Exercise and Auricular Acupuncture for Chronic Low Back Pain: A Feasibility Randomised Controlled Trial

Objectives: To evaluate the feasibility of a randomized-controlled trial (RCT) investigating the effects of adding auricular acupuncture (AA) to exercise for participants with chronic low-back pain (CLBP). Methods: Participants with CLBP were recruited from primary care and a university population and were randomly allocated (n=51) to 1 of 2 groups: (1) "Exercise Alone (E)"-12-week program consisting of 6 weeks of supervised exercise followed by 6 weeks unsupervised exercise (n=27); or (2) "Exercise and AA (EAA)"-12-week exercise program and AA (n=24). Outcome measures were recorded at baseline, week 8, week 13, and 6 months. The primary outcome measure was the Oswestry Disability Questionnaire. Results: Participants in the EAA group demonstrated a greater mean improvement of 10.7% points (95% confidence interval, -15.3,-5.7) (effect size=1.20) in the Oswestry Disability Questionnaire at 6 months compared with 6.7% points (95% confidence interval, -11.4,-1.9) in the E group (effect size=0.58). There was also a trend towards a greater mean improvement in quality of life, LBP intensity and bothersomeness, and fear-avoidance beliefs in the EAA group. The dropout rate for this trial was lower than anticipated (15% at 6 mo), adherence with exercise was similar (72% E; 65% EAA). Adverse effects for AA ranged from 1% to 14% of participants. Discussion: Findings of this study showed that a main RCT is feasible and that 56 participants per group would need to be recruited, using multiple recruitment approaches. AA was safe and demonstrated additional benefits when combined with exercise for people with CLBP, which requires confirmation in a fully powered RCT.

Can group exercise programs improve health outcomes in pregnant women? A systematic review

Current scientific evidence supports the recommendation to initiate or continue the practice of physical exercise in healthy pregnant women. Group exercise programs have positive effects in improving health and well-being, as well as social support. In order to understand the scientific evidence in this field, and the outcomes in maternal health, it has generated wide interest in exploring the studies carried out with more relevant group exercise programs. The aim of this systematic review was to evaluate the available evidence on the effectiveness of group exercise programs in improving women’s and newborns health outcomes during pregnancy. Three databases were used to conduct literature searches and strict inclusion and exclusion criteria were employed. Seventeen studies were selected for analysis. All studies were randomized control trials conducted with pregnant women that evaluated the effect of group exercise programs on the health outcomes of mother and newborn. Most studies followed a supervised structured exercise program including a main aerobic part, resistance training, pelvic floor training and stretching and relaxation sections. The significant effects of the programs are related with improved maternal perception of health status, lower maternal weight gain, improved levels of maternal glucose tolerance, improved aerobic fitness and muscular strength, lower frequency of urinary incontinence, improved sick leave due to lumbopelvic pain, fewer cesarean and instrumental deliveries, higher newborn Apgar score and faster postpartum recovery. Exercise and health professionals should advise pregnant women that aerobic group exercise during pregnancy improves a wide range of health outcomes for the women and newborn

Activity-Dependent Neurorehabilitation Beyond Physical Trainings: "Mental Exercise" Through Mirror Neuron Activation

The activity dependent brain repair mechanism has been widely adopted in many types of neurorehabilitation. The activity leads to target specific and non-specific beneficial effects in different brain regions, such as the releasing of neurotrophic factors, modulation of the cytokines and generation of new neurons in adult hood. However physical exercise program clinically are limited to some of the patients with preserved motor functions; while many patients suffered from paralysis cannot make such efforts. Here the authors proposed the employment of mirror neurons system in promoting brain rehabilitation by "observation based stimulation". Mirror neuron system has been considered as an important basis for action understanding and learning by mimicking others. During the action observation, mirror neuron system mediated the direct activation of the same group of motor neurons that are responsible for the observed action. The effect is clear, direct, specific and evolutionarily conserved. Moreover, recent evidences hinted for the beneficial effects on stroke patients after mirror neuron system activation therapy. Finally some music-relevant therapies were proposed to be related with mirror neuron system.

