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PubMed1998

Lifestyle physical activity interventions. History, short- and long-term effects, and recommendations.

INTRODUCTION: Lifestyle physical activity interventions have resulted in response to the public health problem of promoting regular amounts of physical activity to the majority of U.S. adults who remain inadequately or completely inactive. These lifestyle interventions allow a person to individualize his/her physical activity programs to include a wide variety of activities that are at least of moderate intensity and to accumulate bouts of these activities in a manner befitting his/her life circumstances. METHODS: We reviewed the history of lifestyle physical activity interventions and defined lifestyle physical activity based on this review. We located 14 studies that met this definition. RESULTS: Lifestyle physical activity interventions are effective at increasing and maintaining levels of physical activity that meet or exceed public health guidelines for physical activity in representative samples of previously sedentary adults and obese children. The majority of these interventions have been delivered by face-to-face contact in small groups, which limits their public health impact. However, a small number of studies demonstrate that these interventions can be delivered by mail and telephone, which may enhance their generalizability. Most of these studies utilized behavior change theories such as Social Cognitive Theory, the Transtheoretical Model, and Behavior Learning to shape the interventions. Lifestyle interventions aimed at modifying the environment, such as signs posted to increase stair climbing, also have been shown to be effective over the short term. CONCLUSIONS: The major issues concerning lifestyle physical activity interventions are: (1) testing their ability to be implemented on a large scale; (2) examining cost-effectiveness for different modes of delivery; and (3) researching the efficacy in populations such as the elderly, minorities, economically disadvantaged, and individuals with concurrent disease. More studies aimed at manipulating the environment to increase physical activity need to be tested over periods of one year or longer. It is possible that lifestyle interventions could be integrated and delivered by new technologies such as interactive computer-mediated programs, telephone, or computer web-based formats. All of these recommended approaches should utilize valid and reliable measures of physical activity and should examine the health effects, particularly on a longitudinal basis. Basic dose-response studies in controlled settings also are needed to help us understand the health effects of accumulated moderate intensity activity.

Adult↗
PubMed1999

Physical functioning: definitions, measurement, and expectations.

The nephrology community has begun to recognize the importance of physical functioning in the overall treatment of their patients. Physical functioning is highly associated with such outcomes as hospitalization, nursing home admission, falling, level of dependency, and death in older individuals. Because there are many terms used to refer to physical functioning, this report classifies physical functioning into basic actions and complex activities; activities considered essential for maintaining independence, and those considered discretionary that are not required for independent living, but may have an impact on quality of life. We also present a model of the determinants of physical functioning, which goes beyond the presence or absence of disease and considers physical, sensory, environmental, and behavioral factors. Measurement of physical functioning can be complicated and ranges from self-report questionnaires to performance measures of specific tasks to vigorous laboratory measures. There are limitations to each of the measurement methods; however, some level of assessment provides information about the patient that is not otherwise available. Valid and reliable tests of physical performance are available that are easily administered and provide valuable information about the patient. Just as the patient's nutrition, medications, and adequacy of dialysis are monitored, baseline and subsequent physical functioning assessments allow us to monitor the patient's clinical course as it relates to their physical ability. Such measurement also allows for the identification of patients with lower functioning who would benefit from physical therapy or other exercise intervention.

Exercise↗
PubMed2005

Victims of physical abuse among patients with cancer referred to psychiatric clinic in a cancer center hospital: a pilot study.

