Positive and negative psychosocial factors related to healthy and unhealthy weight control among nursing students.

BACKGROUND: Although nursing students are educated on the importance of exercising regularly and maintaining a well-balanced diet, many do not practice healthy weight management behaviors, and some even use unhealthy weight loss methods. Yet, little research has examined both positive and negative psychosocial variables related to weight control among nursing students. PURPOSE: The present study aimed to identify the most salient psychosocial variables related to healthy and unhealthy weight control among nursing students. METHOD: Using survey data from 241 nursing students, structural equation modeling was conducted to examine the relative contributions of eight interrelated psychosocial variables, including constructs from a strengths perspective (health-specific hope, health self-efficacy, social support, and body satisfaction) and from a deficit perspective (depression, anxiety, weight perception, and barriers to physical activity). RESULTS: Results showed that the degree to which individuals perceive themselves to be overweight was related to both healthy and unhealthy weight control. Aside from weight perception, health self-efficacy produced the strongest association with healthy weight control, and anxiety produced the strongest association with unhealthy weight control. The structural model explained 23 % of the variance in healthy weight control and 29 % of the variance in unhealthy weight control. CONCLUSIONS: These findings emphasize the need for tailored, integrated weight management interventions for nursing students that equip them with effective anxiety management skills and build self-efficacy.

Undergraduate versus graduate nursing students: Differences in nutrition, physical activity, and self-reported body mass index.

ObjectiveThis study compared self-reported nutrition, physical activity, and body mass index (BMI) in undergraduate versus graduate nursing students.ParticipantsRespondents included 233 undergraduate and 230 graduate nursing students in a Southeastern public university.MethodsThe study was an exploratory, descriptive, cross-sectional comparison administered via online questionnaire including self-reported demographics, nutritional intake, physical activity, and BMI.ResultsUndergraduates reported exercising more than graduate students. Graduate students reported consuming significantly more vegetables than undergraduates; however, more graduate students self-reported BMIs in overweight and obese categories than undergraduates.ConclusionsFindings provide a foundational understanding that interventions or educational programs to improve self-care behaviors of nursing students should be tailored depending on the educational level of the students. Educators must establish self-care skills within nursing students at all levels to help them preserve their health in the fast-paced, strenuous, and stressful work of all echelons of nursing upon completion of the educational program.

A practical approach to obesity prevention: Healthy home habits.

ABSTRACT: Families have the potential to foster a healthy home environment aimed at reducing the risk of overweight and obesity. Establishing habits associated with reduced risk of obesity and overweight early in childhood can have lasting effects into adulthood. Nurse practitioners can encourage families to participate in healthy habits by addressing areas of growth for obesity prevention within the home. A review of the most recent literature, approximately over the past decade, was used to provide a consolidated source of reference for healthy home habits for the nurse practitioner. The search included terms such as "obesity," "overweight," "healthy habits," "physical activity," "obesogenic behaviors," "family meals," "screen time," "depression," "sugary beverages," and "portion sizes." The information was synthesized into three content areas: nutrition and consumption, patterns of activity, and stress within the home. Establishing healthy habits early in life can protect against the development of overweight and obesity. Nurse practitioners can serve a vital role in the prevention of pediatric, adolescent, and adult obesity. Equipped with the unique role of assisting those from a diverse patient base, nurse practitioners can inform patients how to improve healthy habits to decrease the likelihood of obesity or overweight. Encouraging behavior change related to the healthy habits associated with the prevention of overweight and obesity can have a long-term impact on the health of an entire family.

An NP's guide to current physical activity recommendations.

Physical inactivity is a public health crisis that contributes to many of the chronic diseases that affect Americans. This review emphasizes the beneficial health implications of physical activity along with the dangers of sedentary lifestyles. It also provides advice tailored to NPs to help their patients become more physically active.

Acute (-)-Epicatechin Consumption: Effects on Local Vasodilation Following Resistance Exercise and High-Intensity Exercise Performance.

