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Physical health consequences of physical and psychological intimate partner violence.

BACKGROUND: Past studies that have addressed the health effects of intimate partner violence (IPV) have defined IPV as violence based on physical blows that frequently cause injuries. To our knowledge, no epidemiologic research has assessed the physical health consequences of psychological forms of IPV. OBJECTIVE: To estimate IPV prevalence by type and associated physical health consequences among women seeking primary health care. DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: A total of 1152 women, aged 18 to 65 years, recruited from family practice clinics from February 1997 through January 1999 and screened for IPV during a brief in-clinic interview; health history and current status were assessed in a follow-up interview. RESULTS: Of 1152 women surveyed, 53.6% ever experienced any type of partner violence; 13.6% experienced psychological IPV without physical IPV. Women experiencing psychological IPV were significantly more likely to report poor physical and mental health (adjusted relative risk [RR], 1.69 for physical health and 1.74 for mental health). Psychological IPV was associated with a number of adverse health outcomes, including a disability preventing work (adjusted RR, 1.49), arthritis (adjusted RR, 1.67), chronic pain (adjusted RR, 1.91), migraine (adjusted RR, 1.54) and other frequent headaches (adjusted RR, 1.41), stammering (adjusted RR, 2.31), sexually transmitted infections (adjusted RR, 1.82), chronic pelvic pain (adjusted RR, 1.62), stomach ulcers (adjusted RR, 1.72), spastic colon (adjusted RR, 3.62), and frequent indigestion, diarrhea, or constipation (adjusted RR, 1.30). Psychological IPV was as strongly associated with the majority of adverse health outcomes as was physical IPV. CONCLUSIONS: Psychological IPV has significant physical health consequences. To reduce the range of health consequences associated with IPV, clinicians should screen for psychological forms of IPV as well as physical and sexual IPV.

Adolescent↗

Physical activity and social status in adolescence as predictors of physical inactivity in adulthood.

BACKGROUND: Physical inactivity is related to an increased risk of certain chronic diseases. The aim here was to evaluate how physical activity and social status in adolescence are associated with physical inactivity in adulthood. METHODS: The sample comprised 3664 males and 4130 females who answered questions on physical activity and social status at 14 and 31 years of age in follow-up surveys of the Northern Finland birth cohort of 1966. Associations between explanatory factors and physical inactivity in adulthood were analyzed using multivariable logistic regression. RESULTS: Infrequent participation in sports after school hours at 14 years of age and, in males, additionally a low grade in school sports, was associated with physical inactivity at the age of 31 years, independent of social circumstances in adulthood. Low social class of the childhood family was associated with physical inactivity in adolescence but not with inactivity at 31 years of age. Poor school achievement in adolescence was associated with adult inactivity independent of adolescent physical activity. CONCLUSION: Infrequent participation in sports, a low grade in school sports, and poor school achievements in adolescence were associated with physical inactivity in adulthood. Participation in sports is to be strongly supported among all adolescents because of its long-term beneficial effects on adult health through its tendency to reduce the probability of adult inactivity.

Adolescent↗

Comparison of energy expenditure estimates from doubly labeled water, a physical activity questionnaire, and physical activity records.

BACKGROUND: Various methods are used by epidemiologists to estimate the energy cost of physical activity; these include physical activity records and recalls. However, there is limited validation of these methods against the doubly labeled water technique for determining energy expenditure (EE). OBJECTIVE: We compared EE as estimated by indirect methods (physical activity records and recall questionnaires) used in epidemiologic studies with EE obtained from doubly labeled water (EE(DLW)) in free-living men. DESIGN: We determined EE(DLW), energy intake at weight maintenance, and EE from 7-d physical activity records (EE(Record)) and a 7-d physical activity recall questionnaire (EE(Recall)) in 24 men aged 41 plus minus 2.0 y ( plus minus SEM) with a body mass index (in kg/m(2)) of 25.1 plus minus 0.5. RESULTS: There was excellent agreement between EE(DLW) (13.27 plus minus 0.35 MJ/d) and energy intake (13.19 plus minus 0.36 MJ/d), with a difference of 0.5 plus minus 1.0% ( plus minus SE). The indirect measures of physical activity and EE were 14.17 plus minus 0.37 MJ/d for EE(Record) (difference from EE(DLW): 7.9 plus minus 3.2%) and 17.40 plus minus 1.45 MJ/d for EE(Recall) (difference from EE(DLW): 30.6 plus minus 9.9%). CONCLUSIONS: Seven-day physical activity records provide an acceptable estimate of EE in free-living adults compared with EE(DLW), but 7-d physical activity recalls have limited application to estimate daily EE. For optimal validity, the 7-d physical activity records require good subject compliance and the provision of careful instructions for their use.