OBJECTIVE: Physical abuse is one of the most important public health problems, but little is known about physical abuse of cancer patients. The objects of this study are (1) to identify whether cancer patients have sustained physical abuse; (2) to explore clinical characteristics of the abused patients. METHODS: We reviewed 584 cancer patients referred to our psychiatry clinic by a cancer center hospital and investigated whether there were victims of physical abuse among these patients. We also investigated psychiatric characteristics of the abused patients. RESULTS: Of these 584 patients, three patients were recognized as victims of physical abuse at the time of referral. The perpetrator of physical abuse was their husband (domestic violence) in all three cases. All three patients had sustained physical abuse from their husbands for years before being diagnosed with cancer. In addition to physical abuse, all three patients had sustained emotional abuse (e.g., threat or intimidation) from their husbands. Psychiatric diagnoses of all three patients fulfilled the DSM-IV criteria for post-traumatic stress disorder (PTSD) and the traumatic event was mainly physical abuse by their husbands. SIGNIFICANCE OF RESULTS: Oncologists and psychiatrists should pay greater attention to the psychosocial and environmental problems of cancer patients and inquire about the presence of physical abuse in suspected cases. Medical staff should also know that early multidisciplinary interventions in addition to cancer treatments are needed for victims of physical abuse among cancer patients and that these interventions are necessary to improve compliance with treatment and proper decision making.

Adult↗
PubMed2003

Secular trends in acute myocardial infarction in relation to physical activity in the general Danish population.

Secular trends in AMI rates were analyzed in relation to physical activity levels. The population attributable risk of physical inactivity was calculated. Participants were randomly selected subjects from a suburb of Copenhagen, Denmark, screened during the years 1964-1991. Occupational physical activity and in leisure time were assessed 1964, 1974, 1976, 1982, 1987 and 1991 by self-administered questionnaire along with smoking habits and alcohol consumption. Blood pressure, weight, height and serum lipids were measured according to WHO-standards. Mortality data were obtained from death certificates, from hospital records or autopsies. Acute myocardial infarctions (AMI) 1964-1994 were included. 13.925 men and women aged 30, 40, 50 and 60 years, were drawn as random samples from a background population of 300.000 inhabitants. A cohort born in 1914 was examined in 1964 and 1974, a cohort born in 1936, was examined in 1976 and 1987; Monica (Monitoring trends and determinants in cardiovascular diseases) I cohort were examined in 1982 and 1987; MONICA II in 1986, and MONICA III in 1991. Mean physical activity level at leisure adjusted for age and sex increased over time (P < 0001). 25% of the men were sedentary, and more women reported a sedentary lifestyle than men. The overall trend was from 1964 to 1992 a decline in physical activity at work (P < 0001) in both gender and all age groups. The difference in AMI incidence rates between leisure time physical activity (LTPA) levels increased over time. No change was found in AMI rates comparing sedentary in different time periods. A remarkable decrease over time in the AMI incidence rate was found in physically active during leisure time. Population attributable risk (PAR) exceeded 40% in both genders in the late 1980s. In conclusion the difference in AMI rates between LTPA subgroups has increased over time. The low AMI rates observed among the most physically active reveal a substantial potential for the prevention of AMI through physical activity. A population attributable risk of more than 40% for physical inactivity suggests a potential for primary prevention through increased physical activity.

Adult↗
PubMed2000

Physical activity and body weight: associations over ten years in the CARDIA study. Coronary Artery Risk Development in Young Adults.

BACKGROUND: Hypothesis 1--sustained changes in physical activity are inversely related to changes in body weight. Hypothesis 2-those who attenuate weight gain because of a temporary increase in physical activity (PA) may maintain a lower body weight over time. METHODS: Data were from the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a cohort of black and white men and women, aged 18-30y at baseline, who attended up to five examinations over a 10y period (n=5,115 at baseline). Longitudinal associations between physical activity and body weight changes were assessed, adjusting for secular trend, age, clinic site, education, smoking, alcohol intake, parity, percentage energy intake from fat, and changes in these variables over time. For hypothesis 1, concurrent associations of physical activity and body weight changes were examined. For hypothesis 2, we explored whether weight gain attenuation associated with increased PA during the initial 2-3 y of follow-up was sustained over 5 y. The study 2 analyses were conducted with three separate 5y intervals: baseline to year 5 (n= 3,641), years 2-7 (n= 3,160), and years 5-10 (n= 2,617). RESULTS: Hypothesis 1 -change in physical activity was inversely associated with change in body weight within all four race and sex sub-groups (P<0.005). The predicted weight change associated with change in physical activity was four to five times larger in participants who were overweight compared with those who were not were overweight at baseline. Hypothesis 2-an increase in physical activity during 2-3 y of follow-up was associated with an attenuation of weight gain that was sustained through 5y of follow-up whether or not the physical activity increase was maintained during the later years. This finding persisted whether the starting point for the 5y follow-up was year 2, year 5 or baseline (women only). Comparing participants who increased physical activity with those who decreased physical activity in the first 2-3 y of follow-up (eg by at least 2 h per week of stationary cycling for at least 6 months per year), the mean 5y weight gain attenuation ranged from 0.8 to 2.8 kg. CONCLUSIONS: The results of these analyses support the need for public health messages for promoting increased physical activity for weight maintenance and attenuation of age-related weight gain, especially for higher weight sub-populations.

