[Determinants of Exercise, Fulfilling the Recommendations for Aerobic Physical Activity and Health Status: Results of a Correlation Study in the Federal States of Austria]. / Bewegungsdeterminanten, Erfüllung der Empfehlungen für ausdauerorientierte Bewegung und Gesundheit: Ergebnisse einer Korrelationsstudie aus den österreichischen Bundesländern.

STUDY AIM: The aim of this study was to examine the association between the proportion of the population that fulfilled the endurance-based recommendations for health-enhancing physical activity and the proportion with correct knowledge of these recommendations, exercise-friendly culture and environment, and health status in the federal states of Austria. METHODS: The analysis is based on data from the Austrian Physical Activity Monitoring 2017, the Austrian Health Interview Survey 2014, the Austrian Mortality Register 2015, the database of Fit Sports Austria, the Austrian Chamber of Commerce, the Federal Ministry for Traffic, and an online platform for running events. Correlation coefficients (Pearson) for the various parameters and the proportion of the population that fulfilled the endurance-based recommendations for health-enhancing physical activity are presented. RESULTS: There is a significant correlation between endurance-based physical activity and the knowledge regarding the recommended extent of physical activity (0.91), the number of offers in sports clubs (0.87), the subjective accessibility of sports clubs (0.85), the accessibility of green spaces (0.84), the number of sports clubs with certified health-promoting programs (0.76), and the perceived possibilities to go running (0.72). In addition, endurance-based physical activity is significantly and negatively correlated with age-adjusted cardiovascular mortality (-0.96), total mortality (-0.95), the prevalence of obesity (-0.83), ischemic heart mortality (-0.76), and the prevalence of chronic diseases in total (-0.68), and is positively correlated with subjective health (0.79). CONCLUSIONS: The correlations show the significant associations between exercise behavior and health knowledge, the infrastructure for exercise, and culture. In addition, they show the significant correlation between exercise behavior and health status in the Austrian federal states. This information is important for tailored recommendations for the individual federal states.

[Austrian Physical Activity Guidelines for Adults and Older Adults with and without Physical, Sensory, or Mental Disabilities, as well as for Adults with Chronic Diseases]. / Österreichische Bewegungsempfehlungen für Erwachsene und ältere Erwachsene ohne und mit Körper-, Sinnes- oder Mentalbehinderung sowie für Menschen mit chronischen Erkrankungen.

There is sound scientific evidence that regular physical activity enhances physical, psychological, and mental health. Specific physical activity guidelines for target groups make an essential contribution to the promotion of physical activity behavior at a population level. In this article, we introduce the updated Austrian physical activity guidelines for adults and older adults with and without physical, sensory, or mental disabilities, as well as for adults with chronic diseases. We have also added comments to key elements of the guidelines. The scientific basis of the physical activity guidelines is the scientific report by the US advisory committee, as well as the 2nd edition of the physical activity guidelines for Americans. Guidelines for a new target group - adults with chronic health conditions - have been included. Furthermore, people with disabilities are now explicitly part of the (older) adult target groups. Instead of providing one cut-off point to separate people into meeting the guidelines/not meeting the guidelines, a range of 150 to 300 minutes per week is now recommended. Placing the guidelines for strength training above those for aerobic training emphasizes the importance of this type of training. In addition, it is now recommended that prolonged sitting is avoided by regularl interruptions. We believe that the publication of the physical activity guidelines for Austria will make an important contribution to the promotion of health through regular physical activity. However, the promotion of regular physical activity will only be successful if all target groups have a fair chance to reach physical activity competence, and attractive environments are created for regular physical activity.

Associations between daily physical activity, handgrip strength, muscle mass, physical performance and quality of life in prefrail and frail community-dwelling older adults.

