Prevalence and correlates of body dysmorphic disorder in health club users in the presence vs absence of eating disorder symptomology.

PURPOSE: Body dysmorphic disorder (BDD) has been consistently linked with eating disorders, however studies that stratify associations between BDD in subjects with and without eating disorder symptomology are sparse. It was, therefore, the aim of this study to assess correlates of BDD (including social media use, motivations for exercise, exercise addiction, and sexuality) stratified by eating disorder symptomology. METHODS: Cross-sectional study of 1665 health club users recruited online completed a battery of surveys. BDD prevalence rates were calculated and logistic regression models were created in two sub-samples: indicated or no-indicated eating disorder symptomology. RESULTS: The key findings showed the prevalence of BDD in participants with indicated-eating disorder symptomology was significantly higher than in participants without indicated-eating disorder symptomology, yielding an odds ratio of 12.23. Furthermore, several correlates were associated with BDD only participants with an absence of eating disorder symptomology (gender, BMI, exercise addiction, exercising for mood improvement, attractiveness and tone), with others being significantly associated with BDD in participants in the presence of indicated eating disorders symptomology (exercising for health and enjoyment, relationship status, and ethnicity). CONCLUSIONS: This study provides more evidence of the complex relationship that exists between BDD and eating disorders. Furthermore, it is recommended that practitioners working with BDD subjects should screen for eating disorders due to the high morbidity associated with eating disorders. LEVEL OF EVIDENCE: Level III: case-control analytic study.

Leisure-Time Sedentary Behavior, Alcohol Consumption, and Sexual Intercourse Among Adolescents Aged 12-15 Years in 19 Countries From Africa, the Americas, and Asia.

BACKGROUND: The association between sedentary behavior and sexual behavior has not been investigated among adolescents. AIM: The aim of this study was to: (i) investigate the association between leisure-time sedentary behavior and sexual intercourse, and (ii) test for mediation by alcohol consumption, drug use, physical activity, bullying victimization, parental support/monitoring, loneliness, and depressive symptoms in a large global sample of young adolescents. METHODS: Data were analyzed from 34,674 adolescents aged 12-15 years participating in the Global School-based Student Health Survey. Participants reported the number of hours spent in leisure-time sedentary behavior on a typical day (<1, 1-2, 3-4, 5-8, and >8 hours). Data on alcohol consumption, drug use, physical activity, bullying victimization, parental support/monitoring, loneliness, and depressive symptoms were considered as potential mediators. OUTCOME: Participants reported whether or not they had sexual intercourse in the past 12 months (yes/no). RESULTS: The prevalence of past 12-month sexual intercourse was 11.9%, whereas the prevalence of <1, 1-2, 3-4, 5-8, and >8 hours per day of leisure-time sedentary behavior were 26.7%, 35.6%, 21.4%, 11.5%, and 4.9%, respectively. There was a dose-dependent relationship between sedentary behavior and odds of reporting sexual intercourse: compared with <1 hour/day of sedentary behavior, the odds ratio (95% CI) of sexual intercourse associated with 1-2, 3-4, 5-8, and >8 hours/day of sedentary behavior were 1.12 (0.94-1.33), 1.22 (1.01-1.48), 1.34 (1.08-1.66), and 1.76 (1.37-2.27), respectively. There was no significant interaction by sex. The largest proportion of the association between sedentary behavior and sexual intercourse was explained by alcohol use (% mediated 21.2%), with other factors explaining an additional 11.2%. CLINICAL TRANSLATION: Interventions to reduce leisure-time sedentary and/or alcohol consumption may contribute to a reduction in the proportion of adolescents engaging in sexual intercourse at a young age. The strengths and limitations of this study are the large, representative sample of adolescents from 19 countries. However, the cross-sectional design means causality or temporal associations could not be established. CONCLUSIONS: In young adolescents, leisure-time sedentary behavior is positively associated with odds of having sexual intercourse in both boys and girls, in a dose-dependent manner. Alcohol consumption seems to be a key mediator of this relationship. Smith L, Jackson SE, Jacob L, et al. Leisure-Time Sedentary Behavior, Alcohol Consumption, and Sexual Intercourse Among Adolescents Aged 12-15 Years in 19 Countries From Africa, the Americas, and Asia. J Sex Med 2019;16:1355-1363.

