrained by lack of experience and had many doubts about female condoms, which need addressing. Additional areas that require attention in training include how to re-use female condoms and the value of female condoms for contraception. VCT counsellors in Kenya already promote male condoms as a routine part of risk reduction counselling alongside HIV testing. This cadre, trained in client-centred approaches, has the potential to champion female condoms as well, to better support the right to a healthy and safe sex life.

Single-Use Internal Condom↗
PubMed2005

Effect of smoking on FEV decline in a cross-sectional and longitudinal study of a large cohort of Japanese males.

OBJECTIVE: The effects of cigarette smoking and smoking cessation on age-related pulmonary function decline was assessed in both cross-sectional and longitudinal studies. METHODOLOGY: In the cross-sectional study, pulmonary function data from 11,875 healthy asymptomatic males, aged between 35 and 74, were analysed and correlated with their smoking history and age. In the longitudinal study, changes in pulmonary function were monitored over a 5-year period in 1888 healthy males. RESULTS: The cross-sectional study showed that the difference in FEV(1) between male never smokers and current smokers was small at a younger age but increased with age. A beneficial effect on FEV(1) decline was observed in those who ceased smoking, even within the previous 12 months. Longitudinally, current smokers showed a more rapid decline in FEV(1) over the 5-year period than non-smokers. Those who ceased smoking had lower rates of decline in FEV(1) than those who continued to smoke. CONCLUSION: These results indicate that cigarette smoking is associated with a reduction in pulmonary function, and that smoking cessation has a beneficial effect on FEV(1) decline. Provision of a smoking cessation program for all smokers, especially those showing a rapid decline of FEV(1), should be considered as an important strategy to prevent progression of COPD.

Adult↗
PubMedDate not supplied

Results of a rural breast health education demonstration project.

The Healthy People 2000-National Health Promotion and Disease Prevention Objectives call for an increase in breast health education to the public to increase women's knowledge about breast cancer and the benefits of screening. A breast health outreach education intervention for community health professionals was designed, implemented, and evaluated. The barriers to continuing education of health professionals of rural areas were addressed. Low-cost, county-based seminars using a comprehensive breast health education curriculum were provided for community health professionals. The intervention demonstrated an increase in a professional's knowledge about breast cancer and breast cancer screening, and an increase in their breast self-examination skills. Six months after intervention, community health professionals reported an increase in the frequency of their breast self-examination performance.

Adult↗
PubMedDate not supplied

Older men's health: motivation, self-ratings, and behaviors.

BACKGROUND: There is a documented need to examine the complex motivational systems that lead individuals to adopt health-promoting behaviors and to evaluate the psychosocial aspects of male health. A study focused on health motivation as a determinant of self-rated health and health behaviors among older men was therefore undertaken. OBJECTIVES: This study aimed to explore the relations among health motivation, self-rated health, and health behaviors in community-dwelling older men. METHODS: A descriptive, correlational survey design was used for this study of 135 community-dwelling men ages 55 years and older. The questionnaire packet included a demographic tool, the Older Men's Health Program and Screening Inventory, the Health-Promotion Activities of Older Adults Measure, and the Health Self-Determinism Index. RESULTS: Older men with more intrinsic motivation rated their health as better (p <or=.001) and assessed their lifestyles as more healthy (p <or=.001) than did their counterparts with more extrinsic motivation. Whereas anticipated benefits (a potential motivator) were significantly related to health-promoting behaviors (p <or=.001), health program attendance (p <or=.001), and health screening participation (p <or=.01), the Health Self-Determinism Index score did not demonstrate significant relations with any of these three variables. CONCLUSIONS: The findings suggest that promoting self-motivation may be key to increasing older men's perceptions of health and well-being. Further exploration of anticipated benefits as a motivator of health-promotion activities is warranted, as well as intervention studies to promote older men's health screening and program attendance.

Black or African American↗
PubMed2001

Measles immunity among young adults in Victoria.