PURPOSE: The aim of this study was to examine the associations between daily physical activity (DPA), handgrip strength, appendicular skeletal muscle mass (ASMM) and physical performance (balance, gait speed, chair stands) with quality of life in prefrail and frail community-dwelling older adults. METHODS: Prefrail and frail individuals were included, as determined by SHARE-FI. Quality of life (QoL) was measured with WHOQOL-BREF and WHOQOL-OLD, DPA with PASE, handgrip strength with a dynamometer, ASMM with bioelectrical impedance analysis and physical performance with the SPPB test. Linear regression models adjusted for sex and age were developed: In model 1, the associations between each independent variable and QoL were assessed separately; in model 2, all the independent variables were included simultaneously. RESULTS: Eighty-three participants with a mean age of 83 (SD: 8) years were analysed. Model 1: DPA (ß = 0.315), handgrip strength (ß = 0.292) and balance (ß = 0.178) were significantly associated with 'overall QoL'. Balance was related to the QoL domains of 'physical health' (ß = 0.371), 'psychological health' (ß = 0.236), 'environment' (ß = 0.253), 'autonomy' (ß = 0.276) and 'social participation' (ß = 0.518). Gait speed (ß = 0.381) and chair stands (ß = 0.282) were associated with 'social participation' only. ASMM was not related to QoL. Model 2: independent variables explained 'overall QoL' (R 2 = 0.309), 'physical health' (R 2 = 0.200), 'autonomy' (R 2 = 0.247) and 'social participation' (R 2 = 0.356), among which balance was the strongest indicator. CONCLUSION: ASMM did not play a role in the QoL context of the prefrail and frail older adults, whereas balance and DPA were relevant. These parameters were particularly associated with 'social participation' and 'autonomy'.

[Baseline- and health enhancing physical activity in adults with obesity]. / Alltagsaktivität und gesundheitswirksame körperliche Aktivität bei erwachsenen Menschen mit Adipositas.

Physical inactivity is one of the major risk factors for people to become overweight or obese. To achieve a substantial health benefit, adults should do at least 150 min of moderate or 75 min of high intensity aerobic activity per week and additionally they should do muscle strengthening exercises. This recommendation represents the lower limit and not the optimum. To loose body weight a significantly higher level of physical activity is required. Exercise programs can play an important part to reach the required level of health-enhancing physical activity. The Austrian pilot projects "Aktiv Bewegt" and "GEHE-Adipositas" showed that obese adults were interested in structured exercise programs and that they were also willing to use them. Clear defined quality criteria, the differentiation from conventional programs for already active and fit people and a recommendation from a doctor or other health professionals were important motivation reasons.

Health resorts as gateways for regional, standardised, sports club based exercise programmes to increase the weekly time of moderate- to vigorous-intensity physical activity: study protocol.

BACKGROUND: More than 10 % (approximately 60,000) of the adult population in Styria, a federal state in the south of Austria, is granted a residential stay in a health resort each year. The target group for these stays is the general population aged between 30 and 65 years with minor symptoms such as risk factors for cardio-metabolic diseases. Stays are financed by health insurance companies and last up to three weeks. The treatment during the stays consists of exercise and nutritional intervention as well as psychological support when needed. However, because of the absence of regional programmes linked with the residential stay, the sustainability of the interventions is questionable. METHODS/DESIGN: This prospective, controlled, multicentre, open-label study will compare two groups. Participants will be included in the study if they live in any of eight predefined Styrian regions and do not meet the minimal WHO physical activity guidelines. Those allocated to the intervention group will receive a voucher for 12 regional, standardised, sports club based exercise sessions. The members of the control group will come from different but matched Styrian regions and will receive an informative written brochure. The primary outcome will be the weekly level of health-enhancing physical activity, which will be objectively measured with an accelerometer and supplemented by an activity log book. Together with potential determinants of physical activity it will be assessed before, 10 weeks after and 12 months after the residential stay. Additionally, psychosocial determinants will be assessed by questionnaire and fitness (cardiorespiratory fitness, handgrip, balance) will be measured. In addition to the changes in measurable parameters, processes will be evaluated to learn about the facilitators and barriers of the implementation of the programme. DISCUSSION: It is known that during the residential stay, participants are receptive to new opportunities supporting health behaviour change, but that these measures are not sustained after discharge. The structured cooperation between the health sector that has to inform the participants and the sports sector that provides the wide network of standardised programmes is the strength of the study, but at the same time a challenge. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT02552134 ; date of registration: 15 September 2015).

