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J.A. Goon, A.H. Noor Aini, M. Musalmah, M.Y. Yasmin Anum, W.M. Wan Nazaimoon and W.Z. Wan Ngah

Background:

The biochemical mechanisms involving oxidative stress to explain the relationship between exercise and healthy aging are still unclear.

Methods:

Tai Chi participants and matched sedentary volunteers age 45 and above were enrolled. Glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) activities; levels of DNA damage using the comet assay; and malondialdehyde (MDA) and advanced glycation end products (AGE) were determined at 0, 6, and 12 months.

Results:

Tai Chi subjects had decreased normal and increased mildly damaged DNA with elevated GPx activity after 6 months (n = 25). Plasma MDA and AGE concentrations decreased significantly after 12 months (n = 15) accompanied by increased SOD activity. This may be attributed to the hormesis effect, whereby mild induction of oxidative stress at the first 6 months of exercise resulted in stimulation of antioxidant defenses. These parameters were unchanged in the sedentary subjects in the first 6 months (n = 27) except for elevated SOD activity. After 12 months, the sedentary subjects (n = 17) had decreased normal DNA and increased severely damaged DNA with unaltered MDA and AGE levels while SOD and GPx activities were significantly elevated.

Conclusion:

Regular Tai Chi exercise stimulated endogenous antioxidant enzymes and reduced oxidative damage markers.

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Darla E. Kendzor, Marlyn Allicock, Michael S. Businelle, Lona F. Sandon, Kelley Pettee Gabriel and Summer G. Frank

Background:

The current study evaluated the feasibility and effectiveness of a diet and physical activity intervention for homeless adults.

Methods:

Shelter residents (N = 32) were randomly assigned to a 4-week diet and physical activity intervention (n = 17) or an assessment-only control group (n = 15). Intervention participants received tailored educational newsletters, pedometers with step goals, and twice daily fruit/vegetable snacks. Key measures included 24-hour dietary recall interviews and accelerometer-measured moderate-to-vigorous intensity physical activity (MVPA).

Results:

At baseline, 68.8% of participants were overweight or obese, 93.8% reported food insecurity, and 43.8% reported activity levels below physical activity guidelines. Baseline dietary recall interviews indicated low fruit/vegetable consumption, and elevated intake of added sugar, saturated fat, and sodium relative to current dietary recommendations. During the 4-week study period, intervention participants engaged in significantly greater accelerometer-measured daily MVPA (P < .001) than controls (median = 60 daily minutes p vs. 41 daily minutes). Between groups differences in fruit/vegetable consumption at the end of treatment did not reach statistical significance. Most participants reported that the intervention was helpful for increasing fruit/vegetable intake and physical activity.

Conclusions:

Findings highlight the potential to improve dietary quality and increase physical activity among sheltered homeless adults.

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Mercedes Vélez-Toral, Débora Godoy-Izquierdo, Nicolás Mendoza Ladrón de Guevara, Carlos de Teresa Galván, Alberto Salamanca Ballesteros and Juan F. Godoy García

Background:

This study explored multidimensional outcomes that were derived from the adherence to regular exercise among previously sedentary postmenopausal 45 to 64 years old women who engaged in a ~20-week exercise program.

Methods:

A randomized controlled trial with between-group (intervention and control women) and within-subject measures (baseline, postintervention, and 3-month and 12-month follow-ups) was conducted. HRQoL and several indicators of cardio-metabolic status and fitness were assessed.

Results:

After the intervention, the participants experienced a positive change in their short and long-term physical and mental health, with significant enhancements in several HRQoL dimensions, particularly mental well-being (23.3% of change) and menopause-related health and subdomains (17.0% of change) (P < .01). Improvements were maintained or continued (eg, mental well-being) overtime. These outcomes were accompanied by significant improvements in cardio-metabolic status and fitness, including weight, BMI, cardio-respiratory fitness and flexibility (up to 16.2% of change, P < .05). After the intervention, the intervention group exhibited better HRQoL than the control group at each of the measurement phases. Between-group differences were also observed for some indicators of cardiovascular health and flexibility.

