Impact of physical activity interventions on anthropometric outcomes: systematic review and meta-analysis

Association between Physical Activity Level, Body Composition, and Phase Angle in University Students from Bioelectrical Impedance Analysis (BIA)

Background: The aim of this study is to determine the relationship between selected components of body composition and the phase angle specified by bioelectrical impedance analysis, depending on the level of physical activity among students. Materials and Methods: The study group consisted of 484 university students from Krosno. The diagnostic survey method (IPAQ-SF), measurements of highs, and analysis of body composition components (BIA) were used. The relationship between variables was determined using the χ2 test, the V-Kramer coefficient, and Spearman's rho coefficient. Results: University students in physical education demonstrated the highest level of physical activity and the lowest incidence of excessive body mass. Among the participants, 28.1% did not engage in any physical activity, or their level was insufficient. The PhA level was correlated with lean body mass and muscle mass. The correlation between higher levels of PA and PhA values was statistically significant, as was the relationship between self-assessment of physical fitness and the level of PA determined by IPAQ-SF. Conclusions: Preventive actions and educational programs, especially about spending leisure time in active ways, should be particularly targeted at students of disciplines with a significant amount of sedentary classes.

A Review of Anthropometric Measurements for Saudi Adults and Elderly, Directions for Future Work and Recommendations to Establish Saudi Guidelines in Line with the Saudi 2030 Vision

Body weight is a significant risk factor for the disease burden of noncommunicable diseases (NCDs). Anthropometric measurements are the first step in determining NCDs risk, and clinicians must have access to valid cutoffs. This study aims to review the literature of Saudi national guidelines and studies previously conducted in Saudi Arabia (SA) and to provide insights and recommendations to establish national guidelines in anthropometric measurements for Saudi adults/elderly in line with the Saudi 2030 Vision. In total, 163 studies were included, and 12 of them contributed to the development of specific anthropometric cutoffs. Cutoffs for metabolic syndrome, waist circumference, and body mass index were established in Saudi adults. However, limited studies were conducted in the elderly. This review warrants establishing standard cutoffs of Saudi adult anthropometrics to avoid over/underreporting of malnutrition and adiposity. This review will help policymakers and the Ministry of Health to establish national guidelines and standard cutoffs to be used in SA for anthropometric measurements that may assist in detecting malnutrition and NCDs.

Health Effects of a 12-Week Web-Based Lifestyle Intervention for Physically Inactive and Overweight or Obese Adults: Study Protocol of Two Randomized Controlled Clinical Trials

Web-based lifestyle interventions have attracted considerable research interest. Available evidence on such interventions suggests health-promoting effects, but further research is needed. Therefore, this study aims to investigate short-, medium-, and long-term health effects of a web-based health program ("TK-HealthCoach", TK-HC) offered by a national statutory health insurance fund (Techniker Krankenkasse, TK). The study comprises two randomized controlled clinical trials to evaluate the health goals "Increasing Fitness" (F_clin) and "Losing and Maintaining Weight" (W_clin). A total of n = 186 physically inactive (F_clin) and n = 150 overweight or obese (W_clin) adults will be randomly assigned to a 12-week interactive (TK-HC) or non-interactive web-based health program using permuted block randomization with a 1:1 allocation ratio. Primary outcomes include cardiorespiratory fitness (F_clin) and body weight (W_clin). Secondary outcomes comprise musculoskeletal fitness (F_clin), physical activity and dietary behavior, anthropometry, blood pressure, blood levels, and vascular health (F_clin, W_clin). All outcomes will be measured before and after the 12-week intervention and after a 6- and 12-month follow-up. Additionally, usage behavior data on the health programs will be assessed. Linear mixed models (LMMs) will be used for statistical analysis. Findings of this study will expand the available evidence on web-based lifestyle interventions.

Small area variations and factors associated with blood pressure and body-mass index in adult women in Accra, Ghana: Bayesian spatial analysis of a representative population survey and census data

BACKGROUND

Body-mass index (BMI) and blood pressure (BP) levels are rising in sub-Saharan African cities, particularly among women. However, there is very limited information on how much they vary within cities, which could inform targeted and equitable health policies. Our study aimed to analyse spatial variations in BMI and BP for adult women at the small area level in the city of Accra, Ghana.