Effects of the Mediterranean diet and exercise in subjects with coronary artery disease

Introduction The association of the Mediterranean diet and exercise appears to have a protective role, reducing cardiovascular risk. This study investigated the effects of education sessions on the Mediterranean diet and an exercise program in modifying eating behaviors, body composition and abdominal fat. Methods An experimental study was performed on 20 subjects with known coronary heart disease randomly assigned to experimental (n=10) and control (n=10) groups. Both groups received education sessions on the Mediterranean diet, but the experimental group also followed an eight-week program of specific exercises. A semiquantitative food frequency questionnaire was administered to analyze food intake, bioimpedance was used to measure weight, fat mass and lean mass, and waist circumference was measured to calculate waist-to-height ratio. Results After eight weeks, protein (p<0.05) and cholesterol (p<0.05) intake in the experimental group had decreased significantly compared with the control group. Between the beginning and end of the study, there were significant decreases in the control group in carbohydrate (p<0.05) and saturated fat intake (p<0.05). In both groups the percentage of total fat (p<0.05) and fat mass (p<0.05) was significantly decreased. In the experimental group the waist-to-height ratio was significantly reduced (p<0.05). Conclusion The Mediterranean diet reduced carbohydrate and saturated fat intake, reflected in reduced fat mass. The association of the exercise program showed additional benefits in reduction of protein and cholesterol intake and abdominal fat.

Effects of microcurrents and physical exercise on the abdominal fat in patients with coronary artery disease

Introduction Coronary artery disease is associated with decreased levels of physical activity, contributing to increases in abdominal fat and consequently increasing metabolic risk. The innovative use of microcurrents may be an effective method to increase the lipolytic rate of abdominal adipocytes. This study aimed to investigate the effects of utilizing microcurrents in a home-based exercise program in subjects with coronary artery disease to assess changes in total, subcutaneous and visceral abdominal adipose tissue. Methods This controlled trial included 44 subjects with myocardial infarction, randomly divided into Intervention Group 1 (IG1; n = 16), Intervention Group 2 (IG2; n = 12) and Control Group (CG; n = 16). IG1 performed a specific exercise program at home during 8 weeks, and IG2 additionally used microcurrents on the abdominal region before the exercise program. All groups were given health education sessions. Computed tomography was used to evaluate abdominal, subcutaneous and visceral fat, accelerometers to measure habitual physical activity and the semi-quantitative food frequency questionnaire for dietary intake. Results After 8 weeks, IG2 showed a significantly decrease in subcutaneous fat (p ≤ 0.05) when compared to CG. Concerning visceral fat, both intervention groups showed a significant decrease in comparison to the CG (p ≤ 0.05). No significant changes were found between groups on dietary intake and habitual physical activity, except for sedentary activity that decreased significantly for IG2 in comparison with CG (p ≤ 0.05). Conclusion This specific home-based exercise program using microcurrent therapy for individuals with coronary artery disease showed improvements in visceral and subcutaneous abdominal fat.

The effect of a weighted-vest strength and balance training program on obstructed walking in postmenopausal women

SUMMARY Background: Age related declines in lower extremity strength have been associated with impaired mobility and changes in gait patterns, which increase the likelihood of falls. Since community dwelling adults encounter a wide range of locomotor challenges including uneven and obstmcted walking surfaces, we examined the effect of a strength 11 and balance exercise program on obstructed walking in postmenopausal women. Objectives: This study examined the effect of a weighted-vest strength and balance exercise program on adaptations of the stance leg during obstacle walking in postmenopausal women. Methods: Eighteen women aged 44-62 years who had not engaged in regular resistance training for the past year were recruited from the St. Catharines community to participate in this study. Eleven women volunteered for an aerobic (walking), strength, and balance training program 3 times per week for 12 weeks while 7 women volunteered as controls. Measurements included: force platform dynamic balance measure of the center of pressure (COP) and ground reaction forces (GRFs) in the stance leg while going over obstacles of different heights (0,5, 10,25 and 30 cm); and isokinetic strength measures of knee and ankle extension and flexion. Results: Of the 18 women, who began the trial, 16 completed it. The EX group showed a significant increase of 40% in ankle plantar flexion strength (P < 0.05). However, no improvements in measures of COP or GRFs were observed for either group. Failure to detect any changes in measures of dynamic balance may be due to small sample size. Conclusions: Postmenopausal women experience significant improvements in ankle strength with 12 weeks of a weighted-vest balance and strength training program, however, these changes do not seem to be associated with any improvement in measures of dynamic balance.

