Prevalence, trends and associated socio-economic factors of obesity in South Asia

Aim Worldwide obesity levels have increased unprecedentedly over the past couple of decades. Although the prevalence, trends and associated socio-economic factors of the condition have been extensively reported in Western populations, less is known regarding South Asian populations. Methods A review of articles using Medline with combinations of the MeSH terms: 'Obesity', 'Overweight' and 'Abdominal Obesity' limiting to epidemiology and South Asian countries. Results Despite methodological heterogeneity and variation according to country, area of residence and gender , the most recent nationally representative and large regional data demonstrates that without any doubt there is a epidemic of obesity, overweight and abdominal obesity in South Asian countries. Prevalence estimates of overweight and obesity (based on Asian cut-offs: overweight ≥ 23 kg/m(2), obesity ≥ 25 kg/m(2)) ranged from 3.5% in rural Bangladesh to over 65% in the Maldives. Abdominal obesity was more prevalent than general obesity in both sexes in this ethnic group. Countries with the lowest prevalence had the highest upward trend of obesity. Socio-economic factors associated with greater obesity in the region included female gender, middle age, urban residence, higher educational and economic status. Conclusion South Asia is significantly affected by the obesity epidemic. Collaborative public health interventions to reverse these trends need to be mindful of many socio-economic constraints in order to provide long-term solutions.

What do we know about recovery interventions used in the management of delayed onset muscle soreness?

Since the pioneering work of Hough in 1902 (1) the term ‘delayed onset muscle soreness (DOMS)’ has dominated the field of athletic recovery. DOMS typically occurs after exercise induced muscle damage (EIMD), particularly if the exercise is unaccustomed or involves a large amount of eccentric (muscle lengthening) contractions. The symptoms of EIMD manifest as a temporary reduction in muscle force, disturbed proprioceptive acuity, increases in inflammatory markers both within the injured muscle and in the blood as well as increased muscle soreness, stiffness and swelling. The intensity of discomfort and soreness associated with DOMS increases within the first 24 hours, peaks between 24 and 72 hours, before subsiding and eventually disappearing 5-7 days after the exercise. Consequently, DOMS may interfere with athletic training or competition and several recovery interventions have been utilised by athletes and coaches in an attempt to offset the negative effects...

Development and validation of anthropometric prediction equations for estimation of lean body mass and appendicular lean soft tissue in Indian men and women

Lean body mass (LBM) and muscle mass remains difficult to quantify in large epidemiological studies due to non-availability of inexpensive methods. We therefore developed anthropometric prediction equations to estimate the LBM and appendicular lean soft tissue (ALST) using dual energy X-ray absorptiometry (DXA) as a reference method. Healthy volunteers (n= 2220; 36% females; age 18-79 y) representing a wide range of body mass index (14-44 kg/m2) participated in this study. Their LBM including ALST was assessed by DXA along with anthropometric measurements. The sample was divided into prediction (60%) and validation (40%) sets. In the prediction set, a number of prediction models were constructed using DXA measured LBM and ALST estimates as dependent variables and a combination of anthropometric indices as independent variables. These equations were cross-validated in the validation set. Simple equations using age, height and weight explained > 90% variation in the LBM and ALST in both men and women. Additional variables (hip and limb circumferences and sum of SFTs) increased the explained variation by 5-8% in the fully adjusted models predicting LBM and ALST. More complex equations using all the above anthropometric variables could predict the DXA measured LBM and ALST accurately as indicated by low standard error of the estimate (LBM: 1.47 kg and 1.63 kg for men and women, respectively) as well as good agreement by Bland Altman analyses. These equations could be a valuable tool in large epidemiological studies assessing these body compartments in Indians and other population groups with similar body composition.

How would you recognise an expert coach if you saw one?

A review of the literature that frames coaching practice and specifically the formation and determination of expert coaching practice reveals a body of research that lacks continuity. It has recently been argued that much of the instability surrounding our professional interpretation of coaching practice stems from a penchant for subjective investigation. This analysis draws on a review of over 100 peer reviewed articles, chapters and books – all published within the last 35 years, that address the notion of coaching practice. The findings of this analysis suggests that much of the research used to establish conceptual clarity fails to distinguish between highly organised or efficient coaching practice and expert coaching practice. This paper concludes with some recommendations from alternate paradigms which suggest that expertise in interceptive sports coaching may be better theorised and suitably identified through a lens of the growing ideas surrounding ‘emergence’.