Adult↗

Perceptions of physical and social environment variables and self-efficacy as correlates of self-reported physical activity among adolescent girls.

OBJECTIVE: This cross-sectional study examined the direct and indirect effects of perceived equipment accessibility, neighborhood safety, and social support on self-reported physical activity among older adolescent girls. METHODS: Adolescent girls (n = 1,655) who were in the 12th grade completed a battery of questionnaires that included self-report measures of the perceived physical environment, social support, barriers self-efficacy, and physical activity. RESULTS: Perceived neighborhood safety did not exhibit direct or indirect effects on self-reported physical activity. Perceived equipment accessibility exhibited an indirect effect on self-reported physical activity that was accounted for by barriers self-efficacy. Perceived social support exhibited direct and indirect effects on self-reported physical activity; the indirect effect was accounted for by barriers self-efficacy. The relationships were independent of parental education and body mass index (BMI). CONCLUSIONS: Perceived physical environmental factors indirectly influenced self-reported physical activity, and perceived social environmental factors both directly and indirectly influenced self-reported physical activity in this sample of older adolescent girls.

Adolescent↗

Physical activity, body composition and physical self-esteem: a 3-year follow-up study among adolescents in Sweden.

AIMS: To measure physical activity by means of daily pedometer steps, body composition, expressed as body mass index (BMI) and bioelectrical impedance as percent body fat, and perceived physical self-esteem and additionally, to evaluate eventual predictors for a healthy lifestyle i.e., highly physically active, normal weighted and a high physical self-esteem in a follow-up group. METHODS: During autumn 2000 physical activity level was assessed and BMI was calculated in 871 children aged 7-14 in south eastern Sweden and in 501 of these, physical self-esteem were also assessed. During autumn 2003 a total of 375 adolescents aged 15-18 were assessed using the same methodology and additionally percent body fat was measured. Ninety-three of these adolescents (46 girls), were also measured in 2000 and they formed the follow-up group. RESULTS: In the follow-up group a significant increase in BMI and stability in physical self-esteem in boys and girls, and in boys a significant decrease in daily steps was found 3 years later. Strongest predictor to be highly physically active, maintain normal BMI and high self-esteem 3 years later, i.e., to have a healthy lifestyle, was for girls increased self-esteem and for boys a decreased BMI. CONCLUSION: Consequently, for a healthy lifestyle, promoting physical self-esteem in girls and weight control in boys is of great importance in early adolescence.

Adolescent↗

Development of a Scottish physical activity questionnaire: a tool for use in physical activity interventions.

OBJECTIVES: Three studies were undertaken to establish the reliability and validity of the Scottish physical activity questionnaire (SPAQ), developed to aid seven day recall of leisure and occupational physical activity. METHODS: To establish reliability, SPAQs (n = 34) were completed on a Monday and the following Wednesday. Thus each questionnaire measured four identical days. To establish concurrent validity, 94 participants completed a SPAQ and an adapted stage of exercise behaviour change questionnaire. Responses to SPAQ were then analysed by stage of exercise behaviour change. In a further study of criterion validity, 30 volunteers wore a Caltrac motion sensor for four consecutive days, after which they completed a SPAQ. RESULTS: In the first study, total physical activity had a coefficient of repeatability (R) of 53 minutes. Occupational physical activity showed a similar variance (R = 54.6 minutes) but leisure physical activity was more reliable (R = 29.3 minutes). The main variation in occupational physical activity was found to be walking (R = 39.8 minutes). In study 2, a one way analysis of variance showed the expected relation between physical activity and stage of exercise behaviour change, confirming the concurrent validity of SPAQ with the stage of exercise behaviour change model. In study 3, several erroneous recordings affected both SPAQ and the Caltrac results (kcal). After relevant corrections had been made, the correlation between the two measurement devices was 0.52 (p < 0.05). CONCLUSIONS: SPAQ has been shown to be reliable and to hold strong concurrent validity and limited criterion validity. The main limitation in SPAQ appears to be the measurement of occupational walking. It is therefore recommended that further work be conducted to refine the measurement of this physical activity component. It is evident nonetheless that SPAQ can be used with confidence to measure outcomes in physical activity interventions when account is taken of its limitations.