The effects of a general excercise program on task self-efficacy and social physique anxiety in older adults

Older adults represent the most sedentary segment of the adult population, and thus it is critical to investigate factors that influence exercise behaviour for this age group. The purpose of this study was to examine the influence of a general exercise program, incorporating cardiovascular, strength, flexibility, and balance components, on task selfefficacy and SPA in older adult men and women. Participants (n=114, Mage = 67 years) were recruited from the Niagara region and randomly assigned to a 12-week supervised exercise program or a wait-list control. Task self-efficacy and SPA measures were taken at baseline and program end. The present study found that task self-efficacy was a significant predictor of leisure time physical activity for older adults. In addition, change in task self-efficacy was a significant predictor of change in SPA. The findings of this study suggest that sources of task self-efficacy should be considered for exercise interventions targeting older adults.

Exercise changes the size of cardiac neurons and protects them from age-related neurodegeneration

Aging leads to changes in cardiac structure and function. Evidence suggests that the practice of regular exercise may prevent disturbances in the cardiovascular system during aging. We studied the effects of aging on the morphology and morphometry of cardiac neurons in Wistar rats and investigated whether a lifelong moderate exercise program could exert a protective effect toward some deleterious effects of aging. Aging caused a significant decline (28%) in the number of NADH-diaphorase-stained cardiac Animals submitted to a daily session of 60 min, 5 day/week, at 1.1 km/h of running in treadmill over the entire life span exhibited a reversion of the observed decline in the number of cardiac neurons. However, most interesting was that the introduction of this lifelong exercise protocol dramatically altered the sizes of cardiac neurons. There was a notable increase in the percentage of small neurons in the rats of the exercise group compared to the sedentary animals. This is the first time that a protective effect of lifelong regular aerobic exercise has been demonstrated on the deleterious effects of aging in cardiac neurons. (C) 2009 Elsevier GmbH. All rights reserved.

Aerobic exercise and resistance training for the management of type 2 diabetes mellitus

BACKGROUND
Implementation of a structured physical exercise program can improve glycemic control in patients with type 2 diabetes mellitus.

OBJECTIVE
To evaluate the efficacy of aerobic exercise and resistance training (either alone or in combination) in the management of type 2 diabetes mellitus.

DESIGN AND INTERVENTION
DARE (Diabetes Aerobic and Resistance Exercise) was a 26-week, single-center, parallel-group, randomized, controlled trial of patients with type 2 diabetes mellitus of >6 months' duration. Participants were aged 39-70 years with a baseline [HbA.sub.1c] level 6.6-9.9%. Exclusion criteria included current insulin therapy, regular exercise regime and blood pressure >160/95 mmHg. All participants underwent a 4-week run-in period that comprised 12 sessions of combined aerobic exercise and resistance training; participants who attended [greater than or equal to] 10 sessions were eligible to enter the study. Eligible participants were randomly allocated to one of four groups: aerobic exercise alone; resistance training alone; combined aerobic exercise and resistance training; and no intervention (control group). Exercise was performed three times weekly. The aerobic exercise group progressed from 15-20 min on a treadmill or bicycle ergometer per session at 60% of the maximum heart rate to 45 min per session at 75% of the maximum heart rate. The resistance training group performed 7 different exercises on weight machines per 45 min session, and progressed to 2-3 sets of each exercise at the maximum weight that could be lifted 7-9 times. The combined exercise group performed the full aerobic exercise program plus the full resistance training program. Participants in the control group reverted to their pre-study exercise levels.

OUTCOME MEASURES
The primary outcome measure was the change in [HbA.sub.1c] from baseline. Secondary outcome measures included changes in blood pressure, lipid profile, and body composition.

RESULTS
A total of 251 participants were eligible for intervention. The median session attendance was 80% (aerobic exercise), 85% (resistance training) and 86% (combined exercise). When compared with the control group, the HbA1c levels were reduced by 0.50% in the aerobic exercise group (P = 0.007) and by 0.38% in the resistance training group (P = 0.038). The combined exercise group had an additional reduction of 0.46% when compared with the aerobic exercise group (P = 0.014) and of 0.59% when compared with the resistance training group (P = 0.001). Decreases in [HbA.sub.1c] levels were greatest for participants with a baseline [HbA.sub.1c] level = 7.5% (P <0.001). For participants with a baseline level [HbA.sub.1c] <7.5%, significant improvements in glycemic control were observed in the combined exercise group only (P = 0.002). Changes in blood pressure and lipid profiles did not differ between the groups. By contrast, participation in a structured exercise program improved body composition.

