Antimicrobial, antioxidant and anti-inflammatory phenolic activities in extra virgin olive oil

The Mediterranean diet is associated with a lower incidence of chronic degenerative diseases and higher life expectancy. These health benefits have been partially attributed to the dietary consumption of extra virgin olive oil (EVOO) by Mediterranean populations, and more specifically the phenolic compounds naturally present in EVOO. Studies involving humans and animals (in vivo and in vitro) have demonstrated that olive oil phenolic compounds have potentially beneficial biological effects resulting from their antimicrobial, antioxidant and anti-inflammatory activities. This paper summarizes current knowledge on the biological activities of specific olive oil phenolic compounds together with information on their concentration in EVOO, bioavailability and stability over time.

Efficacy of a referral and physical activity program for survivors of prostate cancer [ENGAGE] : rationale and design for a cluster randomised controlled trial

Background: Despite evidence that physical activity improves the health and well-being of prostate cancer survivors, many men do not engage in sufficient levels of activity. The primary aim of this study (ENGAGE) is to determine the efficacy of a referral and physical activity program among survivors of prostate cancer, in terms of increasing participation in physical activity. Secondary aims are to determine the effects of the physical activity program on psychological well-being, quality of life and objective physical functioning. The influence of individual and environmental mediators on participation in physical activity will also be determined.
Methods/Design: This study is a cluster randomised controlled trial. Clinicians of prostate cancer survivors will be randomised into either the intervention or control condition. Clinicians in the intervention condition will refer eligible patients (n = 110) to participate in an exercise program, comprising 12 weeks of supervised exercise sessions and unsupervised physical activity. Clinicians allocated to the control condition will provide usual care to eligible patients (n = 110), which does not involve the recommendation of the physical activity program. Participants will be assessed at baseline, 12 weeks, 6 months, and 12 months on physical activity, quality of life, anxiety, depression, self-efficacy, outcome expectations, goals, and socio-structural factors.
Discussion: The findings of this study have implications for clinicians and patients with different cancer types or other chronic health conditions. It will contribute to our understanding on the potential impact of clinicians promoting physical activity to patients and the long term health benefits of participating in physical activity programs.

A cross-sectional study of the individual, social, and built environmental correlates of pedometer based physical activity among elementary school children

Background: Children who participate in regular physical activity obtain health benefits. Preliminary pedometerbased cut-points representing sufficient levels of physical activity among youth have been established; however limited evidence regarding correlates of achieving these cut-points exists. The purpose of this study was to identify correlates of pedometer-based cut-points among elementary school-aged children.
Method: A cross-section of children in grades 5-7 (10-12 years of age) were randomly selected from the most (n = 13) and least (n = 12) ‘walkable’ public elementary schools (Perth, Western Australia), stratified by socioeconomic status. Children (n = 1480; response rate = 56.6%) and parents (n = 1332; response rate = 88.8%) completed a survey, and steps were collected from children using pedometers. Pedometer data were categorized to reflect the sex-specific pedometer-based cut-points of ≥15000 steps/day for boys and ≥12000 steps/day for girls. Associations between socio-demographic characteristics, sedentary and active leisure-time behavior, independent mobility, active transportation and built environmental variables - collected from the child and parent surveys - and meeting pedometer-based cut-points were estimated (odds ratios: OR) using generalized estimating equations.
Results: Overall 927 children participated in all components of the study and provided complete data. On average, children took 11407 ± 3136 steps/day (boys: 12270 ± 3350 vs. girls: 10681 ± 2745 steps/day; p < 0.001) and 25.9% (boys: 19.1 vs. girls: 31.6%; p < 0.001) achieved the pedometer-based cut-points. After adjusting for all other variables and school clustering, meeting the pedometer-based cut-points was negatively associated (p < 0.05) with being male (OR = 0.42), parent self-reported number of different destinations in the neighborhood (OR 0.93), and a friend’s (OR 0.62) or relative’s (OR 0.44, boys only) house being at least a 10-minute walk from home. Achieving the pedometer-based cut-points was positively associated with participating in screen-time < 2 hours/day (OR 1.88), not being driven to school (OR 1.48), attending a school located in a high SES neighborhood (OR 1.33), the average number of steps among children within the respondent’s grade (for each 500 step/day increase: OR 1.29), and living further than a 10-minute walk from a relative’s house (OR 1.69, girls only).
Conclusions: Comprehensive multi-level interventions that reduce screen-time, encourage active travel to/from school and foster a physically active classroom culture might encourage more physical activity among children.