Adult↗

Leisure-time physical activity behavior: structured and unstructured choices according to sex, age, and level of physical activity.

The main goals of this cross-sectional survey were (a) to describe the associations between sex, age, and physical activity behavior and (b) to describe the age and sex-related associations with the choice of structured (formal) and unstructured (nonformal) physical activity programs. At baseline, data were selected randomly from 1,013 students, from the 7th to the 12th grades. A response rate of 73% (n = 739) was obtained. Accordingly, the sample of this study consisted of 594 adolescents (304 females and 290 males) with mean age of 15.9 years (range 13-20). Physical activity was assessed by means of a questionnaire. A questionnaire about leisure activities was applied to the sample to define the nominal variable "nature of physical activity." The data showed that significantly more girls than boys (p < or = .001) belonged to the sedentary group (80.7% girls) and low activity group (64.5% girls). Boys more frequently belonged to the more active groups (92.1%; p < or = .001). The older participants were more engaged in formal physical activities, whereas the younger mostly chose informal ones whatever their level of physical activity. There were more significant differences in girls' physical activity groups (chi 2 = 20.663, p < or = .001) than in boys' (chi 2 = 7.662, p < or = .05). Furthermore, active girls chose more structured physical activities than their sedentary counterparts (18.8% vs. 83.3%). However, boys preferred unstructured activities regardless of physical activity group (83.7% vs. 58.5%; p < or = .05). It can be concluded that as age increased, organized sports activities became a relatively more important component of total weekly activity for both male and female participants.

Adolescent↗

[Physical activity evaluation: metabolic equivalent intensity levels and evaluation of different physical activity].

Physical activities are complex, which are affected by many factors including activities duration, intensity and frequency et al. Traditional physical activity evaluation principle is hard to differentiate miscellaneous physical activities well. The compendium of physical activities is a integrative physical activity coding system, which distinguish physical activity based on the activity objective, type and intensity and is an important tool to study physical activity level. This article introduces the evaluation principles of physical activity level and an update of the compendium of physical activities coding system.

Activities of Daily Living↗

Nutrition and physical activity program to attenuate obesity and promote physical and metabolic fitness in elementary school children.

Obesity and low levels of physical and metabolic fitness are risk factors for cardiovascular disease and diabetes. The purpose of this investigation was to attenuate obesity and improve physical and metabolic fitness in elementary school children. Schools have the opportunity, mechanisms, and personnel in place to deliver nutrition education, fitness activities, and a school food service that is nutritious and healthy. Cohorts from grades 3 to 5 in two school districts in rural Nebraska (Intervention/Control) participated in a 2-year study of physical activity and modified school lunch program. Data collection for aerobic capacity, body composition, blood chemistry, nutrition knowledge, energy intake, and physical activity was at the beginning and end of each year. Int received enhanced physical activity, grade specific nutrition education, and a lower fat and sodium school lunch program. Con continued with a regular school lunch and team sports activity program. At year 2, Int lunches had significantly less energy (9%), fat (25%), sodium (21%), and more fiber (17%). However, measures of 24-hour energy intake for Int and Con showed significant differences for sodium only. Physical activity in the classroom was 6% greater for Int compared to Con (p < 0.05) but physical activity outside of school was approximately 16% less for Int compared to Con (p < 0.05). Body weight and body fat were not different between schools for normal weight or obese children. No differences were found for cholesterol, insulin, and glucose; however, HDL cholesterol was significantly greater and cholesterol/HDL was significantly less for Int compared to Con (p < 0.05). It appears that compensation in both energy intake and physical activity outside of school may be responsible for the lack of differences between Int and Con.

