Socio-economic status, growth, physical activity and fitness: the Madeira growth study

Within a country social conditions change over time and these conditions vary from country to country. The associations between these conditions, somatic growth, physical activity and fitness reflect these changes. Aim: The study documented variation in somatic growth, physical activity and fitness associated with socio-economic status (SES). Subjects and methods: The study involved 507 subjects (256 boys and 251 girls) from the Madeira Growth Study, a mixed longitudinal study of five cohorts (8, 10, 12, 14 and 16 years of age) followed at yearly intervals over 3 years (1996–1998). A total of 1493 observations were made. Anthropometric measurements included lengths, body mass, skeletal breadths, girths and skinfolds. Physical activity and SES were collected via questionnaire and interview. Physical fitness was assessed using the Eurofit test battery. Variation in somatic growth, physical activity and physical fitness by SES (high, average and low) was tested with analysis of variance. Results: Significant differences between SES groups were observed for height, body mass and skinfolds. Boys and girls from high SES groups were taller, heavier and fatter (subscapular and triceps skinfolds) than their peers from average and low SES groups. At some age intervals, the high SES group had larger skeletal breadths (girls) and girths (boys and girls) than low SES. Small SES differences were observed for physical activity (sport and leisure-time indices). SES was significantly associated with physical fitness. At some age levels, boys from the low SES group performed better for muscular and aerobic endurance whereas girls from the high SES group performed better for power. Conclusion: Considerable variation in somatic growth and physical fitness in association with SES has been demonstrated, but little association was found for physical activity.

Paediatric obesity, physical activity and the musculoskeletal system

The current epidemic of paediatric obesity is consistent with a myriad of health-related comorbid conditions. Despite the higher prevalence of orthopaedic conditions in overweight children, a paucity of published research has considered the influence of these conditions on the ability to undertake physical activity. As physical activity participation is directly related to improvements in physical fitness, skeletal health and metabolic conditions, higher levels of physical activity are encouraged, and exercise is commonly prescribed in the treatment and management of childhood obesity. However, research has not correlated orthopaedic conditions, including the increased joint pain and discomfort that is commonly reported by overweight children, with decreases in physical activity. Research has confirmed that overweight children typically display a slower, more tentative walking pattern with increased forces to the hip, knee and ankle during 'normal' gait. This research, combined with anthropometric data indicating a higher prevalence of musculoskeletal malalignment in overweight children, suggests that such individuals are poorly equipped to undertake certain forms of physical activity. Concomitant increases in obesity and decreases in physical activity level strongly support the need to better understand the musculoskeletal factors associated with the performance of motor tasks by overweight and obese children.

Applying the ecological model of behavior change to a physical activity trial in retirement communities : description of the study protocol

Objectives To describe the intervention protocol for the first multilevel ecological intervention for physical activity in retirement communities that addresses individual, interpersonal and community influences on behavior change. Design A cluster randomized controlled trial design was employed with two study arms: a physical activity intervention and an attention control successful aging condition. Setting Sixteen continuing care retirement communities in San Diego County. Participants Three hundred twenty older adults, aged 65 years and older, are being recruited to participate in the trial. In addition, peer leaders are being recruited to lead some study activities, especially to sustain the intervention after study activities ceased. Intervention Participants in the physical activity trial receive individual, interpersonal and community intervention components. The individual level components include pedometers, goal setting and individual phone counseling. The interpersonal level components include group education sessions and peer-led activities. The community level components include resource audits and enumeration, tailored walking maps, and community improvement projects. The successful aging group receives individual and group attention about successful aging topics. Measurements The main outcome is light to moderate physical activity, measured objectively by accelerometry. Other objective outcomes included physical functioning, blood pressure, physical fitness, and cognitive functioning. Self report measures include depressive symptoms and health related quality of life. Results The intervention is being delivered successfully in the communities and compliance rates are high. Conclusion Ecological Models call for interventions that address multiple levels of the model. Previous studies have not included components at each level and retirement communities provide a model environment to demonstrate how to implement such an intervention.

