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David Chenoweth and Joe Leutzinger

Background:

Physical inactivity and excess weight in American adults have reached epidemic levels. This article describes how cost data from previously conducted analyses in several states were used to quantify the costs of physical inactivity and excess weight among American adults.

Methods:

Medical and workers’ compensation cost data on selected medical conditions were obtained from various health plans and state agencies in seven states. Productivity loss norms were obtained from published studies.

Results:

The estimated financial burden which includes direct medical care, workers’ compensation, and productivity loss costs among the seven states is $93.32 billion for physical inactivity and $94.33 billion for excess weight. The estimated nationwide cost of these risk factors is approximately $507 billion with projected costs exceeding $708 billion in 2008. Projected cost-savings of $31 billion per year could be realized with a 5% drop in these risk factors.

Conclusion:

The cost of physical inactivity and excess weight among American adults is significant. More research on best-of-class interventions to curtail the high prevalence of these risk factors is needed.

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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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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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Alyson J. Littman, Isabel G. Jacobson, Edward J. Boyko, and Tyler C. Smith

Background:

Understanding physical activity (PA) after discharge from the military can inform theory on the role of habit and reinforcement in behavior maintenance and has implications for this population’s future health.

Methods:

Using data from 28,866 Millennium Cohort Study participants (n = 3782 of whom were discharged during the years between assessments), we 1) investigated changes in meeting federal PA guidelines for moderate-to-vigorous activity (MVPA) following military discharge and 2) determined predictors of meeting these guidelines after discharge.

Results:

MVPA declined more in those who were discharged than in those who were not (−17.8 percentage points vs. −2.7 percentage points), with greater declines in former active-duty personnel, those who had deployed with combat exposures, had 14 to 25 years of service, and had been discharged more recently (>2 years prior). In those who were discharged, being normal or overweight (vs. obese), and a nonsmoker or former smoker (vs. current smoker) were positively associated with meeting MVPA Guidelines at follow-up, while meeting MVPA Guidelines at baseline and depression were inversely associated.

Conclusions:

Reductions in MVPA were substantial and unexpected. Increased understanding of transitional periods that may benefit from interventions to mitigate declines in PA will help prevent excess weight gain and physical inactivity-associated health consequences.

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Victoria Catenacci, Christopher Barrett, Lorraine Odgen, Ray Browning, Christine Adele Schaefer, James Hill, and Holly Wyatt

Background:

The America on the Move (AOM) Family Intervention Program has been shown to prevent excess weight gain in overweight children. Providing intervention materials via the internet would have the potential to reach more families but may increase sedentary behavior. The purpose was to evaluate whether delivering the AOM Family Intervention via the internet versus printed workbook would have a similar impact on sedentary behaviors in children.

Methods:

131 children (age 8–12) were randomized to receive the AOM Family Intervention via the internet or workbook for 12 weeks. Changes in objectively measured sedentary time and moderate-to vigorous physical activity (MVPA) as well as self-reported screen time were compared between groups.

Results:

There were no significant differences between groups in screen time, sedentary time, or MVPA at the end of the 12 week intervention. Families receiving the intervention via the internet were more likely to remain in the study (98% vs. 82%, P = .016).

Conclusions:

Using the internet to deliver the lifestyle intervention did not increase sedentary behavior in children. Attrition rates were lower when the program was delivered by internet versus via printed materials. These results provide support for using the internet to deliver healthy lifestyle programs for children.

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Yorghos Apostolopoulos, Mona M. Shattell, Sevil Sönmez, Robert Strack, Lauren Haldeman, and Victoria Jones

Background:

As one of the most underserved segments of the U.S. labor force, truck drivers have been associated with a series of morbid conditions intimately linked to their occupational milieux, their mostly unhealthful nutritional intake and sedentary lifestyles, and their resulting excess weight-gain.

Methods:

This paper reports data from a baseline assessment of 25 trucking work settings located around interstate highways I-40 and I-85 in North Carolina. It examines how the environmental attributes of these work settings influence the physical and recreational activity behaviors of truckers, compares findings with those from other occupational environments, and brings to the fore a new health promotion paradigm for trucking worksites.

Results:

Findings support growing empirical and anecdotal evidence that trucking work settings remain not only active-living deserts, but overall unhealthful places. A scan of physical, social, and information environments within trucking worksites as well as physical environments of surrounding communities reveal only meager opportunities for physical and recreational activity for truckers.

Conclusion:

This paper places the highly underserved population of truckers firmly within the discourse of worksite health promotion, and calls for comprehensive multistakeholder wellness strategies that address a multitude of risk factors linked to the occupational context.

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Chelsea L. Kracht, Susan B. Sisson, Emily Hill Guseman, Laura Hubbs-Tait, Sandra H. Arnold, Jennifer Graef, and Allen Knehans

Childhood obesity is a major public health concern, with obesity present in 1 in 5 preadolescent children (6–11 y old) and 13.9% of children ages 2–5 years old in the United States ( 14 ). Excess weight gain in childhood has a negative impact on long-term cardiometabolic health ( 12 ). Promoting

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Carla Elane Silva dos Santos, Sofia Wolker Manta, Guilherme Pereira Maximiano, Susana Cararo Confortin, Tânia Rosane Bertoldo Benedetti, Eleonora d’Orsi, and Cassiano Ricardo Rech

weight) and dichotomized into low/adequate weight and excess weight. The level of leisure-time physical activity was measured with the International Physical Activity Questionnaire, adapted and validated for Brazilian older adults. 25 Older adults reporting ≥150 minutes MVPA per week were classified as

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Krista Schroeder, Martha Y. Kubik, Jiwoo Lee, John R. Sirard, and Jayne A. Fulkerson

growth chart are at risk for excess weight gain during the preadolescent period, and intervention at this time may promote a healthy body weight, making research focused on this population particularly important. 15 – 17 Methods This study was a secondary analysis of baseline data collected from June to

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Miika Tuominen, Kristin Suorsa, Jaana Pentti, Pasi Koski, Sari Stenholm, and Tuija Leskinen

Physical inactivity and excess body weight are 2 major risk factors limiting health and functioning with advancing age. 1 , 2 Physical activity is an important modifiable behavioral factor that protects against accumulation of excess weight and attenuates health risks associated with obesity. 3