Reduced biceps femoris myoelectrical activity influences eccentric knee flexor weakness after repeat sprint running

The aim of this study was to determine whether declines in knee flexor strength following overground repeat sprints were related to changes in hamstrings myoelectrical activity. Seventeen recreationally active males completed maximal isokinetic concentric and eccentric knee flexor strength assessments at 1800.s-1 before and after repeat sprint running. Myoelectrical activity of the biceps femoris (BF) and medial hamstrings (MH) was measured during all isokinetic contractions. Repeated measures mixed model (Fixed factors = time [pre- and post- repeat sprint] and leg [dominant and non-dominant], random factor = participants) design was fitted with the restricted maximal likelihood method. Repeat sprint running resulted in significant declines in eccentric, and concentric, knee flexor strength (eccentric = 25 ± 34 Nm, 15% p<0.001; concentric 11 Nm± 22 Nm, 10% p = 0.001). Eccentric BF myoelectrical activity was significantly reduced (10%; p= 0.033). Concentric BF and all MH myoelectrical activity were not altered. The declines in maximal eccentric torque were associated with the change in eccentric biceps femoris myoelectrical activity (p = 0.013). Following repeat sprint running there were preferential declines in the myoelectrical activity of the BF, which explained declines in eccentric knee flexor strength.

The acute effects of eccentrically-biased versus conventional weight training in older adults : a randomised controlled cross-over study

Background Whilst resistance training has been proven to convey considerable benefits to older people; immediately post-exercise there may be elevated transient risks for cardiac events and falls. Objectives and Measurements We assessed the acute effects of eccentrically-biased (EB) and conventional (CONV) resistance exercise on: platelet number, activation and granule exocytsosis; and mean velocity of centre of pressure displacement (Vm). Design, Setting, Participants and Intervention Ten older adults (7 males, 3 females; 69 ± 4 years) participated in this randomised controlled cross-over study in which they performed EB and CONV training sessions that were matched for total work and a control condition. Results Immediately post-exercise there was a statistically significant difference in platelet count between the control condition, in which it fell (pre 224 ± 35 109/L; post 211 ± 30 109/L: P < 0.05) and CONV in which it increased (pre 236 ± 55 109/L; post 242 ± 51 109/L: P > 0.05). There was no change in platelet activation and granule exocytsosis or Vm following EB and CONV. Conclusions Overall, while minor differences between regimens were observed, no major adverse effect on parameters of platelet function or centre of pressure displacement were observed acutely following either regimen. Eccentrically-biased and conventional resistance exercise training regimens do not appear to present an elevated acute risk in the context of changes to platelet function contributing to a cardiac event or postural stability increasing falls risk for apparently healthy older adults.

Tissue viability imaging of skin microcirculation following exposure to whole body cryotherapy (-110°C) and cold water immersion (8°C)

Cryotherapy is currently used in various clinical, rehabilitative, and sporting settings. However, very little is known regarding the impact of cooling on the microcirculatory response. Objectives: The present study sought to examine the influence of two commonly employed modalities of cryotherapy, whole body cryotherapy (WBC; -110°C) and cold water immersion(CWI; 8±1°C), on skin microcirculation in the mid- thigh region. Methods: The skin area examined was a 3 × 3 cm located between the most anterior aspect of the inguinal fold and the patella. Following 10 minutes of rest, 5 healthy, active males were exposed to either WBC for 3 minutes or CWI for 5 minutes in a randomised order. Volunteers lay supine for five minutes after treatment, in order to monitor the variation of red blood cell (RBC) concentration in the region of interest for a duration of 40 minutes. Microcirculation response was assessed using a non-invasive, portable instrument known as a Tissue Viability imaging system. After a minimum of seven days, the protocol was repeated. Subjective assessment of the volunteer’s thermal comfort and thermal sensation was also recorded. Results: RBC was altered following exposure to both WBC and CWI but appeared to stabilise approximately 35 minutes after treatments. Both WBC and CWI affected thermal sensation (p < 0.05); however no betweengroup differences in thermal comfort or sensation were recorded (p > 0.05). Conclusions: As both WBC and CWI altered RBC, further study is necessary to examine the mechanism for this alteration during whole body cooling.

