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1.
Med Sci Sports Exerc ; 2021 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34431829

RESUMO

PURPOSE: To examine whether higher levels of cardiorespiratory fitness are related to increased alcohol consumption and dependence among a large sample of adults attending a preventive medicine clinic. METHODS: A cross-sectional study of 38,653 apparently healthy patients who visited the Cooper Clinic (Dallas, TX) for preventive medical exams (1988-2019) and enrolled in the Cooper Center Longitudinal Study. The primary independent variable was cardiorespiratory fitness, based on a maximal treadmill test, and the dependent variables were alcohol consumption and dependence (self-reported). The relations between fitness category (low, moderate, high) and alcohol consumption (low, moderate, heavy) and suggested alcohol dependence (CAGE score ≥ 2) among women and men, were estimated via multivariable regression while adjusting for covariates (e.g., age, birth year cohort, marital status, and BMI). RESULTS: Women within the moderate and high fitness categories had 1.58 (95%CI 1.32-1.91) and 2.14 (95%CI 1.77-2.58) greater odds of moderate/heavy alcohol consumption, respectively, in comparison to their low fitness counterparts. Similarly, moderate and high fit men had 1.42 (95%CI 1.30-1.55) and 1.63 (95%CI 1.49-1.80) times greater odds of moderate-to-heavy alcohol consumption, respectively, in comparison to the low fitness group. In addition, among men who were heavy drinkers (but not women), higher fitness levels were related to lower rates of suggested alcohol dependence. Specifically, these men had 45.7%, 41.7%, and 34.9% proportions of clinically relevant alcohol problems across low, moderate, and high fitness categories (adjusted p for trend <0.001). CONCLUSION: Higher fitness levels are significantly related to greater alcohol consumption among a large cohort of adult patients. Interventions focusing on increasing fitness (via physical activity promotion) might consider concurrently aiming to reduce alcohol consumption.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34444117

RESUMO

Tobacco taxation and price policies are considered the most effective for lowering demand for tobacco products. While this statement is based on research from numerous countries, scant evidence exists on this topic for Israel. Accordingly, we assessed the association between cigarette prices and smoking prevalence and intensity from a national sample of adults in Israel (2002-2017). Data on smoking behavior were derived from the Israeli Knowledge Attitudes and Practices (KAP) survey, a repeated cross-sectional survey. Price information is from the Economist Intelligence Unit (EIU) since it was not collected in the KAP survey. We used the price of a pack of 20 cigarettes for Marlboro and the local brand. These two price variables were the primary independent variables, and we adjusted for inflation. The dependent variables were current smoking (yes/no) and smoking intensity, defined as the number of cigarettes smoked per week. Multivariable analysis was employed using a two-part model while adjusting for covariates. The first step of the model utilized logistic regression with current smoking as the dependent variable. The second step examining smoking intensity as the dependent variable, used OLS regression. Price elasticity was estimated as well. Analysis revealed that a one-unit increase (Israeli currency) in the price of local brand of cigarettes was related to 2.0% (OR = 0.98; 95%CI 0.98, 0.99) lower odds of being a current smoker, adjusting for covariates including household income. Moreover, a one unit increase in the price of the local brand of cigarettes was related to consuming 1.49 (95% CI -1.97, -1.00) fewer weekly cigarettes, controlling for household income and covariates. Similar results were found with the Marlboro cigarette prices. The total price elasticity of cigarette demand, given by the sum of price elasticities of smoking prevalence and intensity, showed that a 10.0% increase in the price is associated with a 4.6-9.2% lower cigarette consumption among Israeli adults. Thus, increasing cigarette prices will likely lead to a reduction in cigarette smoking thereby improving public health in Israel.