Adolescent↗
PubMedDate not supplied

Physical functioning and depression among older persons with cancer.

PURPOSE: The purpose of this study was to help identify factors to assess which elderly patients are likely to experience problems with physical and psychological functioning in association with cancer or its treatment. DESCRIPTION OF STUDY: A study was undertaken with a sample of 420 patients with cancer who were between the ages of 65 and 98 years and had received an incident diagnosis of breast, colon, lung, or prostate cancer. An analysis of covariance technique was used to determine how cancer site, treatment type, stage of disease, gender, age, comorbidity, symptom severity, and pre-diagnosis levels of physical functioning were related to physical functioning deficit, and how all of these in turn influenced patient depressive symptomatology. RESULTS: Pre-diagnosis physical functioning, symptom severity, and days since surgery were significant predictors of physical functioning deficit. Patients who had been treated only with surgery experienced greater physical functioning deficits than did patients who had received both surgery and adjuvant therapy. This apparent anomaly was partly explained by the time interval from surgery to interview. Higher levels of symptom severity, lower levels of prior physical functioning, and greater physical functioning deficits all predicted higher levels of depressive symptomatology. CLINICAL IMPLICATIONS: In the care of elderly patients with cancer, it is important for healthcare providers to consider the pre-diagnosis levels of physical functioning of patients with cancer to understand and anticipate the physical and psychological consequences of cancer and its treatment. Equally important is the proper management of patient symptoms in maximizing both the physical and psychological quality of life.

Aged↗
PubMed2002

Fatigue and physical function after orthotopic liver transplantation.

Over the last two decades, orthotopic liver transplantation (OLT) has become an established treatment for acute and chronic liver failure. OLT impacts not only on survival, but also on health-related quality of life. This study was undertaken to describe the self-rated health of Danish liver transplant recipients, compare their self-rated health against that of the general population, and to investigate associations between sex, age, diagnosis, time after OLT, and postoperative physical function and fatigue. All adult surviving liver transplant recipients who underwent OLT in Copenhagen, Denmark, from 1990 to 1998 (n = 154) were contacted by mail and asked to complete a self-administered questionnaire. The questionnaire contained the 36-Item Short Form Health Survey, the Multidimensional Fatigue Inventory, the Hospital Anxiety and Depression Scale, and questions on marital status, education, and work. The response rate was 84.4% (n = 130). Liver transplant recipients reported poorer self-rated health than the general population in physical, but not in mental, health areas. One health aspect, fatigue, was investigated in great detail. This study found that liver transplant recipients experienced physical, rather than mental, fatigue. Diagnosis was found to be a predictor of postoperative physical function and fatigue because patients with an alcoholic or cryptogenic cirrhosis background had significantly poorer physical function and experienced more physical fatigue than liver transplant recipients with other diagnoses. Work status and survival time after OLT had significant effects on postoperative physical function and fatigue. Working and having undergone transplantation 4 to 5 years previously were associated with significantly better physical function and less physical fatigue than not working and having undergone transplantation 1 to 3 years previously. This study suggests that liver transplant recipients experience physical, rather than mental, impairment and fatigue and that diagnosis, work status, and survival time after OLT are associated with physical function and fatigue.