Measles outbreaks in Victoria in 1999 and 2001 have suggested that a substantial proportion of young Victorian adults may be susceptible to measles infection. We performed a serosurvey of 300 18-30-year-old healthy blood donors and 312 sera retrieved after diagnostic testing for a non-rash illness in patients of the same age group, with the aim of estimating the proportion of young adults in Victoria immune to measles. We also aimed to define more precisely the birth cohorts at risk of measles infection, with cohorts reflecting the measles immunisation policies of previous years. There was no significant difference in measles immunity between the 300 blood donors (79.0%, 95% confidence interval 73.9-83.5) and the 312 patients whose sera had been stored (84.0%, 95% CI 79.4-87.9, p=0.11). There was, however, a significant difference in immunity by birth cohort. In the combined results from both samples, the proportion of people born between 1968 and 1974 who were immune to measles was 88.4 per cent (95% CI 84.1-91.6) while the proportion of those born between 1975 and 1981 was 74.1 per cent (95% CI 68.7-79.1). This study confirms that a substantial proportion of young Victorian adults are susceptible to measles, but also demonstrates that those born between 1975 and 1981 are more likely to be non-immune than those born before 1975. A review of published Australian data supports this conclusion and confirms the need for a measles control program aimed at young adults.

Adolescent↗
PubMed2003

Heart failure: how can we prevent the epidemic?

Heart failure prevalence is increasing because of the ageing of the population and the longer survival of people experiencing myocardial infarction and heart failure. The lifetime risk of developing heart failure in Western countries is about 20%. The increasing prevalence of overweight, obesity and diabetes is likely to accelerate heart failure incidence. While there have been major advances in treating heart failure, a preventive approach promises greater benefit to a larger proportion of the community. The medical strategy for heart failure prevention, based on calculation of individual risk, is focused on the minority of individuals who exceed an arbitrary risk threshold. A public health strategy targeting the whole population offers a greater prospect of reducing the incidence of heart failure and other cardiovascular disease. A multitiered approach, encompassing environmental determinants of lifestyle, legislation, and education about healthy lifestyles throughout life, in addition to aggressive control of risk factors in high-risk individuals, is likely to have the greatest impact.

Australia↗
PubMed1995

Comparative study of body composition by dual-energy x-ray absorptiometry.

UNLABELLED: Dual-energy x-ray absorptiometry (DEXA) is a readily available technique that has recently been applied to measurement of body composition. In order to validate this technique, results from DEXA were compared with fat-free mass (FFM) and fat mass (FM) measured by total body levels of potassium (TBK), nitrogen (TBN), water (TBW) and carbon (TBC). METHODS: A healthy population of 127 white women and 38 black women with a body mass index of 18-30 were recruited. RESULTS: Compared with each of the other methods, DEXA overestimated FM and underestimated FFM. The slopes of the FM by DEXA versus the FM from each of the four methods were approximately the same, with a s.e.e. ranging from 2.4 to 3.0 units. The slopes of DEXA in comparison to FFM, however, ranged from 0.61 to 0.74 and were significantly less than unity, with a s.e.e. of 1.6 to 2.4 units. CONCLUSION: These findings suggest that at high values of FFM, DEXA is measuring something different from the FFM measured by TBW, TBN and TBK. The program for separating bone and soft tissue and for separating soft tissue into fat and lean at higher values in the DEXA method may need to be adjusted.

Absorptiometry, Photon↗
PubMed1994

Muscle strength and fiber adaptations to a year-long resistance training program in elderly men and women.