Assuntos
Comércio , Produtos do Tabaco , Adulto , Estudos Transversais , Humanos , Israel/epidemiologia , Fumar/epidemiologia , Impostos
3.
J Aging Phys Act ; : 1-9, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34453026

RESUMO

This study cross-sectionally examines the relations of sitting and physical activity (PA) with cognitive impairment in community-dwelling adults aged 55-87 years (n = 3,780). Multivariable logistic regression assessed independent and joint relations of sitting and PA with Montreal Cognitive Assessment scores adjusting for covariates. Sitting ≥75% of the time and not meeting PA guidelines were related to 60% (95% confidence interval [CI] [1.19, 2.17]) and 27% (95% CI [1.06, 1.53]) higher odds for cognitive impairment, respectively. Stratification by age showed that sitting ≥75% of the time was associated with higher cognitive impairment odds in midlife (odds ratio [OR] = 1.86; 95% CI [1.31, 2.65]), but not older adults (OR = 1.06; 95% CI [0.57, 1.95]). Joint association analysis revealed that, overall, the highest odds for cognitive impairment were in those sitting ≥75% of the time while meeting or not meeting PA guidelines (OR = 1.69, 95% CI [1.13, 2.53]; and OR = 1.66, 95% CI [1.19, 2.32], respectively). In conclusion, prolonged sitting and insufficient PA are independent risk markers for cognitive impairment.

4.
Prev Med ; 150: 106720, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34252504

RESUMO

Few studies have adequately assessed the simultaneous effects of changes in cardiorespiratory fitness (fitness) and body mass on cardiometabolic risk. Hence, the current study's aims were twofold: (1) To determine whether increases in body mass result in higher cardiometabolic risk after controlling for fitness changes; and (2) To assess whether increases in fitness result in lower cardiometabolic risk after controlling for weight changes. The study consisted of 3534 patients who came for preventive medicine visits ≥4 times over any 10-year period (1979-2019). The primary independent variables were body mass and fitness, and the dependent variable was metabolic syndrome (MetS) and its components. Mixed-effects regression was used to model the relationship between changes in body mass, fitness, and MetS. Results indicate that increasing body mass up to a 10-year period was significantly related to increasing risk of MetS while controlling for changes in fitness. Specifically, a 1-kg increase in body mass was associated with a 17% (OR = 1.17; 95% CI 1.15-1.19) increased odds for MetS, while adjusting for fitness changes. A 1-MET increase in fitness was related to a 23% (OR = 0.77; 95% CI 0.70-0.84) decrease in odds for MetS, while adjusting for body mass changes up to 10 years. Moreover, body mass change was significantly related to changes in all cardiometabolic components of MetS. Fitness change was significantly associated with changes in MetS components. Future interventions should focus concurrently on increasing fitness and on body mass loss (or maintenance) to improve cardiometabolic health.


Assuntos
Aptidão Cardiorrespiratória , Doenças Cardiovasculares , Síndrome Metabólica , Índice de Massa Corporal , Doenças Cardiovasculares/prevenção & controle , Humanos , Estudos Longitudinais , Aptidão Física , Fatores de Risco
5.
BMJ Open ; 11(7): e047743, 2021 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-34261685

RESUMO

OBJECTIVE: To describe the relationship between long-term weight loss (LTWL) success and lifestyle behaviours among US adults. DESIGN: Serial cross-sectional data from National Health and Nutrition Examination Survey cycles 2007-2014. SETTING AND PARTICIPANTS: Population-based nationally representative sample. The analytic sample included 3040 adults aged 20-64 years who tried to lose weight in the past year. MEASURES: Participants were grouped into five LTWL categories (<5%, 5%-9.9%, 10%-14.9%, 15%-19.9% and ≥20%). Lifestyle-related behaviours included the following: alcohol intake, physical activity, smoking, fast-food consumption, dietary quality (Healthy Eating Index (HEI)) and caloric intake. Multivariable regression was employed adjusting for age, sex, race/ethnicity, marital status, education, household income and size, current body mass index and self-reported health status. RESULTS: Individuals in the 15%-19.9% LTWL group differed significantly from the reference group (<5% LTWL) in their physical activity and dietary quality (HEI) but not caloric intake. Specifically, they had a higher HEI score (ß=3.19; 95% CI 0.39 to 5.99) and were more likely to meet physical activity guidelines (OR=1.99; 95% CI 1.11 to 3.55). In comparison, the ≥20% LTWL group was significantly more likely to smoke (OR=1.63; 95% CI 1.03 to 2.57) and to consume lower daily calories (ß=-202.91; 95% CI -345.57 to -60.25) than the reference group; however, dietary quality and physical activity did not significantly differ. CONCLUSION: Among a national sample of adults, a higher level of LTWL success does not necessarily equate to healthy weight loss behaviours. Future research should attempt to design interventions aimed at facilitating weight loss success while encouraging healthy lifestyle behaviours.