(-)-Epicatechin is a polyphenol previously shown to enhance vascular health. The purposes of the current studies were to determine the effect of acute (-)-epicatechin supplementation on local vasodilation in conjunction with resistance exercise (study 1) and on high-intensity exercise performance (study 2). For study 1, 11 men participated in two resistance exercise sessions, where they performed three sets of barbell curls while consuming 200 mg of 98% pure (-)-epicatechin or placebo. Measurements of total serum nitrate/nitrite and brachial artery diameter were acquired at baseline (pre-supplement), 90 min after supplement consumption (post-supplement), immediately post-exercise (post-exercise), and 30 min post-exercise (30 min post-exercise). For serum nitric oxide metabolites, no significant interaction between supplement and time nor significant main effect of time was observed (p = 0.38 and p = 0.20; respectively). For brachial artery diameter, no significant interaction between supplement and time was observed (p = 0.24). A significant main effect of time was observed for brachial artery diameter (p < 0.01) with post-exercise brachial artery diameter significantly greater diameter than all other time points (all p < 0.01). For study 2, six women and five men completed the 15.5 CrossFit® Open Workout three times. A familiarization session was performed first where the workout was performed without the consumption of a supplement. In a randomized, balanced fashion, 100 mg of 98% pure (-)-epicatechin or cellulose (placebo) was consumed two times per day for two days before testing sessions two and three. On the day of testing sessions two and three, 60 to 90 min before completing the workout, 200 mg of the assigned supplement was ingested with water. No significant difference was observed for time to complete the workout between testing sessions (p = 0.49). In conclusion, under the conditions of the current studies, acute (-)-epicatechin supplementation did not augment vasodilation in combination with resistance exercise, nor did it increase exercise performance in humans.

Characteristics of and Factors Influencing College Nursing Students' Willingness to Utilize mHealth for Health Promotion.

More than half of practicing nurses have suboptimal physical or mental health. Impaired health is associated with a 76% higher likelihood that nurses will make medical errors. Improving the health habits of nursing students is essential to shaping and sustaining health prior to joining the workforce. Technology such as mobile health applications holds great promise in facilitating behavioral change and encouraging healthy habits in nursing students. Identifying the predictors of willingness to use mobile health is essential to creating mobile health applications that will engage nursing students and promote sustainable usage. Evaluation of psychological, attitudinal, and health-related correlates of mobile health can highlight predictors of willingness to use mobile health, which can influence nursing students' utilization and long-term engagement with mobile health applications. Analysis of these correlates shows that psychological attributes, such as hope, play a role in the willingness to use and may facilitate engagement in the utilization of a mobile health application. Development of a mobile health application that increases hope and helps establish healthy habits may enable nursing students to remain healthy throughout their lives, creating a new generation of happier, healthier nurses and, ultimately, improving safety for patients under their care.

The Development of a BMI-Guided Shape Morphing Technique and the Effects of an Individualized Figure Rating Scale on Self-Perception of Body Size.

The creation of personalized avatars that may be morphed to simulate realistic changes in body size is useful when studying self-perception of body size. One drawback is that these methods are resource intensive compared to rating scales that rely upon generalized drawings. Little is known about how body perception ratings compare across different methods, particularly across differing levels of personalized detail in visualizations. This knowledge is essential to inform future decisions about the appropriate tradeoff between personalized realism and resource availability. The current study aimed to determine the impact of varying degrees of personalized realism on self-perception of body size. We explored this topic in young adult women, using a generalized line drawing scale, as well as several types of personalized avatars, including 3D textured images presented in immersive virtual reality (VR). Body perception ratings using generalized line drawings were often higher than responses using individualized visualization methods. While the personalized details seemed to help with identification, there were few differences among the three conditions containing different amounts of individualized realism (e.g., photo-realistic texture). These results suggest that using scales based on personalized texture and limb dimensions are beneficial, although presentation in immersive VR may not be essential.

Six weeks of oral Echinacea purpurea supplementation does not enhance the production of serum erythropoietin or erythropoietic status in recreationally active males with above-average aerobic fitness.