Atmospheric controls on northeast Pacific temperature variability and change, 1900-2012.

Over the last century, northeast Pacific coastal sea surface temperatures (SSTs) and land-based surface air temperatures (SATs) display multidecadal variations associated with the Pacific Decadal Oscillation, in addition to a warming trend of ∼ 0.5-1 °C. Using independent records of sea-level pressure (SLP), SST, and SAT, this study investigates northeast (NE) Pacific coupled atmosphere-ocean variability from 1900 to 2012, with emphasis on the coastal areas around North America. We use a linear stochastic time series model to show that the SST evolution around the NE Pacific coast can be explained by a combination of regional atmospheric forcing and ocean persistence, accounting for 63% of nonseasonal monthly SST variance (r = 0.79) and 73% of variance in annual means (r = 0.86). We show that SLP reductions and related atmospheric forcing led to century-long warming around the NE Pacific margins, with the strongest trends observed from 1910-1920 to 1940. NE Pacific circulation changes are estimated to account for more than 80% of the 1900-2012 linear warming in coastal NE Pacific SST and US Pacific northwest (Washington, Oregon, and northern California) SAT. An ensemble of climate model simulations run under the same historical radiative forcings fails to reproduce the observed regional circulation trends. These results suggest that natural internally generated changes in atmospheric circulation were the primary cause of coastal NE Pacific warming from 1900 to 2012 and demonstrate more generally that regional mechanisms of interannual and multidecadal temperature variability can also extend to century time scales.

Accelerometery and Heart Rate Responses of Professional Fast-Medium Bowlers in One-Day and Multi-Day Cricket.

The physical demands of fast-medium bowling are increasingly being recognised, yet comparative exploration of the differing demands between competitive formats (i.e. one-day [OD] versus multi-day [MD] matches) remain minimal. The aim of this study was to describe in-match physiological profiles of professional fast-medium bowlers from England across different versions of competitive matches using a multivariable wearable monitoring device. Seven professional cricket fast-medium bowlers wore the BioharnessTM monitoring device during matches, over three seasons (>80 hours in-match). Heart Rate (HR) and Acceleromety (ACC) was compared across match types (OD, MD) and different in-match activity states (Bowling, Between over bowling, Fielding). Peak acceleration during OD bowling was significantly higher in comparison to MD cricket ([OD vs. MD] 234.1 ± 57.9 vs 226.6 ± 32.9 ct·episode-1, p < 0.05, ES = 0.11-0.30). Data for ACC were also higher during OD than MD fielding activities (p < 0.01, ES = 0.11-.30). OD bowling stimulated higher mean HR responses (143 ± 14 vs 137 ± 16 beats·min-1, p < 0.05, ES = 0.21) when compared to MD matches. This increase in OD cricket was evident for both between over (129 ± 9 vs 120 ± 13 beats·min-1,p < 0.01, ES = 0.11-0.50) and during fielding (115 ± 12 vs 106 ± 12 beats·min-1, p < 0.01, ES = 0.36) activity. The increased HR and ACC evident in OD matches suggest greater acute physical loads than MD formats. Therefore, use of wearable technology and the findings provided give a valuable appreciation of the differences in match loads, and thus required physiological preparation and recovery in fast-medium bowlers.

The athletic profile of fast bowling in cricket: a review.

Cricket is a global sport played in over 100 countries with elite performers attracting multimillion dollar contracts. Therefore, performers maintaining optimum physical fitness and remaining injury free is important. Fast bowlers have a vital position in a cricket team, and there is an increasing body of scientific literature that has reviewed this role over the past decade. Previous research on fast bowlers has tended to focus on biomechanical analysis and injury prevention in performers. However, this review aims to critically analyze the emerging contribution of physiological-based literature linked to fast bowling in cricket, highlight the current evidence related to simulated and competitive in-match performance, and relate this practically to the conditioning coach. Furthermore, the review considers limitations with past research and possible avenues for future investigation. It is clear with the advent of new applied mobile monitoring technology that there is scope for more ecologically valid and longitudinal exploration capturing in-match data, providing quantification of physiological workloads, and analysis of the physical demands across the differing formats of the game. Currently, strength and conditioning specialists do not have a critical academic resource with which to shape professional practice, and this review aims to provide a starting point for evidence in the specific area.

