Associations of TV viewing and physical activity with the metabolic syndrome in Australian adults

Aims/hypothesis We analysed a sample of Australian adults to determine the strength of associations of TV viewing and participation in physical activity with the metabolic syndrome.

Methods This population-based cross-sectional study included 6,241 adults aged ge35 years who were free from diagnosed diabetes mellitus and self-reported ischaemic disease and were not taking lipid-lowering or antihypertensive drugs. The metabolic syndrome was defined according to the 1999 World Health Organization criteria. Participants self-reported TV viewing time and physical activity time for the previous week.

Results The adjusted odds ratio of having the metabolic syndrome was 2.07 (95% CI 1.49–2.88) in women and 1.48 (95% CI 0.95–2.31) in men who watched TV for >14 h per week compared with those who watched le7.0 h per week. Compared with those who were less active (<2.5 h per week), the odds ratio for the metabolic syndrome was 0.72 (95% CI 0.58–0.90) in men and 0.53 (95% CI 0.38–0.74) in women who were active (ge2.5 h per week). Longer TV viewing (>14 h per week) was associated with an increased risk of insulin resistance, obesity and dyslipidaemia in both men and women. A total physical activity time of ge2.5 h per week was associated with a reduced prevalence of both insulin resistance and dyslipidaemia in both sexes and reduced prevalence of both obesity and hypertension in women.

Conclusions/interpretation Increased TV viewing time was associated with an increased prevalence of the metabolic syndrome, while physical activity was associated with a reduced prevalence. Population strategies addressing the metabolic syndrome should focus on reducing sedentary behaviours such as TV viewing, as well as increasing physical activity.

Exploring the feasibility and acceptability of using internet technology to promote physical activity within a defined community

ISSUE ADDRESSED: To explore the feasibility of using the Internet and e-mail to promote physical activity in a defined community.

METHODS: An online survey was conducted through a community-based Internet Service Provider (ISP). ISP clients were recruited via electronic newsletter and direct e-mail. Data were collected on preferred sources of assistance for physical activity advice and stage of motivational readiness for physical activity.

RESULTS: Valid surveys were completed by 797 (9% response rate). Participants were: 55% men; 56% aged >45 years; 57% worked full time; mean BMI was 28+/-8. Thirty-six per cent were in the early stages of motivational readiness for physical activity. More than 70% were somewhat to extremely interested in having access to a physical activity website.

CONCLUSION: Promoting physical activity via the Internet and e-mail is feasible and appealing to some people. Expanding the reach, appeal and use of this technology to deliver physical activity programs will be a challenge.

A systematic policy approach to changing the food system and physical activity environments to prevent obesity

As obesity prevention becomes an increasing health priority in many countries, including Australia
and New Zealand, the challenge that governments are now facing is how to adopt a systematic
policy approach to increase healthy eating and regular physical activity. This article sets out a
structure for systematically identifying areas for obesity prevention policy action across the food
system and full range of physical activity environments. Areas amenable to policy intervention can
be systematically identified by considering policy opportunities for each level of governance (local,
state, national, international and organisational) in each sector of the food system (primary
production, food processing, distribution, marketing, retail, catering and food service) and each
sector that influences physical activity environments (infrastructure and planning, education,
employment, transport, sport and recreation). Analysis grids are used to illustrate, in a structured
fashion, the broad array of areas amenable to legal and regulatory intervention across all levels of
governance and all relevant sectors. In the Australian context, potential regulatory policy
intervention areas are widespread throughout the food system, e.g., land-use zoning (primary
production within local government), food safety (food processing within state government), food
labelling (retail within national government). Policy areas for influencing physical activity are
predominantly local and state government responsibilities including, for example, walking and
cycling environments (infrastructure and planning sector) and physical activity education in schools
(education sector). The analysis structure presented in this article provides a tool to systematically
identify policy gaps, barriers and opportunities for obesity prevention, as part of the process of
developing and implementing a comprehensive obesity prevention strategy. It also serves to
highlight the need for a coordinated approach to policy development and implementation across
all levels of government in order to ensure complementary policy action.

Individual, social and environmental determinants of participation in physical activity for prostate cancer survivors

Participation in physical activity helps prostate cancer survivors to cope with the side effects of treatment, enhances quality of life and decreases the risks of many of the comorbidities to which survivors are highly susceptible. Prostate cancer survivors, however, are less likely than other cancer survivors (e.g., breast and colorectal) to increase physical activity after diagnosis. Interventions have been only modestly successful at increasing participation in physical activity for prostate cancers survivors and more research is needed to increase our understanding of the determinants of physical activity for this group. Using a social ecological framework, this qualitative research sought to examine the individual, social and environmental determinants of participation in physical activity for prostate cancer survivors. In-depth interviews were conducted with 20 survivors of prostate cancer aged between 35 and 75 years. Participants were drawn from a public and a private health service and from a range of treatment types. We are currently collecting data for this study and preliminary themes will be discussed at the conference (abstract will be updated once findings are known).