The purpose of this study was to investigate the effect of 6 weeks of oral Echinacea purpurea supplementation on serum erythropoietin (EPO) and erythropoietic status. Twenty-four males (mean ± SE; age = 25.2 ± 1.4 years, height = 178.1 ± 1.4 cm, body mass = 78.1 ± 1.6 kg, body fat = 12.7 ± 0.9%, maximal oxygen uptake = 52.9 ± 0.9 mL·kg-1·min-1) were randomly grouped using a matched-pair, double-blind design and self-administered 8000 mg·day-1 of either E. purpurea (n = 12) or placebo (n = 12) for 42 consecutive days. Blood samples were collected prior to supplementation (day 0) and every 2 weeks during the supplementation period (days 14, 28, and 42) and were analyzed for EPO, red blood cell count, hemoglobin concentration, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin concentration. Separate 2 × 4 (group × time) factorial ANOVA with repeated measures on time were used to determine statistical differences with significance set at p ≤ 0.05. There were no significant interaction, group, or time effects observed for EPO or erythropoietic status markers for any of the measurement points (p ≤ 0.05). The present study indicated that 6 weeks of oral E. purpurea supplementation in recreationally active males with above average aerobic fitness did not enhance EPO or erythropoietic status. These findings are in contrast with previous reports of E. purpurea supplementation in untrained participants with average fitness levels, but consistent with observations in trained endurance athletes.

Creatine supplementation post-exercise does not enhance training-induced adaptations in middle to older aged males.

PURPOSE: The present study evaluated the effects of creatine monohydrate (CrM) consumption post-exercise on body composition and muscle strength in middle to older males following a 12-week resistance training program. METHODS: In a double-blind, randomized trial, 20 males aged between 55 and 70 years were randomly assigned to consume either CrM-carbohydrate (CHO) [20 g days(-1) CrM + 5 g days(-1) CHO × 7 days, then 0.1 g kg(-1) CrM + 5 g CHO on training days (average dosage of ~8.8 g)] or placebo CHO (20 g days(-1) CHO × 7 days, then 5 g CHO on training days) while participating in a high intensity resistance training program [3 sets × 10 repetitions at 75% of 1 repetition maximum (1RM)], 3 days weeks(-1) for 12 weeks. Following the initial 7-day "loading" phase, participants were instructed to ingest their supplement within 60 min post-exercise. Body composition and muscle strength measurements, blood collection and vastus lateralis muscle biopsy were completed at 0, 4, 8 and 12 weeks of the supplement and resistance training program. RESULTS: A significant time effect was observed for 1RM bench press (p = 0.016), leg press (p = 0.012), body mass (p = 0.03), fat-free mass (p = 0.005) and total myofibrillar protein (p = 0.005). A trend for larger muscle fiber cross-sectional area in the type II fibers compared to type I fibers was observed following the 12-week resistance training (p = 0.08). No supplement interaction effects were observed. CONCLUSION: Post-exercise ingestion of creatine monohydrate does not provide greater enhancement of body composition and muscle strength compared to resistance training alone in middle to older males.

Sodium bicarbonate supplementation improves hypertrophy-type resistance exercise performance.

The aim of the present study was to examine the effects of sodium bicarbonate (NaHCO(3)) administration on lower-body, hypertrophy-type resistance exercise (HRE). Using a double-blind randomized counterbalanced design, 12 resistance-trained male participants (mean ± SD; age = 20.3 ± 2 years, mass = 88.3 ± 13.2 kg, height = 1.80 ± 0.07 m) ingested 0.3 g kg(-1) of NaHCO(3) or placebo 60 min before initiation of an HRE regimen. The protocol employed multiple exercises: squat, leg press, and knee extension, utilizing four sets each, with 10-12 repetition-maximum loads and short rest periods between sets. Exercise performance was determined by total repetitions generated during each exercise, total accumulated repetitions, and a performance test involving a fifth set of knee extensions to failure. Arterialized capillary blood was collected via fingertip puncture at four time points and analyzed for pH, [HCO(3)(-)], base excess (BE), and lactate [Lac(-)]. NaHCO(3) supplementation induced a significant alkaline state (pH: NaHCO(3): 7.49 ± 0.02, placebo: 7.42 ± 0.02, P < 0.05; [HCO(3)(-)]: NaHCO(3): 31.50 ± 2.59, placebo: 25.38 ± 1.78 mEq L(-1), P < 0.05; BE: NaHCO(3): 7.92 ± 2.57, placebo: 1.08 ± 2.11 mEq L(-1), P < 0.05). NaHCO(3) administration resulted in significantly more total repetitions than placebo (NaHCO(3): 139.8 ± 13.2, placebo: 134.4 ± 13.5), as well as significantly greater blood [Lac(-)] after the exercise protocol (NaHCO(3): 17.92 ± 2.08, placebo: 15.55 ± 2.50 mM, P < 0.05). These findings demonstrate ergogenic efficacy for NaHCO(3) during HRE and warrant further investigation into chronic training applications.