Achievement of physical activity recommendation and activity levels in students of human medicine compared with the general Austrian population aged between 20 and 29 years.

Weekly 150 min of moderate to vigorous physical activity and muscle-strengthening activities are a major public health goal. The International Physical Activity Questionnaire-short form was applied in 467 students of the 4th year at the Medical University of Vienna and compared with subsamples of data from the Austrian Health Interview Survey, 795 subjects with and 1131 subjects without higher education aged 20-29 years. Median values for weekly total energy expenditure were 3083, 3048, and 3816 MET-minutes (P < 0.001) in medical students, higher and lower educated subjects of the general population. Energy expenditure with vigorous intensity was highest in medical students. A total of 39.4 % of medical students reached the minimum requirements of the national physical activity recommendations. Although medical students are taught those recommendation and are aware of their health benefits, only a minority reach them. If medical students engage in physical activity, they do it with higher intensity than the general population.

Health information regarding diabetes mellitus reduces misconceptions and underestimation of consequences in the general population.

OBJECTIVE: To evaluate self-assessed knowledge about diabetes mellitus, to assess determinants of health knowledge and to evaluate consequences of health knowledge on appraisal about consequences of the disease. DESIGN: Population-based computer-assisted web interview survey, supplemented with a paper-and-pencil survey via post. SETTING: Representative sample of the general Austrian population aged 15 years and older. SUBJECTS: Men (n 1935) and women (n 2065) with and without diabetes mellitus. RESULTS: Some 20.5% of men and 17.7% of women with diabetes, and 46.2% of men and 36.7% of women without diabetes, rated their knowledge about diabetes mellitus to be 'very bad' or 'rather bad'. Individuals with diabetes and individuals with a family member with diabetes rated their information level more often as 'very good' or 'rather good', with adjusted OR (95% CI) of 1.7 (1.1, 2.8) and 2.1 (1.6, 2.7), respectively, in men and 2.7 (1.5, 4.8) and 2.7 (2.1, 3.5), respectively, in women. Additional significant influencing factors on diabetes knowledge were age and educational level in both sexes, and city size in men. Independent of personal diabetes status, diabetes knowledge was associated with a lower perception of restrictions on daily life of diabetes patients and with a lower probability of underestimating health consequences of diabetes. CONCLUSIONS: Health knowledge is associated with fewer misconceptions and less underestimation of health consequences in individuals both with and without diabetes mellitus. Thus health information about diabetes is important on the individual level towards disease management as well as on the public health level towards disease prevention.

Nutritional intervention and physical training in malnourished frail community-dwelling elderly persons carried out by trained lay "buddies": study protocol of a randomized controlled trial.

BACKGROUND: In elderly persons frailty and malnutrition are very common and can lead to serious health hazards such as increased mortality, morbidity, dependency, institutionalization and a reduced quality of life. In Austria, the prevalence of frailty and malnutrition are increasing steadily and are becoming a challenge for our social system. Physical training and adequate nutrition may improve this situation. METHODS/DESIGN: In this randomized controlled trial, 80 malnourished frail community-dwelling patients (≥ 65 years) hospitalized at wards for internal medicine are recruited. Additionally, 80 lay volunteers (≥ 50 years), named buddies are recruited and subsequently trained regarding health enhancing physical activity and nutrition in four standardized training sessions. These buddies visit the malnourished frail persons at home twice a week for about one hour during an initial period of 10-12 weeks. While participants allocated to the intervention group (n = 40) receive intervention to improve their fluid intake, protein and energy intake, perform strength training and try to increase their baseline activities, the control group (n = 40) only gets home visits without any intervention. After 10-12 weeks, both, the intervention and the control group, receive the nutritional intervention and the physical training. Health, nutritional and frailty status, physical fitness, body composition and chronic inflammation of buddies and frail persons are recorded before the intervention, after 10-12 weeks, 6 and 12 months. DISCUSSION: To your knowledge this trial is the first of its kind to provide nutritional and physical activity interventions to malnourished frail community-dwelling persons by trained lay buddies, in which an improvement of the frail persons' and the buddies' health status is measured. This study assesses the efficacy of such an intervention and may offer new perspectives for the management of frailty and malnutrition. TRIAL REGISTRATION: [corrected] ClinicalTrials.gov, NCT01991639.