Psychological determinants and outcomes of sedentary and physical activity behaviours

There is now a large body of literature that supports the protective role of physical activity for both physical and psychological health. Sedentary behaviour was previously considered the functional opposite of physical activity, but 10 years ago, Owen and colleagues highlighted the need to study physical activity and sedentary behaviour as two distinct modes of behaviour that can independently influence health [1]. Since then, there has been growing evidence that participation in sedentary behaviours such as television viewing, computer use and sitting at work are associated with higher risk of chronic disease outcomes (type 2 diabetes, obesity), and leisure-time sitting has recently been associated with increased mortality [2]. Growing research points to the possible synergistic effects of physical activity and sedentary behaviours in contributing to health outcomes

A preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome, glycaemic control, health-related quality of life, and psychological health in adults with elevated blood glucose

Objectives To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme in adults with elevated blood glucose. Design, Setting, and Participants A single group pre–post feasibility trial with 11 participants (3 male and 8 female; aged 42–65 years) with elevated blood glucose. Intervention Participants attended Tai Chi and Qigong exercise training for 1 to 1.5 h, 3 times per week for 12 weeks, and were encouraged to practise the exercises at home. Main Outcome Measures Indicators of metabolic syndrome (body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-cholesterol); glucose control (HbA1c, fasting insulin and insulin resistance (HOMA)); health-related quality of life; stress and depressive symptoms. Results There was good adherence and high acceptability. There were significant improvements in four of the seven indicators of metabolic syndrome including BMI (mean difference −1.05, p<0.001), waist circumference (−2.80 cm, p<0.05), and systolic (−11.64 mm Hg, p<0.01) and diastolic blood pressure (−9.73 mm Hg, p<0.001), as well as in HbA1c (−0.32%, p<0.01), insulin resistance (−0.53, p<0.05), stress (−2.27, p<0.05), depressive symptoms (−3.60, p<0.05), and the SF-36 mental health summary score (5.13, p<0.05) and subscales for general health (19.00, p<0.01), mental health (10.55, p<0.01) and vitality (23.18, p<0.05). Conclusions The programme was feasible and acceptable and participants showed improvements in metabolic and psychological variables. A larger controlled trial is now needed to confirm these promising preliminary results.

Is recovery driven by central or peripheral factors? A role for the brain in recovery following intermittent-sprint exercise

Prolonged intermittent-sprint exercise (i.e., team sports) induce disturbances in skeletal muscle structure and function that are associated with reduced contractile function, a cascade of inflammatory responses, perceptual soreness, and a delayed return to optimal physical performance. In this context, recovery from exercise-induced fatigue is traditionally treated from a peripheral viewpoint, with the regeneration of muscle physiology and other peripheral factors the target of recovery strategies. The direction of this research narrative on post-exercise recovery differs to the increasing emphasis on the complex interaction between both central and peripheral factors regulating exercise intensity during exercise performance. Given the role of the central nervous system (CNS) in motor-unit recruitment during exercise, it too may have an integral role in post-exercise recovery. Indeed, this hypothesis is indirectly supported by an apparent disconnect in time-course changes in physiological and biochemical markers resultant from exercise and the ensuing recovery of exercise performance. Equally, improvements in perceptual recovery, even withstanding the physiological state of recovery, may interact with both feed-forward/feed-back mechanisms to influence subsequent efforts. Considering the research interest afforded to recovery methodologies designed to hasten the return of homeostasis within the muscle, the limited focus on contributors to post-exercise recovery from CNS origins is somewhat surprising. Based on this context, the current review aims to outline the potential contributions of the brain to performance recovery after strenuous exercise.

Physical activity promotion as a school priority : what do parents think?