Conclusions:

Our findings add evidence on the association of positive outcomes on HRQoL with improvements in cardio-metabolic health and fitness status after the adoption of an active lifestyle.

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Markus V. Nahas, Mauro V. G. de Barros, Maria Alice A. de Assis, Pedro C. Hallal, Alex A. Florindo and Lisandra Konrad

Background:

A cross-cultural, randomized study was proposed to observe the effects of a school-based intervention designed to promote physical activity and healthy eating among high school students in 2 cities from different regions in Brazil: Recife and Florianopolis. The objective of this article is to describe the methodology and subjects enrolled in the project.

Methods:

Ten schools from each region were matched and randomized into intervention and control conditions. A questionnaire and anthropometry were used to collect data in the first and last month of the 2006 school year. The sample (n = 2155 at baseline; 55.7% females; 49.1% in the experimental group) included students 15 to 24 years, attending nighttime classes. The intervention focused on simple environmental/organizational changes, diet and physical activity education, and personnel training.

Results:

The central aspects of the intervention have been implemented in all 10 intervention schools. Problems during the intervention included teachers’ strikes in both sites and lack of involvement of the canteen owners in schools.

Conclusions:

The Saude na Boa study provides evidence that public high schools in Brazil represent an important environment for health promotion. Its design and simple measurements increase the chances of it being sustained and disseminated to similar schools in Brazil.

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Lena Viktoria Kallings, Matti E. Leijon, Jan Kowalski, Mai-Lis Hellénius and Agneta Ståhle

Background:

Physical activity on prescription, as a method for increasing physical activity, has attracted attention in recent years. However, few studies have examined adherence as a primary outcome variable. The aim of this article was to examine self-reported adherence to individualized prescribed physical activity in a routine primary health care setting.

Methods:

Patients receiving an individualized physical activity on prescription (FaR) for prevention or treatment of disease were recruited from 13 Swedish primary health care units. Self-reported adherence, physical activity level, readiness to change to a more physically active lifestyle, and well-being were measured with questions at baseline and after 6 months in 240 patients (mean age 51, range 12 to 80, 75% women).

Results:

At the 6-month follow-up a majority (65%) of the patients reported adherence to the prescription. Partial adherence was reported by 19% and nonadherence by 16%. There was a relationship between adherence and well-being and stages of action or maintenance.

Conclusions:

The results demonstrate that adherence to physical activity on prescription is as good as adherence to other treatments for chronic diseases. This is significant because even a small increase in physical activity is important both on an individual level and for public health.

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Erik Hemmingsson, Ulf Ekelund and Joanna Udden

Background:

The impact of walking and bicycling on insulin resistance (IR) in women with abdominal obesity is unclear.

Methods:

Pooled analysis of data from a randomized trial on physically active commuting (bicycling + walking vs walking only) in women with abdominal obesity [n = 98; age:47.3 ± 7.6 yrs; waist circumference (WC):103.1 ± 7.8 cm]. Bicycling and walking data were collected during 7 consecutive days by trip meters (Trelock FC-410) and pedometers (Yamax digiwalker SW-200) at baseline, 2, 4, and 6 months. Owing to a skew distribution we analyzed bicycling as a binary dummy variable with a 10 km/week cut-off. Fasting serum insulin and homeostatic model assessment – insulin resistance (HOMA-IR) were assessed at baseline and 6 months, as were body mass index (BMI), WC, and dual x-ray absorptiometry (DXA)-assessed % whole-body fat.

Results:

Increased bicycling by 10 km/wk was associated with reductions in fasting serum insulin at follow-up independent of age, treatment allocation, baseline phenotype, Δ walking, and Δ % body fat (β = −10.9, P = .042), but not HOMA-IR (β = −2.0, P = .13). Increased walking was not associated with fasting serum insulin (P = .33) or HOMA-IR (P = .44) at follow-up, after adjustment for the same covariates and Δ bicycling.

Conclusion:

Increased bicycling but not walking was associated with reduced insulin levels at follow-up. Bicycling may be more effective than walking for reducing insulin levels in abdominally obese women.