Climatic context and ecological implications of summer fog decline in the coast redwood region.

Biogeographical, physiological, and paleoecological evidence suggests that the coast redwood [Sequoia sempervirens (D. Don) Endl.] is closely associated with the presence of summer marine fog along the Pacific coast of California. Here we present a novel record of summer fog frequency in the coast redwood region upon the basis of direct hourly measurements of cloud ceiling heights from 1951 to 2008. Our analysis shows that coastal summer fog frequency is a remarkably integrative measure of United States Pacific coastal climate, with strong statistical connections to the wind-driven upwelling system of the California Current and the broad ocean temperature pattern known as the Pacific Decadal Oscillation. By using a long-term index of daily maximum land temperatures, we infer a 33% reduction in fog frequency since the early 20th century. We present tree physiological data suggesting that coast redwood and other ecosystems along the United States west coast may be increasingly drought stressed under a summer climate of reduced fog frequency and greater evaporative demand.

Bioharness(™) multivariable monitoring device: part. I: validity.

The Bioharness(™) monitoring system may provide physiological information on human performance but there is limited information on its validity. The objective of this study was to assess the validity of all 5 Bioharness(™) variables using a laboratory based treadmill protocol. 22 healthy males participated. Heart rate (HR), Breathing Frequency (BF) and Accelerometry (ACC) precision were assessed during a discontinuous incremental (0-12 km·h(-1)) treadmill protocol. Infra-red skin temperature (ST) was assessed during a 45 min(-1) sub-maximal cycle ergometer test, completed twice, with environmental temperature controlled at 20 ± 0.1 °C and 30 ± 0.1 °C. Posture (P) was assessed using a tilt table moved through 160°. Adopted precision of measurement devices were; HR: Polar T31 (Polar Electro), BF: Spirometer (Cortex Metalyser), ACC: Oxygen expenditure (Cortex Metalyser), ST: Skin thermistors (Grant Instruments), P:Goniometer (Leighton Flexometer). Strong relationships (r = .89 to .99, p < 0.01) were reported for HR, BF, ACC and P. Limits of agreement identified differences in HR (-3.05 ± 32.20 b·min(-1)), BF (-3.46 ± 43.70 br·min(-1)) and P (0.20 ± 2.62°). ST established a moderate relationships (-0.61 ± 1.98 °C; r = 0.76, p < 0.01). Higher velocities on the treadmill decreased the precision of measurement, especially HR and BF. Global results suggest that the BioharressTM is a valid multivariable monitoring device within the laboratory environment. Key pointsDifferent levels of precision exist for each variable in the Bioharness(™) (Version 1) multi-variable monitoring deviceAccelerometry and posture variables presented the most precise dataData from the heart rate and breathing frequency variable decrease in precision at velocities ≥ 10 km·h(-1)Clear understanding of the limitations of new applied monitoring technology is required before it is used by the exercise scientist.

Bioharness(™) Multivariable Monitoring Device: Part. II: Reliability.

The Bioharness(™) monitoring system may provide physiological information on human performance but the reliability of this data is fundamental for confidence in the equipment being used. The objective of this study was to assess the reliability of each of the 5 Bioharness(™) variables using a treadmill based protocol. 10 healthy males participated. A between and within subject design to assess the reliability of Heart rate (HR), Breathing Frequency (BF), Accelerometry (ACC) and Infra-red skin temperature (ST) was completed via a repeated, discontinuous, incremental treadmill protocol. Posture (P) was assessed by a tilt table, moved through 160°. Between subject data reported low Coefficient of Variation (CV) and strong correlations(r) for ACC and P (CV< 7.6; r = 0.99, p < 0.01). In contrast, HR and BF (CV~19.4; r~0.70, p < 0.01) and ST (CV 3.7; r = 0.61, p < 0.01), present more variable data. Intra and inter device data presented strong relationships (r > 0.89, p < 0.01) and low CV (<10.1) for HR, ACC, P and ST. BF produced weaker relationships (r < 0.72) and higher CV (<17.4). In comparison to the other variables BF variable consistently presents less reliability. Global results suggest that the Bioharness(™) is a reliable multivariable monitoring device during laboratory testing within the limits presented. Key pointsHeart rate and breathing frequency data increased in variance at higher velocities (i.e. ≥ 10 km.h(-1))In comparison to the between subject testing, the intra and inter reliability presented good reliability in data suggesting placement or position of device relative to performer could be important for data collectionUnderstanding a devices variability in measurement is important before it can be used within an exercise testing or monitoring setting.