Mediators of physical activity behavior change among women with young children

Background Women with children are less likely to engage in adequate physical activity (PA) than women without children. This study aimed to evaluate the efficacy of two strategies for promoting increased PA among mothers of preschool-aged children, and to explore the mediators of any resulting change in PA behavior. Design Controlled intervention trial incorporating repeated data collection from 554 women, randomized to one of three experimental conditions. Intervention Group 1 served as a control, while women in Groups 2 and 3 were given print information about overcoming PA barriers. Women in Group 3 were also invited to discuss the development of local strategies for the promotion of PA among mothers of young children. The primary strategies included increasing partner support, social advocacy, and capacity building, and were implemented through collaboration among participants, researchers, and community organizations. Main Outcome Measures Adequate physical activity (PA), self-efficacy (SE) and partner support (PS). Results: Following the intervention, women in Group 3 were significantly more likely to meet guidelines for PA than controls (odds ratio [OR]=1.71, confidence interval [CI]=1.05–2.77)] after controlling for age and PA at baseline. After controlling for baseline PA, residualized change in SE (OR=1.86, CI=1.17–2.94) and PS (OR=2.29, CI=1.46–3.58) significantly predicted meeting guidelines. After controlling for residual change in PS and SE, the significant intervention effect was attenuated (Group 3 OR=1.40, CI=0.76–2.36), indicating that partner support and self-efficacy may be mediators of physical activity behavior change. Conclusions The findings indicate that community participation approaches that facilitate increased self-efficacy and partner support can be effective in increasing PA among mothers of young children.

Correlates of objectively measured physical activity in preadolescent youth

Objective The purpose of this study was to identify the psychosocial and environmental correlates of objectively measured physical activity behavior in a diverse sample of sixth-grade students. Design Cross-sectional. Participants and Setting One hundred ninety-eight sixth-grade students from 4 public middle schools in Columbia, South Carolina. The study group was 52.0% female, 55.1% African-American, with a mean age of 11.4 +/- 0.6 years. Main Outcome Measures Time spent in moderate physical activity (MPA) and vigorous physical activity (VPA) was assessed using a uniaxial accelerometer (CSA WAM 7164) (Computer Science and Applications Inc., Shalimar, FL). Determinant variables included: age, gender, race/ethnicity (demographic); physical activity self-efficacy, social norms related to physical activity, and beliefs regarding physical activity outcomes (psychosocial); and perceived physical activity habits of parents and peers, involvement in community physical activity organizations, involvement in community-based sports programs, access to fitness/sporting equipment at home, and self-reported hours spent watching television or playing video games (environmental). Results For boys, physical activity self-efficacy, social norms related to physical activity, and involvement in community physical activity organizations were salient predictors of MPA and VPA. Among girls, only physical activity self-efficacy emerged as a clear predictor of objectively measured physical activity. Conclusions These findings are consistent with previous studies using self-reported physical activity and suggest that interventions to increase physical. activity in preadolescent youth should endeavor to boost physical activity self-efficacy by offering a wide selection of enjoyable, developmentally-appropriate physical activity options.

Gender differences in physical activity and determinants of physical activity in rural fifth grade children

This study determined if gender differences in physical activity could be accounted for by differences in selected social-cognitive determinants of activity behavior. Some 334 fifth grade, predominantly African-American students provided information regarding after-school physical activity and the hypothesized determinants of activity behavior. Boys reported significantly greater participation in vigorous (greater than or equal to 6 METs) and in moderate to vigorous (greater than or equal to 4 METs). Relative to girls, boys demonstrated higher levels of physical fitness, greater self-efficacy in overcoming barriers to physical activity, greater amounts of television watching, and higher levels of participation in community sports and physical activity organizations. When mean physical activity scores for girls and boys were adjusted for the effects of these determinant variables, the significant gender difference in physical activity remained. However, adjustment for self-efficacy in overcoming barriers and community sports reduced the gender gap by 5% and 7%, respectively. In contrast, adjustment for television watching increased the gender gap by about 8%. Results indicated perceived confidence in overcoming barriers to physical activity and participation in community physical activity programs are factors related to the gender difference in physical activity.