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Catherine B. Chan and Catrine Tudor-Locke

Background:

We evaluated a pedometer-based community intervention under real-world conditions.

Methods:

Participants (n = 559) provided demographic and health information using surveys and steps/d at baseline and during the last week the participants were in the program. A 1-year follow-up was conducted, but in keeping with real-world conditions, no incentives were offered to participate.

Results:

Participants (89% female, age 48.1 [SD = 12] years) took 7864 (3114) steps/d at baseline. Postprogram voluntary response rates to mailed surveys were 41.3% at 12 weeks and 22.8% at 1 year. Program completers reported significantly higher steps/d at 12 weeks (~12,000 steps/d) and 1 year (~11,000 steps/d) compared with baseline.

Conclusions:

The improvement in steps/d in this real-world implementation was consistent with more controlled studies of pedometer-based interventions. Low response to voluntary follow-up is a study limitation but is expected of real-world evaluations.

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Rosemarie Martin and Elaine Murtagh

Background:

A cluster randomized controlled trial was conducted to assess the effectiveness of the Active Classrooms intervention, which integrates movement into academic lessons, on the moderate-to-vigorous physical activity levels (MVPA) of primary school children during class-time and throughout the school day.

Methods:

Ten classroom teachers and their students aged 8 to 12 years were recruited and randomized into the Active Classrooms intervention group (n = 131students, n = 5teachers) or a delayed-treatment controlled group (n = 117students, n = 5teachers). The intervention group participated in active academic lessons taught by the classroom teacher over an 8 week period. Accelerometers were used to gather physical activity data at baseline, postintervention and at 4 months follow-up. Teachers completed a questionnaire to evaluate the program.

Results:

A significant difference for change in daily class time MVPA levels was identified between the treatment (n = 95) and control (n = 91) groups from pre- to postintervention (P < .001) and this difference was maintained at follow-up (P < .001). No significant difference emerged between the treatment and control groups for change in school day MVPA levels from pre- to postintervention (P = .52) or follow-up (P = .09). Teachers reported that they were highly satisfied with the program.

Conclusions:

Movement integration has the potential to improve physical activity levels of primary school children in the classroom.

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Darla M. Castelli and Ang Chen

’ lives. It focuses on PE students’ role in cognitive decision making, self-motivation, and their search for personal meaning that can add connection and relevance to physical activities. (p. 241) In the following, we first provide a general review and critique of large-scale intervention studies. The

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Alyce T. Barnes, Ronald C. Plotnikoff, Clare E. Collins and Philip J. Morgan

Background:

The aim was to assess the feasibility and preliminary efficacy of a community-based physical activity (PA) intervention targeting mothers and daughters.

Methods:

A randomized controlled trial of 48 primary school-aged girls and their 40 mothers were randomized to (i) Mothers And Daughters Exercising for Life (MADE4Life) (n = 21 mothers, n = 25 daughters) or (ii) wait-list control (n = 19 mothers, n = 23 daughters). The 8-week program involved 8 sessions; 25-minute separate mothers and daughters education sessions and 60-minutes PA together. Assessments were at baseline, postintervention and 3-month postintervention. Primary outcome measure was daughters’ moderateto-vigorous physical activity (MVPA) (accelerometer). Secondary outcomes included accelerometer-assessed light/moderate/vigorous PA, BMI, waist circumference, body composition, blood pressure, resting heart rate, sedentary behaviors and mothers’ self-reported PA, parenting measures, and cognitions. Intention-to-treat analysis used linear mixed models.

Results:

Recruitment and retention goals were exceeded. Attendance rates, program acceptability and satisfaction were high. There was no significant group-by-time effect for daughters’ %MVPA (–0.08; 95%CI –1.49, 1.33, d = –0.03) or other secondary outcomes for girls (postintervention range d = 0.01 to –0.46). Significant intervention effects were found for mothers’ %VPA (P = .04, d = 0.25) and role modeling (P = .02, d = 0.66).

Conclusion:

MADE4Life was both feasible and acceptable. Although very small effect sizes were found for the daughters, significant changes were seen for mothers (d = 0.25 to 0.66). Future fully powered trials targeting PA in mothers and daughters is warranted.