Assuntos
Dieta , Perda de Peso , Adulto , Estudos Transversais , Comportamentos Relacionados com a Saúde , Humanos , Inquéritos Nutricionais , Estados Unidos
6.
Artigo em Inglês | MEDLINE | ID: mdl-34067414

RESUMO

Despite adults' desire to reduce body mass (weight) for numerous health benefits, few are able to successfully lose at least 5% of their starting weight. There is evidence on the independent associations of physical activity, sedentary behaviors, and sleep with weight loss; however, this study provided insight on the combined effects of these behaviors on long-term body weight loss success. Hence, the purpose of this cross-sectional study was to evaluate the joint relations of sleep, physical activity, and sedentary behaviors with successful long-term weight loss. Data are from the 2005-2006 wave of the National Health and Examination Survey (NHANES). Physical activity and sedentary behavior were measured with an accelerometer, whereas sleep time was self-reported. Physical activity and sleep were dichotomized into meeting guidelines (active/not active, ideal sleep/short sleep), and sedentary time was categorized into prolonged sedentary time (4th quartile) compared to low sedentary time (1st-3rd quartiles). The dichotomized behaviors were combined to form 12 unique behavioral combinations. Two-step multivariable regression models were used to determine the associations between the behavioral combinations with (1) long-term weight loss success (≥5% body mass reduction for ≥12-months) and (2) the amount of body mass reduction among those who were successful. After adjustment for relevant factors, there were no significant associations between any of the independent body weight loss behaviors (physical activity, sedentary time, and sleep) and successful long-term weight loss. However, after combining the behaviors, those who were active (≥150 min MVPA weekly), regardless of their sedentary time, were significantly (p < 0.05) more likely to have long-term weight loss success compared to the inactive and sedentary referent group. These results should be confirmed in longitudinal analyses, including investigation of characteristics of waking (type, domain, and context) and sleep (quality metrics) behaviors for their association with long-term weight loss success.


Assuntos
Comportamento Sedentário , Perda de Peso , Acelerometria , Adulto , Estudos Transversais , Exercício Físico , Humanos , Inquéritos Nutricionais , Sono
7.
Psychol Health ; : 1-18, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34187269

RESUMO

OBJECTIVE: There is insufficient evidence for the effectiveness of various tones of communication in modifying health behaviours. We examine the moderating role of assertiveness in the effect of positive/negative language on emotional responses (optimism, self-efficacy, and guilt), and resulting preventive health behaviours. DESIGN: Three experiments were employed. An online experiment tests the relationship between positive/negative language and assertiveness when people communicate about healthful eating. Next, a field study examines the moderating effect of assertiveness in positive and negative language encouraging using sunscreen among street passers-by. Third, an online study explores whether the effect of assertiveness in positive and negative messages on hand-washing intentions is mediated by increased optimism and self-efficacy, and decreased guilt, respectively. RESULTS: Positive language increases compliance when expressed assertively because the assertive tone emphasises optimism and self-efficacy. Conversely, negative communication is more effective when expressed non-assertively, because of the replenishing effect of the gentler tone on the guilt evoked by the negative communication. CONCLUSION: Assertiveness serves as an intensifier of what is being communicated. When considering whether to employ positive or negative language in health messaging, assertiveness should be considered as part of the design of effective health communication strategies leading to health promoting behaviour change.

