Physical Activity and Cardiovascular Disease Prevention in Women: How Much Is Good Enough?

Evaluation of Dietary Intake, Leisure-Time Physical Activity, and Metabolic Profile in Women with Mutation in the LMNA Gene

INTRODUCTION

Familial partial lipodystrophy (FPL) is a rare genetic disorder characterized by selective lack of subcutaneous fat, which is associated with insulin-resistant diabetes. The Dunnigan variety (FPLD2) is caused by several missense mutations in the lamin A/C (LMNA) gene, most of which are typically located in exon 8 at the codon position 482.

OBJECTIVE

The aim of this study was to assess and compare the dietary intake, leisure-time physical activity (LTPA), and biochemical measurements (glucose, A1C, and plasma lipids) in women with FPLD2 and without (control group, CG) and to examine the associations between dietary intake and biochemical measurements (BM).

METHODS

LTPA was measured with a questionnaire and metabolic equivalent (MET) hours per week (hours/week) were calculated. Dietary intake by the 3-day recall method and clinical laboratory parameters were collected.

RESULTS

Characteristics of women with FPLD2: 35.8 ± 13.9 years, fat mass = 10 ± 2.3 kg and fat free mass = 41.4 ± 4.5 kg (p < 0.05). Women with FPLD2 showed a smaller intake of energy (kcal), lipids, and carbohydrates and a large intake of protein (p < 0.01) compared to CG. Comparing the 2 groups in terms of LTPA, 78% of women with FPLD2 performed insufficient physical activity. In addition, they had a higher levels of glucose, A1C, and triglycerides (TG) and lower levels of high-density lipoprotein (HDL). There was no correlation between dietary intake and biochemical measurements.

CONCLUSIONS

Women with FPLD2 have a lower intake of energy (kcal), lipids, and carbohydrates and greater changes in biochemical measurements. Because this is a rare disease, future studies are needed with encouragement of the practice of physical activity and of healthy eating habits, preventing the onset of diseases.

Promotoras' roles in integrative validity and treatment fidelity efforts in randomized controlled trials

Promotoras from the communities in which interventions are implemented can be effective contributors to validity and fidelity efforts. This article describes a 48-week randomized controlled trial Madres para la Salud (Mothers for Health) and illustrates the use of promotoras as collaborative members of the research team to contribute to attaining integrative validity and treatment fidelity. Madres para la Salud implements a culturally tailored physical activity program to effect changes in body fat, systemic and fat tissue inflammation, and depression symptoms. The significance of Madres para la Salud treatment validity and fidelity processes includes cultural tailoring of a social support intervention, and a promotora model to incorporate initial and ongoing fidelity monitoring.

Madres para la Salud: design of a theory-based intervention for postpartum Latinas

BACKGROUND

Weight gain in young women suggests that childbearing may be an important contributor to the development of obesity in women. Depressive symptoms can interfere with resumption of normal activity levels following childbirth or with the initiation of or adherence to physical activity programs essential for losing pregnancy weight. Depression symptoms may function directly to promote weight gain through a physiologic mechanism. Obesity and its related insulin resistance may contribute to depressed mood physiologically. Although physical activity has well-established beneficial effects on weight management and depression, women tend to under participate in physical activity during childbearing years. Further, the mechanisms underpinning the interplay of overweight, obesity, physical activity, depression, and inflammatory processes are not clearly explained.

OBJECTIVES

This report describes the theoretical rationale, design considerations, and cultural relevance for "Madres para la Salud" [Mothers for Health].

DESIGN AND METHODS

Madres para la Salud is a 12 month prospective, randomized controlled trial exploring the effectiveness of a culturally specific intervention using "bouts" of physical activity to effect changes in body fat, systemic and fat tissue inflammation, and postpartum depression symptoms in sedentary postpartum Latinas.