[Lifestyle: physical activity and training as prevention and therapy of type 2 diabetes mellitus (Update 2023)]. / Lebensstil: körperliche Aktivität und Training in der Prävention und Therapie des Typ 2 Diabetes mellitus (Update 2023).

Lifestyle, in general and particularly regular physical activity, is known to be an important component in the prevention and therapy of type 2 diabetes.To gain substantial health benefits, a minimum of 150 min of moderate or vigorous intense aerobic physical activity and muscle strengthening activities per week should be performed. Additionally, inactivity should be recognized as health hazard and prolonged episodes of sitting should be avoided.Especially exercise is not only efficient in improving glycaemia by lowering insulin resistance and enhance insulin secretion, but to reduce cardiovascular risk. The positive effect of training correlates directly with the amount of fitness gained and lasts only as long as the fitness level is sustained. Exercise training is effective in all age groups and for all genders. It is reversible and reproducible.Standardized, regional and supervised exercise classes are well known to be attractive for adults to reach a sufficient level of health enhancing physical activity. Additionally, based on the large evidence of exercise referral and prescription, the Austrian Diabetes Associations aims to implement the position of a "physical activity adviser" in multi-professional diabetes care. Unfortunately, the implementation of booth-local exercise classes and advisers is missing so far.

Lifestyle Parameters in Patients with Diabetes Mellitus and in the General Adult Population-Trends over Five Years: Results of the Austrian National Health Interview Series.

BACKGROUND: Not smoking, performing >150 min of aerobic physical activity (PA) and muscle strengthening exercises/week, and consuming >5 portions of fruit and vegetables/day are lifestyle recommendations for both the general population and people with diabetes mellitus (DM). METHODS: A total of 15,771 and 15,461 persons from the Austrian Health Interview Surveys 2014 and 2019, respectively, including 4.9% and 6.0% of people with DM, were analysed in terms of their smoking, PA, and nutritional behaviours. Logistic regression models were performed for the lifestyle factors, adjusted for socio-demographic and health-related factors. Adjusted interactions between the survey year and DM on the lifestyle factors were computed. RESULTS: The proportions of smokers were 23.9% and 20.2%, of people complying with the PA recommendations were 24.9% and 21.4%, and with fruit and vegetables recommendations were 7.1% and 5.5%, respectively, with significantly lower proportions of smokers and persons complying with the PA recommendations among people with DM. The fully adjusted odds ratios (95% confidence interval) for people with DM were 1.09 (0.94-1.26), 1.44 (1.23-1.69), and 0.90 (0.71-1.13) for smoking, not complying with PA recommendations, and not complying with fruit and vegetables recommendations, respectively. The proportion of people complying with PA recommendations decreased to a greater extent (p < 0.001) in people with DM (16.5% to 8.3%) compared to people without DM (25.3% to 22.3%). CONCLUSION: Diabetogenic lifestyle behaviours increased in the general Austrian population in recent years, which was especially true for people with DM regarding PA.

The Influence of Occupational Categories on Overall and Domain-Specific Physical Activity and the Association with Chronic Diseases. An Analysis Using the Austrian Health Interview Survey.