8.
Artigo em Inglês | MEDLINE | ID: mdl-33670147

RESUMO

BACKGROUND: Emotional eating, the tendency to overeat in response to negative emotions, has been linked to weight gain. However, scant evidence exists examining the prevalence and correlates of emotional eating among large samples of adults in the United States (U.S.). Hence, we examine the relationship among individual and socioeconomic factors, health behaviors, and self-regulation with emotional eating patterns among U.S. adults. METHODS: Cross-sectional analysis of 5863 Family Health Habits Survey participants. Multivariable, ordered, logistic regression was employed to examine the relationship between the frequency of the desire to eat when emotionally upset (never, rarely, sometimes, often, and very often) and the independent variables. RESULTS: Analysis reveals that 20.5% of the sample tended to emotionally eat often or very often. Being female, non-Hispanic White, and of younger age were all related to a higher likelihood of emotional eating. Additionally, inability to delay gratification (impatience) was related to an 18% increased likelihood (95% confidence interval (CI) 1.05-1.33) for emotional eating. Finally, emotional eating was significantly related to more frequent fast-food consumption. CONCLUSIONS: Program planners might need to develop targeted interventions aimed at enhancing emotional regulation skills while addressing these less healthful behaviors (e.g., fast-food intake) with the goal of obesity and chronic disease prevention.


Assuntos
Estilo de Vida , Autocontrole , Adulto , Estudos Transversais , Ingestão de Alimentos , Emoções , Comportamento Alimentar , Feminino , Humanos , Estados Unidos/epidemiologia
9.
J Phys Act Health ; 17(10): 1042-1046, 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32908021

RESUMO

BACKGROUND: The Rapid Assessment Disuse Index (RADI) is a brief tool aimed to promptly assess primary care patients' overall physical inactivity and sedentary behavior. This study examines the relation between physical inactivity and sitting time (RADI) to cardiometabolic risk among primary care patients. METHODS: Survey data and electronic medical record information were collated to explore the association between RADI scores (cumulative and sitting) to metabolic syndrome (and components) among women and men, using multivariable logistic regression. RESULTS: Among women, the cumulative RADI score was not significantly associated with metabolic syndrome. However, the RADI sitting score was related to low high-density lipoprotein cholesterol and metabolic syndrome. That is, a transition to a higher RADI sitting score by 1 unit (vs remaining in the score) was related with a 1.4 and 1.3 times higher odds for having low high-density lipoprotein cholesterol (95% confidence interval, 1.05-1.87) and metabolic syndrome (95% confidence interval, 1.02-1.64), respectively. Among men, no significant relations were found. CONCLUSIONS: The RADI sitting score is positively and significantly related to high-density lipoprotein and metabolic syndrome among women, yet not men. Due to the RADI's potential clinical utility, future research should attempt to examine these relations in larger, more robust samples and adjudicated outcomes using a prospective design.

10.
Artigo em Inglês | MEDLINE | ID: mdl-32093167

RESUMO

OBJECTIVES: This study aims to measure trends in cigarette smoking among children and adolescents in Israel, focusing on school grade, sex, and ethnicity. We hypothesized that smoking would be higher among boys and Arab-Israelis, rates would grow with age, and there would be a decline over time. METHODS: Data were derived from the Health Behavior in School-aged Children study between 1998 and 2015 in Israel. The total sample included 56,513 students in grades 6, 8, and 10, with 29,411 girls and 27,102 boys. Descriptive analysis described trends of smoking behavior according to grade, sex, ethnicity, family affluence, and year of study. multivariate logistic regression analysis examined predicting variables. RESULTS: Smoking was higher among boys in all grades, ethnic groups, and years of study, with the highest frequencies among Arab-Israelis. Trends over the years show a decline from 1998 to 2004, followed by an increase for both sexes. The increase was more prominent among girls. Logistic regression analysis revealed strong associations between smoking and grade, sex, ethnicity, and year of study. CONCLUSIONS: The results of this study can significantly enhance the development and implementation of smoking prevention and control programs among students in Israel.