Evaluation of a community-based intervention to promote physical activity in youth : lessons from active winners

Purpose To test the effects of a community-based physical activity intervention designed to increase physical activity and to conduct an extensive process evaluation of the intervention. Design Quasi-experimental. Setting Two rural communities in South Carolina. One community received the intervention, and the other served as the comparison. Subjects Public school students who were in fifth grade at the start of the study (558 at baseline) were eligible to participate. A total of 436 students participated over the course of the study. Intervention The intervention included after-school and summer physical activity programs and home, school, and community components designed to increase physical activity in youth. The intervention took place over an 18-month period. Measures. Students reported after-school physical activity at three data collection points (prior to, during, and following the intervention) using the Previous Day Physical Activity Recall (PDPAR). They also completed a questionnaire designed to measure hypothesized psychosocial and environmental determinants of physical activity behavior The process evaluation used meeting records, documentation of program activities, interviews, focus groups, and heart rate monitoring to evaluate the planning and implementation of the intervention. Results There were no significant differences in the physical activity variables and few significant differences in the psychosocial variables between the intervention and comparison groups. The process evaluation indicated that the after-school and summer physical activity component of the intervention was implemented as planned, but because of resource and time limitations, the home, school, and community components were not implemented as planned. Conclusions The intervention did not have a significant effect on physical activity in the target population of children in the intervention community. This outcome is similar to that reported in other studies of community-based physical activity intervention.

Comparison of surveys used to measure physical activity

Objective To compare the level of agreement in results obtained from four physical activity (PA) measurement instruments that are in use in Australia and around the world. Methods 1,280 randomly selected participants answered two sets of PA questions by telephone. 428 answered the Active Australia (AA) and National Health Surveys, 427 answered the AA and CDC Behavioural Risk Factor Surveillance System surveys (BRFSS), and 425 answered the AA survey and the short International Physical Activity Questionnaire (IPAQ). Results Among the three pairs of survey items, the difference in mean total PA time was lowest when the AA and NHS items were asked (difference=24) (SE:17) minutes, compared with 144 (SE:21) mins for AA/BRFSS and 406 (SE:27) mins for AA/IPAQ). Correspondingly, prevalence estimates for 'sufficiently active' were similar for AA and NHS (56% and 55% respectively), but about 10% higher when BRFSS data were used, and about 26% higher when the IPAQ items were used, compared with estimates from the AA survey. Conclusions The findings clearly demonstrate that there are large differences in reported PA times and hence in prevalence estimates of 'sufficient activity' from these four measures. Implications It is important to consistently use the same survey for population monitoring purposes. As the AA survey has now been used three times in national surveys, its continued use for population surveys is recommended so that trend data ever a longer period of time can be established.

Relationship between Barthel index with physical tests in adults with intellectual disabilities

We usually find low levels of fitness condition affect other aspects of living for people with ID like dependency in carrying out activivities of daily living. Therefore we find high levels of dependency in activities of daily living due to poor fitness condition. The aim of the study is to explore the criterion validity of the Barthel index with a physical fitness test. An observational cross-sectional study was conducted. Data from the Barthel index and a physical fitness test were measured in 122 adults with intellectual disability. The data were analysed to find out the relationship between four categories of the physical fitness test and the Barthel index. It needs to be stressed that the correlations between the Barthel index and leg, abdominal and arm strength can confirm that these physical test are predictive of the Barthel index. The correlations between the balance variables as functional reach and single-leg stance with eyes open shown relationships with Barthel Index. We found important correlations between the physical fitness test and the Barthel index, so we can affirm that some physical fitness features are predictor variables of the Barthel index.