Background: The performance of physical activity (PA) in different domains varies between different occupational groups and they contribute differently to the prevention and management of chronic diseases. This study aimed to give a fuller picture of the potential influence occupational categories have on the different domains of PA among the Austrian population of working age. Methods: A total of 8251 gainfully employed persons in 9 major and 39 sub-major occupational groups from the Austrian Health Interview Survey 2014 were analyzed. PA was measured with the Physical Activity Questionnaire of the European Health Interview Survey (EHIS-PAQ) and the prevalence of 17 chronic diseases was obtained. Results: A total of 48.2% were mostly active when working, 18.4% reported transport-related PA in the upper quintile, 50.4% performed at least 150 min per week of moderate PA or cycling, 32.7% performed muscle-strengthening PA at least twice a week, and 76.3% were either mostly physically active when working or complied with the aerobic PA guidelines. As a general rule, people in physically active occupational groups tended to perform less PA in their leisure time and vice versa. Occupational groups with especially low amount of PA were Information Technology workers, directors, and secretarial staff. People with a chronic disease tended to perform less PA, but there was an interaction between occupation and chronic disease on PA. Conclusions: Domain-specific programs to promote PA should be developed for various occupational categories.

Adherence Is More Than Just Being Present: Example of a Lay-Led Home-Based Programme with Physical Exercise, Nutritional Improvement and Social Support, in Prefrail and Frail Community-Dwelling Older Adults.

BACKGROUND: Little is known about the implementation of lifestyle interventions in frail, community-dwelling people. This study highlights different domains of adherence to explain an effectively delivered home-based intervention. METHODS: Eighty prefrail and frail persons (≥65 years) participated in a physical training, nutritional, and social support intervention over 24 weeks. A detailed log book was kept for comprehensive documentation in order to assess adherence and further organizational, exercise, and nutritional parameters. RESULTS: Participants reached an adherence rate (performed home visits/number of planned visits) of 84.0/80.5% from week 1-12/13-24. Out of those, 59% carried out ≥75% of the offered visits. Older age was associated with a higher adherence rate. A mean of 1.5 (0.6) visits/week (2 were planned) were realized lasting for a mean of 1.5 (0.9) hours (154% of the planned duration). Per visit, 1.2 (0.6) circuits of strength training were performed (60.5% of the planned value) and 0.5 (0.3) nutritional interventions (47%). After twelve months, 4.2% still carried out the home visits regularly and 25.0% occasionally. CONCLUSION: Adherence is much more than "being there". Adherence rate and category are limited parameters to describe the implementation of a complex lifestyle intervention, therefore a comprehensive documentation is needed.

Physical Activity as Part of an Intramural Health Promotion Programme for People with and without Chronic Diseases. A New Tool in Health Care Run by a Public Social Health Insurance.

BACKGROUND: Regular physical activity is a corner stone for healthy living, and preventing the onset or progression of diseases. The Social Insurance Fund for Public Service, Railway and Mining Industries is building an intramural health promotion facility in Austria with the aim to provide a comprehensive evidence-based health promotion programme for their insured. The target group are all people who, regardless of their health status and the presence of diseases, are ready to make their lifestyle more health-oriented. The health promotion facility offers health promotion measures in five areas: promoting physical training, optimizing nutritional patterns, managing everyday stress, increasing social capital, and improving health literacy. The focus is on increasing resources and on overcoming barriers. Depending on age, previous illnesses, range of motion, stress level, body weight and personal aims and expectations, the measures are individually tailored. The stay is divided into a two-week initial stay and a follow-up week. A comprehensive scientific evaluation concept of all measures and the entire stay is an integral part of the design. CONCLUSION: This project combines the advantages of comprehensive active health promotion, and an intramural stay. It is a pioneering social insurance project for sustainable health promotion and integrated care.

[Lifestyle: physical activity and training as prevetion and therapy of type 2 diabetes mellitus (Update 2019)]. / Lebensstil: körperliche Aktivität und Training in der Prävention und Therapie des Typ 2 Diabetes mellitus (Update 2019).