Physical activity among cancer survivors : a literature review

Aim Physical activity offers a variety of health benefits to cancer survivors, both during and post-treatment. The aim here is to review: the preferences of cancer survivors regarding exercise counselling and participation in a physical activity programme; adherence rates among cancer survivors to physical activity programmes; and predictors of adherence to exercise training.

Methods Two electronic databases, Ovid MEDLINE(R) 1950 to Present with Daily Update and SCOPUS, were used to undertake literature searches for studies examining exercise preferences of adult cancer survivors, and physical activity programmes for adults at any point of the cancer trajectory.

Results Studies suggest that, while physical activity levels are low among cancer survivors, most are interested in increasing their participation. Preferences and adherence to physical activity programmes differ across a range of demographic, medical, and behavioural variables, suggesting the importance of tailoring exercise programmes to patient-specific and disease-specific needs.

Conclusions Current evidence supports the benefits of physical activity for improving risk factors associated with cancer prognosis. Physical activity programmes developed for oncology patients and cancer survivors need to take into account the needs of the target population in order to optimise adherence, outcomes, and long-term behavioural changes in this population.

Jumping on the omega-3 bandwagon : distinguishing the role of long-chain and short-chain omega-3 fatty acids

Omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA) are almost unanimously recognized for their health benefits, while only limited evidence of any health benefit is currently available specifically for the main precursor of these fatty acids, namely α-linolenic acid (ALA, 18:3n-3). However, both the n-3 LC-PUFA and the short-chain C18 PUFA (i.e., ALA) are commonly referred to as “omega-3” fatty acids, and it is difficult for consumers to recognize this difference. A current gap of many food labelling legislations worldwide allow products containing only ALA and without n-3 LC-PUFA to be marketed as “omega-3 source” and this misleading information can negatively impact the ability of consumers to choose more healthy diets. Within the context of the documented nutritional and health promoting roles of omega-3 fatty acids, we briefly review the different metabolic fates of dietary ALA and n-3 LC-PUFA. We also review food sources rich in n-3 LC-PUFA, some characteristics of LC-PUFA and current industry and regulatory trends. A further objective is to present a case for regulatory bodies to clearly distinguish food products containing only ALA from foods containing n-3 LC-PUFA. Such information, when available, would then avoid misleading information and empower consumers to make a more informed choice in their food purchasing behavior.

Physical activity promotion for male factory workers : a realistic option?

Issue addressed: Worksites are a promising setting for health promotion initiatives. While there is an accumulated body of evidence indicating favourable health and cost outcomes, there have been difficulties identified in recruiting and influencing blue- collar workers. This descriptive study aimed to identify specific opportunities and barriers which may impact upon physical activity options at work for male blue-collar factory workers.

Methods: Fifteen manager interviews and worksite observations, and eight employee group discussions were conducted in manufacturing industry worksites.

Results: Several key barriers emerged which limit opportunities for blue-collar employees to participate in physical activity at work: time constraints; limited facilities; and lack of interest from management to facilitate physical activity due to limited resources and concerns about safety issues. Potential opportunities included the presence of change rooms, showers, outdoor areas suitable for physical activity, nearby parks and local fitness facilities, and occupational health and safety committees.

Conclusions: Increasing opportunities for workers to be active at work did not emerge as a priority of managers who may need to be convinced that allocating time and resources to physical activity is a wise investment and that workers need an environment that both supports and encourages participation in physical activity. The role of physical activity in relation to injury prevention and potential reductions in Workcover premiums is worthy of further investigation.

So what? While worksite physical activity promotion is a national health objective, there are numerous actual and perceived barriers to initiatives directed at factory workers. Rather than offering specific programs, it may be more productive to address work practices and environmental and regulatory barriers through established occupational health and safety channels. Information and education strategies to change the attitudes and beliefs of management and workers about these issues, as well as about the health benefits of physical activity, may also be helpful.

A university campus physical activity program

Issue addressed: The transition from youth to adulthood is associated with significant decreases in leisure time physical activity. University campuses are settings in which young adults' physical activity may be influenced.

Methods: Following a survey of students at two urban university campuses, a physical activity program was implemented at one campus over 8 weeks. A follow up survey was then conducted at both campuses. Physical activity was assessed by deriving leisure time participation categories from self reported activity in the last 2 weeks.

Results: Following the campus based programs, students at the intervention campus were significantly more likely to be sufficiently active for long term health benefits than were those at the comparison campus (P<0.001) due to an increase in the proportion of vigorously active students.

Conclusions: Providing programs and opportunities to be physically active in university campuses may help to promote physical activity in young adults.