Assuntos
Fumar , Uso de Tabaco , Adolescente , Criança , Feminino , Humanos , Israel/epidemiologia , Masculino , Instituições Acadêmicas , Fumar/epidemiologia , Prevenção do Hábito de Fumar
11.
BMC Public Health ; 19(1): 1538, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752798

RESUMO

BACKGROUND: Many individuals aspire to attain various goals in life, such as committing to a healthful diet to slim down or saving for retirement to enhance future welfare. While these behaviors (weight loss and saving) share the common denominator of self-regulation, it is unclear whether success in one domain is related to the other. Therefore, we examined the relationship between long term weight loss (LTWL) success and monetary savings among U.S. adults who at one point in life diverged from normal weight status. METHODS: Data on 1994 adults with a maximum BMI ≥ 25 kg/m2 and with an annual household income equal or less than 200% poverty level. Data were derived from a U.S. population-based study (NHANES). The independent variable was LTWL success (loss maintained for at least 1 year), which was operationalized as < 10% (reference group), 10.00-19.99%, and ≥ 20.00%. The dependent variable was monetary savings (e.g., 401 K), defined as a 3-category ordinal variable. We employed ordered logistic regression to estimate the relationship between LTWL success and increased odds for higher overall savings. RESULTS: Multivariable analysis revealed that adjusting for income, education and other covariates, being in the highest LTWL category (≥20.00%) significantly reduced the likelihood of monetary savings in comparison to the reference group (OR = 0.55, 95%CI = 0.34-0.91). This relationship was not observed in the lower LTWL category (10.00-19.99%). CONCLUSIONS: Adults who in the past were overweight or obese and who presently exhibit high levels of LTWL, were markedly less successful when it came to their finances. This might stem from significant cognitive-affective resources exerted during the weight loss process coupled with a paucity of financial resources which impede financial decision making. This supposition, however, warrants future research.


Assuntos
Renda/estatística & dados numéricos , Pobreza , Perda de Peso , Adulto , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Estados Unidos
12.
J Phys Act Health ; 16(5): 308-317, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30982380

RESUMO

Background: Improving sidewalks may encourage physical activity by providing safe, defined, and connected walking spaces. However, it is unknown if reduced health care expenditures assumed by increased physical activity offset the investment for sidewalk improvements. Methods: This cost-effectiveness analysis of sidewalk improvements in Houston, TX, was among adults enrolled in the Houston Travel-Related Activity in Neighborhoods Study, 2013-2017 . The 1-year change in physical activity was measured using self-report (n = 430) and accelerometry (n = 228) and expressed in metabolic equivalent (MET) hours per year (MET·h·y-1). Cost-effectiveness ratios were calculated by comparing annualized sidewalk improvement costs (per person) with 1-year changes in physical activity. Results: The estimated cost-effectiveness ratio were $0.01 and -$0.46 per MET·h·y-1 for self-reported and accelerometer-derived physical activity, respectively. The cost-effectiveness benchmark was $0.18 (95% confidence interval, $0.06-$0.43) per MET·h·y-1 gained based on the volume of physical activity necessary to avoid health care costs. Conclusions: Improving sidewalks was cost-effective based on self-reported physical activity, but not cost-effective based on accelerometry. Study findings suggest that improving sidewalks may not be a sufficient catalyst for changing total physical activity; however, other benefits of making sidewalks more walkable should be considered when deciding to invest in sidewalk improvements.


Assuntos
Acelerometria/métodos , Análise Custo-Benefício/métodos , Planejamento Ambiental/economia , Exercício Físico/fisiologia , Feminino , Humanos , Masculino
13.
Am J Health Behav ; 43(2): 337-348, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30808473

RESUMO

Objectives: In this study, we examined physical activity (PA) levels among Jewish and Arab adolescents in Israel, as well as factors associated with PA. We used a socio-ecological framework to understand differences in levels of PA across ethnic groups and the factors associated with these differences. Methods: We used data based on the Israeli population as reported in the 2014-15 Health Behavior of School-Aged Children standardized survey, which studied 16,145 Israeli adolescents. Levels of PA, as well as parent, sibling, and peer engagement in PA, in-school PA breaks, and liking PA were measured across ethnic groups and sex. Results: Jewish adolescents reported higher levels of PA. Girls were significantly less physically active than boys in both ethnicities. In addition, we found that family, peer, and school related factors were positively associated with levels of PA. Conclusions: Our findings show a disparity in PA levels by ethnicity among Israel adolescents, which can lead to health disparities. We propose targeted interventions involving the factors affecting PA to reduce health disparities.