Lifestyle in general and particularly health enhancing physical activity is known to be an important component in the prevention and therapy of type 2 diabetes mellitus.To gain substantial health benefits a minimum of 150 min of moderate or vigorous intense aerobic physical activity and muscle strengthening activities per week are needed. Additionally, inactivity should be recognised as health hazard and prolonged episodes of sitting should be avoided.Exercise in particular is not only useful in improving glycaemia by lowering insulin resistance and positively affect insulin secretion, but to reduce cardiovascular risk. The positive effect of training correlates directly with the amount of fitness gained and lasts only as long as the fitness level is sustained. The effect of exercise is independent of age and gender. It is reversible and reproducible.Supervised exercise classes are well known to be attractive for adults to reach a sufficient level of health enhancing physical activity. The potential of regional, standardised exercise programmes could have been shown, although existing barriers to entry must be reduced. To tackle this public health challenge and based on the large evidence of exercise referral and prescription the Austrian Diabetes Associations aims to implement the position of a "physical activity adviser" in multi-professional diabetes care.

Association between physical activity and the utilization of general practitioners in different age groups.

BACKGROUND: Physical activity (PA) is an important tool in health promotion, prevention, curation, and rehabilitation and should be part of general practitioners (GP) consultations. For tailoring GP's service it is important to know the PA habits of the clients. METHODS: Data from the Austrian Health Interview Survey 2014 with 15,770 subjects were analyzed. The association between PA, measured with the Physical Activity Questionnaire of the European Health Intervies Survey (EHIS-PAQ) and having visited a GP within the last 4 weeks was examined in different age groups (15-29, 30-64, and 65+ years). In multivariate analyses we adjusted for sociodemographic and health-related variables (body mass index, 17 chronic diseases, and the use of medication). RESULTS: In subjects aged 15-29 years and 30-64 years fulfilling aerobic PA recommendations was significantly associated with a lower chance of having consulted the GP with unadjusted OR (95% CI) 0.82 (0.70-0.96) and 0.90 (0.82-0.99), respectively, whereas work-related PA was associated with a higher chance, with OR 1.21 (1.03-1.42) and 1.10 (1.00-1.20), respectively. Adjusting for sociodemographic and health-related factors led to loss of significance. In subjects aged 30-64 years, muscle strengthening PA was associated with a higher chance for GP consultation with OR 1.12 (1.00-1.24) in the fully adjusted model. In subjects aged 65+ years, PA was associated with a lower chance of having visited the GP with OR 0.74 (0.64-0.86) and 0.83 (0.71-0.97) for work related PA and total PA, respectively, in the fully adjusted model. CONCLUSION: The association of PA and GP consultation is dependent on age and type of PA, and partly mediated by sociodemographic and health-related factors.

Behavior changes by a buddy-style intervention including physical training, and nutritional and social support.

AIM: Previous research suggests that multicomponent interventions including physical training, and nutritional and social support are required to improve a person's behavior. As a pre-specified secondary outcome, this analysis aimed to ascertain whether a "buddy-style" intervention could produce physical activity and nutritional behavior changes in older adults. METHODS: A 12-week, home-based, randomized controlled trial was carried out with 80 older persons, who were randomly assigned to an intervention group (n = 39), including physical training and nutritional support, and a control group (n = 41). Trained non-professional volunteers visited the participants at home twice a week. Physical activity and nutritional behavior were assessed through validated questionnaires. RESULTS: In total, 36 participants in the intervention group and 26 participants in the control group completed the final questionnaire. The intervention group showed significant improvements in physical activity behavior, such as light sport activity (ß = 9.13, 95% CI 0.90-17.37 min/day; P = 0.030), muscle strength exercise (ß = 68.18, 95% CI 46.45-89.91 min/week; P < 0.001) and overall activities (ß = 0.69, 95% CI 0.21-1.18 h/day; P = 0.006), compared with the control group. Nutritional behavior improvements for the intervention group were observed in the consumption of legumes/nuts (ß = 0.18, 95% CI 0.00-0.35 portions/day; P = 0.047) and fluids (ß = 0.48, 95% CI 0.01-0.98 portions/day; P = 0.050), relative to controls. CONCLUSIONS: A "buddy-style" program in older adults living at home can produce effective physical activity changes and, to a lesser extent, changes in dietary behavior, and has the potential to be efficient and feasible. Geriatr Gerontol Int 2019; 19: 323-329.