Adult↗
PubMed2000

Physical and observational practice afford unique learning opportunities.

In 2 experiments, the authors studied the effectiveness of physical and observational practice on learning and the effect on learning of combining physical practice and observation, as compared with providing physical practice alone. In Experiment 1, retention and transfer performance of 30 university students after physical, observational, or no practice were contrasted. Consistent with findings from other studies, the retention results indicated that observational practice is inferior to physical practice. The transfer data indicated no differences between observation and physical practice groups. In Experiment 2, retention and transfer performance of 30 participants in physical and combined (alternating physical and observational) practice groups were contrasted. The retention results showed no differences between the combined and physical practice groups, but the combined group performed significantly better than the physical practice group on the transfer test. Those findings suggest that a combination of observation and physical practice permits unique opportunities for learning beyond those available via either practice regimen alone.

Analysis of Variance↗
PubMed2006

Suffering at the end of life in the setting of low physical symptom distress.

BACKGROUND: Alleviation of suffering is a fundamental goal of medicine, especially at the end of life. Although physical distress is a component of suffering, other determinants likely play a role. This study attempted to elucidate these other components in an effort to understand the nature of suffering better. METHODS: Prospective cohort study conducted in the Population-based Palliative Care Research Network (PoPCRN) among English-speaking adults. Data were collected at hospice admission and at frequent intervals until death or discharge. This paper presents patient-reported data collected at the first available assessment after admission, using the Condensed Memorial Symptom Assessment Scale (MSAS; 0=not distressing, 4=very distressing), the McGill Quality of Life Questionnaire (MQOL; 0=worst QOL, 10=best QOL) and 2 suffering scales, overall suffering and suffering caused by physical symptoms (0=not suffering, 10=extreme suffering). The study population (n=48) is limited to those with physical symptoms less than "somewhat" distressing on the MSAS-PHYS. Respondents were divided into two groups: no-mild overall suffering (0-3) and moderate-severe overall suffering (4-10) and compared based on demographics, MQOL scores, MSAS-PSYCH scores and suffering caused by physical symptoms. RESULTS: Mean age 70 years (range, 33-91), mean Karnofsky score 46, 46% married, 54% male, 71% cancer, 93% non-Hispanic white. Compared to patients reporting no-mild overall suffering, patients reporting moderate-severe overall suffering were more likely to have a diagnosis other than cancer (83% vs. 57%, p=0.05), be younger (65 vs. 75 years, p=0.02) and have lower scores on the MQOL-psychological subscale (6.4 vs. 8.0, p=0.02) and overall QOL scale (6.2 vs. 7.2, p=0.04). No significant differences were noted with respect to gender, marital status, MSAS-PSYCH, or MQOL existential and support subscales. Study patients reporting worse overall suffering also reported worse suffering caused by physical symptoms (6.3 vs. 2.1, p<0.0001). There was little association between the MSAS-PHYS score and either overall suffering (correlation coefficient=0.18, p=0.21) or suffering resulting from physical symptoms (correlation coefficient=0.22, p=0.13). CONCLUSION: Patients reporting lack of distress resulting from physical symptoms did not necessarily indicate lack of suffering because of physical symptoms or lack of overall suffering. Factors other than physical symptom distress, such as diagnosis, age, and QOL appear to affect the perception of suffering. In order to better address suffering at the end of life, care must be taken to understand differences between physical symptom distress, suffering caused by physical symptoms and overall suffering.

Adult↗
PubMed2004

Why older people do not participate in leisure time physical activity: a survey of activity levels, beliefs and deterrents.