Field based reliability and validity of the bioharness™ multivariable monitoring device.

The Bioharness™ device is designed for monitoring physiological variables in free-living situations but has only been proven to be reliable and valid in a laboratory environment. Therefore, this study aimed to determine the reliability and validity of the Bioharness™ using a field based protocol. Twenty healthy males participated. Heart rate (HR), breathing frequency (BF) and accelerometry (ACC) were assessed by simultaneous measurement of two Bioharness™ devices and a test-retest of a discontinuous incremental walk-jog-run protocol (4 - 11 km·h(-1)) completed in a sports hall. Adopted precision of measurement devices were; HR: Polar T31 (Polar Electro), BF: Spirometer (Cortex Metalyser), ACC: Oxygen expenditure (Cortex Metalyser). For all data, precision of measurement reported good relationships (r = 0.61 to 0.67, p < 0.01) and large Limits of Agreement for HR (>79.2 b·min(-1)) and BF (>54.7 br·min(-1)). ACC presented excellent precision (r = 0.94, p < 0.01). Results for HR (r= ~0.91, p < 0.01: CV <7.6) and ACC (r > 0.97, p < 0.01; CV <14.7) suggested these variables are reliable. BF presented more variable data (r = 0.46-0.61, p < 0.01; CV < 23.7). As velocity of movement increased (>8 km·h(-1)) data became more erroneous. A data cleaning protocol removed gross errors in the data analysis and subsequent reliability and validity statistics improved across all variables. In conclusion, the Bioharness™ HR and ACC variables have demonstrated reliability and validity in a field setting, though data collected at higher velocities should be treated with caution. Measuring human physiological responses in a field based environment allows for more ecologically valid data to be collected and devices such as the Bioharness™ could be used by exercise professionals to begin to further investigate this area.

Changes in body dysmorphic disorder, eating disorder, and exercise addiction symptomology during the COVID-19 pandemic: A longitudinal study of 319 health club users.

The aim of this longitudinal study was to examine the effect of COVID-19 quarantines on morbid exercise, eating, and body image behaviours pre vs post COVID-19 lockdown. Participants (n=319; mean age 36.77 SD=11.75; 84% female) were recruited to complete a battery of questions with 14 month follow-up. Exercise addiction scores were significantly lower post-lockdown; eating disorder symptomology scores were significantly higher post-COVID-19 lockdown; and leisure-time exercise significantly increased post-COVID-19 lockdown. No differences in body dysmorphic disorder were found. If future lockdowns are enforced, practitioners working with people with suspected morbid eating habits should monitor this closely.

Home Administration of CVD 103-HgR: A Live Attenuated Oral Cholera Vaccine.

Vaccination is a well-established means for prevention and spread of disease in people traveling abroad. Although vaccines to diseases such as cholera are recommended by world health agencies, they are seldom required even when traveling to endemic regions. Consequences of noncompliance can affect traveler's health and spread diseases to new regions, as occurred in Haiti in 2010 when United Nations peacekeepers from Nepal, where a cholera outbreak was underway, introduced the disease to the region. Steps to increase vaccine recommendation compliance should therefore be an integral part of vaccine development. PXVX0200 contains Center for Vaccine Development 103-HgR live, attenuated recombinant Vibrio cholerae vaccine strain, and is indicated for single-dose immunization against the bacteria that causes cholera. It is supplied as one buffer and one active component packet to be mixed into water and ingested. Administration instructions are designed to be "user friendly" with flexibility for self-administration, thus promoting compliance. Studies to support self-administration were conducted to cover stability of the vaccine outside of normal storage conditions, potency in case of misadministration, and disposal procedures to minimize environmental impact. The principal findings showed that the stability of vaccine was maintained under conditions allowing for transport times and temperature conditions as well as when misadministration errors were made. Finally, the vaccine was effectively neutralized with hot water and soap to prevent bacterial environmental contamination in the event of an accidental spill. The conclusion is that PXVX0200 oral vaccine is stable, easy to formulate and dispose of, and is amenable to self-administration.

