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David R. Bassett Jr.

The built environment has profound effects on physical activity and health. Many communities in the US are built around the automobile, with little consideration given to pedestrians, cyclists, and transit users. These places tend to have higher rates of physical inactivity (defined as “no leisure time physical activity”) and higher rates of obesity, diabetes, heart disease, and stroke. However, in some European countries and selected US cities, communities have been constructed in ways that encourage active modes of transportation. In these places, a large segment of the population meets physical activity guidelines, due in part to the activity they acquire in performing daily tasks. In addition to promoting active transportation, these environments promote recreational walking, jogging, and cycling. Kinesiologists can and should work with urban planners, transportation officials, developers, public health practitioners, and the general public to design cities in ways that enhance physical activity and health.

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Barbara E. Ainsworth and Cheryl Der Ananian

There is a growing recognition of the need for the primary prevention of chronic illnesses across the lifespan. In recent years, diseases that were formerly associated with adulthood such as diabetes are being diagnosed in adolescents and young adults. While there have been many prevention efforts focusing on health in children and adolescents, there is a limited body of research examining prevention in young adults. This article examines the concept of wellness in the Millennial generation and describes how their life course experiences impact seven domains of wellness. Specifically, this article describes the period and cohort effects that influence the domains of wellness and how the Millennial generation differs from other generations in these aspects of wellness. Finally, this paper provides an overview of the technological and cultural influences on wellness in the Millennial generation.

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Bernard Gutin and Scott Owens

The purposes of this article were to (1): review recent studies of relations between physical activity and cardiometabolic biomarkers of youths (2); highlight areas in which additional research is needed; and (3) make recommendations for preventive interventions. Observational studies show that youths who engage in high amounts of moderate-vigorous physical activity display a more favorable cardiometabolic biomarker profile than youths who engage in lesser amounts of moderate-vigorous physical activity. Intervention studies in obese youths show that favorable changes in biomarkers are produced by moderate-vigorous physical activity doses of 150–180 min/week. However, for nonobese youths, intervention studies suggest that such doses are not effective; higher moderate-vigorous physical activity doses of approximately 300 min/week seem necessary. Continuing a physically active lifestyle from childhood into the adult years will enable people to maintain less end-organ damage and lower rates of morbidity and mortality from cardiovascular disease and type 2 diabetes.

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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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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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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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James H. Rimmer, David Braddock and Glenn Fujiura

A body mass index (BMI) greater than 27 has been cited as a risk factor for heart disease and diabetes mellitus resulting from excess weight. The purpose of this study was to determine the association between BMI (>27) and two other obesity indices–height-weight and percent body fat–as well as to investigate the relationship between BMI and three blood lipid parameters–total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in 329 adults with mental retardation (MR). Males were significantly taller and heavier than females, but females had a significantly higher BMI. Kendall’s Tau-C revealed a significant association between BMI and each of the following: height-weight, percent body fat, LDL-C, and HDL-C. However, there were a significant number of false negatives and false positives on each of the criteria. The congruence between at-risk BMI and two other obesity parameters (height-weight and percent body fat) in a population of adults with MR is not strong. Professionals should employ the BMI along with skinfold measures to assess a person’s at-risk status for excess weight.

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Stanley Sai-chuen Hui

Promoting regular physical activity has been considered one of the most important aspects of preventive medicine in recent years. This is due to the fact that tremendous evidence has been found about the positive association between increasing physical activity and desirable health effects. Findings have been summarized in a number of review documents; however, most of these reviews emphasize findings retrieved from research conducted in Western countries. Few papers were found to summarize findings in physical activity and health of the Hong Kong Chinese population. Epidemiological studies revealed that there exists distinct diverse health status among different ethnic groups due to culture, beliefs, genetic makeup, health practices, and behaviors in these highly diverse groups. This chapter reviews what is known about the association between physical activity and health in the Chinese population of Hong Kong. Current health issues including coronary heart disease, obesity, diabetes, cancer, osteoporosis, and so on, that are specific to the Hong Kong situation are reviewed. Moreover, findings in physical activity participation levels of Hong Kong adults and children are introduced. Results indicate that the associations between physical activity and health found in the Chinese population of Hong Kong share similar trends as those reported in Western countries. Three quarters of Hong Kong children and adults are not physically active enough to achieve health benefits. The physical activity level for the Hong Kong Chinese population remains low. The need for promotional and intervention programs on physical activity participation is pressing.

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Charbel El Bcheraoui, Marwa Tuffaha, Farah Daoud, Hannah Kravitz, Mohammad A. Al Mazroa, Mohammad Al Saeedi, Ziad A. Memish, Mohammed Basulaiman, Abdullah A. Al Rabeeah and Ali H. Mokdad

Background:

With the lack of appropriate data, we conducted a large household survey in 2013 to determine current rates of physical activity in the Kingdom of Saudi Arabia (KSA).

Methods:

The Saudi Health Interview Survey is a national multistage survey of individuals aged 15 years or older. We used a multivariate logistic regression model to measure association between sociodemographic and selected characteristics and meeting the recommended levels of moderate and vigorous weekly physical activity.

Results:

Of a total of 12,000 households contacted, 10,735 (89.4%) participants completed Saudi Health Interview Survey. An estimated 4.5 million (34.5%) Saudis aged 15 years or older reported no weekly physical activity, while only 1.7 million (12.9%) meet the recommended levels of moderate physical activity (MPA). The likelihood of meeting MPA decreased with age, education, among women, those with a history of diagnosis of select chronic conditions, including diabetes. Similar results were found for the likelihood of meeting the recommended levels of vigorous weekly physical activity.

Conclusions:

We found very low levels of physical activity in KSA. Perhaps, KSA can challenge communities or employers to devise solutions and reward those with the best results. These solutions would be of great value to other Gulf countries, as well.

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Brian D. Tran, Szu-Yun Leu, Stacy Oliver, Scott Graf, Diana Vigil and Pietro Galassetti

Pediatric obesity typically induces insulin resistance, often later evolving into type 2 diabetes. While exercise, enhancing insulin sensitivity, is broadly used to prevent this transition, it is unknown whether alterations in the exercise insulin response pattern occur in obese children. Therefore, we measured exercise insulin responses in 57 healthy weight (NW), 20 overweight (OW), and 56 obese (Ob) children. Blood samples were drawn before and after 30min of intermittent (2min on, 1min off) cycling at ~80% VO2max. In a smaller group (14 NW, 6 OW, 15 Ob), a high-fat meal was ingested 45 min preexercise. Baseline glycemia was similar and increased slightly and similarly in all groups during exercise. Basal insulin (pmol/L) was significantly higher in Ob vs. other groups; postexercise, insulin increased in NW (+7 ± 3) and OW (+5 ± 8), but decreased in Ob (−15 ±5, p < .0167 vs. NW). This insulin drop in Ob was disproportionately more pronounced in the half of Ob children with higher basal insulin (Ob-H). In all groups, high-fat feeding caused a rapid rise in insulin, promptly corrected by exercise. In Ob, however, insulin rose again 30 min postexercise. Our data indicates a distinct pattern of exercise-induced insulin modulation in pediatric obesity, possibly modulated by basal insulin concentrations.