Assuntos
Comportamento do Adolescente/etnologia , Árabes/estatística & dados numéricos , Comportamentos Relacionados com a Saúde/etnologia , Judeus/estatística & dados numéricos , Adolescente , Feminino , Disparidades nos Níveis de Saúde , Humanos , Israel/etnologia , Masculino , Fatores Sexuais
14.
CA Cancer J Clin ; 69(2): 88-112, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30548482

RESUMO

The prevalence of excess body weight and the associated cancer burden have been rising over the past several decades globally. Between 1975 and 2016, the prevalence of excess body weight in adults-defined as a body mass index (BMI) ≥ 25 kg/m2 -increased from nearly 21% in men and 24% in women to approximately 40% in both sexes. Notably, the prevalence of obesity (BMI ≥ 30 kg/m2 ) quadrupled in men, from 3% to 12%, and more than doubled in women, from 7% to 16%. This change, combined with population growth, resulted in a more than 6-fold increase in the number of obese adults, from 100 to 671 million. The largest absolute increase in obesity occurred among men and boys in high-income Western countries and among women and girls in Central Asia, the Middle East, and North Africa. The simultaneous rise in excess body weight in almost all countries is thought to be driven largely by changes in the global food system, which promotes energy-dense, nutrient-poor foods, alongside reduced opportunities for physical activity. In 2012, excess body weight accounted for approximately 3.9% of all cancers (544,300 cases) with proportion varying from less than 1% in low-income countries to 7% or 8% in some high-income Western countries and in Middle Eastern and Northern African countries. The attributable burden by sex was higher for women (368,500 cases) than for men (175,800 cases). Given the pandemic proportion of excess body weight in high-income countries and the increasing prevalence in low- and middle-income countries, the global cancer burden attributable to this condition is likely to increase in the future. There is emerging consensus on opportunities for obesity control through the multisectoral coordinated implementation of core policy actions to promote an environment conducive to a healthy diet and active living. The rapid increase in both the prevalence of excess body weight and the associated cancer burden highlights the need for a rejuvenated focus on identifying, implementing, and evaluating interventions to prevent and control excess body weight.


Assuntos
Saúde Global/estatística & dados numéricos , Neoplasias/etiologia , Sobrepeso/epidemiologia , Índice de Massa Corporal , Efeitos Psicossociais da Doença , Feminino , Humanos , Masculino , Neoplasias/epidemiologia , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/epidemiologia , Sobrepeso/complicações , Sobrepeso/diagnóstico , Prevalência , Fatores de Risco , Fatores Sexuais
15.
J Sports Med Phys Fitness ; 59(8): 1405-1412, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30293409

RESUMO

BACKGROUND: The preventive role of precancer diagnosis cardiorespiratory fitness (CRF) and physical activity (PA) in cancer mortality is poorly characterized. The aim of this study was to assess the association between CRF, PA at precancer-diagnosis and cancer mortality in men who diagnosed with cancer later in life. METHODS: A total of 699 men (63±10 years) who were diagnosed with cancer during 7.5±4.9 years from a baseline treadmill exercise test and reported PA were analyzed. Multivariate Cox models for CRF and univariate model for PA were conducted. Population Attributable Risks (PARs%) and exposure impact number (EIN) of low CRF (<5 METs) and inactivity were determined. RESULTS: During 6.5±5.2 years from cancer diagnosis, 56% died from cancer. CRF was inversely, graded and independently associated with cancer death. A 1-MET increase and categories of moderate and high CRF were associated with 7%, 28% and 51% reductions in risk of cancer death, respectively. Active compared to inactive individuals had a 23% reduced risk of cancer mortality (HR=0.77, 95% CI [0.63-0.94], P=0.01). PARs% of low CRF and inactivity were 4.8% and 9.4%, respectively, while the respective EIN were 3 and 9. CONCLUSIONS: Higher CRF and being active at precancer-diagnosis were associated with lower cancer mortality and longer survival time in men who developed cancer later in life. Screening and intervening for low CRF and inactivity as risk factors during middle-age and maintaining at least moderate CRF and activity levels may be effective strategies for prevention of cancer mortality.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Exercício Físico/fisiologia , Neoplasias/mortalidade , Idoso , Teste de Esforço , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco
16.
Transl J Am Coll Sports Med ; 3(9): 66-71, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-30148210