Is the pink ball still under review? Cricket umpires' perceptions of the pink ball for day/night matches.

OBJECTIVES: The visibility of the pink ball used in day/night Test cricket has been under scrutiny, with recent research suggesting cricketers find the pink ball less visible at dusk under floodlights. With increasing interest in this match format, this study sought to investigate elite umpires' opinions pertaining to the visibility of the pink cricket ball during day/night matches. DESIGN: Purposeful sampling of a cross-section of elite umpires with experience adjudicating matches played using a pink cricket ball. METHODS: Twenty-seven international/first-class umpires completed a questionnaire consisting of Likert scale and free text responses covering perceptions of the pink cricket ball, with a particular emphasis on visibility. RESULTS: The pink ball when viewed at night under floodlights was rated as being significantly more visible than the red ball during natural lighting (ps<0.050). Umpires who actively participated in training reported a significantly higher rating of the visibility of the pink ball (mean -3.14) at night under floodlights compared to those who didn't (mean p=0.010). No significant difference was reported in visibility in natural light or dusk under floodlights. Free text responses (n=10) revealed the following themes: use of eyewear (coverage 0.30), and adjustment to positioning (coverage 0.20) to improve visibility of the pink ball. CONCLUSIONS: Umpires report the visibility of the pink ball is equal to the red in natural light and at dusk but is significantly better at night. Preference for the pink ball is likely due to the predominantly perceptual nature of visual tasks performed by umpires.

Cricketers are not tickled pink by the new coloured ball.

OBJECTIVES: Cricket administrators have started scheduling long-form matches which finish at night and are played with a pink as opposed to a red ball. However, there are reports that the pink ball may introduce new dangers and alter performance. The aim of this study was to investigate professional cricketers' opinions about the visibility of the pink ball whilst playing in different lighting conditions (afternoon, dusk and night). DESIGN: Purposeful sampling of a cross-section of elite cricketers with pink ball experiences playing in the United Kingdom. METHODS: Eighty-eight international or first-class professional cricketers completed a questionnaire consisting of Likert scale and free text responses to questions covering perceptions of the pink ball, with a particular emphasis on visibility. RESULTS: The pink ball was reported as less visible than the red ball when batting (p<0.001) and fielding (p<0.001). Within the three lighting conditions the pink ball was significantly less visible at dusk under floodlights compared to afternoon and night both when batting and fielding (ps<0.001). Free text comments confirmed that visibility of the pink cricket ball was most challenging at dusk (coverage 0.37), and that players sometimes experienced a blurring sensation with the pink ball leaving a visual 'trail' when viewed under floodlights (coverage 0.24). CONCLUSIONS: Results advocate that governing bodies should consider the inclusion of a break in play during dusk to enhance player safety and performance. Empirical research is needed to quantify the risks to player safety in different lighting conditions.

Physiologic profile of professional cricketers.