Prevalence and trends in overweight and obesity among Mississippi public school students, 2005-2011.

This study estimated the prevalence of overweight and obesity in Mississippi public school students in grades K - 12 and assessed changes in the prevalence between 2005 and 2011. In 2011, Body Mass Index was calculated using measured height and weight data for a weighted representative sample of 4,235 public school students. Additional analyses compared 2011 prevalence estimates by gender, race, and grade levels and for changes between 2005 and 2011. The prevalence of overweight and obesity among public school students no longer appears to be increasing although a significant downward trend was not observed (p = 0.0845), and rates remain higher than national averages. In 2011, the combined prevalence of overweight and obesity for all students in grades K - 12 was 40.9% as compared to 42.4% in 2009, 42.1% in 2007 and 43.9% in 2005. Significant decreases in overweight and obesity were found among white students and elementary school student groups from 2005 to 2011. White students' combined rates fell from 40.6% in 2005 to 34.8% in 2011 (p = 0.0006). Similarly, combined rates in elementary school students dropped from 43.0% in 2005 to 37.3% in 2011 (p = 0.0045). In 2011, the prevalence of overweight and obesity was significantly lower among white students than black students (p < 0.001) and significantly lower among white female students than black female students at all three grade levels. These findings are discussed in light of recent statewide educational initiatives and health disparities. Implications for future practice, policy, and research are presented.

Obesity and Overweight Prevalence among a Mississippi Low-Income Preschool Population: A Five-Year Comparison.

Purpose. This study determined 2010 rates of overweight/obesity in a representative sample of low-income preschoolers in Mississippi, USA and compared rates between 2005 (N = 1250) and 2010 (N = 1765). Significance. Obesity is a significant global health issue because of its well-established negative health consequences. Child obesity is a concern due to risk of early-onset obesity-related illnesses and the longevity of lifetime exposure to those illnesses. Methods. Identical measures were used in 2005 and 2010 with complex-stratified sampling designs. Results. Chi-square tests revealed that overall obesity/overweight rates between 2005 (20.6%/17.9%) and 2010 (20.8%/17.0%) had not changed significantly for the samples as a whole, nor by gender or race. Age group comparisons indicated a significant decline in obesity rates of 3 year olds (20.3% in 2005, reduced to 13.1% in 2010, P = 0.035). These findings mimic the trend toward stabilization of obesity rates noted in national low-income preschool populations.

Differential gene expression of FoxO1, ID1, and ID3 between young and older men and associations with muscle mass and function.

BACKGROUND AND AIMS: Aging is associated with significant losses of skeletal muscle mass and function. Numerous biochemical molecules have been implicated in the development of these age-related changes, however evidence from human models is sparse. Assessment of transcript expression is useful as it requires minimal tissue and may potentially be used in clinical trials. This study aimed to compare mRNA expression of proteolytic genes in skeletal muscle of young (18-35 yrs) and older (55-75 yrs) men. METHODS: Muscle tissue was obtained from young (n=14, 21.35±1.03 yrs) and older (n=13, 63.85±1.83 yrs) men using percutaneous biopsy, and transcript expression was quantified using real-time polymerase chain reaction. Lower limb muscle mass was assessed using DEXA while concentric peak torque (PT) and power were assessed via isokinetic dynamometer. When age-related differences in mRNA expression were observed, Pearson correlation coefficients were obtained to examine the relationship of transcripts to muscle mass and function. RESULTS: Older muscle contained significantly more transcript for Forkhead Box O 1 (FoxO1, p=0.001), Inhibitor of DNA binding 1 (ID1, p=0.009), and Inhibitor of DNA Binding 3 (ID3, p=0.043) than young muscle. FoxO1 was significantly correlated with lean mass (R=-0.44, p=0.023) and PT (R=-0.40, p=0.046) while ID3 was significantly correlated with PT (R=-0.58, p=0.001) and power (R=-0.65, p<0.001). Moreover, ID1 was significantly correlated with all assessed measures of muscle function - mass (R=-0.39, p=0.046), PT (R=-0.53, p=0.005), and power (R=-0.520, p=0.005). CONCLUSION: These data suggest that FoxO1, ID1, and ID3 are potentially useful as clinical biomarkers of age-related muscle atrophy and dysfunction.