So what?: Settings based approaches to promoting physical activity in young adults may be pursued at university campuses where facilities and infrastructure exist to support such strategies.

How doctors and lawyers can help vulnerable patients

Medical-legal partnerships have broken down the barriers to accessible legal services for people experiencing health issues in the United States. Such programs demonstrate the health benefits of effective legal advocacy on behalf of patients and Australia could learn from this model to improve access to justice and deliver better health outcomes.

Food fortification : the evidence, ethics and politics of adding nutrients to food

This research book presents a critical analysis of mandatory food fortification as a technology for protecting and promoting public health. Increasing numbers of foods fortified with novel amounts and combinations of nutrients are being introduced into the food supplies of countries around the world to raise populations’ nutrient intakes. Three topical food fortification case studies representing the different public health rationales for adding nutrients to food were assessed for their public health benefits, risks and ethical considerations: Universal salt iodisation (USI) to help prevent iodine deficiency disorders; mandatory flour fortification with folic acid (MFFFA) to help prevent neural tube defects; and mandatory milk fortification with vitamin D (MMFVD) to help prevent vitamin D deficiency. These assessments found that whereas USI performs strongly as a public health intervention, MFFFA and MMFVD are associated with more risks and less ethical justification than an alternative policy option. Food fortification can be a blunt policy response to complex policy problems. The findings highlight that the primary predictor of a mandatory food fortification policy’s benefits, risks and ethics is its ability to address the underlying cause of the policy problem. The analysis of the policy-making processes for each case study found that certain powerful actors use their influence to determine what counts as evidence in policy processes to privilege food fortification activities over alternative policy options. Policy-making frequently was notable for the low prominence it afforded ethical considerations and its lack of public engagement. Priority activities to help strengthen policy processes and outcomes are suggested.

Change in active travel and changes in recreational and total physical activity in adults : longitudinal findings from the iConnect study

Background : To better understand the health benefits of promoting active travel, it is important to understand the relationship between a change in active travel and changes in recreational and total physical activity.

Methods : These analyses, carried out in April 2012, use longitudinal data from 1628 adult respondents (mean age 54 years; 47% male) in the UK-based iConnect study. Travel and recreational physical activity were measured using detailed seven-day recall instruments. Adjusted linear regression models were fitted with change in active travel defined as ‘decreased’ (<−15 min/week), ‘maintained’ (±15 min/week) or ‘increased’ (>15 min/week) as the primary exposure variable and changes in (a) recreational and (b) total physical activity (min/week) as the primary outcome variables.

Results : Active travel increased in 32% (n=529), was maintained in 33% (n=534) and decreased in 35% (n=565) of respondents. Recreational physical activity decreased in all groups but this decrease was not greater in those whose active travel increased. Conversely, changes in active travel were associated with commensurate changes in total physical activity. Compared with those whose active travel remained unchanged, total physical activity decreased by 176.9 min/week in those whose active travel had decreased (adjusted regression coefficient −154.9, 95% CI −195.3 to −114.5) and was 112.2 min/week greater among those whose active travel had increased (adjusted regression coefficient 135.1, 95% CI 94.3 to 175.9).

Conclusion : An increase in active travel was associated with a commensurate increase in total physical activity and not a decrease in recreational physical activity.

Dose-dependent increases in heart rate variability and arterial compliance in overweight and obese adults with DHA-rich fish oil supplementation

Heart rate (HR) variability and large arterial compliance can be improved using fish oils. DHA, a component of fish oil, has cardiovascular health benefits, but its effect on HR variability (HRV) and arterial compliance is yet to be quantified. Sixty-seven overweight or obese adults (thirty-six males and thirty-one females; 53 (sem 2) year; BMI 31·7 (sem 1·1) kg/m²) were randomly allocated to consume either 6 g/d sunola oil (control; n 17), fish oil (260 mg DHA+60 mg EPA per g) at doses of 2 g/d (n 16), 4 g/d (n 17) or 6 g/d (n 17). Blood pressure, HR and compliance of large and small arteries were measured while supine at baseline and after 12 weeks in all participants, and HRV was assessed in a subgroup of forty-six participants. There was no effect of fish oil on blood pressure, small artery compliance or HR. However, the low frequency:high frequency ratio of HRV decreased with increasing doses of fish oil (r − 0·34, P = 0·02), while large artery compliance increased (r 0·34, P = 0·006). Moreover, the changes in these biomarkers were significantly correlated (r − 0·31, P = 0·04) and may reflect fish oil-induced improvements in arterial function and cardiac autonomic regulation.