CONCLUSION
Although aerobic exercise or resistance training alone improved glycemic control, additional improvements were observed with the combined exercise regimen.

Role of exercise in the development of bone strength during growth

Exercise during growth may increase peak bone mass; if the benefits are maintained it may reduce the risk of fracture later in life (1). It is hypothesised that exercise will preferentially enhance bone formation on the surface of cortical bone that is undergoing bone modeling at the time (2). Therefore, exercise may increase bone mass accrual on the outer periosteal surface during the pre- and peri-pubertal years, and on the inner endocortical surface during puberty (3). An increase in bone formation on the periosteal surface is, however, more effective for increasing bone strength than medullary contraction (4). While exercise may have a role in osteoporosis prevention, there is little evidential basis to support this notion. It is generally accepted that weight-bearing exercise is important, but it is not known how much, how often, what magnitude or how long children need to exercise before a clinically important increase in bone density is obtained. In this thesis, the effect of exercise on the growing skeleton is investigated in two projects. The first quantifies the magnitude and number of loads associated with and in a moderate and low impact exercise program and non-structured play. The second project examines how exercise affects bone size and shape during different stages of growth. Study One: The Assessment of the Magnitude of Exercise Loading and the Skeletal Response in Girls Questions: 1) Does moderate impact exercise lead to a greater increase in BMC than low impact exercise? 2) Does loading history influence the osteogenic response to moderate impact exercise? 3) What is the magnitude and number of loads that are associated with a moderate and low impact exercise program? Methods: Sixty-eight pre-and early-pubertal girls (aged 8.9±0.2 years) were randomised to either a moderate or low impact exercise regime for 8.5-months. In each exercise group the girls received either calcium fortified (-2000 mg/week) or non-fortified foods for the duration of the study. The magnitude and number of loads associated with the exercise programs and non-structured play were assessed using a Pedar in-sole mobile system and video footage, respectively. Findings: After adjusting for baseline BMC, change in length and calcium intake, the girls in the moderate exercise intervention showed greater increases in BMC at the tibia (2.7%) and total body (1.3%) (p ≤0.05). Girl's who participated in moderate impact sports outside of school, showed greater gains in BMC in response to the moderate impact exercise program compared to the low impact exercise program (2.5 to 4.5%, p ≤0.06 to 0.01). The moderate exercise program included -400 impacts per class, that were applied in a dynamic manner and the magnitude of impact was up to 4 times body weight. Conclusion: Moderate-impact exercise may be sufficient to enhance BMC accrual during the pre-pubertal years. However, loading history is likely to influence the osteogenic response to additional moderate impact exercise. These findings contribute towards the development of school-based exercise programs aimed at improving bone health of children. Study Two: Exercise Effect on Cortical Bone Morphology During Different Stages of Maturation in Tennis Players Questions: 1) How does exercise affect bone mass (BMC) bone geometry and bone strength during different stages of growth? 2) Is there an optimal stage during growth when exercise has the greatest affect on bone strength? Methods: MRI was used to measure average total bone, cortical and medullary areas at the mid- and distal-regions of the playing and non-playing humerii in 47 pre-, peri- and post-pubertal competitive female tennis players aged 8 to 17 years. To assess bone rigidity, each image was imported into Scion Image 4.0.2 and the maximum, minimum and polar second moments of area were calculated using a custom macro. DXA was used to measure BMC of the whole humerus. Longitudinal data was collected on 37 of the original cohort. Findings: Analysis of the entire cohort showed that exercise was associated with increased BMC and cortical area (8 to 14%), and bone rigidity (11 to 23%) (all p ≤0.05). The increase in cortical bone area was associated with periosteal expansion in the pre-pubertal years and endocortical contraction in the post-pubertal years (p ≤0.05). The exercise-related gains in bone mass that were accrued at the periosteum during the pre-pubertal years, did not increase with advanced maturation and/or additional training. Conclusion: Exercise increased cortical BMC by enhancing bone formation on the periosteal surface during the pre-pubertal years and on the endocortical surface in the post-pubertal years. However, bone strength only increased in response to bone acquisition on the periosteal surface. Therefore the pre-pubertal years appear to be the most opportune time for exercise to enhance BMC accrual and bone strength