METHODS AND FINDINGS

We combined a representative survey of adult women's health in Accra, Ghana (2008 to 2009) with a 10% random sample of the national census (2010). We applied a hierarchical model with a spatial term to estimate the associations of BMI and systolic blood pressure (SBP) and diastolic blood pressure (DBP) with demographic, socioeconomic, behavioural, and environmental factors. We then used the model to estimate BMI and BP for all women in the census in Accra and calculated mean BMI, SBP, and DBP for each enumeration area (EA). BMI and/or BP were positively associated with age, ethnicity (Ga), being currently married, and religion (Muslim) as their 95% credible intervals (95% CrIs) did not include zero, while BP was also negatively associated with literacy and physical activity. BMI and BP had opposite associations with socioeconomic status (SES) and alcohol consumption. In 2010, 26% of women aged 18 and older had obesity (BMI ≥ 30 kg/m2), and 21% had uncontrolled hypertension (SBP ≥ 140 and/or DBP ≥ 90 mm Hg). The differences in mean BMI and BP between EAs at the 10th and 90th percentiles were 2.7 kg/m2 (BMI) and in BP 7.9 mm Hg (SBP) and 4.8 mm Hg (DBP). BMI was generally higher in the more affluent eastern parts of Accra, and BP was higher in the western part of the city. A limitation of our study was that the 2010 census dataset used for predicting small area variations is potentially outdated; the results should be updated when the next census data are available, to the contemporary population, and changes over time should be evaluated.

CONCLUSIONS

We observed that variation of BMI and BP across neighbourhoods within Accra was almost as large as variation across countries among women globally. Localised measures are needed to address this unequal public health challenge in Accra.

Complex lifestyle intervention among inactive older adults with elevated cardiovascular disease risk and obesity: a mixed-method, single-arm feasibility study for RESTART-a randomized controlled trial

Background

Physical inactivity and obesity are global public health challenges. Older adults are important to target for prevention and management of disease and chronic conditions. However, many individuals struggle with maintaining increased physical activity (PA) and improved diet. This feasibility study provides the foundation for the RESTART trial, a randomized controlled trial (RCT) to test a complex intervention to facilitate favourable lifestyle changes older adults can sustain. The primary objective of this study was to investigate study feasibility (recruitment, adherence, side-effects, and logistics) using an interdisciplinary approach.

Methods

This 1-year prospective mixed-method single-arm feasibility study was conducted in Tromsø, Norway, from September 2017. We invited by mail randomly selected participants from the seventh survey of the Tromsø Study (2015–2016) aged 55–75 years with sedentary lifestyle, obesity, and elevated cardiovascular risk. Participants attended a 6-month complex lifestyle intervention program, comprising instructor-led high-intensive exercise and nutritionist- and psychologist-led counselling, followed by a 6-month follow-up. All participants used a Polar activity tracker for daily activity monitoring during the intervention. Participants were interviewed three times throughout the study. Primary outcome was study feasibility measures.

Results

We invited potential participants (n=75) by mail of which 27 % (n=20) agreed to participate. Telephone screening excluded four participants, and altogether 16 participants completed baseline screening. The intervention and test procedures of primary and secondary outcomes were feasible and acceptable for the participants. There were no exercise-induced injuries, indicating that the intervention program is safe. Participants experienced that the dietary and psychological counselling were delivered too early in the intervention and in too close proximity to the start of the exercise program. Minor logistic improvements were implemented throughout the intervention period.

Conclusion

This study indicates that it is feasible to conduct a full-scale RCT of a multi-component randomized intervention trial, based on the model of the present study. No dropouts due to exercise-induced injury indicates that the exercises were safe. While minor improvements in logistics were implemented during the intervention, we will improve recruitment and adherence strategies, rearrange schedule of intervention contents (exercise, diet, and psychology), as well as improve the content of the dietary and behavioural counselling to maximize outcome effects in the RESTART protocol.

Trial registration

ClinicalTrials.gov Identifier: NCT03807323 Registered 16 January 2019 – retrospectively registered.