BACKGROUND: Regular physical activity has been shown to have many health benefits. However, many older people are physically inactive. OBJECTIVE: To investigate why older people are reluctant to participate in leisure time physical activity and to identify strategies to encourage increased activity. DESIGN: Cross-sectional survey. SETTING: 16 general practices in Dundee, Scotland. METHODS: 409 randomly selected older people (65-84 years) who lived independently were interviewed at home. Forty-six percent of those invited to take part were recruited into the study. RESULTS: Levels of knowledge about the specific health benefits of physical activity were high. Almost all participants (95%) believed that physical activity was beneficial and 79% believed that they did enough to keep healthy. However, 36% did no leisure time physical activity and a further 17% did less than 2 hours per week. Regression modelling identified 11 factors that exerted significant independent effects on levels of leisure time physical activity. The most powerful deterrent was lack of interest (OR = 7.8). Other factors included lack of daily access to a car, shortness of breath, joint pain, dislike of going out alone or in the evening, perceived lack of fitness, lack of energy, doubting that exercise can lengthen life, not belonging to a group and doubting that meeting new people is beneficial. CONCLUSIONS: Increasing leisure time physical activities poses major challenges. Beliefs about desirable levels of activity in older people would need to be changed. Action would be needed to relieve physical symptoms and address fears about perceived ability to undertake physical activity. Finally, easily accessible facilities would be needed to encourage participation in physical activity.

Aged↗
PubMed1996

Characteristics of leisure time physical activity associated with decreased risk of premature all-cause and cardiovascular disease mortality in middle-aged men.

The association between leisure time physical activity and the risk of all-cause and cardiovascular disease mortality was analyzed in a Finnish cohort of 1,072 men age 35-63 years who were followed up for 10 years and 10 months. During the period, 168 deaths were recorded, 93 of which were the result of cardiovascular diseases. Leisure time physical activity was assessed by several measures: 1) a single question combining an estimate of the frequency and intensity of the total amount of leisure time physical activity, 2) a compiled measure of leisure time physical activity derived from three separate questions concerning the intensity and frequency of activity, 3) a physical energy expenditure index computed as an estimate of weekly energy expenditure for leisure time activity and commuting to work, 4) 16 separate specified activities of daily living and domestic chores included in the leisure time physical activity index. The association between baseline leisure time physical activity and the risk of death was assessed using the Cox proportional hazards model. After adjustment for potential confounders, the leisure time physical activity energy expenditure index and participation in several specific activities of daily living and domestic chores showed that the mortality risk for all causes and cardiovascular diseases was highest in the most sedentary men. With respect to the leisure time physical activity energy expenditure index, sedentary men ( those with an estimated weekly energy expenditure in leisure time physical activity of < 800 kcal) had an increased risk of 2.74 (95% confidence interval 1.46-5.14) for all-cause mortality and a risk of 3.58 (95% confidence interval 1.45-8.85) for cardiovascular disease mortality compared with the most active persons (those with an estimated weekly energy expenditure in leisure time physical activity of at least 2,100 kcal) when age, initial health status, marital status, employment status, and smoking were controlled.

Adult↗
PubMed1994

Effects of persistent physical activity and inactivity on coronary risk factors in children and young adults. The Cardiovascular Risk in Young Finns Study.