Short-and Long-Term Effectiveness of a Physical Activity Intervention with Coordinated Action between the Health Care Sector and Local Sports Clubs. A Pragmatic Trial in Austrian Adults.

(1) Background: Collaboration between the health care sector and the sports sector to increase physical activity (PA) behaviour among inactive adults is still rare. The objective of the study was to evaluate the short- and long-term effectiveness of a mixed PA intervention on the PA behaviour in an adult population. (2) Methods: In a quasi-experimental study with two follow-up measurements (four and 12 months), adults were contacted by post before their stay in a health resort. During the health resort stay, the intervention group (IG) received PA counselling and a coupon for 12 standardised free-of-charge sessions in a sports club. The participants in the comparator group (CG) received PA counselling and written material. PA was measured with an accelerometer (GENEActive). Linear mixed-effects models were applied to examine the change in PA behaviour, both within and between groups in moderate- to vigorous-intensity PA over time. (3) Results: We obtained at least one follow-up measurement from 217 participants (IG = 167, CG = 50), who were 50% female, with an average age of 53 (±6) years. PA significantly increased from the baseline to the four-month measurement by 58 min./wk (95% CI 36, 80) and to the 12-month measurement by 24 min./wk (95% CI 2, 46) within the IG. No change in PA occurred in the CG. We also found a short-term between-group (IG vs. CG) difference in change over time, but not a long-term difference. (4) Conclusions: The study confirms that a collaboration between the health care sector and local sports clubs is a feasible method of recruiting people into a standardised PA programme and to increase their PA over the long term.

Nutritional Lifestyle Intervention in Obese Pregnant Women, Including Lower Carbohydrate Intake, Is Associated With Increased Maternal Free Fatty Acids, 3-ß-Hydroxybutyrate, and Fasting Glucose Concentrations: A Secondary Factorial Analysis of the European Multicenter, Randomized Controlled DALI Lifestyle Intervention Trial.

OBJECTIVE: In our randomized controlled trial, we investigated the impact of healthy eating (HE) aiming for restricted gestational weight gain (GWG) and physical activity (PA) interventions on maternal and neonatal lipid metabolism. RESEARCH DESIGN AND METHODS: Obese pregnant women (n = 436) were included before 20 weeks' gestation and underwent glucose testing (oral glucose tolerance test) and lipid profiling at baseline and 24-28 and 35-37 gestational weeks after an at least 10-h overnight fast. This secondary analysis had a factorial design with comparison of HE (n = 221) versus no HE (n = 215) and PA (n = 218) versus no PA (n = 218). Maternal changes in triglycerides (TG), LDL cholesterol, HDL cholesterol, free fatty acids (FFAs), and leptin from baseline to end of pregnancy and neonatal outcomes were analyzed using general linear models with adjustment for relevant parameters. RESULTS: At 24-28 weeks' gestation, FFAs (mean ± SD, 0.60 ± 0.19 vs. 0.55 ± 0.17 mmol/L, P < 0.01) were increased after adjustment for FFA at baseline, maternal age, BMI at time of examination, gestational week, insulin resistance, self-reported food intake, self-reported physical activity, and maternal smoking, and GWG was lower (3.3 ± 2.6 vs. 4.3 ± 2.8 kg, P < 0.001, adjusted mean differences -1.0 [95% CI -1.5; -0.5]) in HE versus no HE. Fasting glucose levels (4.7 ± 0.4 vs. 4.6 ± 0.4 mmol/L, P < 0.05) and 3-ß-hydroxybutyrate (3BHB) (0.082 ± 0.065 vs. 0.068 ± 0.067 mmol/L, P < 0.05) were higher in HE. Significant negative associations between carbohydrate intake and FFA, 3BHB, and fasting glucose at 24-28 weeks' gestation were observed. No differences between groups were found in oral glucose tolerance test or leptin or TG levels at any time. Furthermore, in PA versus no PA, no similar changes were found. In cord blood, elevated FFA levels were found in HE after full adjustment (0.34 ± 0.22 vs. 0.29 ± 0.16 mmol/L, P = 0.01). CONCLUSIONS: HE intervention was associated with reduced GWG, higher FFAs, higher 3BHB, and higher fasting glucose at 24-28 weeks of gestation, suggesting induction of lipolysis. Increased FFA was negatively associated with carbohydrate intake and was also observed in cord blood. These findings support the hypothesis that maternal antenatal dietary restriction including carbohydrates is associated with increased FFA mobilization.