Objectively Measured Physical Activity Is Associated With Body Composition and Metabolic Profiles of Pacific and New Zealand European Women With Different Metabolic Disease Risks

Objective: To assess associations between physical activity (PA), body composition, and biomarkers of metabolic health in Pacific and New Zealand European (NZE) women who are known to have different metabolic disease risks. Methods: Pacific (n = 142) or NZE (n = 162) women aged 18-45 years with a self-reported body mass index (BMI) of either 18.5-25.0 kg⋅m-2 or ≥30.0 kg⋅m-2 were recruited and subsequently stratified as either low (<35%) or high (≥35%) BF%, with approximately half of each group in either category. Seven-day accelerometery was used to assess PA levels. Fasting blood was analysed for biomarkers of metabolic health, and whole body dual-energy X-ray absorptiometry (DXA) was used to estimate body composition. Results: Mean moderate-to-vigorous physical activity (MVPA; min⋅day-1) levels differed between BF% (p < 0.05) and ethnic (p < 0.05) groups: Pacific high- 19.1 (SD 15.2) and low-BF% 26.3 (SD 15.6) and NZE high- 30.5 (SD 19.1) and low-BF% 39.1 (SD 18.4). On average Pacific women in the low-BF% group engaged in significantly less total PA when compared to NZE women in the low-BF% group (133 cpm); no ethnic difference in mean total PA (cpm) between high-BF% groups were observed: Pacific high- 607 (SD 185) and low-BF% 598 (SD 168) and NZE high- 674 (SD 210) and low-BF% 731 (SD 179). Multiple linear regression analysis controlling for age and deprivation showed a significant inverse association between increasing total PA and fasting plasma insulin among Pacific women; every 100 cpm increase in total PA was associated with a 6% lower fasting plasma insulin; no significant association was observed in NZE women. For both Pacific and NZE women, there was an 8% reduction in fasting plasma insulin for every 10-min increase in MVPA (p ≤ 0.05). Conclusion: Increases in total PA and MVPA are associated with lower fasting plasma insulin, thus indicating a reduction in metabolic disease risk. Importantly, compared to NZE, the impact of increased total PA on fasting insulin may be greater in Pacific women. Considering Pacific women are a high metabolic disease risk population, these pre-clinical responses to PA may be important in this population; indicating promotion of PA in Pacific women should remain a priority.

Role of physical activity and fitness on sleep in sedentary middle-aged adults: the FIT-AGEING study

The association of physical activity and fitness with sleep still remains unclear since there is a lack of studies in this field of research using objective measurements of these variables. This study aimed to investigate the association of objectively-measured sedentariness, physical activity levels, and physical fitness with sleep quantity and quality in sedentary middle-aged adults. A total of 74 volunteers (52.7% women; aged 53.7 ± 5.1) were recruited for the present study. Cardiorespiratory fitness was measured through a maximal treadmill test, and muscular strength by extension and flexion peak torque, and by the hand grip test. Physical activity and objective sleep parameters were determined through accelerometry, and subjective sleep by the Pittsburgh Sleep Quality Index (PSQI). Reduced levels of sedentariness, greater VO_2max, and greater muscular strength were positively related to improved objective sleep quantity and quality (all P ≤ 0.05). Furthermore, higher levels of overall physical activity, VO_2max, and muscular strength were related to better subjective sleep quantity and quality (all P ≤ 0.05). Reduced sedentariness and increased physical activity and fitness may be a potential prevention and/or treatment pathway to reduce sleep disturbances and, in general, to improve patients physical and psychological health for a successful aging process.

Prevalence and risk factors associated with the formation of dermal lesions on the foot during hiking

BACKGROUND

The aim of this study is to assess the prevalence of blisters on the foot during hiking and the factors associated with this condition.

MATERIAL AND METHODS

A cross-sectional observational comparative study was conducted of 315 patients treated at two hostels, located on the Way of Saint James, in northern Spain. The study participants were interviewed and clinically examined to obtain sociodemographic and clinical variables. The variables recorded concerned the type of terrain covered (asphalt or dirt trails), the weight carried (backpack), the footwear used (weight, type, impermeability), the type of socks worn and the hydration of the skin obtained. The inclusion criteria were at least 18 years and to walk at least 20 km in the last five days.

RESULTS

74% (n = 233) of the hikers presented a bullous lesion on the foot after completing several stages of hiking. The most frequent locations were the first or second metatarsal head and the fifth toe. Logistic regression showed that risk factors for the appearance of blistering were the number of kilometres walked on asphalt (p = .001 [95% CI (1.019-1.064)]) and having wet socks at the end of the day (p = . 006 [95% CI (1.286-4.479)]). The protective factors identified were walking on a dirt, grass or gravel surface (p < .001 [95% CI (0.982- 0.995)]) and using customised plantar orthoses (p = .001 [95% CI (0.085) - 0.512)]).