This study aims to provide a physiologic profile of professional cricketers and note positional differences at the start of the 2007/08 competitive season. Fifteen participants (9 bowlers, 6 batsmen) aged 25.0 ± 5.0 years (mean ± SD) took part in this study. Participants (bowlers and batsmen) completed a series of field-based fitness assessments: body composition (sum of 7 skinfolds, 72.5 ± 16.5 and 65.5 ± 19.3 mm, respectively), flexibility (sit and reach 8.1 ± 10.3 and 6.0 ± 6.2 cm, respectively), predicted maximal oxygen uptake (multistage shuttle run, 54.1 ± 2.8 and 56.1 ± 4.5 ml-1·kg-1·min-1, respectively), upper- (medicine ball throw, 7.7 ± 0.6 and 7.0 ± 0.1 m, respectively) and lower-body strength (countermovement jump, 45.7 ± 5.8 and 43.9 ± 4.1 cm, respectively), speed (sprint 17.7 m, 2.76 ± 0.6 and 2.77 ± 0.1 s, respectively), and explosive power (repeated jump, 31.0 ± 2.0 and 34.1 ± 4.8 cm, respectively). The data provided the physical fitness profile for each player, which, compared with normative data, identified that this cohort of professional cricketers had some superior fitness parameters compared with the general population, and where applicable, were comparable with other professional athletes. In addition, after effect size calculations, the results showed that some physical fitness differences existed between playing positions. Cricket professionals possess a superior level of physical fitness and strength, and conditioning coaches should seek to progress these physical parameters and further identify position-specific physical requirements to progress the modern game.

Exercise Addiction Prevalence and Correlates in the Absence of Eating Disorder Symptomology: A Systematic Review and Meta-analysis.

BACKGROUND: Exercise addiction (EA) can be debilitating and can be a symptom of an eating disorder. To date, the prevalence rates of EA without indicated eating disorders in the general population and associated correlates remain unreported. METHODS: Two authors searched major databases from inception to 31/12/2018 to identify studies investigating the prevalence of EA in any population without indicated eating disorders. We conducted a random effects meta-analysis to report (i) prevalence rates of EA using the exercise addiction inventory and exercise dependence scale and compare sub-populations, (ii) compare methods of EA measurement and explore heterogeneity, and (iii) report on correlates. RESULTS: A total of 13 studies including 3635 people were included. The prevalence of EA among general exercisers was 8.1% (95% CI 1.5%-34.2%), amateur competitive athletes was 5.0% (95% CI 1.3%-17.3%), and university students was 5.5% (95% CI 1.4-19.1%%). Overall prevalence rates varied depending on the EA measurement tool. EA subjects were more likely to have lower levels of overall wellbeing (only in amateur competitive athletes), higher anxiety levels, and have greater frontal brain activity. CONCLUSIONS: EA is prevalent in the absence of indicated eating disorders across populations but varies depending on measurement tool. Further research is needed to explore EA without indicated eating disorders in different populations using homogenous measurement tools, further determine psychological correlates, and examine which measures of EA without indicated eating disorders predict poor health outcomes.

Effect of a short-term low fermentable oligiosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet on exercise-related gastrointestinal symptoms.

BACKGROUND: Research has demonstrated that low fermentable oligiosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diets improve gastrointestinal (GI) symptoms in irritable bowel syndrome sufferers. Exercise-related GI issues are a common cause of underperformance, with current evidence focusing on the use of FODMAP approaches with recreationally competitive or highly trained athletes. However, there is a paucity of research exploring the potential benefit of FODMAP strategies to support healthy, recreational athletes who experience GI  issues during training. This study therefore aimed to assess whether a short-term LOWFODMAP diet improved exercise-related GI symptoms and the perceived ability to exercise in recreational runners. METHODS: Sixteen healthy volunteers were randomly assigned in a crossover design manner to either a LOWFODMAP (16.06 ± 1.79 g·d- 1) or HIGHFODMAP (38.65 ± 6.66 g·d- 1) diet for 7 days, with a one week washout period followed by a further 7 days on the alternate diet. Participants rated their gastrointestinal symptoms on an adapted version of the Irritable Bowel Syndrome-Severity Scoring System (IBS-SSS) questionnaire before and at the end of each dietary period. Perceived ability to exercise (frequency, intensity and duration) in relation to each dietary period was also rated using a visual analogue scale. Resting blood samples were collected prior to and on completion of each diet to determine plasma intestinal fatty acid binding protein (I-FABP) as a marker of acute GI injury. RESULTS: Overall IBS-SSS score significantly reduced in the LOWFODMAP condition from 81.1 ± 16.4 to 31.3 ± 9.2 (arbitrary units; P = 0.004). Perceived exercise frequency (z = 2.309, P = 0.02) and intensity (z = 2.687, P = 0.007) was significantly improved following a short-term LOWFODMAP approach compared to HIGHFODMAP. No significant differences were reported between dietary conditions for plasma I-FABP (P > 0.05). CONCLUSIONS: A short-term LOWFODMAP diet under free-living conditions reduced exercise-related GI symptoms and improved the perceived ability to exercise in otherwise healthy, recreational runners. These findings may be explained by a reduction in indigestible carbohydrates available for fermentation in the gut. The therapeutic benefits of LOWFODMAP diets in recreational and trained athletes during sustained training periods warrants further investigation.