The tracking of physical activity and its influence on selected coronary heart disease risk factors were studied in a 6-year (original survey in 1980, with follow-ups in 1983 and 1986) study of Finnish adolescents and young adults as part of the Cardiovascular Risk in Young Finns Study. The subjects in this analysis were aged 12, 15, and 18 years at baseline. Physical activity was assessed with a standardized questionnaire, and a sum index was derived from the product of intensity, frequency, and duration of leisure time physical activity. Complete data on physical activity index from each study year were available on 961 participants. Significant tracking of physical activity was observed with 3-year correlations of the index ranging from 0.35 to 0.54 in boys and from 0.33 to 0.39 in girls. Tracking was better in older age groups. Two groups of adolescents (active and sedentary groups) were formed at baseline according to high and low values of the index, respectively. Approximately 57% of those classified as inactive remained inactive after a 6-year follow-up. The corresponding value for active subjects was 44% (p < 0.01, active vs. inactive). The long-term effects of physically active and sedentary life-styles were studied by comparing groups of young adults who had remained active or inactive in every three examinations. Serum insulin and serum triglyceride concentrations were significantly lower in active young men. They had a more beneficial high density lipoprotein to total cholesterol ratio and thinner subscapular skinfolds. Among young women, significant differences were seen in adiposity (subscapular skinfold) and in serum triglyceride concentration. Physical activity was also related to less smoking in both sexes and, among young men, to lower consumption of saturated fatty acids and to higher polyunsaturated to saturated fatty acids ratio of the diet. In regression analyses adjusted for the 6-year change in obesity, smoking status, and diet, the change in physical activity was inversely associated with changes in serum insulin and triglycerides in boys. Independent association with triglycerides disappeared when insulin change was added to the model, suggesting that the effect may partly be mediated through insulin metabolism. The authors conclude that the level of physical activity tracks significantly from adolescence to young adulthood. Physical inactivity shows better tracking than does physical activity, and subjects who are constantly inactive express a less beneficial coronary risk profile compared with those who are constantly active.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed2005

Low physical activity as a predictor for antihypertensive drug treatment in 25-64-year-old populations in eastern and south-western Finland.

OBJECTIVE: To determine whether low leisure-time physical activity, occupational physical activity and commuting activity independently increase the risk of hypertension when adjusted for most risk factors for hypertension and for different forms of physical activity. DESIGN: Population-based prospective cohort study. SETTING: Eastern and south-western Finland. PARTICIPANTS: Men (n = 5935) and women (n = 6227) aged 25-64 years. MAIN OUTCOME MEASURE: Initiation of free-of-charge medication for hypertension during a mean follow-up time of 11.3 years. RESULTS: Men with high leisure-time physical activity had a reduced risk of hypertension when adjustment had been made for age, area and year of survey, education, smoking, alcohol intake, baseline systolic blood pressure (SBP), body mass index (BMI), commuting activity and occupational physical activity [hazard ratio (HR) 0.79; 95% confidence interval (CI) 0.63 to 0.99]. Women with high leisure-time physical activity had a reduced risk of hypertension when adjusted for age, area and time of survey (HR 0.65; 95% CI 0.46 to 0.91). This association was no longer significant when further adjustments were made for other covariates (HR 0.73; 95% CI 0.52 to 1.03). High occupational physical activity reduced the risk of hypertension only among men and women combined when adjustment was made for age, area and time of survey, education, smoking and alcohol intake, in addition to baseline SBP, BMI, commuting activity and leisure-time physical activity (HR 0.83; 95% CI 0.72 to 0.96). Commuting activity was not associated with risk of hypertension in multivariate models. CONCLUSION: High levels of leisure-time physical activity are associated with a reduced risk of hypertension, independently of most common risk factors for hypertension, occupational physical activity and commuting activity. Promoting leisure-time physical activity is essential to prevent hypertension.

Adult↗
PubMed1998

SF-36 summary scores: are physical and mental health truly distinct?

OBJECTIVES: Data from 536 primary care patients initiating antidepressant treatment were used to examine the performance of the Medical Outcomes Study SF-36 Physical Component and Mental Component summary scores. METHODS: The SF-36 was administered at baseline and readministered after 1 month and 3 months (n = 482). RESULTS: At the baseline assessment, patients reported modest impairment on the Physical Function, Role--Physical, Bodily Pain, and General Health Perceptions subscales (0.10 to 0.68 standard deviations below national norms), but the Physical Component summary (mean = 51) indicated no impairment based on a population norm of 50. During 3 months of follow-up evaluation, the Physical Function, Role--Physical, Bodily Pain, and General Health Perceptions subscales all showed moderate and statistically significant improvement (range from 0.28 to 0.49 standard deviation units), whereas the Physical Component summary score was essentially unchanged (mean = 50 at both 1-month and 3-month assessments). This pattern of results is a natural consequence of the assumptions and methods used to calculate these summary scores-orthogonal factor rotation and negative scoring coefficients. CONCLUSIONS: These findings suggest caution in the interpretation of Mental Component Summary and Physical Component Summary scores when the condition or treatment of interest has strong effects on scales with negative scoring coefficients (Mental Health and Role--Emotional for the Physical Component; Physical Function, Role--Physical, and Bodily Pain for the Mental Component).