Blood Glucose↗

Physical fitness and sports skills in relation to sports injuries. A four-year prospective investigation of sports injuries among physical education students.

In order to study the relationship between physical fitness/sport-specific skills and sports injuries 136 physical education students were studied during their 4-years of training in a prospective investigation. Physical fitness was measured every year using a battery of fitness tests, and the performance marks of a number of sports scored at the exams of the academy were used as parameters for the sport-specific skills. Sports injuries were recorded every 3 weeks on standard forms. Relative risk ratios were calculated between the tertile groups good, average and poor for all variables of physical fitness and sport-specific skills. Injury-proneness was defined for all and for acute and chronic injuries separately near the median number of injuries sustained. In only 6 out of 126 computed relative risks was a significant difference found. Discriminant analysis revealed an explanation of 16%, 14% and 11% of the variance for respectively all, acute and chronic injuries, at which 5 or 6 variables in varying combination were included. From our findings it may be concluded that physical fitness and sport-specific skills have little impact on sports injuries for the following two main reasons. Firstly, subjects at risk for sports injuries participate per definition in sports activities and have consequently developed their fitness and skills compared to the sedentary population. Thus, the range in physical fitness or sports skills in the population at risk is relatively small (physical education students belong to the 7th-10th decile in fitness test scores within a general college student population) and therefore an effect is hard to show. Secondly, the total number of sports injuries is very small and moreover, it should be distributed over several categories for analysis. The favourable advantages of using physical education students to study intrinsic risk factors (comparable and varied sports program, excellent compliance) appeared to be insufficient to compensate for drawbacks of selection.

Athletic Injuries↗

Obesity and physical fitness of pre-adolescent children during the academic year and the summer period: effects of organized physical activity.

This study examined obesity and parameters of physical fitness in 178 elementary schoolchildren during an academic year as well as after the summer holidays. Results showed significant physical fitness improvements during the school year, with little or no changes in the summer holidays. Children who reported less than 30 minutes of daily participation in physical activity demonstrated lower prevalence rates for overweight and obesity as well as superior fitness performance. The detrimental effect of the summer break on the progress of physical fitness was less in children who did participate in physical activity than in those who did not. Longitudinal modelling using generalized estimating equations demonstrated that physical activity is a major contributing factor for obesity over time, masking the singular effect of various fitness parameters. It is concluded that pre-adolescent children advance in physical fitness mainly during the school year, with physical activity being a beneficial countermeasure for the development of obesity.

Body Mass Index↗

The level of physical activity and the growth hormone (GH) response to acute physical exercise.

There is no clear evidence about the influence of programmed physical activity (training) on growth hormone (GH) response to acute physical exercise. The aim of this study was to estimate the relationship between the level of physical activity and the serum growth hormone concentration in response to acute physical exercise. The study was performed on 20, healthy male subjects. Based on the level of their physical activities they were divided in two groups of equal size: group 1, trained, and group 2, untrained subjects. All subjects performed one boot of exercise on cycle ergometer, lasting 30 minutes. Work intensity was approx. 65% of VO2 max, and the rate of cycling was 60/min. Serum GH concentrations were measured by IRMA (immunoradiometric assays) method in blood samples obtained in the period of rest, during exercise and in the recovery period. There were marked differences in the dynamics of changes in the serum GH concentrations during exercise period between the groups of various level of physical activity despite the lack of the significant differences in basal level and maximal level of serum GH concentration at the end of exercise. Untrained subjects showed faster increase in serum GH concentration than trained subjects, but in trained subjects the restoration of the basal values in the recovery period was faster. These results indicate that the level of physical activities in young, healthy male subjects has no influence on GH response to acute physical exercise.

Adaptation, Physiological↗

Relationships between self-reported physical activity and physical fitness in active men.