Physical activity and diabetic complications in patients with type 1 diabetes

Type 1 diabetes is associated with the risk for late diabetic complications which are divided into microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular (cardiovascular disease, CVD) diseases. The risk for diabetic complication can be reduced by effective treatment, most importantly the glycaemic control. Glycaemia in type 1 diabetes is influenced by the interplay between insulin injections and lifestyle factors such as physical activity and diet. The effect of physical activity in patients with type 1 diabetes is not well known, however. The aim of this thesis was to investigate the physical activity and the physical fitness of patients with type 1 diabetes with special emphasis on glycaemic control and the diabetic complications. The patients included in the study were all part of the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) Study which aims to characterise genetic, clinical, and environmental factors that predispose to diabetic complications in patients with type 1 diabetes. In addition, subjects from the IDentification of EArly mechanisms in the pathogenesis of diabetic Late complications (IDEAL) Study were studied. Physical activity was assessed in the FinnDiane Study in 1945 patients by a validated questionnaire. Physical fitness was measured in the IDEAL Study by spiroergometry (cycle test with measurement of respiratory gases) in 86 young adults with type 1 diabetes and in 27 healthy controls. All patients underwent thorough clinical characterisation of their diabetic complication status. Four substudies were cross-sectional using baseline data and one study additionally used follow-up data. Physical activity, especially the intensity of activities, was reduced in patients affected by diabetic nephropathy, retinopathy, and CVD. Low physical activity was associated with poor glycaemic control, a finding most clear in women and evident also in patients with no signs of diabetic complications. Furthermore, low physical activity was associated with a higher HbA1c variability, which in turn was associated with the progression of renal disease and CVD during follow-up. A higher level of physical activity was also associated with better insulin sensitivity. The prevalence of the metabolic syndrome in type 1 diabetes was also lower the higher the physical activity. The aerobic physical fitness level of young adults with type 1 diabetes was reduced compared with healthy peers and in men an association between higher fitness level and lower HbA1c was observed. In patients with type 1 diabetes, a higher physical activity was associated with better glycaemic control and may thus be beneficial with respect to the prevention of diabetic complications.

Worksite Fitness Policy in an Intellectual Capital Framework

In a framework of Intellectual Capital (IC), the effects and interactions of a Worksite Fitness Program (WFP) policy was studied with a multidisciplinary approach. In a preliminary study, indicators for physical activity (PAI), physical fitness (PFI), activity in WFP on a regular (WFPI) and on a events basis (WFPE) were created in line with positive findings regarding the associations between physical activity and fitness patterns and sick leave, perceived health, and self-assessed work ability. The intensity of physical activity was found to be the most important variable to predict positive associations with the above mentioned wellness parameters. In four case study follow-up settings, the effects and interactions of physical activity and fitness patterns and the company’s WFP-policy on different elements of IC were studied. Qualitative methods were applied in constructing indicators and a descriptive IC measure for each case company. In cross-sectional and follow-up settings, several findings with respect to IC were found regarding physical activity in general and activity in WFP in particular. Findings were relatively strong in health and wellness related indicators in Human Capital, where, as also in Structural Capital indicators such as the company climate and employee-superior relationship, revealed positive associations. Physical activity patterns were found to act in minor role in Relational Capital. Overall, WFP was seen to be an integrated part of Structural Capital. From the viewpoint of Worksite Fitness Program as a phenomenon, this study positioned WFP as an active element of Intellectual Capital. The literature in the field of WFP emphasizes the role of WFP as an instrument to activate employees in physical activity, and thus promote their health and wellbeing. With the wider perspective the active and long range WFP policy can support a company’s Structural and Relational Capital in line with the fundamental role it has on Human Capital.