BACKGROUND: To study the effects of resistance training on muscle strength and size in older people, we enrolled 8 men and 17 women (mean age 68.2 +/- 1 SEM) into a one-year exercise trial. METHODS: Subjects were randomly assigned to exercise or control groups. Muscle biopsies were obtained from 11 subjects (8 exercisers/3 controls) at baseline and after 15 weeks; exercisers underwent another biopsy at 30 weeks. After testing maximum strength using the 1-RM method, the exercisers began a 12-exercise circuit (3 sets of 8 repetitions at 75% of 1-RM), 3 times a week. The controls repeated the strength testing every 15 weeks. They were asked to continue usual activities and not to start any exercise program. RESULTS: With exercise, muscle strength increased, average increases ranging from 30% (hip extensors) to 97% (hip flexors). Strength increased rapidly over 3 months, then plateaued for the duration of the experiment. No strength changes were observed in sedentary controls. Cross-sectional area of type 1 muscle fibers increased in exercisers by 15 weeks (29.4 +/- 1%, p < .02) and after 30 weeks (58.5 +/- 13.7%, p < .002) compared to baseline. Type 2 fiber area did not change at 15 weeks, but increased by 30 weeks of training (66.6 +/- 9.5%, p < .0002). CONCLUSIONS: These results suggest that prolonged moderate to high intensity resistance training may be carried out by healthy older adults with reasonable compliance, and that such training leads to sustained increases in muscle strength. These improvements are rapidly achieved and are accompanied by hypertrophy of both type 1 and type 2 muscle fibers.

Aged↗
PubMedDate not supplied

DATA2000: CDC WONDER information system linking Healthy People 2000 objectives to data sets.

To monitor progress on the Healthy People (HP) 2000 objectives, planners and researchers will need information on relevant data sources. DATA2000 is a project designed to identify these data and link them with objectives and to develop a computerized information system providing access to this information. Sources of information on objectives and data included Healthy People 2000, catalogs and data bases of data sets, and the HP 2000 Steering Committee. We created an "assessment" of the utility of the data set for the particular objective. A Centers for Disease Control (CDC) WONDER-based information system was developed (using methods previously described). We identified 204 data sets and created 408 assessments. All but one of the objectives were paired with corresponding data. Over half the data come from CDC. The CDC WONDER-based information system crosslinks the objectives, data sets, and assessments and provides 5-10 pages of information about each. Understanding the contribution of prevention will be critical in planning reforms of the health care system. DATA2000 can be an important resource in this process.

Centers for Disease Control and Prevention, U.S.↗
PubMed1991

Metabolism of carbamazepine: evidence of autoinduction in Chinese.

To investigate the autoinduction of carbamazepine (CBZ) metabolism in Chinese, eleven healthy male volunteers joined in this study. There were two phases of drug administration with a wash-out interval of one month, 400 mg CBZ was taken orally in single-dose phase, and 200 mg three times per day were given for seven days in multiple-dose phase. Plasma samples were obtained in series of time after the last dose of drug in each phase. CBZ concentrations were determined by a high pressure liquid chromatography method. A non-linear regression program was applied in a personal computer to estimate the pharmacokinetic parameters. The average CBZ half-lives in single- and multiple-dose phases were 50.1 +/- 12.1 (mean +/- SD) hours and 26.1 +/- 4.2 hours and the clearances were 16.4 +/- 3.3 ml/kg/h and 45.3 +/- 23.4 ml/kg/h respectively, both with significant differences (p less than 0.005). There is evidence to support the presumption of autoinduction in Chinese.

Adult↗
PubMed1995

Long-term resistance training in the elderly: effects on dynamic strength, exercise capacity, muscle, and bone.

We examined the effects of 42 weeks of progressive weight-lifting training on dynamic muscle strength, peak power output in cycle ergometry, symptom limited endurance during progressive treadmill walking and stair climbing, knee extensor cross-sectional areas, and bone mineral density and content in healthy males and females aged 60-80 years, currently enrolled in a 2-year resistance training program. Subjects were randomized into either exercise (EX) or control (CON) groups (60-70 years: 38 males and 36 females; 70-80 years: 25 males and 43 females). EX trained several muscle groups twice per week for 42 weeks at intensities ranging from 50-80% of the load that they could lift once only (1 RM); CON did usual daily activities. After the 10 months there was no change in 1 RM strength in CON, but significant gains (mean increases up to 65%) in EX (no independent age or gender effects); 30% and 47% of the increase in 1 RM had occurred by 6 and 12 weeks, respectively. In EX, the 7.1% increase in peak cycling power output was significantly greater than in CON (+1.1%). The 17.8% improvement in symptom limited treadmill walking endurance was also greater than in CON (+3.4%), but the difference between groups during stair climbing was not significant (EX + 57%, CON + 33%). The cross-sectional areas of the knee extensors increased significantly by 5.5% in EX but were unchanged in CON. There were no changes in bone mineral density or content in either group. We conclude that long-term resistance training in older people is feasible and results in increases in dynamic muscle strength, muscle size, and functional capacity.