RESUMO

Improving sidewalks could lead to more physical activity through improved access, while providing a safe and defined space to walk. Yet, findings on the association between sidewalks and physical activity are inconclusive. PURPOSE: The purpose of this study was to examine changes in self-reported and accelerometer-derived physical activity associated with living near recently improved sidewalks in a diverse, community-based sample from the Houston Travel Related Activity in Neighborhoods (TRAIN) Study. METHODS: Data are from 430 adults and include baseline and first annual follow-up (2014-2017). Fully adjusted, two-step regression models were built to test the hypothesis that living near (within 250-meters) an improved sidewalk was associated with greater levels of physical activity than not living near an improved sidewalk. RESULTS: The majority of participants were female, non-Hispanic black, low income, low education, and nearly half lived near at least one improved sidewalk. After adjustment, among participants reporting some physical activity, living near two sidewalk improvements was associated with 1.6 times more minutes per week of walking and leisure-time physical activity than those not living near a sidewalk improvement (p<0.05). Based on accelerometry, which does not specifically quantify domain-specific physical activity, there were no significant associations. CONCLUSION: Although these mixed findings warrant further research, results suggest that improving sidewalks may have an effect on participants' physical activity. Nonspecific definitions of sidewalk improvements could be contributing to type 1 error. Future work should also examine behavioral interventions alongside changes to the built environment to determine the effects on physical activity.

17.
Mayo Clin Proc ; 93(11): 1611-1616, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30119916

RESUMO

More than two-thirds of American adults are overweight or obese, with many attempting to lose weight to avoid adverse health outcomes and improve well-being. Achieving long-term weight loss (LTWL) success, defined as reaching at least a 5% to 10% weight loss goal, is challenging, yet important for overall metabolic health. It is currently unclear whether achieving higher thresholds of LTWL is associated with improved health. Therefore, the purpose of this study was to examine the association between LTWL thresholds (5%-9.9%, 10%-14.9%, 15%-19.9%, ≥20%) and metabolic health (metabolic syndrome and metabolic risk z score) among 7670 US adult respondents to the National Health and Nutrition Examination Survey (2007-2014) who were overweight or obese (past or present), were not underweight in the past year, not pregnant, and attempting to lose or maintain weight. A subsample of 3362 participants was used in the analysis of the metabolic risk z score. Multivariable regression models were constructed adjusting for covariates. Results indicate that the lowest and the 2 highest LTWL thresholds were related to lower odds for metabolic syndrome; for example, greater than or equal to 20% LTWL (odds ratio=0.52; 95% CI, 0.23-0.44; P<.001). All LTWL thresholds were significantly associated with the metabolic risk z score, with the largest effect among the 2 highest LTWL thresholds, that is, 15% to 19.9% LTWL (ß=-0.45; 95% CI, -0.54 to -0.36; P<.001) and greater than or equal to 20% LTWL (ß=-0.35; 95% CI, -0.53 to -0.17; P<.001). In conclusion, although achieving the currently recommended LTWL target was related to improved metabolic health, the 15% LTWL threshold was associated with more favorable outcomes.


Assuntos
Nível de Saúde , Síndrome Metabólica/epidemiologia , Obesidade/epidemiologia , Perda de Peso , Adulto , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Inquéritos Nutricionais , Fatores de Risco , Estados Unidos/epidemiologia
18.
Prev Chronic Dis ; 15: E65, 2018 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-29806579

