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Prevalence of regular physical activity among adults - United States, 2001 and 2005
Abstract
Regular physical activity is associated with decreased risk for obesity, heart disease, hypertension, diabetes, certain cancers, and premature mortality. CDC and the American College of Sports Medicine recommend that adults engage in at least 30 minutes of moderate physical activity on most days and preferably on all days. Healthy People 2010 objectives include increasing the proportion of adults who engage regularly in moderate or vigorous activity to at least 50% (objective 22-2). In addition, reducing racial and ethnic health disparities, including disparities in physical activity, is an overarching national goal. To examine changes in the prevalence of regular, leisure-time, physical activity from 2001 to 2005, CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicated that, from 2001 to 2005, the prevalence of regular physical activity increased 8.6% among women overall (from 43.0% to 46.7%) and 3.5% among men (from 48.0% to 49.7%). In addition, the prevalence of regular physical activity increased 15.0% (from 31.4% to 36.1%) among non-Hispanic black women and 12.4% (from 40.3% to 45.3%) among non-Hispanic black men, slightly narrowing previous racial disparities when compared with increases of 7.8% (from 46.0% to 49.6%) for white women and 3.4% (from 50.6% to 52.3%) for white men, respectively. CDC, state and local public health agencies, and other public health partners should continue to implement evidence-based, culturally appropriate initiatives to further increase physical-activity levels among all adults, with special focus on eliminating racial/ethnic disparities.
... This gives rise to the need to understand factors associated with living healthy lifestyles which can be measured by health-related outcomes (e.g., health behaviors). Education has already been shown to be associated with physical activity, with a higher percentage of college graduates reported as engaging in regular physical activity compared to those without a high school education [10]. Among the estimated 20 million students expected to attend universities in the US in 2015, an estimated 39.9% were between the ages of 18-24 years of age [9]. ...
... Racial and ethnic differences may also be associated with physical activity. In the US, racial and ethnic disparities existed with regard to physical activity among adults [10]. Among both men and women, non-Hispanic White adults had higher regular physical activity than all other groups [10]. ...
... In the US, racial and ethnic disparities existed with regard to physical activity among adults [10]. Among both men and women, non-Hispanic White adults had higher regular physical activity than all other groups [10]. Thus, racial and ethnic variation may be important in identifying factors associated with physical activity. ...
Background
Identifying factors associated with recommended physical activity (PA) levels are critical in efforts to combat the obesity epidemic and related comorbidities.
Methods
We conducted cross-sectional analyses of college students (n = 490) enrolled in a large southern state university in October of 2014. Our aim was to identify sociodemographic characteristics, technology use, and sleep patterns among college students and their independent relationship to recommended PA. An online survey was sent to all enrolled students. Logistic regression predicted achieving recommended ≥150 min per week of moderate-vigorous PA (MVPA) versus not (≤149 min MVPA).
Results
Approximately 69% of study participants were males, 18% were Hispanic, and more than half (60%) were within the normal body mass index (12% were obese). The average age of students was 21 years. On a daily average, individuals used smartphones most often (nearly 4.4 h), followed by laptops at 4.0 h, desktops at 1.2 h, and tablets at 0.6 h. The mean number of hours individuals reported sleeping was 6.7. Sociodemographic factors associated with reporting ≥150 min of MVPA included being male (OR = 4.0, 95% CI 2.2–7.1) versus female, being non-Hispanic White (OR = 1.8, CI 1.1–3.2) versus being a member of minority race group. Behavioral factors associated with reporting ≥150 min of MVPA included technology use (being moderate-heavy (OR = 2.3, CI 1.1–4.8) or heavy (OR = 3.4, CI 1.6–7.5) users of technology), and receiving low-moderate (OR = 1.9, 1.01–3.7) levels of sleep versus the lowest level of sleep.
Conclusions
In the current study, minority status and being female were the strongest sociodemographic factors associated with inadequate PA levels, while high technology use (primarily driven by smartphone use) were associated with recommended PA levels. Identifying factors associated with being physically active will allow for targeted interventions to improve the health of young adults.
