Changes in obesity, cardiorespiratory fitness and habitual physical activity following a one-year intervention program in obese youth: a pilot study.

AIM: The aim To assess the effects of a unique twelve month program of physical activity and health education on body mass index, cardiorespiratory fitness and physical activity habits in obese youth. METHODS: Thirty-seven physician referred subjects, nineteen girls (12.7 ± 3.1 years) and eighteen boys (12.2 ± 2.8 years) participated in the study. Treatment consisted of a unique program of physical activity that emphasized playing games. Activity sessions were offered one time per week, two hours each session, for twelve months. A two hour health education class was provided every 3 months. Weight, height, Body Mass Index, cardiorespiratory fitness and habitual physical activity were measured. RESULTS: Findings of the study demonstrated a significant improvement in body mass index, cardiorespiratory fitness (P<0.001), and habitual physical activity (P<0.05). CONCLUSION: Results of the pilot study were favorable in addressing serious health issues in young obese boys and girls.

Coronary disease risk factor reduction and behavior modification in minority adolescents: the PATH program.

PURPOSE: To evaluate the impact of a unique school-based program of exercise, health education, and behavior modification on health knowledge, health behaviors, coronary risk factors, and cardiovascular fitness in minority adolescents. METHODS: A total of 346 students from an inner-city public high school participated in health promotion intervention or regular physical education volleyball classes. Subjects were African-American (47%), Asian-American (9%), Hispanic (21%), white (3%), and other (19%). The health promotion curriculum consisted of 11 weeks of daily circuit training exercise and health lecture-discussions. RESULTS: The groups were similar in age, height, weight, ethnicity, and socioeconomic status. Following intervention both boys (P < .001) and girls (P < .006) significantly improved health knowledge test scores. Significant benefits for girls included improved dietary habits (P < .05), reduced cholesterol (P < .004), and higher estimated V(O2)max (P < .0001). There were no other significant changes in boys. CONCLUSIONS: The results suggest that a school-based health promotion program of exercise and health lecture-discussion is beneficial for multiethnic, inner-city adolescents, especially females.

Body fat distribution in pre-and post-menopausal women: metabolic and anthropometric variables.

BACKGROUND: Abdominal obesity is associated with coronary risk although the causality is not well established. OBJECTIVE: To compare body fat distribution and metabolic variables in obese pre- and post- menopausal women. DESIGN: The study was conducted in 55 obese female subjects (22 pre- and 33 post- menopausal) with body mass indices (BMI) from 27 to 35 Kg/m2. Body fat distribution was measured using waist and hip circumference and computerized tomography. Hormones such as estradiol, testosterone, androstenedione, dehydroepiandrosterone-sulfate, as well as plasma lipids such as triglycerides, total cholesterol, high density lipoprotein, low density lipoprotein, apoproteins A and B, were also determined. RESULTS: No significant differences were found between the two groups in BMI, percentage of body fat, waist circumference, triceps, biceps, suprailiac and abdominal skinfolds. Hip circumference, subscapular skinfold and subcutaneous abdominal adipose tissue area were significantly lower, and waist-hip ratio, visceral area and visceral to subcutaneous area ratios significantly higher in post- menopausal women (P < 0.05). As was expected, basal plasma estrogens, and dehydroepiandrosterone-sulfate, were significantly higher in pre-menopausal women. When comparing plasma lipids, blood cholesterol and low density lipoprotein, values were significantly higher in the post-menopausal group (P < 0.05). CONCLUSIONS: Our data suggest that body fat distribution changes according to menopausal status, with central obesity more pronounced in post- menopausal women. Metabolic abnormalities are related more to visceral adipose tissue and estrogen plasma levels than to BMI.

Isometric Exercise and the Cardiovascular System.

In brief: There is little evidence that isometric exercise benefits the cardiovascular system, and many physicians believe that it imposes undue demands on the myocardium, so they prohibit such exercises for middle-aged or coronary disease patients. This review article examines the validity of this conclusion by summarizing the effects of isometric exercise on heart rate, blood pressure, myocardial demand, cardiac output, peripheral blood flow, and left ventricular function. Dr. Fardy concludes that isometric exercise is less hazardous than has been presumed and says guidelines should be established according to each patient's history.

Benefits of Arm Exercise in Cardiac Rehabilitation.