CONCLUSIONS

The type of terrain is a determining factor in the appearance of blisters. Walking on a dirt trail reduces the risk. Using custom made insoles and controlling humidity are other factors that should be considered as preventive measures.

Longitudinal Study of Body Composition and Energy Expenditure in Overweight or Obese Young Adults

The aim of this study was to compare the effects of an aerobic training program with a strength training program on body composition and energy expenditure in overweight or obese (29.06 ± 3.49 kg/m²) young adults (21.96 ± 1.90 years). Subjects (N = 109) were randomly assigned to one of three groups: a control group (CG), an aerobic training (AT) group and a strength training (ST) group. Training took place over twelve weeks comprising three sessions per week with each session lasting 60 to 90 minutes. Before and after the program, weight, height, body mass index, lean mass percentage and fat mass percentage were evaluated. In addition, The International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to estimate energy expenditure. The results of both aerobic training and strength training produced statistically significant improvements in weight (AT-CG = −2.892 kg; ST-CG = −2.986 kg); BMI (AT-CG = −1.075 kg/m²; ST-CG = −1.118 kg/m²); total body fat (AT-CG = −1529.172 g; ST-CG = −763.815); and total body fat percentage (AT-CG = −1.421%; AT-ST = −0.855%). These two exercise prescription models were therefore useful in reducing overweight and obesity, which could have an impact on improving the health and quality of life of individuals with these characteristics.

Correlates of Moderate-to-Vigorous Physical Activity and Exercise Motivation in Underserved African American Men

Effective interventions are needed to increase physical activity (PA) in African American men, but little is known about correlates of PA and exercise motivation in this population. Using an ecological approach that considers cognitive, social, and environmental factors, correlates of moderate-to-vigorous physical activity (MVPA) and exercise motivation in underserved African American men were examined. Greater exercise motivation, greater social support for exercise, and more favorable environmental perceptions were hypothesized to be associated with higher MVPA, and greater social support and environmental perceptions were hypothesized to be associated with higher exercise motivation. This secondary analysis used baseline data from the Positive Action for Today’s Health (PATH) trial. African American men (n = 166, aged 48 ± 15 years) completed surveys that assessed cognitive, social, and environmental factors theoretically relevant to MVPA. Accelerometers were used to obtain a 7-day estimate of MVPA. Hierarchical linear regression analyses showed that exercise motivation was positively associated with MVPA (B = 1.15, SE = .41, p = .006). Exercise attitudes (B = .16, SE = .07, p = .037), exercise self-concept (B = .28, SE = .06, p < .001), exercise support from friends (B = .12, SE = .06, p = .048), and places for walking and cycling (B = .13, SE = .06, p = .032) were positively associated with exercise motivation. Interventions that improve exercise motivation and associated variables may be warranted to increase MVPA in underserved African American men.

ClinicalTrials.gov # NCT01025726

Associations of physical activity and sedentary time with body composition in Brazilian young adults

The findings of studies on the association between physical activity and adiposity are not consistent, and most are cross-sectional and used only self-reported measures. The aims of this study were to evaluate: 1) independent and combined cross-sectional associations of objectively-measured physical activity and sedentary time with body composition outcomes at 30 years, and 2) prospective associations of changes in self-reported physical activity from 23 to 30 years with the same outcomes in participants from the 1982 Pelotas (Brazil) Birth Cohort. Body mass index, waist circumference, visceral abdominal fat, fat mass index, and android/gynoid fat ratio were the outcomes. 3,206 participants were analysed. In cross-sectional analyses, higher objectively-measured moderate-to-vigorous physical activity was associated with lower body mass index (β = 0.017, 95%CI: −0.026; −0.009), waist circumference (β = −0.043, 95%CI: −0.061; −0.025), visceral abdominal fat (β = −0.006, 95%CI: −0.009; −0.003), and fat mass index (β = −0.015, 95%CI: −0.021; −0.009), independent of sedentary time. Sedentary time was independently associated only with higher fat mass index (β = 0.003, 95%CI: 0.001; 0.005). In longitudinal analyses, using self-reported measure, adiposity was lower among those who were consistently active or who became active. Adiposity was similar among the “became inactive” and “consistently inactive” subjects. Our findings suggest metabolic benefits from engagement in physical activity throughout young adulthood, with stronger associations on concurrent levels.

