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Priscila M. Nakamura, Grégore I. Mielke, Bernardo L. Horta, Maria Cecília Assunção, Helen Gonçalves, Ana M.B. Menezes, Fernando C. Barros, Ulf Ekelund, Soren Brage, Fernando C. Wehrmeister, Isabel O. Oliveira and Pedro C. Hallal

Background:

Physical inactivity is responsible for 7% of diabetes deaths worldwide, but little is known whether low levels of physical activity (PA) during adolescence increase the risk of diabetes in early adulthood. We evaluated the cross-sectional and longitudinal associations between PA throughout adolescence and HbA1c concentration in early adulthood.

Methods:

HbA1c was measured by high performance liquid chromatography. PA was assessed by self-report at the ages of 11, 15, and 18 years and by accelerometry at the ages of 13 (subsample) and 18 years. The loss percentages of follow up were 12.5% at 11 years, 14.4% at 15 years, and 18.7% at 18 years.

Results:

At 18 years, boys showed higher HbA1c than girls. At age 18 years, accelerometrybased PA at 18 years was inversely related to HbA1c levels in boys. Self-reported leisure-time PA at ages 11, 15, and 18 were unrelated to HbA1c in both genders. PA at 13 years of age was unrelated to HbA1c among both genders. In trajectory analysis, PA and accelerometer PA trajectories were not associated with later HbA1c.

Conclusions:

Objectively measured PA at 18 years was cross-sectionally inversely associated with HbA1c in boys only. No prospective associations were identified.

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Alireza Esteghamati, Omid Khalilzadeh, Armin Rashidi, Mandana Kamgar, Alipasha Meysamie and Mehrshad Abbasi

Background:

Physical inactivity is a modifiable risk factor for obesity, diabetes, cardiovascular diseases, and certain types of cancer. This study aimed to investigate the patterns and demographic correlates of physical activity in Iran.

Methods:

The data collected through the third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007) on 4120 adults were studied. Physical activity was assessed by the global physical activity questionnaire (GPAQ) in domains of work, commuting and recreation. Participants were categorized into low, moderate and high activity categories. Total physical activity (TPA) was calculated using metabolic equivalents (MET).

Results:

40% of Iranian adults (31.6% of men and 48.6% of women) belonged to the low physical activity category. The median value of TPA was 206 (342 in men and 129 in women) MET-minutes/day. Physical activity at work, commuting and recreation contributed to 71%, 20% and 9% of TPA, respectively. Approximately 15% of Iranian adults (4.7 million people) do not have any physical activity in any of the 3 studied domains.

Conclusions:

Physical inactivity is common in Iran, particularly in females and in the older age groups. Preventing a rapid growth of conditions such as diabetes and cardiovascular diseases requires health programs with more focus on physical activity.

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Mitchell M. Kanter

Free radicals have been implicated in the development of diverse diseases such as cancer, diabetes, and cataracts, and recent epidemic-logical data suggest an inverse relationship between antioxidant intake and cardiovascular disease risk. Data also suggest that antioxidants may delay aging, Research has indicated that free radical production and subsequent lipid peroxidation are normal sequelae to the rise in oxygen consumption with exercise. Consequently, antioxidant supplementation may detoxify the peroxides produced during exercise and diminish muscle damage and soreness. Vitamin E, beta carotene, and vitamin C have shown promise as protective antioxidants. Other ingestible products with antioxidant properties include selenium and coenzyme Q10. The role (if any) that free radicals play in the development of exercise-induced tissue damage, or the protective role that antioxidants may play, remains to be elucidated. Current methods used to assess exercise-induced lipid peroxidation are not extremely specific or sensitive; research that utilizes more sophisticated methodologies should help to answer many questions regarding dietary antioxidants.

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Peter T. Katzmarzyk

Background:

Although the prevalence of physical inactivity is high in Canada, few studies have assessed its public health impact.

Methods:

A cause-deleted methodology was employed to estimate the effects of physical inactivity on life expectancy. Life expectancy in 2002 was estimated from an abridged life table analysis, which was repeated after removing deaths from physical inactivity. Deaths from physical inactivity were estimated from published population-attributable fractions for coronary artery disease, stroke, hypertension, colon cancer, breast cancer, and type 2 diabetes.

Results:

Life expectancy was 79.7 y in the total population, 77.2 y in males, and 82.1 y in females. Compared to overall life expectancy, physical inactivity cause-deleted values were 0.86 y lower in the total population, 0.65 y lower in males, and 1.0 y lower in females.

Conclusions:

Life expectancy could be increased by over 10 months if Canadians could be encouraged to be physically active.