The burden of physical activity-related ill health in the UK

Background: Despite evidence that physical inactivity is a risk factor for a number of diseases, only a third of men and a quarter of women are meeting government targets for physical activity. This paper provides an estimate of the economic and health burden of disease related to physical inactivity in the UK. These estimates are examined in relation to current UK government policy on physical activity.

Methods: Information from the World Health Organisation global burden of disease project was used to calculate the mortality and morbidity costs of physical inactivity in the UK. Diseases attributable to physical inactivity included ischaemic heart disease, ischaemic stroke, breast cancer, colon/rectum cancer and diabetes mellitus. Population attributable fractions for physical inactivity for each disease were applied to the UK Health Service cost data to estimate the financial cost.

Results: Physical inactivity was directly responsible for 3% of disability adjusted life years lost in the UK in 2002. The estimated direct cost to the National Health Service is £1.06 billion.

Conclusion: There is a considerable public health burden due to physical inactivity in the UK. Accurately establishing the financial cost of physical inactivity and other risk factors should be the first step in a developing national public health strategy.

Life-change events and participation in physical activity : a systematic review

Physical inactivity and related diseases are of global public health concern. In many developing countries, levels of health promoting physical activity (PA) are falling despite government initiatives. Previous work has identified that periods of transition across a life course, or ‘life-change events’ have implications for drop out from PA. As yet, there has been little work to understand the life course as a whole and to furnish a complete list of possible life changes that might affect participation in PA. Our paper presents a review of the published literature in which life events have been studied in relation to their effect on participation in PA. A literature search was conducted for papers published between 1977 and April 2007 and referenced in Pubmed. Papers were reviewed if they; reported the effect of a life-change event; had PA as an outcome; reported results in English; and reported results from observational studies. The references for studies identified during this first phase were searched for further papers. Eighty-seven papers were identified as potentially relevant on the basis of title, of which 19 papers met the inclusion criteria on the basis of full text. Five life changes were identified; change in employment status; change in residence; change in physical status; change in relationships; and change in family structure. It was noted that few longitudinal studies examined PA both before and after a life event. A list of possible life events which might effect participation in PA is presented. This paper represents a first step towards a detailed programme of work on life-change events and PA.

The effectiveness of physical activity interventions for the treatment of overweight and obesity and type 2 diabetes

This review summarises current evidence relating to the effectiveness of physical activity (PA) interventions for treating overweight and obesity and type 2 diabetes. Interventions to increase PA for the treatment of overweight and obesity in both children and adults have primarily consisted of health education and behaviour modification strategies in clinical settings or with selected families or individuals. Although evidence is limited, strategies to reduce sedentary behaviours appear to have potential for reducing obesity among children and adolescents. Among adults, strategies that combine diet and PA are more effective than PA strategies alone. Combined lifestyle strategies are most successful for maintained weight loss, although most programs are unsuccessful in producing long-term changes. There is little evidence about compliance to prescribed behaviour changes or the factors that promote or hinder compliance to lifestyle changes. Limited evidence suggests that continued professional contact and self-help groups can help sustain weight loss. Most of the interventions for the treatment of type 2 diabetes have been conducted in clinical settings and have typically required the use of extensive resources. Evidence suggests that interventions can lead to small but clinically meaningful improvements in glycaemic control, even in the absence of weight loss. A recent study demonstrated that a multifactorial intervention (diet, PA and pharmaceutical) can reduce the risk of diabetes complications in individuals with type 2 diabetes. Nevertheless, there is little evidence about the effectiveness of community-based interventions in producing long-term changes in glycaemic control and reduced mortality in people with type 2 diabetes.

A preliminary analysis of barriers, intentions, and attitudes towards moderate physical activity in women who are overweight

Physical activity is important for the health of all individuals, however, the determinants of physical activity behaviour for women who are overweight remain largely unexplored. The purpose of this investigation was to explore a range of factors that influence participation in physical activity for a group of women who are overweight. Participants were 30 women, aged 25–71 years, with a mean age of 46.8 years (+12.95) and an average BMI of 31.2 kg/m2 (+5.6). Self-reported level of physical activity, perceived barriers and facilitators of physical activity, attitudes, intentions and perceived behavioural control to physical activity were measured. Seventeen participants were generally active, with self-reported moderate physical activity of 218.53 min (±113.82) in the last 7 days; whereas 13 participants were reportedly less active 43.46 (±42.98) min. Active participants were more likely to identify social reasons for participating in physical activity, while inactive participants perceived that their laziness prevented them from being physically active. There were no significant differences between active and inactive overweight women for attitude, intention or subjective norm for moderate-intensity physical activity. There was a significant difference between these women in perceived behavioural control (p = .014) for moderate-intensity physical activity, as women who felt more in control of their physical activity behaviour were more likely to engage in physical activity than inactive women. Future research should investigate interventions to increase behavioural control of moderate-intensity physical activity in women who are overweight.