Increasing Employees' Health by Workplace Physical Activity Counseling: The Mediating Role of Step-Based Physical Activity Behavior Change

BACKGROUND

This study evaluated the effects of a 3-month workplace physical activity (PA) intervention on employees' health-related fitness and well-being. Moreover, mediational pathways were examined.

METHODS

A longitudinal, quasi-experimental trial was evaluated in Belgian employees. The intervention group (IG: n = 246) received 3-months individualized, tailored PA counseling, consisting of face-to-face counseling and follow-up e-mail and telephone contacts. The reference group (n = 54) received no PA counseling. Outcome measures (assessed at baseline, 3 mo [short term], and 9 mo [long term]) included body composition, cardiorespiratory fitness, well-being, and step-based PA.

RESULTS

With no changes in the reference group, the IG showed short-term improvements in body mass index (-0.24 kg/m², P < .001), body fat (-0.88%, P < .001), waist circumference (-1.47 cm, P < .001), and muscle percentage (+0.47%, P < .001). Moreover, with respect to cardiorespiratory fitness, IG participants improved on perceived exertion, both in the short term (-0.91, P < .001) and long term (-0.83, P < .001). Furthermore, perceived physical well-being increased in the IG, both in the short term (+0.57, P < .001) and long term (+0.57, P < .001). The observed intervention effects on body composition, perceived exertion, and well-being were mediated by (increases in) step-based PA.

CONCLUSIONS

Workplace PA counseling programs have the potential to enhance employees' health-related fitness and well-being. Importantly, step-based PA behavior change was found to contribute to the postintervention improvements.

Participation in group-based physical activity programmes for adults in Germany and associated factors: data from a nationwide cohort study

BACKGROUND

Characteristics of different participation groups can provide important information to increase participation in group-based physical activity programmes (GPAPs). This study examined four types of participation in GPAPs and the factors that characterised these participant groups.

METHODS

The present sample comprised 3219 participants. The analyses were based on data from the 'German Health Interview and Examination Survey for Adults' (t1) conducted in 2009-2011, which included 3959 people who had participated in the 'German National Health Interview and Examination Survey 1998' (t0). The outcome variable was participation in GPAPs, classified in four groups: 'once at t1' (participation only at t1), 'twice' (participation at t0 and t1), 'once at t0' (participation only at t0) and 'no' (no participation). Predictor variables were sex, age, educational level, income, sports activity, self-rated health and counselling for physical activity, measured at t0 and t1. Frequencies with 95% confidence intervals (CI) for each group were calculated. Four stepwise logistic regression models with estimated odds ratios (OR) were used to determine group differences.

RESULTS

The largest participant group was 'no' (80.8%). Among those who participated in GPAPs, the 'once at t1' group was the largest (13.1%), followed by the 'once at t0' (4.0%) and 'twice' (2.1%) groups. 'Once at t1' participation was associated with female sex (OR 2.58), being active in sports (OR 6.59), a high level of education (OR 1.88). If additionally health status and the physician's counselling are included into the models, then having fair/poor/very poor health (OR 1.71) and having had physician counselling on physical activity (OR 2.50) are relevant factors. For 'twice' participation, being female (OR 5.19) and practising sports (OR 4.51) were predictors.

CONCLUSIONS

GPAPs should be tailored to build on previous experience of sports activities and to reach men as well as people with low education, groups that have been the least reached. To reach more people and encourage participation in GPAPs, providing opportunity for physician counselling for physical activity may be promising, especially with groups of poorer health.

A tailored telephone and email based exercise intervention induced reductions in various measures of body composition in physically inactive adults: A randomized controlled trial