Leisure-time physical activity, health related functioning and retirement : a prospective cohort study among middle-aged employees

Physical inactivity has become a major threat to public health worldwide. The Finnish health and welfare policies emphasize that the working population should maintain good health and functioning until their normal retirement age and remain in good health and independence later in life. Health behaviours like physical activity potentially play an important role in reaching this target as physical activity contributes to better physical fitness and to reduced risk of major chronic diseases. The aim of this study was to examine first whether the volume and intensity of leisure-time physical activity impacts on subsequent physical health functioning, sickness absence and disability retirement. The second aim was to examine changes in leisure-time physical activity of moderate and vigorous intensity after transition to retirement. This study is part of the ongoing Helsinki Health Study. The baseline data were collected by questionnaires in 2000 - 02 among the employees of the City of Helsinki aged 40 to 60. The follow-up survey data were collected in 2007. Data on sickness absence were obtained from the employer s (City of Helsinki) sickness absence registers and pension data were obtained from the Finnish Centre for Pensions. Leisure-time physical activity was measured in four grades of intensity and classified according to physical activity recommendations considering both the volume and intensity of physical activity. Statistical techniques including analysis of covariance, logistic regression, Cox proportional hazards models and Poisson regression were used. Employees who were vigorously active during leisure time especially had better physical health functioning than those physically inactive. High physical activity in particular contributed to the maintenance of good physical health functioning. High physical activity also reduced the risk of subsequent sickness absences as well as the risk of all-cause disability retirement and retirement due to musculoskeletal and mental causes. Among those transferred to old-age retirement moderate-intensity leisure-time physical activity increased on average by more than half an hour per week and in addition the occurrence of physical inactivity reduced. Such changes were not observed among those remained employed and those transferred to disability retirement. This prospective cohort study provided novel results on the effects of leisure-time physical activity on health related functioning and changes in leisure-time physical activity after retirement. Although the benefits of moderate-intensity physical activity for health are well known these results suggest the importance of vigorous physical activity for subsequent health related functioning. Thus vigorous physical activity to enhance fitness should be given more emphasis from a public health perspective. In addition, physical activity should be encouraged among those who are about to retire.

Cardiorespiratory fitness and cognitive function in midlife: neuroprotection or neuroselection?

OBJECTIVE: A study was undertaken to determine whether better cognitive functioning at midlife among more physically fit individuals reflects neuroprotection, by which fitness protects against age-related cognitive decline, or neuroselection, by which children with higher cognitive functioning select more active lifestyles. METHODS: Children in the Dunedin Longitudinal Study (N = 1,037) completed the Wechsler Intelligence Scales and the Trail Making, Rey Delayed Recall, and Grooved Pegboard tasks as children and again at midlife (age = 38 years). Adult cardiorespiratory fitness was assessed using a submaximal exercise test to estimate maximum oxygen consumption adjusted for body weight in milliliters/minute/kilogram. We tested whether more fit individuals had better cognitive functioning than their less fit counterparts (which could be consistent with neuroprotection), and whether better childhood cognitive functioning predisposed to better adult cardiorespiratory fitness (neuroselection). Finally, we examined possible mechanisms of neuroselection. RESULTS: Participants with better cardiorespiratory fitness had higher cognitive test scores at midlife. However, fitness-associated advantages in cognitive functioning were already present in childhood. After accounting for childhood baseline performance on the same cognitive tests, there was no association between cardiorespiratory fitness and midlife cognitive functioning. Socioeconomic and health advantages in childhood and healthier lifestyles during young adulthood explained most of the association between childhood cognitive functioning and adult cardiorespiratory fitness. INTERPRETATION: We found no evidence for a neuroprotective effect of cardiorespiratory fitness as of midlife. Instead, children with better cognitive functioning are selecting healthier lives. Fitness interventions may enhance cognitive functioning. However, observational and experimental studies testing neuroprotective effects of physical fitness should consider confounding by neuroselection.