Aged↗
PubMed1998

Moderate-intensity aerobic training improves glucose tolerance in aging independent of abdominal adiposity.

OBJECTIVE: To test the hypothesis that training-related improvements in glucose and insulin responses to an oral glucose tolerance test (OGTT) are independent of changes in abdominal adiposity. DESIGN: Adiposity and responses to an OGTT were measured before and after a 4-month randomized, controlled aerobic training program. SETTING: An academic medical institution. PARTICIPANTS: Sixteen healthy older (73+/-1 year) men and women. INTERVENTION: Both the training (T) (n=9) and control (C) (n=7) groups exercised 4 times a week for 60-minute sessions. T exercised on mini-trampolines at 55 to 65% of HRmax (determined from a graded treadmill test) for 1 month and then at 75% for 3 months; C engaged in supervised stretching and yoga. MEASUREMENTS: At baseline and follow-up, we estimated abdominal fat (from computed tomography and anthropometry), plasma glucose, and serum insulin responses to the OGTT and fasting concentrations of free fatty acids (FFA). RESULTS: Aerobic training resulted in a 16% increase in VO2 peak and a 24% decrease in FFA in the T group (P < .05), but training had no effect on abdominal fat. In the T group, the glucose response curve shifted to the left, and the incremental area under the glucose curve decreased by 25% (P < .05). This improvement in glucose response occurred, however, only in those with impaired glucose tolerance at baseline and without any observed change in insulin response. No change in any variables occurred in the C group. CONCLUSIONS: Our data suggest that moderate-intensity aerobic training has a favorable effect on glucose tolerance in older people, independent of changes in abdominal adiposity.

Abdomen↗
PubMed2004

A pilot study of falls, fear of falling, activity levels and fall prevention actions in older people with polio.

BACKGROUND AND AIMS: Polio survivors are ageing, and reporting new complications including falls. The aims of this study were: 1) to determine the frequency of falls, circumstances surrounding them, and the consequences of falls in older people who have polio; and 2) to investigate the range of fall prevention interventions undertaken to reduce the individual's risk of falling. METHODS: A survey was conducted of members of the Eastern Polio Support Group of Victoria. Twenty-eight respondents (70%; 7 male, 21 female) had a mean age of 66 years and an average duration of 57 years since the onset of polio. The survey addressed demographic data, mobility, frequency and description of falls over the last 12 months, their consequences, and community services utilized. The Modified Falls Efficacy Scale (MFES) and Human Activity Profile (HAP) were also completed. Comparative data on the MFES and HAP were obtained from age- and gender-matched healthy community-dwelling older people. RESULTS: Fourteen respondents (50%) reported one or more falls over the past 12 months, half reporting multiple falls. Two-thirds of falls occurred while walking. Of those who fell, 67% did not require medical attention. The highest percentage of injuries were bruises or grazes (44%), with one fracture reported. Sixty-one percent reported being fearful of falling, with an average MFES of 7.4 (+/-2.0), compared with the average of 9.7 (+/-0.5) for the age- and gender-matched controls (p<0.05). Only 5 of the respondents reported changing their level of activity as the result of a fall. A significant difference was identified on the Adjusted Activity Score (AAS) of the HAP between polio non-fallers (mean 56.3+/-19.1), polio fallers (mean 40.1+/-15.6) and age- and gender-matched controls (mean 73.5+/-10.3) (F2,46=25.5, p=0.000). The median number of fall prevention activities undertaken in the previous 12 months was one, 11 of the 28 respondents undertaking two or more. The most common interventions implemented were vision checks (42%) and review of medications by a doctor (25%). CONCLUSIONS: A high rate of falling, fear of falling and low activity levels exist in older people with polio. There is a need for further research and clinical programs to reduce falls and injuries in this group.