SUMMARY

The significance and innovation of Madres para la Salud includes use of a theory-driven approach to intervention, specification and cultural relevance of a social support intervention, use of a Promotora model to incorporate cultural approaches, use of objective measures of physical activity in post partum Latinas women, and the examination of biomarkers indicative of cardiovascular risk related to physical activity behaviors in postpartum Latinas.

Cardiac health: primary prevention of heart disease in women

Heart disease is the number one cause of death among women. Although 450,000 women die annually from heart disease, this fact is unknown to many women. Because heart disease is frequently preventable, increasing awareness of personal risk and preventative measures is a key element of health care for women. Nurse clinicians can evaluate, educate, and counsel women regarding their risk for this pervasive disease and promote behavior changes that will decrease that risk. Research evidence supports that lifestyle behaviors are the cornerstone of heart disease prevention. This article presents current evidence for the prevention of heart disease related to dietary intake, physical activity, weight management, smoking cessation, blood pressure control, and lipid management. Guidelines for implementing findings in clinical practice are discussed.

Amount of Leisure-Time Physical Activity and Risk of Nonfatal Myocardial Infarction

PURPOSE

To investigate the shape of the relation between amount of leisure-time physical activity (LTPA) and myocardial infarction (MI) risk.

METHODS

Data were from a case-control study in a Washington State health maintenance organization, 1986 to 2002. Participants had no prior cardiovascular disease and good self-reported health before selection. Telephone interviews asked 697 nonfatal MI cases and 3,397 control subjects about 26 types of LTPA. Models adjusted for age, sex, year, treated hypertension, family history of heart disease, smoking, alcohol, aspirin, race, retirement, income, and education.

RESULTS

Some LTPA was reported by 90% of control subjects and 84% of cases. Compared with no LTPA, participation in LTPA was associated with lower risk of MI (adjusted odds ratio [OR] = 0.67, 95% confidence interval [CI]: 0.52, 0.86). Among active participants, LTPA time was associated with risk of MI (OR = 0.66 for high versus low quartile, 95% CI: 0.51, 0.86). Risk of MI decreased with increasing total or nonstrenuous LTPA time up to the median, beyond which we could not detect an association between LTPA time and MI risk.

CONCLUSIONS

Time engaged in LTPA, even nonstrenuous LTPA, was associated with lower risk of MI, and the shape of this relationship was nonlinear.

Impacto da prática habitual de atividade física no perfil lipídico de adultos

O objetivo do estudo foi analisar o impacto da prática habitual de atividade física, mediante informações reunidas por intermédio do International Physical Activity Questionnaire (IPAQ), no perfil lipídico em amostra representativa de sujeitos adultos. A amostra foi constituída por 361 sujeitos (196 mulheres e 165 homens) com idades entre 20 e 60 anos. As concentrações de lipídeos plasmáticos foram estabelecidas mediante procedimentos laboratoriais. Os achados revelaram que, em ambos os sexos, os níveis plasmáticos de HDL-colesterol e VLDL-colesterol não apresentaram diferenças significativas entre os grupos de prática habitual de atividade física. Os valores de triglicerídeos, colesterol sérico total e LDL-colesterol foram significativamente diferentes em mulheres e homens, porém o comportamento de variação foi diferente nos dois sexos. As informações da análise de regressão logística indicaram que as odds ratios para menores valores de lipídeos plasmáticos foram significativas somente nos sujeitos classificados como muito-ativos em comparação com os sedentários. Como conclusão, os resultados sugerem que mais elevada prática habitual de atividade física determinada pelo IPAQ apresenta significativo impacto no perfil lipídico em adultos de ambos os sexos, independentemente da idade e das variações do peso corporal.

