Dietary practices and influences on diet intake among women in a Woodland Cree community.

BACKGROUND: Overweight and obesity are increasing concerns among Aboriginal women, and lifestyle behaviours (i.e. dietary patterns and physical activity) are considered to be contributing factors. The present study aimed to explore the social, cultural, behavioural and environmental factors influencing diet intake from a trans-generational perspective and to characterise the dietary practices among Woodland Cree women. METHODS: A mixed methods design using a concurrent triangulation approach explored the factors influencing diet intake and healthy eating among First Nations women on a reserve community in northern Saskatchewan, Canada. Dietary practices were assessed using 24-h recalls. RESULTS: Dietary analysis revealed low intake of fruits and vegetables and milk and alternatives in the sample, with high intake of 'other' foods. Limited amounts of traditional food (TF) were reported. Taste primarily influenced food choice, with a preference for TF highlighted among older participants. Healthy eating was considered to be a health-promoting behaviour, yet a lack of availability, high costs and difficulties accessing various foods were the most noted barriers to healthy eating. CONCLUSIONS: The dietary practices in this sample indicate the limited consumption and variety of TF and fruits and vegetables, and a high consumption of 'other' foods, which suggests inadequate intakes of various vitamins and nutrients. The findings from a trans-generational perspective highlight various barriers across the age groups that can substantially impact food choices, and reinforces the need for community and age-specific strategies to address issues of exposure, accessibility and affordability to nutritious foods that improve the diet and preserve cultural identity among residents living in reserve communities.

Home versus center based physical activity programs in older adults.

BACKGROUND: Physical inactivity is a leading cause of preventable death and morbidity in developed countries. In addition physical activity can potentially be an effective treatment for various medical conditions (e.g. cardiovascular disease, osteoarthritis). Many types of physical activity programs exist ranging from simple home exercise programs to intense highly supervised hospital (center) based programs. OBJECTIVES: To assess the effectiveness of 'home based' versus 'center based' physical activity programs on the health of older adults. SEARCH STRATEGY: The reviewers searched the Cochrane Central Register of Controlled Trials (CENTRAL) (1991-present), MEDLINE (1966-Sept 2002), EMBASE (1988 to Sept 2002), CINAHL (1982-Sept 2002), Health Star (1975-Sept 2002), Dissertation Abstracts (1980 to Sept 2002), Sport Discus (1975-Sept 2002) and Science Citation Index (1975-Sept 2002), reference lists of relevant articles and contacted principal authors where possible. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials of different physical activity interventions in older adults (50 years or older) comparing a 'home based' to a 'center based' exercise program. Study participants had to have either a recognised cardiovascular risk factor, or existing cardiovascular disease, or chronic obstructive airways disease (COPD) or osteoarthritis. Cardiac and post-operative programs within one year of the event were excluded. DATA COLLECTION AND ANALYSIS: Three reviewers selected and appraised the identified studies independently. Data from studies that then met the inclusion/exclusion criteria were extracted by two additional reviewers. MAIN RESULTS: Six trials including 224 participants who received a 'home based' exercise program and 148 who received a 'center based' exercise program were included in this review. Five studies were of medium quality and one poor. A meta-analysis was not undertaken given the heterogeneity of these studies. CARDIOVASCULAR. The largest trial (accounting for approximately 60% of the participants) looked at sedentary older adults. Three trials looked at patients with peripheral vascular disease (intermittent claudication). In patients with peripheral vascular disease center based programs were superior to home at improving distance walked and time to claudication pain at up to 6 months. However the risk of a training effect may be high. There are no longer term studies in this population. Notably home based programs appeared to have a significantly higher adherence rate than center based programs. However this was based primarily on the one study (with the highest quality rating of the studies found) of sedentary older adults. This showed an adherence rate of 68% in the home based program at two year follow-up compared with a 36% adherence in the center based group. There was essentially no difference in terms of treadmill performance or cardiovascular risk factors between groups. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). Two trials looked at older adults with COPD. In patients with COPD the evidence is conflicting. One study showed similar changes in various physiological measures at 3 months that persisted in the home based group up to 18 months but not in the center based group. The other study showed significantly better improvements in physiological measures in the center based group after 8 weeks but again the possibility of a training effect is high. OSTEOARTHRITIS. No studies were found. None of the studies dealt with measures of cost, or health service utilization. AUTHORS' CONCLUSIONS: In the short-term, center based programs are superior to home based programs in patients with PVD. There is a high possibility of a training effect however as the center based groups were trained primarily on treadmills (and the home based were not) and the outcome measures were treadmill based. There is conflicting evidence which is better in patients with COPD. Home based programs appear to be superior to center based programs in terms of the adherence to exercise (especially in the long-term).