Promoting physical activity in vulnerable adults 'at risk' of homelessness: a randomised controlled trial protocol.

INTRODUCTION: People who are homeless, or at risk of homelessness, have substantially poorer health. Sustained and regular participation in physical activity is beneficial for both mental and physical health. Limited data suggest that levels of physical activity in the homeless and those at risk of homelessness are low, and access to community-based exercise is limited or non-existent for this population. Nonetheless, exercise programmes for the homeless could provide a feasible and scalable intervention for providing beneficial effects on physical and mental health in this population. The primary aim of this study is to evaluate the impact of a group exercise intervention on activity levels in people who are homeless or at risk of homelessness in central London, UK. The secondary aim is to evaluate the impact of the intervention on mental and physical health outcomes. METHOD AND ANALYSIS: A 2-arm, individually randomised controlled trial in people who are homeless and those vulnerable and at risk of homelessness in central London, UK. Participants will be recruited through a London-based homeless charity, Single Homeless Project. Following baseline assessments and allocation to intervention (exercise classes) or control (usual care), participants will be followed up at 3, 6, 9 and 12 months. The primary outcomes will be change in objective physical activity. The secondary outcomes will include change in fitness assessments and mental health parameters. Changes in drug use and alcohol dependency will also be explored. ETHICS AND DISSEMINATION: Ethical approval to process and analyse data and disseminate findings was obtained through the Anglia Ruskin University Department of Sport and Exercise Sciences Research Ethics Committee. Results of this study will be disseminated through peer-reviewed publications and scientific presentations.

Correction: Roberts et al. "Satiating Effect of High Protein Diets on Resistance-Trained Individuals in Energy Deficit" Nutrients 2019, 11(1), 56.

The authors wish to make a correction to the published version of their paper [...].

Health behaviours and mental and physical health status in older adults with a history of homelessness: a cross-sectional population-based study in England.

OBJECTIVES: This study compared (1) levels of engagement in lifestyle risk behaviours and (2) mental and physical health status in individuals who have previously been homeless to those of individuals who have not. DESIGN: Cross-sectional. PARTICIPANTS: Data were from participants (n=6931) of the English Longitudinal Study of Ageing. : Measures : Participants reported whether they had ever been homeless. We used regression models to analyse associations between homelessness and (1) cigarette smoking, daily alcohol consumption and physical inactivity, adjusting for sociodemographic covariates (age, sex, ethnicity, highest level of education, marital status and household non-pension wealth) and (2) self-rated health, limiting long-standing illness, depressive symptoms, life satisfaction, quality of life and loneliness, adjusting for sociodemographics and health behaviours. RESULTS: 104 participants (1.5%) reported having been homeless. Individuals who had been homeless were significantly more likely to be physically inactive (OR 1.62, 95% CI 1.44 to 2.52), report fair/bad/very bad self-rated health (OR 1.75, 95% CI 1.07 to 2.86), have a limiting long-standing illness (OR 2.66, 95% CI 1.65 to 4.30) and be depressed (OR 3.06, 95% CI 1.85 to 5.05) and scored lower on measures of life satisfaction (17.34 vs 19.96, p<0.001) and quality of life (39.02 vs 41.21, p=0.013). Rates of smoking (20.2% vs 15.4%, p=0.436), daily drinking (27.6% vs 22.8%, p=0.385) and loneliness (27.1% vs 21.0%, p=0.080) were also elevated. CONCLUSIONS: Those who were once homeless have poorer mental and physical health outcomes and are more likely to be physically inactive. Interventions to improve their health and quality of life are required.