Characteristics of joggers among Japanese men in Hawaii

Primary Prevention in Public Health: An Analysis of Basic Assumptions

The common definition of primary prevention is straightforward; but how it is transformed into a framework to guide action is based on personal and societal feelings and beliefs about the basis for social organization. This article focuses on the two contending primary prevention strategies of health promotion and health protection. The contention between the two strategies stems from a basic disagreement about disease causality in modern society. Health promotion is based on the “lifestyle” theory of disease causality, which sees individual health status linked ultimately to personal decisions about diet, stress, and drug habits. Primary prevention, from this perspective, entails persuading individuals to forgo their risk- taking, self-destructive behavior. Health protection, on the other hand, is based on the “social-structural” theory of disease causality. This theory sees the health status of populations linked ultimately to the unequal distribution of social resources, industrial pollution, occupational stress, and “anti-health promotion” marketing practices. Primary prevention, from this perspective, requires changing existing social and, particularly, economic policies and structures. In order to provide a basis for choosing between these contending strategies, the demonstrated (i.e., past) impact of each strategy on the health of the public is examined. Two conclusions are drawn. First, the health promotion strategy shows little potential for improving the public health, because it systematically ignores the risk- imposing, other-destructive behavior of influential actors (policy-makers and institutions) in society. And second, effective primary prevention efforts entail an “upstream” approach that results in far-reaching sociopolitical and economic change.

Dimensions of health-related lifestyle in young adulthood: results from a national population survey

AIM

This study assessed the underlying structure of health-related behaviours among young adults in Iceland. A number of individual behaviours were considered, including both positive and negative health-related behaviours. A central question was whether distinct underlying health-related lifestyles can be identified in this age group.

METHOD

The study was based on the data from a national health survey entitled 'Health and Living Conditions in Iceland'. The original survey comprised a random sample of 18-75 year olds drawn from the National Register (response rate 69%). The current study used a subsample from the survey, consisting of young adults, age: 18-24 (N = 348). A total of 37 variables pertaining to health-related behaviour were analysed. The 37 variables were factor-analysed using principal component (PC) factor analysis.

RESULTS

The PC analysis yielded four underlying health lifestyle dimensions: (i) physical activity; (ii) unhealthy diet; (iii) substance use; and (iv) healthy diet. The four factors explained 35.3% of the total item variance. The mean Cronbach's alpha for the four factors was 0.69. Correlations between factors were generally weak.

CONCLUSION

Distinct health-related lifestyle dimensions underlie the numerous health-related behaviours that young adults engage in. The analysis of positive and negative lifestyle dimensions helps identify vulnerable young adults disproportionally involved in unfavourable patterns of health-related behaviour. Weak factor correlations and high unexplained item variance suggests that individual health-related behaviours need consideration, albeit within a larger framework acknowledging interconnected and sometimes inconsistent behaviours.

Food choice, appetite and physical activity

Food choices and diet composition have been studied less often than energy intake in subjects with varying levels of physical activity. The reported effects of exercise on food choices are not fully consistent, especially on the short term. Type of exercise, intensity, duration can affect the results as well as subjects' characteristics (gender, age, previous training and fitness). A crucial role could also be played by psychological (chronic dieting, attitudes toward health and food, long-established food habits and preferences) and social (traditions, food availability, appropriate times and places) factors. In short-term intervention studies, where a meal is ingested a few minutes following a bout of exercise of varying duration and intensity, an increase in CHO intake is most often reported, while increased protein intake is an occasional observation. In long-term (several weeks) training interventions, intake is assessed from dietary records. Again CHO intake is augmented in exercised subjects as compared to controls, while that of saturated fats and cholesterol may also be affected. Epidemiological studies (without dietary or exercise intervention) often report that habitually active persons eat more and ingest more fruits and vegetables than less active peers. It is not known to what extent such food choices are driven by biological needs (e.g. replacement of glycogen) or elicited by social and psychological factors.

A study of factors associated with weight change in women who attempt smoking cessation

This study investigated behavioral and attitudinal relationships over a 12-week time period in 48 women enrolled in a commercial smoking cessation program who were categorized as non-recidivists (NR), early recidivists (ER) and late recidivists (LR) to cigarette smoking. NR had significantly higher weight gains (F = 6.70), significantly higher levels of physical activity (F = 6.42), and significantly less concern of postsmoking cessation weight gain (F = 5.08) than either two groups of recidivists, (p less than or equal to .05). Other findings, although not significant, were that NR exhibited lower caloric intake and more frequent snacking behaviors than either ER or LR. These results indicate an overall stronger commitment to more positive health behaviors in the NR than those who returned to cigarette smoking.

Health and fitness at work: a participants' perspective

In the 1980s worksite health promotion or wellness programs have become more common in American corporations. Corporations see them as a way to control rising health care costs and to improve employee health. This paper examines participants' perspectives on participation in a health and fitness program, based on participant-observation and 35 in-depth interviews with members of one corporate program. Participants have a decided fitness-orientation (as opposed to a health-orientation), focusing on staying in shape and controlling weight. The consequences of this orientation for the promotion of health, the future of wellness programs, and the corporation are discussed.

Jogging in middle age

The risks and possible cardiovascular benefits of beginning a programme of jogging in middle age are critically reviewed. A lifelong habit of vigorous exercise results in lower incidence rates of ischaemic heart disease. There is, however, no direct evidence that the same is true when sedentary middle-aged people decide to begin exercise. Exercise can have a beneficial effect on the risk factors for ischaemic heart disease but whether this reduces the likelihood of death from ischaemic heart disease remains unproven. There are approximately 12 sudden deaths per 100 000 male joggers in the USA attributable to jogging annually, while almost a third of all joggers report a musculoskeletal injury in a 12-month period.

Comparison of dietary and smoking habit changes in physical fitness improvers and nonimprovers

Changes in dietary, smoking, and alcohol intake habits of men who voluntarily increased their physical fitness level (n = 532) were compared with men who did not increase physical fitness (n = 390). These men were middle-aged (average age = 43 years), initially sedentary and free of disease, and had been examined twice at a preventive medicine clinic within a 1- to 6-year period. Subjects were retrospectively assigned to two fitness groups--improvers and nonimprovers--based on changes in treadmill performance between baseline and follow-up examinations. Fifteen lifestyle variables were assessed by questionnaire and evaluated for change. At baseline the two groups were similar in demographic variables and diet, differing significantly only in follow-up interval (P less than 0.001), treadmill time (P less than 0.001), whole milk consumption (P less than 0.003), and smoking (P less than 0.001). At follow-up, positive changes in health habits were seen for both groups. Statistically significant differences in health habit change between the groups were seen only for beef (P less than 0.003) and coffee (P less than 0.003) consumption (consumption of both decreasing in more improvers than nonimprovers). Smokers at baseline were less likely to improve their physical fitness. We concluded that individuals who voluntarily increased their physical fitness level were not more likely to change their dietary and alcohol habits than persons who maintained a more sedentary lifestyle.