Obesity prevalence has increased the past decades and has become a serious public health problem. The aim of this six-month assessor-blinded, parallel-group randomized controlled trial was to assess the effect of a tailored telephone and email-based exercise intervention on various measures of body composition in a sample of apparently healthy and physically inactive adults. A total of 111 volunteering adults (40-55 yr) in Southern Norway were randomly assigned to an intervention group (IG; n = 39) or a no-information control group (CG; n = 50), by random allocation numbering. The IG received feedback on their health-related physical fitness, information on guidelines and recommendations for physical activity, a leaflet on national dietary recommendations, prompts and reminders in addition to three tailored exercise programs, one every two months, and fortnightly motivational counselling by email or telephone, alternately. The CG received no follow-up during the intervention period. The main outcome measures: weight, body mass index (BMI), waist circumference (WC) and fat percentage by skinfolds (FPskf) were assessed objectively at baseline and posttest. A one-way ANCOVA analysis, adjusted for baseline scores, gender, age, and educational level, revealed a larger reduction on all body compositional measures in the IG compared to the CG (p ≤ 0.043), except for BMI when adjusted for baseline scores. Additionally, a significantly higher percentage of the IG (64.1%) achieved a clinically significant reduction in FPskf compared to the CG (36.2%, p = 0.018). This six-month tailored telephone and email-based exercise intervention induced significant reductions on several measures of body composition in physically inactive adults.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT03164239).

Adult adiposity linked to relationship hostility for low-cortisol reactors

Past research on the relation between hostility in intimate relationships and adiposity has yielded mixed findings. The present study investigated whether the association between relationship hostility and adiposity is moderated by people's biological reactions to couple conflict. Cohabiting adult couples (N = 117 couples) engaged in two conflict interactions, before and after which salivary cortisol levels were measured. Results revealed an association between relationship hostility and adiposity, but this association was concentrated among people with relatively low levels of cortisol reactivity to couple conflict. Results are interpreted in light of research demonstrating that cortisol reactivity can become blunted over time in response to repeated stressors. These results provide precision to etiological models of obesity by identifying cortisol reactivity as a factor that moderates the association between relationship hostility and adiposity. (PsycINFO Database Record

Physical activity and asthma: A longitudinal and multi-country study

OBJECTIVE

To investigate the impact of physical activity on asthma in middle-aged adults, in one longitudinal analysis, and one multi-centre cross-sectional analysis.

METHODS

The Respiratory Health in Northern Europe (RHINE) is a population-based postal questionnaire cohort study. Physical activity, height and weight were self-reported in Bergen, Norway, at RHINE II (1999-2001) and all centres at RHINE III (2010-2012). A longitudinal analysis of Bergen data investigated the association of baseline physical activity with follow-up asthma, incident asthma and symptoms, using logistic and zero-inflated Poisson regression (n = 1782). A cross-sectional analysis of all RHINE III centres investigated the association of physical activity with concurrent asthma and symptoms (n = 13,542) using mixed-effects models. Body mass index (BMI) was categorised (<20, 20-24.99, 25-29.99, 30+ kg/m²) and physical activity grouped by amount and frequency of lighter (no sweating/heavy breathing) and vigorous (sweating/heavy breathing) activity.

RESULTS

In the Bergen longitudinal analysis, undertaking light activity 3+ times/week at baseline was associated with less follow-up asthma (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.22, 0.89), whilst an effect from undertaking vigorous activity 3+ times/week was not detected (OR 1.22, 95% CI 0.44, 2.76). The associations were attenuated with BMI adjustment. In the all-centre cross-sectional analysis an interaction was found, with the association between physical activity and asthma varying across BMI categories.

CONCLUSION

These findings suggest potential longer-term benefit from lighter physical activity, whilst improvement in asthma outcomes from increasing activity intensity was not evident. Additionally, it appears the benefit from physical activity may differ according to BMI.

Obesity, Asthma, and Exercise in Child and Adolescent Health

Obesity increases the risk of asthma throughout life but the underlying mechanisms linking these all too common threats to child health are poorly understood. Acute bouts of exercise, aerobic fitness, and levels of physical activity clearly play a role in the pathogenesis and/or management of both childhood obesity and asthma. Moreover, both obesity and physical inactivity are associated with asthma symptomatology and response to therapy (a particularly challenging feature of obesity-related asthma). In this article, we review current understandings of the link between physical activity, aerobic fitness and the asthma-obesity link in children and adolescents (e.g., the impact of chronic low-grade inflammation, lung mechanics, and direct effects of metabolic health on the lung). Gaps in our knowledge regarding the physiological mechanisms linking asthma, obesity and exercise are often compounded by imprecise estimations of adiposity and challenges of assessing aerobic fitness in children. Addressing these gaps could lead to practical interventions and clinical approaches that could mitigate the profound health care crisis of the increasing comorbidity of asthma, physical inactivity, and obesity in children.