Creatine monohydrate and resistance training increase bone mineral content and density in older men.

Our purpose was to determine the effects of creatine supplementation combined with resistance training on bone mineral content and density in older men. Twenty-nine older men (age 71 y) were randomized (double blind) to receive creatine (0.3 g/kg creatine for 5 d and 0.07 g/kg thereafter) or placebo while participating in resistance training (12 weeks). Bone mineral content and density were determined by dual energy X-ray absorptiometry before and after training. There was a time main effect for whole-body and leg bone mineral density (p < or = 0.05) with these measures increasing by approximately 0.5%, and 1%, respectively in the combined groups. There was a group by time interaction for arms bone mineral content, with the group receiving creatine increasing by 3.2% (p < 0.01) and the group receiving placebo decreasing by 1.0% (not significant). Changes in lean tissue mass of the arms correlated with changes in bone mineral content of the arms (r = 0.67; p < 0.01). Resistance training of 12 weeks increases bone mineral density in older men and creatine supplementation may provide an additional benefit for increasing regional bone mineral content. The increase in bone mineral content may be due to an enhanced muscle mass with creatine, with potentially greater tension on bone at sites of muscle attachment.

Exercise intensity: effect on postexercise O2 uptake in trained and untrained women.

Despite many reports of long-lasting elevation of metabolism after exercise, little is known regarding the effects of exercise intensity and duration on this phenomenon. This study examined the effect of a constant duration (30 min) of cycle ergometer exercise at varied intensity levels [50 and 70% of maximal O2 consumption (VO2max)] on 3-h recovery of oxygen uptake (VO2). VO2 and respiratory exchange ratios were measured by open-circuit spirometry in five trained female cyclists (age 25 +/- 1.7 yr) and five untrained females (age 27 +/- 0.8 yr). Postexercise VO2 measured at intervals for 3 h after exercise was greater (P less than 0.01) after exercise at 50% VO2max in trained (0.40 +/- 0.01 l/min) and untrained subjects (0.39 +/- 0.01 l/min) than after 70% VO2max in (0.31 +/- 0.02 l/min) and untrained subjects (0.29 +/- 0.02 l/min). The lower respiratory exchange ratio values (P less than 0.01) after 50% VO2max in trained (0.78 +/- 0.01) and untrained subjects (0.80 +/- 0.01) compared with 70% VO2max in trained (0.81 +/- 0.01) and untrained subjects (0.83 +/- 0.01) suggest that an increase in fat metabolism may be implicated in the long-term elevation of metabolism after exercise. This was supported by the greater estimated fatty acid oxidation (P less than 0.05) after 50% VO2max in trained (147 +/- 4 mg/min) and untrained subjects (133 +/- 9 mg/min) compared with 70% VO2max in trained (101 +/- 6 mg/min) and untrained subjects (85 +/- 7 mg/min).

Creatine supplementation combined with resistance training in older men.

PURPOSE: To study the effect of creatine (Cr) supplementation combined with resistance training on muscular performance and body composition in older men. METHODS: Thirty men were randomized to receive creatine supplementation (CRE, N = 16, age = 70.4 +/- 1.6 yr) or placebo (PLA, N = 14, age = 71.1 +/- 1.8 yr), using a double blind procedure. Cr supplementation consisted of 0.3-g Cr.kg(-1) body weight for the first 5 d (loading phase) and 0.07-g Cr.kg(-1) body weight thereafter. Both groups participated in resistance training (36 sessions, 3 times per week, 3 sets of 10 repetitions, 12 exercises). Muscular strength was assessed by 1-repetition maximum (1-RM) for leg press (LP), knee extension (KE), and bench press (BP). Muscular endurance was assessed by the maximum number of repetitions over 3 sets (separated by 1-min rest intervals) at an intensity corresponding to 70% baseline 1-RM for BP and 80% baseline 1-RM for the KE and LP. Average power (AP) was assessed using a Biodex isokinetic knee extension/flexion exercise (3 sets of 10 repetitions at 60 degrees.s(-1) separated by 1-min rest). Lean tissue (LTM) and fat mass were assessed using dual energy x-ray absorptiometry. RESULTS: Compared with PLA, the CRE group had significantly greater increases in LTM (CRE, +3.3 kg; PLA, +1.3 kg), LP 1-RM (CRE, +50.1 kg; PLA +31.3 kg), KE 1-RM (CRE, +14.9 kg; PLA, +10.7 kg), LP endurance (CRE, +47 reps; PLA, +32 reps), KE endurance (CRE, +21 reps; PLA +14 reps), and AP (CRE, +26.7 W; PLA, +18 W). Changes in fat mass, fat percentage, BP 1-RM, and BP endurance were similar between groups. CONCLUSION: Creatine supplementation, when combined with resistance training, increases lean tissue mass and improves leg strength, endurance, and average power in men of mean age 70 yr.