... Despite these recommendations, research has shown that approximately 14% of cancer patients and survivors meet these guidelines [38,39]. Particularly Hispanic and Latina women report lower levels of physical activity when compared to their non-Hispanic White counterparts [40]. In this regard, Hispanic and Latina breast cancer patients may face specific structural and personal barriers to engaging in physical activity and exercise oncology clinical trials [41]. ...
Purpose of Review
This review aims to access the current state of the evidence in exercise as medicine for cardio-oncology in Hispanic and Latina breast cancer survivors and to provide our preliminary data on the effects of supervised aerobic and resistance training on cardiovascular disease (CVD) risk in this population.
Recent Findings
Breast cancer survivors have a higher risk of CVD; particularly Hispanic and Latina breast cancer survivors have a higher burden than their White counterparts. Exercise has been shown to reduce CVD risk in breast cancer survivors; however, evidence in Hispanic and Latina breast cancer survivors is scarce.
Summary
Our review highlights a clear need for exercise oncology clinical trials in Hispanic and Latina breast cancer survivors targeting CVD risk factors. Moreover, our exploratory results highlight that 16 weeks of aerobic and resistance training may reduce the 10-year risk of developing CVD by 15% in Hispanic and Latina breast cancer survivors.
... 7 An accelerometer data shows that only 15% of adult individuals in Canada meet the criteria of national physical activity recommendations and less than 50% of adults engage themselves in frequent physical activity living in the United States. 8,9 Instead of wide known benefits, only a small number of the adult population take part in physical activity and exercise at the optimal level that is required to maintain a healthy body. 10 In current times, a considerable amount of literature is available, both qualifying and quantifying the consequences of physical inactivity and the risk factors associated with it. ...
Introduction: Physical activity not only has positive effects on health, but is also linked to various aspects of life. Physical activity is considered one of the main components that contribute to a healthy lifestyle and general improvement in health including physical strength, muscle endurance and flexibility. A variety of evidences show that regular physical activity is beneficial to health and strong scientific research exists that reported decreased mortality rate with an optimal level of physical activity. This study was designed to evaluate the physical activity status of university students and their suggestions to promote physical activity.
Material & Methods: From January to October 2019, a cross-sectional study was conducted among 2,916 university students, studying at different universities in Faisalabad. The aim was to measure the levels of physical activity according to the pre-defined inclusion/exclusion criteria. Participants were enrolled in the study using convenient sampling. The questionnaire used in this study consisted of three sections, with the first part recording the demographics of the participants, the second part an International Physical Activity Questionnaire and the third part containing several suggestions for promoting physical activity. Logistic regression analysis was used for factors influencing physical activity behaviour. Confidence interval (CI=95%) and odds ratio (OR) were calculated and P-value
... It was supported by the study conducted by Ng S (b), which reported that physical activity levels are low among Emiratis, especially among females [15] . The study found that only 41% of Emirati women carry out mild or high-level of exercise, contrasted with 82% of U.S. females [16]. In the same line, the study of Kherkheulidze M, who stated that the school age students play active games only 20-30 minutes per day [17]. ...
Background: Adolescence is a period of extreme growth changes.Malnutrition along with the adolescence growth changes has significant effects for maternal and neonatal wellbeing. Bad sequences in the prenatal period and childbearing are the most important reason of deathsin adolescent girls aged 15-19 years. Aim: To assess the overall dietary "Food Habits" of adolescent girls. Also, to assess the relationship between obesity, food habits and physical activity patterns in adolescents. Subjects and Method: A quantitative-correlational research design was utilized. A Cluster random sampling strategy was used. The study conducted at six middle and high schools, Al Ahsa, Saudi Arabia. The three sectors covered through two schools from each sector.The survey was conducted among 593 female school students between November 2019-January 2020. The questionnaire contained two sections. Ethical approval obtained from the Education Department of Ministry of Education after obtaining approval from the College of Applied Medical Sciences Research and Ethical Committee. Results: The mean of body mass index of the participants was 21.1±3.5. It was clear that (23.6%) of the participants were underweight, while (67.1%) were within normal weight and (7.9%) were overweight and (1.4%) were obese. Near to half of the participants (47.1%) did not make any daily activity.(19.2%)of the participants took supplementation medicine. Adolescent Food Habits Checklist (AFHC) Score was low between the schoolgirls. Conclusion: The current study reinforced that Adolescent Food Habits Checklist (AFHC) Score was at a low level among the schoolgirls. Near to half of the adolescent did not make any daily physical training. While range of the physical activity was from (15-30) minutes per day.