The lipid-lowering effects of 4 weeks of daily soymilk or dairy milk ingestion in a postmenopausal female population.

Alterations in plasma cholesterol concentrations, especially increases in low-density lipoprotein (LDL), are well-known risk factors in the development of atherosclerosis. Numerous studies have examined the lipid-lowering effects of functional soy-containing foods, but few have specifically examined soymilk, with equivocal findings reported. In September 2008, a single-blind, randomized, controlled trial was conducted on 32 postmenopausal women at Baylor University, Waco, TX, USA. After a 2-week run-in period, subjects were randomly assigned to consume three servings of vanilla soy (n = 16) or reduced-fat dairy (n = 16) milk per day for 4 weeks. Plasma lipid profiles were obtained pre- and post-supplementation. Plasma high-density lipoprotein, LDL, and triglycerides were not significantly different between groups post-intervention (P = .45) or from baseline (P = .83). Separate analysis of plasma total cholesterol levels yielded similar results (P = .19 and P = .92, respectively). Furthermore, subanalyses controlling for dyslipidemia (n = 23) and lipid-lowering medication usage (n = 28) did not significantly alter results. Despite good dietary compliance, our study failed to show a significant hypocholesterolemic effect of soymilk consumption in this postmenopausal female population. Potential reasons for this nonsignificant finding are discussed, and future research directions are presented.

Protease supplementation improves muscle function after eccentric exercise.

UNLABELLED: Protease supplementation has been purported to reduce the damaging effects of eccentric exercise and accelerate recovery of muscle function, possibly by regulating inflammation. PURPOSE: To determine the effectiveness of protease supplementation in attenuating eccentric exercise-induced skeletal muscle damage and inflammation. METHODS: After standard physical and hemodynamic assessment and fasting venous blood samples, subjects performed isokinetic extension/flexion of the quadriceps group on a Biodex isokinetic dynamometer at 60°·s(-1), followed by VO2max testing. Subjects were randomly assigned to consume 5.83 g daily of either a cellulose placebo (N = 15; 22.27 ± 3.33 yr, 71.17 ± 2.91 inches, 179.4 ± 24.05 lb, 50.55 ± 5.66 mL·kg(-1)·min(-1)) or a proteolytic supplement containing fungal proteases, bromelain, and papain (N = 14; 22.85 ± 5.9 yr, 70.0 ± 2.67 inches, 173.11 ± 29.94 lb, 49.69 ± 6.15 mL·kg(-1)·min(-1)) for a period of 21 d. After the supplementation period, subjects donated blood samples before performing a 45-min downhill (-17.5%) treadmill protocol at 60% of VO2max. An additional four blood draws and three muscle function tests were performed during the next 48 h. Blood was analyzed using standard hematology and clinical chemistry, enzyme-linked immunosorbent assay, and bead array. Blood data were analyzed using multivariate analysis of variance (MANOVA) with repeated measures, whereas Biodex data were analyzed using a MANOVA on %Δ values. RESULTS: Significant group differences (T1-T3, P = 0.033; T1-T4, P = 0.043) and another strong trend (T1-3 h, P = 0.055) were observed for flexion (peak torque %Δ at 60°·s(-1)) indicating higher force production in the protease group. Significant group × time interactions (P < 0.05) were observed, including elevations in circulating eosinophils and basophils in the protease group coinciding with lower levels of serum cyclooxygenase 2, interleukin 6, and interleukin 12 in this group. CONCLUSIONS: Protease supplementation seems to attenuate muscle strength losses after eccentric exercise by regulating leukocyte activity and inflammation.