Effects of strength, flexibility and moderate intensity cardiovascular exercise on measures of fitness in sedentary women

The maintenance of functional physical fitness across the lifespan depends upon the presence or absence of disease, injury, and the level of habitual physical activity. The prevalence of sedentariness rises with increasing age culminating in 31% of elderly women being classified as leading a sedentary lifestyle. Exercise prescription that involves easily accomplished physical activity may result in the maintenance of mobility into old age through a reduction in the risk of premature death and disablement from cardiovascular disease and a reduction in the risk of falls and injuries from falls. It may be that short bouts of physical activity are more appealing to the sedentary and to those in full time employment than longer bouts, and it may be that short bouts of exercise, performed three times per day, can improve physical fitness. The purpose of this study was therefore to examine the problem: Does exercise session duration, initial cardiovascular fitness, and age group effect changes in functional physical fitness in sedentary women training for strength, flexibility and aerobic fitness? Twenty-three, sedentary women aged between 19 and 54 years who were employed at a major metropolitan hospital undertook six weeks of moderate intensity physical activity in one of two training groups. Participants were randomly allocated to either short duration (3 x 10 minute), or long duration (30 minute), exercise groups. The 3 x 10 minute group (n=13), participated in three, 10 minute sessions per day separated by at least 2 hours, 3 days per week. The 30 minute group (n=10), participated in three 30 minute sessions per week. The total amount of work was similar, with an average of 129 and 148 kcal training day for the 3 x 10 minute and 30 minute groups, respectively. The training program incorporated three walking and stair climbing courses for aerobic conditioning, a series of eleven static stretches for joint flexibility, and isotonic and isometric strength exercises for lower and upper body muscular strength. Measures of functional strength, functional flexibility and cardiovascular fitness were assessed prior to training, and immediately following the six week exercise program. A two way analysis of variance (Group x Time) was used to examine the effect of training and group on the dependent variables. The level of significance, 0.05 was adopted for all statistical tests. Mean hand grip strength showed for both groups no significant change over time for the 3 x 10 minute group (30.7kg to 31.7kg) and 30 minute group (30.2kg to 32.4kg). Leg strength showed a trend for improvement (p=0.098) in both the 3 x 10 minute and 30 minute training groups representing a 15% and 18% improvement, respectively. Combined right and left neck rotation significantly improved in the 3 x 10 minute group (82.8° to 92.0°) and 30 minute group (82.5° to 91.5°). Wrist flexion and extension improved significantly in 3 out of the 4 measurements. Left wrist flexion improved significantly by an average of 7.0% for the 3 x 10 minute and 4.9% for the 30 minute group. Right and left wrist extension improved significantly in the 3 x 10 minute and 30 minute training groups (5.9% and 6.8%, respectively). Hip and spine flexibility improved 3.4cm (35.2cm to 38.6cm) in the 3 x 10 minute group, and 6.6cm (37.4cm to 44.0cm) in the 30 minute group. There was a significant improvement in cardiovascular fitness for both groups representing a 22% improvement in the 3 x 10 minute group (27.2 to 33.2 ml kg min), and a 25% improvement in the 30 minute group (27.5 to 34.4 ml -kg min). No significant difference was shown in the degree of improvement in cardiovascular fitness over six weeks of training for subjects of either low or moderate initial aerobic fitness. Grip strength showed no significant changes over time for either the young-aged (19-35 years) or middle-aged (36-54 years) groups. Leg strength showed a trend for improvement (p=0.093) in the young-aged group (63.5kg to 71.9kg) and middle-aged group (69.3kg to 85.8kg). Neck rotation flexibility improved a similar amount in both the young and middle aged groups representing an improvement of 9.9° and 8.0° respectively. There was significant improvement in two of the four measures of wrist flexibility. Hip and spine flexibility was significantly greater in the young-aged group compared to the middle-aged group (38.5cm and 30.7cm, respectively). There was a significant improvement in hip and spine flexibility over the six week training program representing an increase in reach of 6.5cm for the young age group and 4.9cm for the older group. The middle-aged subjects had significantly lower cardiovascular fitness than their younger peers, scoring 22.8 and 30.7 ml -kg min, respectively. Cardiovascular fitness improved a similar amount in both age groups representing a significant improvement of 23.8% and 28.1% for the younger-aged and middle-aged subjects, respectively. The findings of this study suggest that short bouts of exercise may be equally as effective as longer bouts of exercise for improving the flexibility and cardiovascular components of functional physical fitness in sedentary young and middle aged women. Additionally short bouts of exercise may be more attractive than longer bouts of exercise for the beginning exerciser as they may more easily fit into the busy lifestyle encountered by many people in today's society. Sedentary young and middle-aged women should benefit from static flexibility exercises designed to improve and/or maintain functional flexibility and thus maintain mobility and reduce the incidence of muscular injury. Regular, brisk walking, incorporating some stair climbing, is likely to be beneficial in improving cardiovascular health and perhaps also in improving leg strength, thereby helping to improve and maintain functional physical fitness for both young and middle-aged sedentary women.