Study protocol for "Moving bright, eating smart"- a phase 2 clinical trial on the acceptability and feasibility of a diet and physical activity intervention to prevent recurrence in colorectal cancer survivors

Background: Colorectal cancer is the second most common cancer and cancer-killer in Hong Kong with an alarming increasing incidence in recent years. The latest World Cancer Research Fund report concluded that foods low in fibre, and high in red and processed meat cause colorectal cancer whereas physical activity protects against
colon cancer. Yet, the influence of these lifestyle factors on cancer outcome is largely unknown even though cancer survivors are eager for lifestyle modifications. Observational studies suggested that low intake of a Western-pattern diet and high physical activity level reduced colorectal cancer mortality. The Theory of Planned
Behaviour and the Health Action Process Approach have guided the design of intervention models targeting a wide range of health-related behaviours.
Methods/design: We aim to demonstrate the feasibility of two behavioural interventions intended to improve colorectal cancer outcome and which are designed to increase physical activity level and reduce consumption of a Western-pattern diet. This three year study will be a multicentre, randomised controlled trial in a 2x2 factorial
design comparing the “Moving Bright, Eating Smart” (physical activity and diet) programme against usual care. Subjects will be recruited over a 12-month period, undertake intervention for 12 months and followed up for a further 12 months. Baseline, interim and three post-intervention assessments will be conducted. Two hundred and twenty-two colorectal cancer patients who completed curative treatment without evidence of recurrence will be recruited into the study. Primary outcome measure will be whether physical activity and dietary targets are met at the end of the 12-month intervention. Secondary outcome measures include the magnitude and
mechanism of behavioural change, the degree and determinants of compliance, and the additional health benefits and side effects of the intervention.
Discussion: The results of this study will establish the feasibility of targeting the two behaviours (diet and physical activity) and demonstrate the magnitude of behaviour change. The information will facilitate the design of a further larger phase III randomised controlled trial with colorectal cancer outcome as the study endpoint to determine whether this intervention model would reduce colorectal cancer recurrence and mortality.

Light-intensity physical activity and cardiometabolic biomarkers in US adolescents

Walkable area within which destinations matter : differences between Australian and Japanese cities

Adults’ walking for transport is important for health benefits and can be associated with availability of destinations such as shops and services within a walking distance of 10 to 15 minutes from home. However, relevant evidence is mostly from Western countries. This study examined associations of destinations with walking for transport in Australian and Japanese cities. Data were collected from Adelaide, Australia (n = 2508), and 4 Japanese cities (n = 1285). Logistic regressions examined associations of self-reported walking for transport with the number of destination types within walk-distance categories. Walking was significantly associated with the number of destination types within a 10-minute walk from home for Australia and with the number of destination types within a 6- to 20-minute walk for Japan. Further research is needed on why walking by residents of Japanese cities can be influenced by more distant local destinations than in Australia to inform physical activity–related environmental and policy initiatives.

The association of cycling with all-cause, cardiovascular and cancer mortality: findings from the population-based EPIC-Norfolk cohort

Objectives
To investigate associations between modest levels of total and domain-specific (commuting, other utility, recreational) cycling and mortality from all causes, cardiovascular disease and cancer.

Design
Population-based cohort study (European Prospective Investigation into Cancer and Nutrition study-Norfolk).

Setting
Participants were recruited from general practices in the east of England and attended health examinations between 1993 and 1997 and again between 1998 and 2000. At the first health assessment, participants reported their average weekly duration of cycling for all purposes using a simple measure of physical activity. At the second health assessment, participants reported a more detailed breakdown of their weekly cycling behaviour using the EPAQ2 physical activity questionnaire.

Participants
Adults aged 40–79 years at the first health assessment.

Primary outcome measure
All participants were followed for mortality (all-cause, cardiovascular and cancer) until March 2011.

Results
There were 22 450 participants with complete data at the first health assessment, of whom 4398 died during follow-up; and 13 346 participants with complete data at the second health assessment, of whom 1670 died during follow-up. Preliminary analyses using exposure data from the first health assessment showed that cycling for at least 60 min/week in total was associated with a 9% reduced risk of all-cause mortality (adjusted HR 0.91, 95% CI 0.84 to 0.99). Using the more precise measures of cycling available from the second health assessment, all types of cycling were associated with greater total moderate-to-vigorous physical activity; however, there was little evidence of an association between overall or domain-specific cycling and mortality.

Conclusions
Cycling, in particular for utility purposes, was associated with greater moderate-to-vigorous and total physical activity. While this study provides tentative evidence that modest levels of cycling may reduce the risk of mortality, further research is required to confirm how much cycling is sufficient to induce health benefits.