... Studies conducted in the UK, between migrants and the native population in terms of PA, have concluded that PA levels in the native population are higher than those of immigrant groups studied (Kruger & Kohl III, 2008;Williams et al., 2011). One reason for this well may be that the barriers preventing people from participating in regular PA differ for particular ethnic and cultural groups. ...
... In the United States, data from the Behavioral Risk Factor Surveillance System (BRFSS) suggested that nearly half of American adults (49.7% of men, 46.7% of women) participated in regular physical activity, defined as at least 30 minutes per day of moderate intensity activity on five or more days per week, or at least 20 minutes per day of vigorous intensity activity on three or more days per week, or both (Kruger, Kohl, & Miles, 2007). In contrast, based on accelerometry data from the National Health and Nutritional Examination Survey, the percentage of adults reaching the threshold of 30 minutes of moderate intensity physical activity per day on at least 5 days per week was 3.5% for individuals 20 to 59 years of age and 2.4% for those 60 or more years of age (Troiano et al., 2008). ...
Scholars have long speculated about the links between physical exercise and the human psyche. This chapter facilitates the process of critical self-reflection by reviewing the conceptual underpinnings of exercise psychology. From the branch of exercise psychology that examines the effects of exercise and physical activity on mental health, the chapter focuses on the outcomes of depression and dementia. From the branch examining the role of psychological factors in exercise and physical activity behavior, the chapter focuses on the conceptual foundations of interventions designed to enhance participation and adherence. The ultimate objective of any field of applied science is to develop empirically supported methods to improve the lives of people worldwide. Therefore, within each section, the chapter first assesses whether the respective line of research is achieving its objective. It identifies and critically appraises the dominant conceptual themes and emerging trends. The chapter concludes by proposing possible next steps.
... We observed that white males were the most common demographic using the greenways in Winston-Salem. Our data suggest disparity across demographics of the greenway users in Winston-Salem, corroborating reports from other published data [13,14]. There is no data specifically available to North Carolina regarding the demographics of bicyclists or active pedestrians. ...
Citizen science is a growing method of scientific discovery and community engagement. To date, there is a paucity of data using citizen scientists to monitor community level physical activity, such as bicycling or walking; these data are critical to inform community level intervention. Volunteers were recruited from the local community to make observations at five local greenways. The volunteers picked their location, time to collect data and duration of data collection. Volunteer observations included recording estimated age, race or ethnicity and activity level of each individual they encountered walking, running or bicycling on the greenway. A total of 102 volunteers were recruited to participate in the study, of which 60% completed one or more observations. Average observational time lasted 81 minutes and resulted in recording the demographics and physical activity of a mean of 48 people per session. The majority of adult bicyclists observed were biking at a moderate pace (86%) and were white (72%) males (62%). Similar results were observed for those walking. We demonstrate the feasibility of using citizen scientists to address the current scarcity of data describing community-level physical activity behavior patterns. Future work should focus on refining the citizen science approach for the collection of physical activity data to inform community-specific interventions in order to increase greenway use.
... Recent evidence suggests that more than half of the adult population in the U.S. is overweight or obese, with the percentages increasing significantly over the last 15 years (Ogden et al., 2006). Reduced physical activity contributes significantly to the risk of overweight and obesity in adolescents and adults in the U.S. (Kruger & Kohl, 2007). Creating communities and workplaces that encourage and promote physical activity are important ways to reduce the risk of obesity while incorporating healthy lifestyle and behavior changes. ...
The purpose of this study was to examine the effects of two interventions, motivational signs and artwork, on stair use in a campus building. Methods: A longitudinal intervention study with no control group was designed to evaluate the effects of motivational signs and art murals on stair use in a six-story building. Sensors were installed in stairwells to monitor stair use. After a three week baseline period, two intervention periods (motivational signs and art murals, both three weeks in length) were utilized to encourage stair use. Weekly values for stair trips/day were calculated and expressed relative to estimated campus student enrollment and faculty and staff with offices in the building (means+SEM). Values were compared using ANOVA and post-hoc tests (p
... Physical inactivity is responsible for 6% of all deaths globally [1] and causes 6% of the burden of coronary heart disease, 10% of the burden of colon and breast cancer and reduces life expectancy [2]. Recent data indicates approximately half of all adults in the United States of America, Canada, United Kingdom and Australia are insufficiently active [3][4][5][6][7][8]. Since people from low socioeconomic status (SES) groups are more likely to be inactive or not reach recommended levels of health-enhancing physical activity participation [9][10][11][12][13][14][15][16], physical activity interventions should aim to increase physical activity levels among low SES groups in order to reduce socioeconomic disparities. ...