Knowing the importance of arm exercise as well as leg exercise, and the physiological benefits of both, can aid the physician in designing a rehabilitation program for cardiac patients.

Relationship between sleep habits, anthropometric characteristics and lifestyle habits in adolescents with intellectual disabilities.

The aim was to explore the relationship between sleep habits and overweight/obesity, physical activity and sedentary behaviours in French adolescents with intellectual disabilities. This observational study was conducted on 535 French adolescents with intellectual deficiency. Sleep habits were analyzed and related to anthropometric measures, physical activity and sedentary behaviours. The study was conducted using a self-administered questionnaire. Adolescents completed the questionnaire during an interview with the principle investigator. Sleep timing behaviour was classified into 4 sleep patterns: Early-bed/Early-rise, Early-bed/Late-rise, Late-bed/Late-rise, and Late-bed/Early-rise. Of 573 eligible participants, 125 were excluded because of missing data on age, weight or height. The number of participants identified in each of the four sleep patterns was as follows: Early-bed/Early-rise, N=59 (15.4%), Early-bed/Late-rise, N=164 (43%), Late-bed/Early-rise, N=56 (15%), Late-bed/Late-rise N=102 (27%). Adolescents who woke up early were more active than those from the late rise group (p<0.001). The number of adolescents who are sedentary was higher in late rise vs. early rise subjects (p<0.001). Subjects in the late-bed group were more likely overweight and obese (p<0.05). Results suggest that sleep behaviour was associated with overweight/obesity, physical activity and sedentary behaviour in adolescents with intellectual deficiency. Sleep behaviours should be considered in planning health promotion strategies.

Cardiac rehabilitation program focuses on total patient.

One hospital's attempt to combat the nation's leading cause of death is presented here. This medium-sized community hospital has initiated a cardiac rehabilitation program that encompasses the psychosocial as well as the physical well-being of the patient. The three-phase plan involves regular physical examinations, educational counseling for patients and families, and individualized inpatient and outpatient exercise regimens.

Evaluating the effects and feasibility of an at work stairclimbing intervention program for men.

Thirty healthy men, aged 17.5-64.0, were assigned to matched treatment and control groups an evaluated on selected anthropometric and cardio-respiratory measures before and after a twelve week at work stairclimbing intervention program. The only significant change in the treated group was a decrease of rear calf skinfold thickness. There were no significant changes within the control group, nor were differences between groups significant when taking the entire treatment group into account. When the treatment group was dichotomized according to the amount of weekly stairclimbing, the subgroup which climbed stairs the most showed significant aerobic improvements. The Baseline VO2 max was not significantly related to either pre-program stairclimbing habits or aerobic power improvements. A significant relationship was observed between baseline % body fat and pre-program stairclimbing. The correlation between pre-program and in-program stairclimbing was statistically insignificant. The experiment showed that 5500 kgm/day stairclimbing (approximately 25 flights for a 70 kg man) could result in significant improvement of maximal aerobic power.

A comparison of continuous and intermittent progressive multistage exercise testing.

Twelve male subjects were compared on continuous and intermittent treadmill test of identical exercise stages. Each stage was three minutes in duration. Oxygen uptake during minutes one and two was significantly lower in the intermittent test. Heart rate VE and R were lower and oxygen pulse greater during all three minutes at moderate and strenuous workloads and throughout recovery of the intermittent protocol. There were no significant differences in exercise minute three or recovery VO2 and blood pressure. Regression equations for the relationship between VO2 oxygen pulse heart rate, VE systolic blood pressure and workload during the third minute of exercise included curvilinear functions whereas the regression equations between VO2 and heart rate, and between R and workload were linear. Slopes of percent maximal heart rate vs. percent percent maximal VO2 of the third minute were not different. Heart rate responded more rapidly to onset and cessation of exercise than did VO2. A near steady state was obtained during low and moderate workloads prior to minute three supporting the feasibility of reducing test time. Result suggest a slight advantage in intermittent testing compared to continuous testing for evaluating cardiovascular function and for exercise prescription.

A comparison of myocardial function in former athletes and non-athletes.