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Michael C. Riddell, Oded Bar-Or, Beatriz V. Ayub, Randolph E. Calvert and George J.F. Heigenhauser

There are currently no guidelines regarding the carbohydrate (CHO) dosage required to prevent exercise-induced hypoglycemia in children with insulin-dependent diabetes mellitus (IDDM). To prevent hypoglycemia by matching glucose ingestion with total-CHO utilization, 20 adolescents with IDDM attended 2 trials: control (CT; drinking water) and glucose (GT; drinking 6-8% glucose). Participants performed 60 min of moderate-intensity cycling 100 min after insulin injection and breakfast. CT's total-CHO utilization during exercise was determined using indirect calorimetry. In GT, participants ingested glucose in the amount equal to total CHO utilization in the CT. A total of 9 participants had BG <4.0 mmol/L in CT compared to 3 in GT (p < .05). In conclusion, glucose ingestion equal to total-CHO utilization attenuates the drop in blood glucose and reduces the likelihood of hypoglycemia during exercise in adolescents with IDDM.

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Takashi Kinugasa, Hiroshi Nagasaki, Taketo Furuna and Hajime Itoh

The goal of this study was to identify methods for characterizing high-functioning older adults living in the community. The subjects were 495 older adults from the Longitudinal Interdisciplinary Study on Aging conducted by the Tokyo Metropolitan Institute of Gerontology. Physical performance measures included grip strength, walking at preferred and maximum speeds, one-leg standing with eyes open, and finger tapping rate. Performance scores were created by summing each categorical score. Consistent differences were found among age groups and genders. Scores were lower in subjects who had stroke or diabetes than in those without these conditions. These results suggest that physical performance measures have both discriminant validity and construct validity, which make them useful methods for characterizing high-functioning older persons.

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Suele Manjourany Silva Duro, Elaine Tomasi, Fernando Vinholes Siqueira, Denise Silva Silveira, Elaine Thumé and Luiz Augusto Facchini

Background:

Physical activity counseling is an attribution of health professionals. As such, this paper aims to analyze the receipt of this form of counseling.

Methods:

Cross-sectional national study interviewing 12,402 adults living in the urban area of 100 Brazilian municipalities.

Results:

Overall counseling prevalence was 30%, falling to 20% when considering only counseling provided by health professionals. Counseling was significantly more frequent among women and among individuals who were older, married, had higher socioeconomic status, were former smokers, physically active, and reporting hypertension, diabetes, and excess weight.

Conclusions:

Little counseling was found to be done, this being a missed opportunity for health promotion. Health services and professionals therefore need to be trained and encouraged to provide adequate information to all health service users on the benefits of leading healthy lifestyles.

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Susan J. Coram and Michael Mangum

The large number of diabetic individuals, children and adults, and the potential problems that may arise in a fitness setting calls for a better understanding of the diabetic state. This review is therefore intended to stimulate an awareness of the complexity of the diabetic state and to emphasize the beneficial and potential hazardous effects of exercise. An overview is provided to orient the reader to basic concepts concerning diabetes. A variety of topics related to exercise and the diabetic are then presented. These include the metabolic benefits from exercise, exercise and coronary heart disease risk factors, factors influencing decreased exercise performance in diabetics, hypoglycemia and ketoacidosis, preliminary considerations and precautions for diabetic participants, and the role of education and self-discipline in diabetic control. Finally, practical guidelines for the diabetic and the physical educator are suggested.

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Christine L. Wells

The following article is a synthesis of current physiological research regarding women and physical activity with an emphasis on what that research means in regard to both performance and health. The first part is a discussion of the effects of heavy physical training on the menstrual cycle, with particular emphasis on the detrimental effects of hypoestrogenemia on bone. The second part of the paper is a discussion of the generally high prevalence of inactivity in American women and its relationship to the development of obesity, type II diabetes, hypercholesterolemia, hypertension, heart disease and cancer. The final section of the paper consists of a call for interdisciplinary and collaborative research by women investigators on issues of major importance to women.

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Kevin M. Guskiewicz

“Concussion” is all over the news, and—yes—it has implications for combating chronic diseases such as obesity and diabetes. Many parents are pushing their children away from collision sports such as football, hockey, and lacrosse because they fear the risk of chronic neurodegenerative problems later in life. However, there is good logic in emphasizing the importance of physical activities such as collision type sports, during the developmental years. Physical educators, researchers, policy makers, and coaches must work together to encourage safe play and rules changes that can keep youth and adolescents active in sports that build character, discipline, and teach teamwork. Understanding the complexity of the highly adaptable adolescent brain both prior to and following sport-related concussion is critically important in accomplishing this goal.