RESUMO

INTRODUCTION: The transition from active cancer treatment into survivorship, known as re-entry, remains understudied. During re-entry, clinicians can educate survivors on the benefits of healthy behaviors, including physical activity, as survivors adjust to life after cancer. We examine the prevalence of adherence to established aerobic physical activity guidelines (≥150 minutes of moderate-intensity physical activity per week) in addition to related medico-demographic factors among cancer survivors during re-entry. METHODS: Data from 1,160 breast, colorectal, and prostate cancer survivors participating in the American Cancer Society's National Cancer Survivor Transition Study were examined. Multinomial logistic regression was used to calculate adjusted odds ratios (AOR) for various medico-demographic variables in relation to 4 established levels of physical activity (inactive, insufficiently active, 1-<2 times the guideline level, and ≥2 times the guideline level [referent group]). RESULTS: Overall, 8.1% were inactive, 34.1% were insufficiently active, 24.3% were within 1 to less than 2 times the guidelines, and 33.4% exceeded guidelines by 2 or more times. Inactive people had significantly higher odds of being women (AOR, 1.88; 95% confidence interval [CI], 1.10-3.23) and having lower education levels (AOR, 2.02; 95% CI, 1.21-3.38) compared with those who exceeded guidelines by 2 or more times. Each additional comorbidity was associated with a 26% increase in odds of inactivity (AOR, 1.26; 95% CI, 1.08-1.47). CONCLUSION: Patient education on the benefits of regular physical activity is important for all cancer survivors and may be especially important to review after treatment completion to promote healthy habits during this transition period. Survivors who are women, are less educated, and have comorbid conditions may be less likely to be compliant with physical activity guidelines.


Assuntos
Sobreviventes de Câncer , Exercício Físico , Comorbidade , Feminino , Humanos , Masculino , Neoplasias , Razão de Chances , Cooperação do Paciente , Fatores de Risco
19.
Prev Med Rep ; 9: 55-61, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29340271

RESUMO

Transportation-related physical activity can significantly increase daily total physical activity through active transportation or walking/biking to transit stops. The purpose of this study was to assess the relations between transit-use and self-reported and monitor-based physical activity levels in a predominantly minority population from the Houston Travel-Related Activity in Neighborhoods (TRAIN) Study. This was a cross-sectional analysis of 865 adults living in Houston, Texas between 2013 and 2015. The exposure variable was transit-use (non-users, occasional users, and primary users). Self-reported and accelerometer-determined physical activity were the outcomes of interest. Regression models adjusting for age, sex, race/ethnicity, and other covariates of interest were built to test the hypothesis that transit user status was directly associated with 1) minutes of moderate-intensity physical activity and 2) the prevalence of achieving the physical activity guidelines. The majority of participants were female, non-Hispanic black, and almost one-third had a high school education or less. After adjustment, primary transit-use was associated with 134.2 (p < 0.01) additional mean minutes per week of self-reported moderate-intensity transportation-related physical activity compared to non-users. Further, primary users had 7.3 (95% CI: 2.6-20.1) times the relative adjusted odds of meeting physical activity recommendations than non-users based on self-reported transportation-related physical activity. There were no statistically significant associations of transit-use with self-reported leisure-time or accelerometer-derived physical activity. Transit-use has the potential for a large public health impact due to its sustainability and scalability. Therefore, encouraging the use of transit as a means to promote physical activity should be examined in future studies.

20.
Econ Hum Biol ; 28: 92-106, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29294461

RESUMO

Previous research has found that impatient time preferences and self-control problems (present bias) are related to increased obesity risk. However, scant evidence exists pertaining to whether parents' impatience and self-control problems impact the obesity status of their children, too. Accordingly, we explore this study question among a large national sample of US adults and their children. Study results confirm previous findings indicating that intertemporal preferences are related to adults' obesity status. Moreover, these results extend the literature by finding that children of impatient or present-biased parents have a significantly higher likelihood of being obese, too. Specifically, parents' low levels of patience and present bias were each independently related to a five-percentage point increase in the likelihood of obesity of their children. These findings were more pronounced when all children were combined in analyses and for the first child; however, they varied for the second and third child. Thus, findings suggest that parents' time preferences and self-control problems likely affect not only their own weight status but that of their children.


Assuntos
Obesidade/epidemiologia , Obesidade/psicologia , Pais/psicologia , Autocontrole/psicologia , Adulto , Índice de Massa Corporal , Peso Corporal , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Estados Unidos/epidemiologia
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