Heart rate (HR), total electromechanical systole (Q-S2), left ventricular ejection time (LVET), pre-ejection period (PEP), and diastole (D) were compared in 350 former athletes and 156 non-athletes, age 27-74. The two cohorts had been equated according to habitual leisure time physical activity. Former athletes exhibited significantly longer Q-S2 and PEP at rest, and significantly lower HR and lengthened Q-S2, LVET, PEP, and D at one minute following a standard two minute step test (less than 0.05). Significantly differences were observed between athletes and non-athletes in the light and moderate activity categories. There were no significant differences between former athletes and non-athletes currently engaged in strenuous leisure time physical activity. Comparisons were made among the three levels of habitual leisure time physical activity with each group and revealed that HR was lower and Q-S2, LVET, PEP, and D were longer at rest and following exercise as the level of physical activity increased. There were more significant differences among former athletes than among non-athletes. Most of these differences were between light to moderate and light to strenuous levels of activity. The evidence suggests an advantage in myocardial function among former athletes compared to their non-athlete counterparts.

Health promotion in minority adolescents: a Healthy People 2000 pilot study.

PURPOSE: The purpose was to evaluate the effects of a health promotion curriculum on health knowledge, behavior, cardiovascular fitness, and cardiovascular risk factors. METHODS: A multi-ethnic, multi-cultural sample (n = 54) of 10th grade males and females participated in a study of cardiovascular health promotion and coronary risk factor reduction. The sample was comprised of Asian-Americans (39%), blacks (33%), Hispanics (11%), whites (2%), and others (15%). Intervention consisted of a 10-week health promotion curriculum of classroom education modules in physical activity, nutrition, smoking cessation, stress management and personal problem solving, and an exercise program of walking and running. A nonintervention control group served as a basis for comparison. Classroom and exercise sessions met on alternate days. RESULTS: Following intervention, a significant treatment effect (P = .007) was observed in lowered total cholesterol, and significant within group improvements (P < .01) were observed in diet habits, percent body fat, and cardiovascular health knowledge. Comparisons of knowledge and social effects revealed higher cardiovascular health knowledge (P < .05) in subjects of nonsmoking compared to smoking parents, higher self-perception of health (P < .01) in more active vs less active subjects and better dietary habits (P < .07) in children whose parents were college educated compared to parents who did not attend college. CONCLUSIONS: Preliminary findings suggest that a health promotion curriculum consisting of health education, behavior modification, and regular aerobic exercise lowers cholesterol, improves health behavior and increases health knowledge.

Gender and ethnic differences in health behaviors and risk factors for coronary disease among urban teenagers: the PATH program.

OBJECTIVE: To assess gender and ethnic differences among teenagers in heart health behaviors, risk factors for coronary heart disease (CHD), and cardiovascular fitness. DESIGN: Observations consist of cross-sectional data collected prior to a school-based health promotion intervention program. PARTICIPANTS: Teenage girls (N = 865) and boys (N = 497) from three New York City high schools. The ethnic composition of this sample was 20% Asian-American, 40% African-American, 25% Hispanic, and 15% white. METHOD: Subjects were compared on the following: height, weight, body mass index, percentage body fat, total cholesterol, blood pressure, heart health knowledge, family history, socioeconomic status, dietary habits, smoking, physical activity, and estimated aerobic capacity. Differences were assessed with independent t tests, analysis of variance, and chi-square statistical techniques. RESULTS: Compared with girls, boys were more active and had higher estimated aerobic capacity, higher systolic blood pressure, and better self-perception of health. Compared with boys, girls had higher cholesterol, percentage body fat, and heart health knowledge scores and ate fewer foods high in saturated fat, cholesterol, salt, and simple sugars. Among girls, African-Americans had the highest blood pressure, cholesterol, body mass index, and intake of foods high in saturated fat, cholesterol, and sugar. Among boys, Hispanics had the highest body mass index and percentage body fat and the lowest heart health knowledge scores. White girls and white boys were the most frequent smokers. CONCLUSIONS: Poor health behaviors and risk factors for CHD occurred frequently among urban teenagers. In general, teenage girls had poorer health behaviors and a greater prevalence of risk factors than teenage boys, even though they scored better in heart health knowledge testing. Ethnic comparisons revealed poorer health behaviors and higher prevalence of risk factors in African-American and Hispanic teens compared with white and Asian-American teens. Results support the need for health promotion intervention among urban teenagers.