The demands and responsibilities placed on schools in contemporary education systems are vast. However, with growing obesity levels and physical inactivity, the prevention of chronic disease has focused on youth populations, with schools playing the focal educative asset in this strategy. Parents play a decisive role in their child’s educational setting, and as fee and tax payers, are ultimately a consumer. Parents (82 males and 208 females) of secondary school children were recruited from three private (n=151) and two government schools (n=150) in Brisbane, Australia. The mean (standard deviation) age was 44.57 (6.21) years. Participants responded to a series of questions about physical activity at their child’s school, in addition to completing the International Physical Activity Questionnaire. Data were analysed using descriptive statistics, frequency distributions and logistic regressions. Parents were deemed sufficiently physically active if they participated in at least 150 minutes of moderate-to-vigorous physical activity per week. Overall, 83 (59.7%) parents from private and 60 (50.8%) parents from government schools were deemed sufficiently physically active. Concerning whether physical activity promotion should be a priority at their child’s school, 111 (73.5%) parents from private schools either agreed or strongly agreed, as opposed to 97 (64.7%) parents from government schools. Logistic regressions indicated that the concept of physical activity promotion being prioritised at schools was dependent on whether the child attended a private school (OR =1.34, z = 2.30, p = 0.02), and whether the participant was sufficiently active (OR =.71, z = -2.48, p = 0.01). Physical activity promotion within schools may provide substantial future benefits on a population scale. The demands on schools may need to be addressed to meet the needs of students and the desires of their parents.

Physiological tolerance times while wearing explosive ordnance disposal protective clothing in simulated environmental extremes

Explosive ordnance disposal (EOD) technicians are required to wear protective clothing to protect themselves from the threat of overpressure, fragmentation, impact and heat. The engineering requirements to minimise these threats results in an extremely heavy and cumbersome clothing ensemble that increases the internal heat generation of the wearer, while the clothing’s thermal properties reduce heat dissipation. This study aimed to evaluate the heat strain encountered wearing EOD protective clothing in simulated environmental extremes across a range of differing work intensities. Eight healthy males [age 25±6 years (mean ± sd), height 180±7 cm, body mass 79±9 kg, V˙O2max 57±6 ml.kg−1.min−1] undertook nine trials while wearing an EOD9 suit (weighing 33.4 kg). The trials involved walking on a treadmill at 2.5, 4 and 5.5 km⋅h−1 at each of the following environmental conditions, 21, 30 and 37°C wet bulb globe temperature (WBGT) in a randomised controlled crossover design. The trials were ceased if the participants’ core temperature reached 39°C, if heart rate exceeded 90% of maximum, if walking time reached 60 minutes or due to fatigue/nausea. Tolerance times ranged from 10–60 minutes and were significantly reduced in the higher walking speeds and environmental conditions. In a total of 15 trials (21%) participants completed 60 minutes of walking; however, this was predominantly at the slower walking speeds in the 21°C WBGT environment. Of the remaining 57 trials, 50 were ceased, due to attainment of 90% maximal heart rate. These near maximal heart rates resulted in moderate-high levels of physiological strain in all trials, despite core temperature only reaching 39°C in one of the 72 trials.

Science of winning soccer : emergent pattern-forming dynamics in association football

Quantitative analysis is increasingly being used in team sports to better understand performance in these stylized, delineated, complex social systems. Here we provide a first step toward understanding the pattern-forming dynamics that emerge from collective offensive and defensive behavior in team sports. We propose a novel method of analysis that captures how teams occupy sub-areas of the field as the ball changes location. We used the method to analyze a game of association football (soccer) based upon a hypothesis that local player numerical dominance is key to defensive stability and offensive opportunity. We found that the teams consistently allocated more players than their opponents in sub-areas of play closer to their own goal. This is consistent with a predominantly defensive strategy intended to prevent yielding even a single goal. We also find differences between the two teams' strategies: while both adopted the same distribution of defensive, midfield, and attacking players (a 4:3:3 system of play), one team was significantly more effective both in maintaining defensive and offensive numerical dominance for defensive stability and offensive opportunity. That team indeed won the match with an advantage of one goal (2 to 1) but the analysis shows the advantage in play was more pervasive than the single goal victory would indicate. Our focus on the local dynamics of team collective behavior is distinct from the traditional focus on individual player capability. It supports a broader view in which specific player abilities contribute within the context of the dynamics of multiplayer team coordination and coaching strategy. By applying this complex system analysis to association football, we can understand how players' and teams' strategies result in successful and unsuccessful relationships between teammates and opponents in the area of play.