Women's bodies, self perception and physical activity : a naturalistic study of women's participation in aerobics classes

The aim of this study was to describe the behaviour and perceptions of women in aerobic or exercise to music classes. In particular, the study examined the meaning women attach to this activity choice and the interaction of aerobics participation with cultural pressures and beliefs such as that of the ‘ideal female bodyshape’. A naturalistic method of study was chosen in order to gain a comprehensive view of the subjective experience of aerobics participation. Approximately fifty female health club members were observed over a three month period in order to identify and describe patterns of involvement, behaviour and perception and the factors affecting them. Six groups of women were identified. These were ‘Naturals’, ‘Compulsive’, ‘Functional Feminist’. Several factors were observed as potentially contributing to the patterns observed. These included attitude toward perceived cultural ideals and pressures of female expectation and shape, perceptions of aerobics and exercise, pre-occupation with slenderness and bodyshape, self-image and body image. The relationship between these factors was found to be dynamic and reciprocal, with participation possibly intensifying or alternately reducing bodyshape concern. Aerobics was seen to have a multifaceted yet very individual and important appeal to the women observed.

‘I can’t do any serious exercise’ : barriers to physical activity amongst people of Pakistani and Indian origin with Type 2 diabetes

Type 2 diabetes is at least 4 times more common among British South Asians than in the general population. South Asians also have a higher risk of diabetic complications, a situation which has been linked to low levels of physical activity observed amongst this group. Little is known about the factors and considerations which prohibit and/or facilitate physical activity amongst South Asians. This qualitative study explored Pakistani (n = 23) and Indian (n = 9) patients' perceptions and experiences of undertaking physical activity as part of their diabetes care. Although respondents reported an awareness of the need to undertake physical activity, few had put this lifestyle advice into practice. For many, practical considerations, such as lack of time, were interwoven with cultural norms and social expectations. Whilst respondents reported health problems which could make physical activity difficult, these were reinforced by their perceptions and understandings of their diabetes, and its impact upon their future health. Education may play a role in physical activity promotion; however, health promoters may need to work with, rather than against, cultural norms and individual perceptions. We recommend a realistic and culturally sensitive approach, which identifies and capitalizes on the kinds of activities patients already do in their everyday lives.

Physical activity advice and obesity

Current physical activity guidelines need to be modified to incorporate specific recommendations for obese people and consideration needs to be given to greater collaboration among health care providers to provide a multi disciplinary team approach that may be a more effective method of managing obesity and promoting physical activity.

Associations between neighbourhood safety and physical activity among youth

This thesis examined how perceptions of neighbourhood safety and objective measures of the local road environment were related to physical activity among youth. Results demonstrated that neighbourhoods with walking tracks and traffic-calming measures promote active transport (walking/cycling) and may help stem age-related declines in physical activity among children and adolescents.

Physical activity levels of normal-weight and overweight girls and boys during primary school recess

Objective: This study aimed to compare moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA) in normal-weight and overweight boys and girls during school recess.

Research Methods and Procedures: Four hundred twenty children, age 6 to 10 years, were randomly selected from 25 schools in England. Three hundred seventy-seven children completed the study. BMI was calculated from height and weight measurements, and heart rate reserve thresholds of 50% and 75% reflected children's engagement in MVPA and VPA, respectively.

Results: There was a significant main effect for sex and a significant interaction between BMI category and sex for the percent of recess time spent in MVPA and VPA. Normal-weight girls were the least active group, compared with overweight boys and girls who were equally active. Fifty-one boys and 24 girls of normal weight achieved the 40% threshold; of these, 30 boys and 10 girls exceeded 50% of recess time in MVPA. Eighteen overweight boys and 22 overweight girls exceeded the 40% threshold, whereas 8 boys and 8 girls exceeded the 50% threshold.

Discussion: Overweight boys were significantly less active than their normal-weight male counterparts; this difference did not hold true for girls. Even though nearly double the number of normal-weight children achieved the 40% of MVPA during recess compared with overweight children, physical activity promotion in school playgrounds needs to be targeted not only at overweight but at other health parameters, as 40 overweight children met the 40% MVPA target proposed for recess

Physical activity, sedentary behavior and depression among disadvantaged women

This study investigated associations between components of physical activity (PA; e.g. domain and social context) and sedentary behaviors (SBs) and risk of depression in women from disadvantaged neighborhoods. A total of 3645 women, aged 18–45 years, from disadvantaged neighborhoods, self-reported their PA, SB and depressive symptoms. Crude and adjusted odds ratios and 95% confidence intervals were calculated for each component of PA, SB and risk of depression using logistic regression analyses, adjusting for clustering by women's neighborhood of residence. Being in a higher tertile of leisure-time PA and transport-related PA was associated with lower risk of depression. No associations were apparent for domestic or work-related PA. Women who undertook a small proportion of their leisure-time PA with someone were less likely to be at risk of depression than those who undertook all leisure-time PA on their own. Women reporting greater time sitting at the computer, screen time and overall sitting time had higher odds of risk of depression compared with those reporting low levels. The domain and social context of PA may be important components in reducing the risk of depression. Reducing time spent in SB may be a key strategy in the promotion of better mental health in women from disadvantaged neighborhoods.