Interactive effects of exercise plus calcium-vitamin D3 on bone strength in older men

The findings from this 18-month, community-based study revealed that an exercise program involving strength training and jumping activities was feasible and effective for improving bone density, muscle mass and strength in older men. There were no additional skeletal benefits derived from consuming a high calcium-vitamin D milk drink.

Effects of a daily school based physical activity intervention program on muscle development in prepubertal girls

This 12-month prospective controlled intervention evaluated the effect of a general school based physical activity program on muscle strength, physical performance and body composition in prepubertal girls. Fifty-three girls aged 7–9 years involved in a school based exercise program [40 min/day of general physical activity per school day (200 min/week)] were compared with 50 age-matched girls who participated in the general Swedish physical education curriculum (mean 60 min/week). Body composition (DXA), isokinetic peak torque (PT) of the knee extensors and flexors at 60 and 180°/s, and vertical jump height (VJH) were assessed at baseline and 12 months. The annual gain in weight was similar between the groups, but there was a greater increase in total body and regional lean mass (P < 0.05) and fat mass (P < 0.01) in the exercise group. Mean gains in knee extensor PT at 60 and 180°/s were 7.0–7.6% greater in the exercise group (P ranging <0.05–<0.001). No significant differences were detected in VJH. In conclusion, increasing school based physical education to at least 3 h/week provides a feasible strategy to enhance the development of muscle strength and lean mass in prepubertal girls.

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.

The effect of physical activity on psychological distress, cortisol and obesity: results of the farming fit intervention program

Background:
Rural and regional Australians have a higher likelihood of mental illness throughout their lifetime than people living in major cities, although the underlying reasons are not yet well defined. Additionally, rural populations experience more lifestyle associated co-morbidities including obesity, diabetes and cardiovascular disease. Research conducted by the National Centre for Farmer Health between 2004 and 2009 revealed a positive correlation between obesity and psychological distress among the farming community. Chronic stress is known to overstimulate the regulation of the hypothalamic-pituitary-adrenal (HPA) axis and cortisol secretion which are associated with abdominal adiposity. Increasing physical activity may normalise cortisol secretion and thereby positively impact both physical and mental health. This paper assesses the effects of increasing physical activity on obesity, health behaviors and mental health in Victorian farming men and women.

Methods:
Farming Fit was a six month quasi-experimental (convenience sample) longitudinal design control-intervention study. Overweight or obese (BMI ?25?kg/m2) farm men (n?=?43) and women (n?=?29) were recruited with demographic, health behaviors, anthropometric, blood pressure and biochemistry data collected at baseline and at a six months. Salivary cortisol and depression anxiety stress scale results were collected at baseline, three and six months. The intervention group (n?=?37) received a personalized exercise program and regular phone coaching to promote physical activity.

Results:
The intervention group showed significant reductions in body weight and waist circumference. Results indicated that following the six month exercise program, the intervention group were 2.64???0.65?kg lighter (p?<?0.001), had reduced waist circumference by 2.01???0.86?cm (p?=?0.02) and BMI by 0.97???0.22?kg/m2 (p?<?0.001) relative to the control group.

Conclusion:
Increasing physical activity altered measures of obesity in farm men and women but did not affect mental health measures or cortisol secretion levels.