Physical inactivity is a major contributor to non-communicable disease and people of low socioeconomic status (SES) are more likely to be insufficiently active. Physical activity mass media campaigns aim to increase physical activity participation, but little is known about their impact on low SES groups. We reviewed the published literature from 1990 to June 2016 to identify reports of physical activity mass media campaigns. We documented evaluation/study design, target population, campaign outcomes assessed, SES measures used and analysed the results of the SES comparisons. A total of 23 papers were reviewed, reporting on 17 physical activity campaigns and 12 campaigns compared SES differences for 85 outcomes: 45 comparisons showed no difference between lowest and highest SES groups, 20 showed a better outcome for the lowest SES group and 20 showed a worse outcome. Some campaigns found inconsistent results, but seven found only equal and/or better results for low SES groups. Post-campaign physical activity behaviour most commonly showed no SES differences, but no other patterns were seen. Our review found that physical activity mass media campaigns have mostly equitable or better impacts for low SES groups, but to reduce inequalities these campaigns need to be maximally effective for low SES populations.
... Although men tend to engage in more physical activity than women (Kruger, 2007;Porch et al., 2016), most African American and Latino men do not meet current recommendations for physical activity (Affuso, Cox, Durant, & Allison, 2011;Arredondo et al., 2016;Carlson, Fulton, Schoenborn, & Loustalot, 2010;Troiano et al., 2008). Half of African American men report no vigorous leisure-time physical activity (Ball, Jeffery, Abbott, McNaughton, & Crawford, 2010), and African American men over age 45 are less likely than their white counter- parts to participate in leisure time physical activity or walking for exercise (Whitt-Glover, Nwaokelemeh, Price, & Hopkins, 2017). ...
Relatively little is known about what helps increase physical activity in African American men, and even less is known about promoting physical activity among Latino men. This systematic review aimed to address the key questions: (a) what is the state of the evidence on health-related behavior change interventions targeting physical activity among African American or Latino men? and (b) What factors facilitate physical activity for these men? For this review, nine electronic databases were searched to identify peer-reviewed articles published between 2011–2017 that reported interventions to promote physical activity among African American or Latino men. Following PRISMA guidelines, nine articles representing seven studies that met our criteria were identified: six published studies that provided data for African American men, and one published study provided data for Latino men. Consistent with previous reviews, more research is needed to better understand how gender can be incorporated in physical activity interventions for African American and Latino men. Future interventions should explore how being an adult male and a man of color shapes motivations, attitudes, and preferences to be physically active. Studies should consider how race and ethnicity intersect with notions of masculinity, manhood and Machismo to enhance the effectiveness of physical activity interventions for these populations. Despite the health benefits of physical activity, rates of these behaviors remain low among African American and Latino men. It is essential to determine how best to increase the motivation and salience for these men to overcome the obesogenic environments and contexts in which they often live.
... Endurance exercises is always less favorable for students. During the flexibility and strength exercises, extracurricular sports theory knowledge related to fitness and workout should be transmitted to the students as well, and students also need physical fitness exercise after class (Kruger et al., 2007). ...
The reform of teaching and physical quality of university students is the hope of the future, university life is the period for their body and mind to get the comprehensive development. Students only have the good physical quality, can be energetic to study. In order to better promote students' physical and mental development, physical education is set in higher schools to promote the health of students and improve the physical quality of students. At present, the reform of physical education in China is carried out for the development of students' physique. This paper analyzes the causes of decreased physical quality of contemporary university students, suggestion are proposed through changing the traditional concept of education, reforming university physical education, improving the school sports facilities and conditions to constantly improve the level of students' mental health, and provide the theoretical reference for optimizing the physical education quality and enhance the physical health of university students. Students' health consists of two aspects: physical and psychological aspects. In order to improve the students' self-confidence and willpower and adjust the mental state of students through sports, especially in the teaching of physical education, only paying attention to teaching sports skills and ignoring the health and education of university students should be prevented. During the process of physical exercise, university students should not only master the basic motor skills, but also develop the psychological quality. Teachers need to take some special measures to promote university students' mental health according to the psychological characteristics and physical characteristics of university students.