We examined relationships between self-reported physical activity and physical fitness in a group of 202 male military officers, 36 to 51 years of age. Physical activity was estimated from the Minnesota Leisure Time Physical Activity Questionnaire and classified as heavy, moderate, or light depending on the intensity of individual activities. Directly measured components of physical fitness included aerobic capacity (treadmill walking peak VO2), body composition (densitometry), muscle strength (isokinetic mode), and flexibility (bend-and-reach test). Both total and heavy activity were significantly (P < .05) related to aerobic capacity, body fat, fat-free mass, upper body strength, and flexibility. Moderate and light activity were not related to the fitness measures. We divided subjects into quartiles of physical activity and corrected the fitness measures for age and cigarette smoking status. Subjects with more total and heavy activity had higher aerobic capacity and lower body fat; subjects with more heavy activity also had greater upper body strength. Again, moderate and low activity were not related to any fitness measure. These data indicate that heavy physical activity is related to various components of physical fitness even after correction for age and smoking status in a group of men who are healthy, generally very active, and fit.

Adult↗

Physical activity, physical fitness, and general health perception among individuals with rheumatoid arthritis.

OBJECTIVE: To describe self-reported physical activity and physical fitness and to identify correlates of physical activity and general health perception. METHODS: Data on self-reported physical activity, physical fitness, activity performance, and disease activity were collected from a sample of 298 patients with rheumatoid arthritis (RA). RESULTS: Forty-seven percent of our sample reported physical activity behaviors that did not comply with public health recommendations. A majority of the patients had decreased lower-limb muscle function (72%), grip force (94%), joint motion (94%), and functional balance (68%). Correlations between self-reported physical activity and other variables were r(s) = 0.25 or less. Variation in general health perception was explained (total adjusted R(2) = 0.65) by pain and activity performance. CONCLUSION: Our findings indicate that there is a case for recommendations on and support for healthy physical activity behaviors among people with RA.

Adult↗

Physical activity and physical fitness in African-American girls with and without obesity.

Lack of physical activity and low levels of physical fitness are thought to be contributing factors to the high prevalence of obesity in African-American girls. To examine this hypothesis, we compared habitual physical activity and physical fitness in 54 African-American girls with obesity and 96 African-American girls without obesity residing in rural South Carolina. Participation in vigorous (> or = 6 METs) (VPA) or moderate and vigorous physical activity (> or = 4 METs) (MVPA) was assessed on three consecutive days using the Previous Day Physical Activity Recall. Cardiorespiratory fitness was assessed using the PWC 170 cycle ergometer test. Upper body strength was determined at two sites via isometric cable tensiometer tests. Relative to their counterparts without obesity, girls with obesity reported significantly fewer 30-minute blocks of VPA (0.90 +/- 0.14 vs. 1.3 +/- 0.14) and MVPA (1.2 +/- 0.18 vs. 1.7 +/- 0.16) (p < 0.01). Within the entire sample, VPA and MVPA were inversely associated with body mass index (r = -0.17 and r = -0.19) and triceps skinfold thickness (r = -0.19 and r = -0.22) (p < 0.05). In the PWC 170 test and isometric strength tests, girls with obesity demonstrated absolute scores that were similar to, or greater than, those of girls without obesity; however, when scores were expressed relative to bodyweight, girls with obesity demonstrated significantly lower values (p < 0.05). The results support the hypothesis that lack of physical activity and low physical fitness are important contributing factors in the development and/or maintenance of obesity in African-American girls.

Black People↗

Adiposity, physical fitness and incident diabetes: the physical activity longitudinal study.