The relationship of pubertal status to body image, social physique anxiety, preoccupation with weight and nutritional status in young females.

The relationship of puberty to body image, social physique anxiety, preoccupation with weight and nutritional status was examined in 77 non-obese females (7-16 years). Results showed that 34% of the pre-pubescent girls, 36% of the early pubescent girls and 76% of the post-pubescent girls were dissatisfied with their body shape. Social physique anxiety, determined by the SPAS scale, and preoccupation with weight, measured by the Eating Disorder Inventory were observed in all pubertal groups but were more evident in the early and post-pubescent groups. No significant difference existed among the maturation groups in mean caloric and nutrient intake. The results showed that antecedents for developing an eating disorder existed in all maturational groups studied, although no health risk behaviours regarding nutritional status were observed.

Components of quality of life for persons with a quadriplegic and paraplegic spinal cord injury.

This investigation determined the themes that represented quality of life for persons with a spinal cord injury. Fifteen people (6 females, 9 males; 7 persons with quadriplegia, 8 with paraplegia) participated in this study, which used naturalistic inquiry methodologies. Results showed that quality of life for this population, regardless of severity of impairment, consisted of nine themes: (a) physical function and independence, (b) accessibility, (c) emotional well-being, (d) stigma, (e) spontaneity, (f) relationships and social function, (g) occupation, (h) finances, and (i) physical well-being. The themes of life quality were similar for quadriplegics and paraplegics; however, physical function and independence and physical well-being affected the quality of life of persons with a quadriplegic injury to a greater extent. These findings may provide health professionals with information necessary to assist in the development of programs to enhance quality of life.

Fitness characteristics of competitors in a six day sailboard marathon.

The purpose of this study was to profile the fitness characteristics of competitors in a 6 day sailboard marathon and assess the aerobic demands encountered. Twenty one male sailboarders were assessed for body composition, horizontal shoulder adduction and abduction strength as well as grip strength. Body composition was assessed by skinfold measurement and strength measured by dynamometer. A subgroup of 5 subjects were assessed for VO2 max by indirect calorimetry using a treadmill protocol. Functional capacity was determined as the quotient of VO2 max and the VO2 at rest and the aerobic conditioning threshold estimated. The corresponding threshold heart rate was determined. During each days racing, heart rate was continuously monitored from 2 different members of the subgroup. In the total group body fat was 19.1 +/- 5.1%, grip strength was 502.3 +/- 61.8 N and horizontal shoulder adduction and abduction strength was 449.3 +/- 121.6 N and 437 +/- 94.2 N respectively. In the subgroup, VO2 max was 49.6 +/- 3.7 ml/kg/min, functional capacity was 8.8 +/- 0.9 METS and threshold heart rate occurred between 155 +/- 5.2 and 161 +/- 4.6 beats/min. Heart rate response during sailing was typically in the 120-150 beats/min range. The results indicated that sailboarding does not promote high levels of aerobic fitness.

Climatic stress in the workplace: its effect on thermoregulatory responses and muscle fatigue in female workers.

The present study was designed to determine the differences in thermoregulatory responses and the levels of muscle fatigue in the seated worker, performing a task involving a light metabolic load (typing), versus the standing worker, undertaking a task of a heavier metabolic load (lifting), in different climatic conditions (neutral and hot, humid). The results showed that environmental heat significantly influenced the cardiovascular and thermoregulatory systems in workers performing both light and heavy work tasks. In addition, environmental heat was shown to influence the magnitude of the frequency shift during the fatiguing muscle contraction in the typists rather than the lifters. These results suggest that: (1) performance of even sedentary workers performing a light manual task may be deleteriously affected by environmental heat; and (2) environmental heat may be of secondary importance to the nature of the task investigated on the level of muscle fatigue.

Determining the relation between quality of life, handicap, fitness, and physical activity for persons with spinal cord injury.