Adolescent↗
PubMed2001

Physical activity and fat-free and fat mass by bioelectrical impedance in 3853 adults.

OBJECTIVE: To determine the effects of regular physical activity on body composition, as measured by bioelectrical impedance analysis (BIA), in a large Caucasian population of healthy subjects between 15 and 64 yr of age, and to observe the cross-sectional changes in body composition with increasing age. DESIGN: Cross-sectional comparison between sedentary and physically active adults (at least 3 h x wk(-1) at moderate or hard intensity level activity) during aging. SUBJECTS: A total of 3853 healthy adults (1036 sedentary and 1019 physically active men, and 1280 sedentary and 518 physically active women) between 15 and 64 yr of age. MEASUREMENTS: Height, weight, body mass index (BMI), and fat-free mass (FFM), fat mass, and % fat mass measured by 50-kHz BIA. RESULTS: Higher weight in older sedentary adults was due to a higher fat mass. In 55- to 64-yr-olds compared with 25- to 34-yr-olds, fat mass was 5.5 kg (P < 0.0001) higher in sedentary and 0.6 kg (P < 0.3) higher in physically active men, and 4.5 kg (P < 0.0001) and 2.0 kg (P < 0.04) higher in sedentary and physically active women, respectively. Physical activity was able to limit fat mass and weight gain in men over 25 yr of age and in women until 54 yr of age. Endurance type physical activity was not associated with increased FFM. For the same BMI, sedentary men and women have < 0.7 kg (P < 0.001) higher fat mass than physically active men and women. CONCLUSION: Therefore, the benefits of physical activity seem to include maintenance or prevention of an increase of BMI that in turn correlates with prevention of a fat mass increase for physically active subjects.

Adipose Tissue↗
PubMed2002

Physical activity and the presence and extent of calcified coronary atherosclerosis.

PURPOSE: Regular physical activity leads to a more favorable cardiovascular risk factor profile and a lower risk of developing incident coronary heart disease (CHD). These correlations suggest that higher levels of physical activity should also attenuate the presence and extent of coronary atherosclerosis. METHODS: Physical activity was measured using the Baecke Physical Activity Index in 630 consecutive asymptomatic men and women ages 39-45 without known heart disease. The degree of physical activity was compared with the cardiovascular risk factor profile and the presence and extent of subclinical atherosclerosis measured using electron beam computed tomography. RESULTS: Sports-related physical activity was associated with lower body mass index (r = -0.11; P = 0.001), higher high-density lipoprotein (HDL) cholesterol (r = 0.13; P = 0.003) and less glucose resistance as assessed by fasting serum insulin levels (r = -0.16; P = 0.001). Leisure-time and work-related physical activity were unrelated to any coronary risk variables. Calcified subclinical atherosclerosis was unrelated to all physical activity dimensions. Comparing the most sedentary (lowest quartile) and most active (highest quartile) patients, the prevalence of coronary calcium (17.0% vs 18.5%; P = 0.92) and mean coronary calcium scores (8 +/- 31 vs 5 +/- 15; P = 0.87) were similar. In a multivariate model controlling for standard cardiovascular risk factors and physical activity level, only low-density lipoprotein (LDL) cholesterol was associated with the presence of coronary calcium. CONCLUSION: Physical activity, particularly high-intensity exercise in sports-related activities, promotes a healthy cardiovascular risk profile, including lower body mass index and insulin resistance, but is unrelated to coronary calcification. This suggests that the risk reduction associated with physical activity is mediated by factors other than retarding the development of calcified atherosclerosis.