... 73 Recent cross-sectional studies have shown that approximately 40% of Emirati women 61 and 65% of Saudi women 74 participate in high or moderate levels of physical activity compared with > 80% of women in the United States. 75 The causality of a more sedentary lifestyle among Gulf women must be considered in light of recent studies suggesting a 10% to 25% reduction in breast cancer risk for postmenopausal women who engage in regular physical activity. 76,77 A reduction of about 14% in breast cancer risk has been demonstrated for women who walked ! ...
Breast cancer is the most frequently diagnosed non-cutaneous malignancy among women living in Gulf Cooperation Council countries. The present paper aims to highlight similarities and variations in terms of breast cancer incidence, age at diagnosis, clinic-pathological features, molecular characteristics and lifestyle factors that contribute to an increasing incidence of breast cancer with neighboring Arab and westernized countries. The data presented whilst having important implications for policy makers, highlights the need for further research. Such research would ensure that effective prevention and detection strategies are tailored to the specific needs of the Gulf women so that the management of breast cancer is optimized.
... 이들의 관심 영역을 크게 세분화하면 규칙적 신체활동과 생리적, 심리적 및 정서적 건강의 관계를 규 명하는 것 [1][2][3], 규칙적 운동 및 신체활동의 영향력 연구 [4], 그리고 이러한 요인간 관계를 구체적으로 설명하는 기전에 관한 분석이다 [5][6]. 특히 선행연구 [7][8][9][10][11][12] ...
The purpose of this study was to examine the differences in the direct medical expenditure of community residents according to their physical activity level. The quota sampling method was used to select samples from a youth community center, senior center, community cultural center, and community recreational sports center in G city in Gyeongbuk-do. Of the 773 questionnaires distributed, 716 were completed. The questionnaires consisted of the demographic characteristics, regular exercise and physical activity levels, health status and medical costs. While the beneficial effect of regular exercise and physical activity on dental costs was not (significant), its effect on the costs of visiting hospital services was (significant). The mean differences in the total monthly direct medical expenditures on outpatient services and medicine for those with very high, high, moderate, low, and very low levels of physical activity were 7,500, 26,299, 47,517, 9,314, and 9,9978 won, respectively. The result of this study supported the findings of previous studies that regular exercise and physical activity. are not associated with the reduction of medical expenditure.
... To keep the integrity and transparency of the separately reported weekend and weekday data as validated in the questionnaire's original design (Paffenbarger et al., 1993), these data were analyzed separately by weekend and weekday categories. Furthermore, this allowed for examination of the potential "weekend warrior" effect that occurs in approximately 1-3 percent of US adults (Kruger et al., 2007). ...
The effect of physical activity intensity on subjective well-being has not been well established. We examined this relationship among 419 healthy adults using objective and subjective physical activity measurements (sample size varied among well-being assessments). For accelerometers, light-intensity physical activity positively associated with psychological well-being (n = 150) and negatively associated with depression (n = 99); moderate intensity negatively associated with pain severity (n = 419) and positively associated with psychological well-being; sedentary behavior negatively associated with psychological well-being and positively associated with depression (ps < .05). These findings were generally consistent with subjective measurements of physical activity (Question 8, Paffenbarger Questionnaire). Higher levels of sedentary behavior are associated with lower subjective well-being.
... The factors responsible for these racial/ethnic disparities in physical activity among men are poorly understood (Abercrombie et al., 2008;Porch et al., 2015;Thorpe, Kelley, et al., 2015). Even after accounting for individual-level characteristics, race disparities in physical activity among men persist, despite national public health initiatives geared toward promoting physical activity (Crespo et al., 2000;Kruger, Kohl, & Miles, 2007;Marshall et al., 2007). ...