Changes in health parameters in older lay volunteers who delivered a lifestyle-based program to frail older people at home.

OBJECTIVE: To measure health effects in lay volunteers who made home visits consisting of social interaction, nutritional and physical exercise interventions to pre-frail and frail older people (trial registration ClinicalTrials.gov, NCT01991639). METHODS: After baseline, participants were followed-up at 12 (V1) and 24 (V2) weeks. A one-repetition maximum (1-RPM) and handgrip were measured with the Concept2®DYNO and a dynamometer. The Physical Activity Scale for the Elderly was used to assess physical activity, and Food Frequency Questionnaire and the Mediterranean Diet Adherence Screener for nutrition. Additionally, quality of life (QoL) was measured with the World Health Organization (WHO) quality of life brief questionnaire and anthropometric measurements were performed using bioelectrical impedance analysis. RESULTS: Handgrip values significantly increased from 32.14 ±â€¯7.94 kg to 33.69 ±â€¯6.72 kg at V1 and 34.36 ±â€¯6.96 kg at V2. The 1­RPM on the leg press showed a significant increase from 72.47 ±â€¯25.37 kg to 78.12 ±â€¯23.77 kg and 80.85 ±â€¯27.99 kg, respectively. We observed a significant decrease of protein intake from 0.38 ±â€¯0.26 g/kgBW/day to 0.32 ±â€¯0.19 g/kgBW/day and 0.26 ±â€¯0.16 g/kgBW/day, respectively. There were no changes in physical activity, QoL and anthropometric measurements. CONCLUSION: The findings indicate that projects involving aging healthy volunteers may have additional limited health benefits.

How Does Counselling in a Stationary Health Care Setting Affect the Attendance in a Standardised Sports Club Programme? Process Evaluation of a Quasi-Experimental Study.

Actions in partnership across sectors is one principle for the promotion of health behaviours. The objective of this study was to describe the participation in a sports club-based exercise programme-named JACKPOT-following an intervention in a health care setting. Focus was given to the recruitment into JACKPOT, the attendance level, and whether the different programme elements were implemented as intented. The practicability of the project was also retrospectively rated. Participants were 238 inactive people (50% women) between 30 and 65 years of age who attended a health resort. Of these, 77% were assigned to the intervention group (IG). The recruitment into the 12 JACKPOT sessions and the attendance levels were recorded via attendance lists. The implementation of the intervention standards was assessed with structured interviews and participatory observation. The Pragmatic Explanatory Continuum Indicator Summary (PRECIS)-2 tool served to rate the practicability of the project. Almost 50% of the IG subjects attended JACKPOT sessions at least once and 54% of the attenders visited ≥75% of the 12 sessions. Some of the programme elements were not delivered fully. The process evaluation results showed that the project worked in a real-world setting, and also uncovered potential reasons such as incomplete information delivery for the moderate recruitment and attendance level.