Competing together : assessing the dynamics of team-team and player-team synchrony in professional association football

This study investigated movement synchronization of players within and between teams during competitive association football performance. Cluster phase analysis was introduced as a method to assess synchronies between whole teams and between individual players with their team as a function of time, ball possession and field direction. Measures of dispersion (SD) and regularity (sample entropy – SampEn – and cross sample entropy – Cross-SampEn) were used to quantify the magnitude and structure of synchrony. Large synergistic relations within each professional team sport collective were observed, particularly in the longitudinal direction of the field (0.89 ± 0.12) compared to the lateral direction (0.73 ± 0.16, p < .01). The coupling between the group measures of the two teams also revealed that changes in the synchrony of each team were intimately related (Cross-SampEn values of 0.02 ± 0.01). Interestingly, ball possession did not influence team synchronization levels. In player–team synchronization, individuals tended to be coordinated under near in-phase modes with team behavior (mean ranges between −7 and 5° of relative phase). The magnitudes of variations were low, but more irregular in time, for the longitudinal (SD: 18 ± 3°; SampEn: 0.07 ± 0.01), compared to the lateral direction (SD: 28 ± 5°; SampEn: 0.06 ± 0.01, p < .05) on-field. Increases in regularity were also observed between the first (SampEn: 0.07 ± 0.01) and second half (SampEn: 0.06 ± 0.01, p < .05) of the observed competitive game. Findings suggest that the method of analysis introduced in the current study may offer a suitable tool for examining team’s synchronization behaviors and the mutual influence of each team’s cohesiveness in competing social collectives.

Variations in acculturation and Australian physical education teacher education students' receptiveness to an alternative pedagogical approach to games teaching

Background The development of intelligent, thinking performers as a central theme in Physical Education curriculum documents worldwide has highlighted the need for an evolution of teaching styles from the dominant reproductive approach. This has prompted an Australian university to change the content and delivery of a games unit within their Physical Education Teacher Education (PETE) course and adopt a productive student centred approach that is compatible with current curriculum directives. The significance of prospective physical educators’ biographies on their receptiveness to this pedagogical innovation was studied to help recognise and understand potential differences and subsequently guide programme development to help improve the impact of teacher education. Purpose To investigate whether past school and sporting experiences are powerful influences on Australian PETE recruits’ initial perspectives about effective physical education teaching practice and their receptiveness to an alternative pedagogical approach. Participants and Setting 49 first year pre-service PETE students (53% male; 47% female; mean age 18.88 ± 1.57 years) undertaking a compulsory unit on games teaching at an Australian university volunteered to take part in the study and were grouped according to their highest level of representation in games, either school/club (n=13), regional (n=20), or state/national (n=16). Students experienced the constraints-led approach as learners and teachers during an 8-week games unit informed by nonlinear pedagogy and underpinned by motor learning theory. Data collection and Analysis Prior to the commencement of the unit participants completed part A of a two part mixed response questionnaire aimed at gathering data about their physical education and sporting background. The data were summarised using descriptive statistics. Pre and post intervention, participants completed part B responding, via Likert Scale with their opinion of the importance of each sub-component of the traditional reproductive style for an effective games teaching session. This resulted in a traditional reproductive games teaching belief score. For each sub-component, participants were invited to respond in more detail to justify their opinions. A one-way between groups analysis of variance (ANOVA), Tukey’s HSD Post Hoc Test and a two - tailed, paired samples t test were used to analyse the quantitative data. Content analysis was used to analyse the qualitative data. Findings The traditional, reproductive approach was the most frequently reported teaching approach used by the physical education teachers and sports coaches of participants in all groups. Prior to the commencement of the alternate games unit, participants in each representative level group held very strong custodial traditional reproductive games teaching beliefs. After experiencing the alternative games unit there were statistically significant differences in the traditional reproductive games teaching belief mean scores for each group, This combined with participants’ qualitative responses indicated a receptiveness to the alternative pedagogy. Conclusions The results of this present study show that, contrary to previous research undertaken in North America, in Australia, it is possible for PETE educators to change beliefs in order to overcome the constraint of acculturation and provide PETE students with the knowledge, understanding and belief in an alternate approach to teaching games in physical education compatible with curriculum documents.