Engaging in regular physical activity reduces one's risk of chronic disease, stroke, cardiovascular disease, and some forms of cancer. These preventive benefits associated with physical activity are of particular importance for men, who have shorter life expectancy and experience higher rates of chronic diseases as compared to women. Studies at the community and national levels have found that social and environmental factors are important determinants of men's physical activity, but little is known about how regional influences affect physical activity behaviors among men. The objective of this study is to examine the association between geographic region and physical activity among men in the United States, and to determine if there are racial/ethnic differences in physical activity within these geographic regions. Cross-sectional data from men who participated the 2000 to 2010 National Health Interview Survey ( N = 327,556) was used. The primary outcome in this study was whether or not men had engaged in sufficient physical activity to receive health benefits, defined as meeting the 2008 Physical Activity Guidelines for Americans. Race/ethnicity and geographic region were the primary independent variables. Within every region, Hispanic and Asian men had lower odds of engaging in sufficient physical activity compared to white men. Within the Northeast, South, and West, black men had lower odds of engaging in sufficient physical activity compared to white men. The key findings indicate that the odds of engaging in sufficient physical activity among men differ significantly between geographic regions and within regions by race/ethnicity.
... The prevalence of meeting physical activity guidelines observed in this study is in the mid-range for other countries in the Gulf Cooperation Council area, where prevalence ranges from 47.9% to 73% for men and 32.3% to 60.6% for women (7), but higher than in the Eastern Mediterranean Region as a whole (15). The sex differences, although much wider than in some developed countries (16,17), are similar to neighbouring countries (18). The physical and social environment of Oman -with its high dependency on cars, inadequate infrastructure, hot arid climate, employment of domestic workers and cultural norms placing a low value on physical activity -inhibits ...
There is an increasing burden of obesity and obesity-related noncommunicable diseases in Gulf Cooperation Council countries, including Oman. This descriptive, epidemiological study assessed physical activity among 2977 Omani adults using a population-based household survey in 2008. Overall, 54.2% of men and 41.6% of women were physically active; the rate was higher in younger cohorts and varied significantly by region of residence. Physical activity related to the transportation (walking and cycling) domain was higher than in the leisure or work domains. Unmarried men aged 30–39 years were twice as likely to be physically active (OR 2.25) and unmarried women aged 40+ years were half as likely to be active (OR 0.58) than their married counterparts. Young women not working were less active (OR 0.18) than working women. Higher education was significantly associated with leisure activity for men aged 30+ years and women aged 40+ years. Further research to understand regional variations and to identify culturally appropriate strategies to promote physical activity is required.
... [20][21][22][23] Studies have also shown that females reported less physical activity than males. 24,25 In this study, the higher the number of clustered risk factors, the higher the mean values of the risk factors. This suggests the need for appropriate preventative and therapeutic intervention to retard progression and prevent poor outcomes, with our limited health resources. ...
Background:
In addition to poor socio-economic indices and a high prevalence of infectious diseases, there have been various reports of a rising prevalence of cardiovascular diseases, with associated morbidity and mortality in developing countries. These factors co-exist, resulting in a synergy, with serious complications, difficult-to-treat conditions and fatal outcomes. Hence this study was conducted to determine the clustering of cardiovascular disease risk factors and its pattern in semi-urban communities in south-western Nigeria.
Methods:
This was a cross sectional study over seven months in 11 semi-urban communities in south-western Nigeria.
Results:
The total number of participants was 1 285 but only 1 083, with 785 (65%) females, completed the data. Participants were 18 years and older, and 51.2% were over 60 years. The mean age was 55.12 ± 19.85 years. There were 2.6% current cigarette smokers, 22% drank alcohol and 12.2% added salt at the table, while 2% had been told by their doctors they had diabetes, and 23.6% had hypertension. The atherogenic index of plasma was at a high-risk level of 11.1%. Elevated total cholesterol and low-density lipoprotein cholesterol, and low high-density lipoprotein cholesterol levels were seen in 5.7, 3.7 and 65.1%, respectively. Prevalence of hypertension was 44.9%, diabetes was 5.2%, obesity with body mass index (BMI) > 30 kg/m(2) was 5.7%, and abdominal circumference was 25.7%. Prevalence of clusters of two, three, and four or more risk factors was 23.1, 15.5 and 8.4%, respectively. Increasing age 2.94 (95% CI: 1.30-6.67), BMI 1.18 (95% CI: 1.02-1.37), fasting plasma glucose level 1.03 (95% CI: 1.00-1.05), albuminuria 1.03 (95% CI: 1.00-1.05), systolic blood pressure 1.07 (95% CI: 1.04-1.10), diastolic blood pressure 1.06 (95% CI: 1.00-1.11) and female gender 2.94 (95% CI: 1.30-6.67) showed increased odds of clustering of two or more cardiovascular risk factors.