Accident Prevention↗
PubMed1994

Terrestrial applications of bone and muscle research in microgravity.

Major applications to people on Earth are possible from NASA-sponsored research on bone and muscle which is conducted either in microgravity or on Earth using models mimicking microgravity. In microgravity bone and muscle mass are lost. Humans experience a similar loss under certain conditions on Earth. Bone and muscle loss exist on Earth as humans age from adulthood to senescence, during limb immobilization for healing of orthopedic injuries, during wheelchair confinement because of certain diseases, and during chronic bed rest prescribed for curing of diseases. NASA-sponsored research is dedicated to learning both what cause bone and muscle loss as well as finding out how to prevent this loss. The health ramifications of these discoveries will have major impact. Objective 1.6 of Healthy People 2000, a report from the U.S. Department of Health and Human Services, states that the performance of physical activities that improve muscular strength, muscular endurance, and flexibility is particularly important to maintaining functional independence and social integration in older adults. This objective further states that these types of physical activities are important because they may protect against disability, an event which costs the U.S. economy huge sums of money. Thus NASA research related to bone and muscle loss has potential major impact on the quality of life in the U.S. Relative to its potential health benefits, NASA and Congressional support of bone and muscle research is funded at a very low level.

Adult↗
PubMed2004

Relationship between high weight and caries frequency in German elementary school children.

OBJECTIVE: Most industrialized countries experienced a change in dietary habits within the last 10 years. Growing obesity may result in an increased incidence of metabolic diseases as well as in a higher caries frequency. METHODS: In an interdisciplinary study, 842 elementary school children (414 girls and 428 boys, age: 6-11 years; elementary grades 1-4) we examined. The dental examination included the determination of caries frequency (DF-T-/ df-t-values) and the medical evaluation assessed the pupils general health (i.e. the height and body weight; body mass index). RESULTS: The study showed that 33.7% of all school children had no decayed or filled teeth (38% of the girls, 30% of the boys). 73.9% of all pupils were within the normal weight range (74.3% of the boys, 73.4% of the girls), 12.9% of the children were overweight (12.4% of the boys, 13.5% of the girls), and 13.2% were even obese (13.3% of the boys, 13% of the girls). 35.5% of the pupils with normal weight had healthy teeth, whereas the number dropped to 27.5% in children that were overweight, and to 29.7% in the obese children. The caries prevalence (DF-T-, df-t-values) also showed a significant association to weight (Fisher-Test, p = 0.022 for df-t-distribution and p = 0.011 for DF-T-distributions). Children with normal weight were found to have average df-t-values of 2.09 (DF-T: 0.57), overweight children an average df-t-value of 2.48 (DF-T-value: 0.91), and obese children showed 3.3 (DF-T.value:0.88). CONCLUSIONS: Since this study showed an association between an increase of dental caries and high weight in elementary school children, the importance of nutrition with respect to high weight should be considered in future preventive programs, in addition to oral hygiene measures.

Body Mass Index↗
PubMed1987

Age and prevalence of sickle-cell trait in a large ambulatory population.

We performed hemoglobin electrophoresis in 30,400 apparently healthy black individuals in the Washington D.C. Metropolitan area, who were participating in a community based sickle-cell screening program during the period 1978-1985. The overall prevalence of sickle-cell trait was 6.7%. The frequency of sickle-cell trait in various age groups, which included young children, adults, and individuals over 65 years of age, ranged from 6.4 to 7.4%. There were no statistically significant differences in the prevalence of sickle-cell trait among the various age groups, nor did we detect a significant trend for increasing or decreasing sickle cell frequency with advancing age (P = 0.418). Thus, in this population sickle-cell trait appears to have no effect on longevity. If the various complications of sickle-cell trait reported in the literature are not fortuitous, their frequency and/or severity must be too low to affect prevalence figures.

Adolescent↗