Adult↗
PubMedDate not supplied

Physical activity monitoring in patients with peripheral arterial occlusive disease.

PURPOSE: Physical activity is an important variable to measure in patients with peripheral arterial occlusive disease (PAOD) because of this relationship to cardiovascular disease morbidity and mortality. The purposes of this study were to (1) determine the reliability of measures of daily physical activity in PAOD participants using an accelerometer and a pedometer; and (2) assess the validity of both instruments by comparing them against validated physical activity questionnaires. METHODS: Forty-three patients with PAOD with a resting ankle/brachial index of 0.63 +/- 0.19 were monitored for 2 consecutive weekdays with an accelerometer and pedometer worn on each hip. The 48-hour monitoring period was repeated approximately 1 week later. RESULTS: The daily physical activity values obtained from the accelerometer were similar between the two testing periods, 352 +/- 248 kcal/day vs. 337 +/- 199 kcal/day; P = 0.61, with a reliability coefficient of r = 0.84. The steps obtained from the pedometer during each 2-day period also were similar, 4615 +/- 2839 steps/day vs. 4498 +/- 2768 steps /day; P = 0.75, with a reliability coefficient of r = 0.86. The physical activity values from the accelerometer moderately correlated with the Minnesota Leisure Time Physical Activity Questionnaire, r = 0.33; P < 0.01, and the NASA/Johnson Space Center Physical Activity Scale, r = 0.44; P < 0.001. Similarly, the relationship between the steps obtained from the pedometer and physical Activity and the Minnesota Leisure Time Physical Activity and NASA/Johnson Space Center Physical Activity Scale questionnaires were significant, r = 0.46 and r = 0.51; P < 0.001, respectively. CONCLUSION: These findings indicate that an accelerometer and pedometer are two instruments that reliably estimate the physical activity levels of patients with PAOD over 2 consecutive days. Furthermore, the activity questionnaires, suggesting that activity monitoring measures a different component of activities in patients with PAOD with intermittent claudication.

Activities of Daily Living↗
PubMed2006

The effects of commuting activity and occupational and leisure time physical activity on risk of myocardial infarction.

BACKGROUND: Risk reduction of myocardial infarction has been shown for leisure time physical activity. The results of studies on occupational physical activity and risk of myocardial infarction are incongruous and studies on commuting activity are scarce. The aim of this study was to investigate how commuting activity, occupational physical activity and leisure time physical activity were associated with risk of future first myocardial infarction. DESIGN: We used a prospective incident case-referent study design nested in Västerbotten Intervention Program and the Northern Sweden MONICA study. METHODS: Commuting habits, occupational physical activity, leisure time physical activity and cardiovascular risk factors were assessed at baseline screening and compared in 583 cases (20% women) with a first myocardial infarction and 2098 matched referents. RESULTS: Regular car commuting was associated with increased risk of myocardial infarction versus commuting by bus, cycling or walking [odds ratio (OR) 1.74; 95% confidence interval (CI), 1.20-2.52] after multivariate adjustment. High versus low leisure time physical activity was associated with reduced risk of myocardial infarction (OR 0.69; 95% CI, 0.50-0.95) after adjustment for occupational physical activity and commuting activity, but the association was not statistically significant after further multivariate adjustment. After multivariate adjustment we observed a reduced risk for myocardial infarction in men with moderate (OR 0.70; 95% CI, 0.50-0.98) or high (OR 0.67; 95% CI, 0.42-1.08) versus low occupational physical activity. CONCLUSIONS: We found a clear association between car commuting and a first myocardial infarction and a corresponding inverse association with leisure time physical activity, while the impact of occupational physical activity on the risk of myocardial infarction was weaker.

Chi-Square Distribution↗