OBJECTIVE: Determining relationships among fitness, physical activity, subjective quality of life, and handicap in persons with spinal cord injury (SCI). DESIGN: Cross-sectional exploratory study. SETTING: University research laboratory setting. PARTICIPANTS: Twenty-eight men and 10 women (age 35.9+/-9.3 yrs) with SCI (17 quadriplegic, 21 paraplegic). MAIN OUTCOME MEASURES: Fitness (maximal incremental exercise test on arm ergometer), physical activity (leisure time exercise questionnaire), subjective quality of life (Quality of Life Profile: Physical and Sensory Disabilities Version), and level of handicap (Craig Handicap Assessment Reporting Technique). Correlational analyses examined relationships between the measures. RESULTS: Physical activity was correlated with composite handicap score in quadriplegic and paraplegic persons. Handicap domain scores for physical independence, mobility, and occupation were correlated with physical activity in quadriplegic persons. There was no relation between the subjective quality of life scores and fitness and physical activity in either group. CONCLUSIONS: Physical activity may play an important role in handicap for persons with SCI, particularly persons with quadriplegic injuries. The lack of a relation between activity variables and subjective quality of life may be related to the global nature of the measure used.

The effect of exercise duration on the exercise and post-exercise oxygen consumption.

This study was designed to determine the effect of duration (30, 45, 60 min) of exercise at 70% VO2 max on oxygen consumption during the exercise and post-exercise periods and if the post-exercise oxygen consumption (EPOC) is related to elevated tympanic temperature. Two male and three female volunteer subjects cycled at 70% VO2 max for 30, 45 and 60 min. The EPOC increased 2.35 and 5.3 fold when exercise duration was increased from 30 to 45 min and from 30 to 60 min respectively. The time for VO2 to return to resting levels following exercise was 128 +/- 4.4 min, 204 +/- 15.9 min and 455 +/- 30.0 min after the 30, 45 and 60 min exercise bouts. Tympanic temperatures were stable at 38.6 degrees C after approximately 30 min of exercise, but all had fallen to resting conditions approximately two hours post-exercise. The correlation between core temperature and EPOC, and RER and EPOC, was r = 0.64-0.75 and r = 0.86-0.89, respectively. These data emphasize the importance of extending the work time for elevating the energy cost during and post-exercise, and suggest that the EPOC can be explained in part by the effects of elevated temperature and metabolic substrate.

The effectiveness of the Canadian Quality Daily Physical Education program on school physical education.

The effectiveness of the Canadian Quality Daily Physical Education (QDPE) program in creating awareness, support, and influencing school based physical education programs was determined using quantitative and qualitative methodologies. Participants included teachers, principals and vice principals, school board officials and trustees, professional agencies and association, and provincial ministry of education officials. Findings showed this national initiative increased awareness and support of QDPE among all participants. Although the influence of this increased awareness and support on school physical education programming was limited, the greatest impact was in time committed to instruction, development of curricula, instruction of classes, delivery of intramural programs, professional development, and student response to physical education. The least impact was on hiring of physical education specialists, the number of staff, and funding for physical education.

Body composition in nutritionally adequate ambulatory and non-ambulatory children with cerebral palsy and a healthy reference group.

Bone-mineral content (BMC; g) and density (BMD; g/cm2) were measured by dual energy X-ray absorptiometry in the proximal femur, femoral neck, and total body of nutritionally adequate children (n=17; 11 girls, six boys; aged 7.6 to 13.8 years) with spastic cerebral palsy (CP). Bone-mineral-free lean tissue (BMFL; g) and fat mass (FM; g) were obtained from total body scans. Chronological and developmental age-based z scores for the children with CP were derived from a pediatric database (n=894). Children with CP had BMC z scores from -1.8 (total body) to -3.2 (femoral neck) SDs below the normative sample. Non-independent ambulators had lower z scores for total body BMD, femoral neck BMD, and BMC than independent ambulators. The BMFL z score of individuals with CP was 2 SDs below that of the reference group and higher in the independent ambulators than in the non-independent ambulators, whereas FM deviated little. These findings suggest that non-nutritional factors, such as ambulation, account for the low BMC, BMD, and BMFL tissue observed in this population.

The effect of a weight-bearing physical activity program on bone mineral content and estimated volumetric density in children with spastic cerebral palsy.

After an 8-month physical activity intervention in children with cerebral palsy, increases in femoral neck bone mineral content (BMC) (9.6%), volumetric bone mineral density (v BMD) (5.6%), and total proximal femur BMC (11.5%) were observed in the intervention group (n = 9) compared with control subjects (n = 9; femoral neck BMC, -5. 8%; v BMD, -6.3%; total proximal femur BMC, 3.5%).