Effects of eccentric treadmill exercise on inflammatory gene expression in human skeletal muscle.

The present study examined the skeletal muscle expression of several genes related to the inflammatory process before and after a bout of downhill running. Twenty-nine males between the ages of 18 and 35 years performed a 45-min downhill (-17.5%) treadmill protocol at 60% of maximal oxygen consumption. Venous bloods samples and muscle biopsy samples from the vastus lateralis were donated prior to and at 3-h and 24-h postexercise, along with ratings of perceived muscle soreness. Serum creatine kinase (CK) was determined, as was skeletal muscle gene expression of interleukin (IL)-6, IL-8, IL-12 (p35), tumor necrosis factor-alpha (TNF-alpha), IL-1beta, cyclooxygenase 2 (COX2), and nuclear factor kappa B (NFkB) (p105/p50). Gene expression was analyzed using RT-PCR and compared with a standard housekeeping gene (beta-actin). Data were analyzed for statistical differences using multivariate analysis of variance with univariate follow-up. In addition, Pearson correlations were conducted to determine if any significant relationship exists between any of these transcripts and both CK and muscle soreness. Significant (p < 0.05) up-regulations in IL-6, IL-8, and COX2 mRNA expression were observed compared with baseline, whereas no significant changes for IL-12, IL-1beta, TNF-alpha, or NFkB were noted. Significant increases in IL-6 mRNA were observed at 3 h (p < 0.001) and 24 h (p = 0.043), whereas significant increases in IL-8 (p = 0.001) and COX2 (p = 0.046) mRNA were observed at 3-h postexercise. In addition, muscle soreness was significantly correlated with IL-8 at 24 h (r = -0.370; p = 0.048), whereas CK was significantly related to NFkB at baseline (r = -0.460; p = 0.012). These data indicate that increases in the mRNA expression of IL-6, IL-8, and COX2 occur in the vastus lateralis as a result of damaging eccentric exercise in young, recreationally trained males. Further, it appears that IL-8 transcription may play some role in inhibiting postexercise muscle soreness, possibly through regulation of angiogenesis.

Effects of caffeine and aspirin on light resistance training performance, perceived exertion, and pain perception.

This study compared independent effects of caffeine and aspirin on muscular endurance (repetitions), heart rate (HR), perceived exertion (RPE), and perceived pain index (PPI) during light resistance training bouts performed to volitional failure. It was hypothesized that the hypoalgesic properties of these ergogenic aids would decrease pain perception and potentially result in enhanced performance. College-aged men (n = 15) participated in a within-subjects, double-blind study with three independent, counterbalanced sessions wherein aspirin (10 mg x kg(-1)), caffeine (6 mg x kg(-1)), or matched placebo were ingested 1 hour before exercise, and RPE, HR, PPI, and repetitions (per set and total per exercise) were recorded at 100% of individual, predetermined, 12-repetition maximum for leg extensions (LE) and seated arm curls (AC). Repeated-measures analyses of variance were used for between-trial comparisons. Caffeine resulted in significantly greater (p < 0.05) HR (LE and AC), total repetitions (LE), and repetitions in set 1 (LE and AC) compared with aspirin and placebo. Aspirin resulted in significantly higher PPI in set 1 (LE). In LE, 47% of participants' performance exceeded the predetermined effect size (>or= 5 repetitions) for total repetitions, with 53% exceeding the effect size (>or= 2 repetitions) for repetitions in set 1 with caffeine (vs. placebo). In AC, 53% (total repetitions) and 47% (set 1 repetitions) of participants exceeded effect sizes with caffeine (vs. placebo), with only 13% experiencing decrements in performance (total repetitions). Aspirin also produced a higher PPI and RPE overall and in set 1 (vs. placebo). This study demonstrates that caffeine significantly enhanced resistance training performance in LE and AC, whereas aspirin did not. Athletes may improve their resistance training performance by acute ingestion of caffeine. As with most ergogenic aids, our analyses indicate that individual responses vary greatly.