AIMS/HYPOTHESIS: The purpose of this study was to investigate the relationships among adiposity, physical activity, physical fitness and the development of diabetes in a diverse sample of Canadians. METHODS: The sample included 1,543 adults (709 men and 834 women) from the Canadian Physical Activity Longitudinal Study who were free of diabetes at baseline (1988). Several indicators of adiposity (BMI, waist circumference, WHR, sum of skinfold thicknesses), musculoskeletal fitness (sit-ups, push-ups, grip strength, trunk flexibility), cardiorespiratory fitness (maximal metabolic equivalents [METs]) and leisure-time physical activity levels were measured at baseline. Participants were followed until 2002-2004 for the ascertainment of new cases of diabetes. RESULTS: The 15.5-year cumulative incidence of diabetes was 5.0% (5.2% in men, 4.9% in women). Adiposity and physical fitness, but not physical activity, were significant predictors of diabetes after adjustment for age, sex and several covariates. For each standard deviation of the indicators of adiposity, the risk of diabetes was 99-194% higher. Conversely, the risk was 70 and 61% lower for each standard deviation of maximal METs and composite musculoskeletal fitness score, respectively. Receiver operating characteristic curve analyses confirmed that neither adiposity nor physical fitness provided a superior prediction of incident diabetes. CONCLUSIONS/INTERPRETATION: Adiposity and physical fitness were both important predictors of the development of diabetes in this cohort of Canadians.

Adipose Tissue↗

Physical activity and endometrial cancer risk: a review of the current evidence, biologic mechanisms and the quality of physical activity assessment methods.

OBJECTIVES: To (1) determine the nature of the association between physical activity and endometrial cancer risk; (2) assess the contribution of variation in the quality of physical activity measurement to inconsistencies in study results; and (3) review the biologic mechanisms that might mediate possible effects of physical activity on risk. METHODS: We reviewed and summarized all published epidemiologic studies examining physical activity and endometrial cancer risk, and evidence relating to possible biologic mechanisms. We assigned each study a quality score for physical activity measurement. RESULTS: Fourteen of the 18 studies showed a convincing or possible protective effect of physical activity on endometrial cancer risk, with an average relative risk reduction of around 30%. A dose-response relation was observed in 7 of 13 studies. The quality score was not related to the observed strength of association or the presence of a dose-response relation. There was epidemiologic and biologic evidence that vigorous activity, as well as light and moderate intensity activities, such as housework, gardening or walking for transportation, may reduce risk. CONCLUSIONS: Physical activity probably has a protective role in endometrial cancer development. More epidemiologic and biologic evidence is needed to make conclusive recommendations on optimal types, characteristics or time periods of physical activity.

Endometrial Neoplasms↗

Racial differences in insulin secretion and sensitivity in prepubertal children: role of physical fitness and physical activity.

OBJECTIVE: To investigate in prepubertal children whether physical fitness and/or physical activity are: 1) associated with insulin secretion and sensitivity and 2) account for racial differences in insulin secretion and sensitivity. RESEARCH METHODS AND PROCEDURES: Subjects included 34 African American and 34 white nondiabetic children aged 5 to 11 years. Data were divided into two sets according to the availability of VO2max and physical activity data. Body composition was measured by dual-energy X-ray absorptiometry. Subcutaneous abdominal adipose tissue and intra-abdominal adipose tissue were examined by computed tomography. Insulin sensitivity (S1) and acute insulin response (AIR) were determined by a frequently sampled intravenous glucose tolerance test. An all-out, progressive treadmill exercise test was used for measuring VO2max. Physical activity data were collected by questionnaire. RESULTS: African American children had lower SI and higher AIR than white children, after adjusting for total body fat mass. African Americans reported higher levels of physical activity (hours/wk) than whites, but had a lower VO2max. In multiple linear regression analysis, hours/wk of activity and hours/wk of vigorous activity, but not moderate activity, were independently related to SI and AIR after adjusting for race, total body fat mass or fat distribution, and total lean tissue mass. VO2max was not related to AIR, and was inversely related to SI, after adjusting for body composition. Race remained significantly associated with both SI and AIR, even after adjusting for body composition, fat distribution, and hours/wk of activity or hours/wk of vigorous activity. DISCUSSION: In summary, overall physical activity and, especially, vigorous activity were associated with insulin secretion and sensitivity. However, neither physical activity nor VO2max explained the racial difference in insulin secretion (higher in African Americans) and sensitivity (lower in African Americans). Thus, racial (African American to white) differences in aspects of insulin action seem to be due to factors other than body composition, fat distribution, cardiovascular fitness, and amount of physical activity.

Absorptiometry, Photon↗