New insights into the vascular mechanisms underlying the beneficial effect of swimming training on the endothelial vasodilator function in apolipoprotein E-deficient mice

The antiatherogenic role of exercise is poorly understood. We examined the swimming exercise-induced vascular mechanisms which enhance the endothelial vasodilator function in apoE(-/-) mice. Male apoE(-/-) mice treated for 9 weeks with a lipid-rich diet were divided into two groups: the exercise group (apoE(-/-) X), which underwent a 9-week swimming protocol (50 min/day; 5days/week) and the sedentary group (apoE(-/-) S). C57BL/6 mice were used as the control group. Atherosclerotic lesions in the aortic roots were significantly reduced in apoE(-/-) X compared to apoE(-/-) S. Relaxation to acetylcholine was improved in apoE(-/-) X as compared to apoE(-/-) S and control mice with E(max) and pD(2) values significantly higher. pD(2) values in response to papaverine were higher in apoE(-/-) X than in the other groups. Relaxation in response to A23187 and DEA-NONOate were similar. These findings suggest that swimming training may increase the sensitivity of relaxation to acetylcholine, which in turn activates acetylcholine-mediated signaling pathways leading to increased NO bioactivity. Swimming may also prolong the signaling actions of NO by stimulating the sensitivity of vascular smooth muscle cells to cyclic nucleotides. These appear to be the key mechanisms underlying the improvement of the NO-cGMP pathway in exercised apoE(-/-) mice.

Physical activity of moderate intensity in leisure time and the risk of all cause mortality

BACKGROUND

There are conflicting data about the health benefits of moderately intense physical activity.

OBJECTIVES

To examine the effect of such activity on all cause mortality in a German sample of men and women.

METHODS

Physical activity during leisure time of 3742 men and 3445 women aged 30 to 69 was assessed in a baseline questionnaire from 1984 to 1986. The participants were observed during the follow up period until 1998 when a mortality follow up was conducted.

RESULTS

During the follow up period, 300 women and 643 men had died. The multivariate rate ratios (RR) for the volume of lifestyle activities of moderate intensity (for example, gardening, walking, cycling) compared with sedentary lifestyle showed a clearly protective dose-response relation (p for trend <0.001) in women but not in men (p for trend 0.20). Following the recommendation for health enhancing physical activity a second analysis was conducted; 2.5 hours per week taking part in physical activity of moderate intensity decreased the relative risk of overall mortality (0.65 (95% confidence interval, 0.51 to 0.82) and 0.90 (0.77 to 1.01) for women and men, respectively).

CONCLUSIONS

The volume of lifestyle activities of moderate intensity in leisure time was inversely associated with all cause mortality in women but not in men. With regard to the health enhancing physical activity recommendation as a threshold, there were favourable findings only in women.

Nivel de actividad física global en la población adulta de Bogotá (Colombia). Prevalencia y factores asociados

OBJECTIVE

To determine the prevalence of physical activity levels in adults aged 18 to 65 years in Bogotá city and identify the factors associated with regular physical activity.

METHODS

We conducted a population-based, cross-sectional survey in 3,000 adult residents of Bogotá in 2003 who were selected through a multistage probabilistic sample. Physical activity levels were determined using the short version of the International Physical Activity Questionnaire. Factors associated with regular physical activity were identified by logistic regression models.

RESULTS

The adjusted prevalence of persons undertaking regular physical activity was 36.8%. After adjustment for potential confounders, regular physical activity was more likely in men (odds ratio [OR] = 1.62; 95% CI, 1.31-2.01) and in those whose self-perceived health status was good or very good (OR = 1.87; 95% CI, 1.41-2.49) and was less likely in those aged 30-49 years or 50-65 years (OR = 0.78; 95% CI, 0.63-0.96, and OR = 0.60; 95% CI, 0.43-0.82, respectively) and in those whose main activity in the previous 30 days was searching for a job (OR = 0.71; 95% CI, 0.51-0.97) or carrying out household tasks (OR = 0.72; 95% CI, 0.54-0.96). In women, unlike men, age groups showed no association with regular physical activity.

CONCLUSION

This study shows gender differences in the prevalence of physical activity levels and associated factors. Future studies should establish, in the context of Latin American cities, whether it is appropriate to determine specific measures in each domain, in addition to overall physical activity levels.