Cardiopulmonary Exercise Testing in Children and Adolescents with High Body Mass Index

Consensus has yet to be achieved on whether obesity is inexorably tied to poor fitness. We tested the hypothesis that appropriate reference of cardiopulmonary exercise testing (CPET) variables to lean body mass (LBM) would eliminate differences in fitness between high-BMI (≥ 95th percentile, n = 72, 50% female) and normal-BMI (< 85th percentile, n = 142, 49% female), otherwise-healthy children and adolescents typically seen when referencing body weight. We measured body composition with dual x-ray absorptiometry (DXA) and CPET variables from cycle ergometry using both peak values and submaximal exercise slopes (peak VO2, ΔVO2/ΔHR, ΔWR/ΔHR, ΔVO2/ΔWR, and ΔVE/ΔVCO2). In contrast to our hypothesis, referencing to LBM tended to lessen, but did not eliminate, the differences (peak VO2 [p < .004] and ΔVO2/ΔHR [p < .02]) in males and females; ΔWR/ΔHR differed between the two groups in females (p = .041) but not males (p = .1). The mean percent predicted values for all CPET variables were below 100% in the high-BMI group. The pattern of CPET abnormalities suggested a pervasive impairment of O2 delivery in the high-BMI group (ΔVO2/ΔWR was in fact highest in normal-BMI males). Tailoring lifestyle interventions to the specific fitness capabilities of each child (personalized exercise medicine) may be one of the ways to stem what has been an intractable epidemic.

Assessing the usefulness of systematic reviews for policymakers in public health: A case study of overweight and obesity prevention interventions

OBJECTIVE

Systematic reviews (SRs) should include policy-relevant information in order to more readily inform policy and practice. We investigated whether SRs of overweight and obesity prevention interventions are framed in such a way that maximises their usefulness for policymakers.

METHOD

We conducted a systematic review of SRs of overweight and obesity prevention interventions published in 4 databases any time up to December 2014. We analysed the SRs for their usefulness to policymakers, using a coding frame developed based on literature around what policymakers want and need from systematic reviews. Systematic reviews were assessed for a) policy links and framing; b) quality assessment and conflict of interest statements: and c) discussion of policy implications.

RESULTS

Of the 153 SRs that met the inclusion criteria, very few (7%) had authors from policy-based organisations, 48% had funding from such organisations, and almost a third (31%) framed their introduction or aims around policy. Most (69%) discussed issues affecting generalisability of the SR findings but only a quarter (24%) discussed cost or cost-effectiveness of the intervention under investigation. Less than a third (29%) of SRs discussed the policy implications of their findings. SRs that were policy-framed were significantly more likely to discuss costs (PR=1.8, 95%CI 1.0-3.0) and policy implications (PR=2.5, 95%CI 1.5-4.0).

CONCLUSION

SRs should discuss the policy and practice implications of their findings to maximise the influence of SRs on policy making. It is recommended that SR guidelines are updated to include generalisability and discussion of policy and practice implications as a requirement.

Effect of specific educational program on dietary change and weight loss in breast-cancer survivors

AIMS

Consumption of Western foods with high dietary glycemic load is associated with breast cancer development, whereas adherence to Mediterranean diet has been linked to a reduced risk. Changing lifestyle can decrease risk of recurrences and mortality. Thus decreasing the weight, improving the diet and promoting lifestyle are among of the most important issues of public health. We evaluated the effects of a specific educational intervention conducted by dietitians, nutritionists physicians, oncologist and sport physician to promote lifestyle in breast cancer survivors.

METHODS

We recruited 100 pts in breast cancer follow up. The intervention program consisted of four meetings once a week including lectures, training sessions and workshops lasting overall a month. Dietary recommendations were provided on the basis of WCRF/AICR guidelines and were modelled on Mediterranean diet. Sport physician recommended adapted physical activity, based on clinical experiences and scientific evidences.

RESULTS

Significantly decrease of BMI and waist circumference was observed after 2 and 6 months. Adherence to Mediterranean diet was significantly improved, both in heightening typical Mediterranean foods, both in decreasing consumption of non typical foods. At baseline 63% of women was inactive, 37% was mild active and 0% active, while at the end inactive patients felt by half (30%) and mild active women almost doubled (67%).

CONCLUSIONS

We found this dietary intervention effective in reducing BMI and waist circumference, and enhancing healthy lifestyle in BC survivors. It has surely contributed to achieve these results besides the change in diet quality, mostly a marked reduction in sedentary habits.