Conclusion:
Clustering of cardiovascular risk factors is prevalent in these communities. Patterns of clustering vary. This calls for aggressive and targeted public health interventions to prevent or reduce the burden of cardiovascular disease, as the consequences could be detrimental to the country.
... Most reported unhealthy habits, such as consuming sweets and 'junk foods.' Engaging in the recommended levels of physical activity and fruit/vegetable consumption are protective against high BMIs (Kushi, et al. 2012); however, in this study, 71% of survivors reported not engaging in the recommended physical activity levels. Physical activity rates reported for BCSs (Irwin, et al. 2004) and among healthy US women (Kruger, Kohl III & Miles, 2007) are 32% and 49.7%, respectively. ...
Background: Weight gain after diagnosis and treatment is common among breast cancer survivors (BCSs). Little information exists regarding associations between body mass index (BMI) and lifestyle factors and health-related quality of life (HR-QoL) among African American (AA) BCSs. The present study sought to determine associations between BMI, dietary intake, and physical activity as lifestyle modification strategies and HR-QoL among AA BCSs.
Methods: For this cross-sectional study, a lifestyle assessment tool was administered to 195 AA BCSs. Possible predictor variables included socio-demographic and medical characteristics, dietary intake and physical activity patterns, and physical health. The outcome variable was BMI.
Results: Many BCSs (63%) had BMIs ≥25 Kg/M2 and presented with stage I cancer (41%) at diagnosis. Among those presenting with late-stage cancer (IIIA, IIIB, IV), 76% were overweight or obese (p=0.0008). Eighty-four percent reported excellent-to-good physical health (p=0.0499) and were less likely to have higher BMIs compared to those reporting fair-to-poor physical health (OR=0.616 [CI=0.192-1.978]). Responders with graduate level education were more likely to have healthy body weights than those attaining high school or less educational levels (OR=2.379 [CI=0.617-9.166]).
Conclusions: Most AA BCSs surveyed were overweight or obese, did not engage in recommended physical activity levels and failed to consume diets linked to breast cancer prevention. Interventions are needed to promote weight loss, improve dietary intake, and enhance physical activity among AA BCSs.
Key Words: Body mass index; dietary intake, physical activity, HR-QoL, cancer survivors
Objective
The aims of this study were to estimate the rates of regular exercise and its trends among the adult population in Jiangsu, from 2010 to 2018, China, and to assess associations with sociodemographic factors.
Methods
Chronic disease and risk factor surveillance data from adults aged ≥18 years were gathered in Jiangsu Province from 2010 to 2018. Rates of regular exercise were calculated after post-stratification weighting, and time trends were compared among participants with different characteristics, including gender, age, urban–rural region, educational level, occupation, annual household income, body mass index (BMI), baseline self-reported chronic diseases, smoking status, alcohol consumption, and region. Multivariable logistic regression analyses were performed to assess the associations of sociodemographic characteristics with regular exercise.
Results
A total of 33,448 participants aged 54.05 ± 14.62 years and 55.4% female (8,374 in 2010, 8,302 in 2013, 8,372 in 2015, and 8,400 in 2018) were included in this study. The weighted rate of regular exercise was 12.28% (95% confidence interval [CI]: 9.11–15.45%) in 2010 and 21.47% (95% CI, 17.26–25.69%) in 2018, showing an overall increasing trend (P for trend = 0.009). Nevertheless, stratification analysis showed that the regular exercise rate decreased from 33.79% in 2010 to 29.78% in 2018 among retired adults. Significant associations were observed between regular exercise and age >45 years (45– < 60 years, odds ratio [OR]: 1.24, 95% CI: 1.14–1.34; ≥60 years, OR: 1.20, 95% CI: 1.08–1.34), urban residence (OR: 1.43, 95% CI: 1.32–1.54), higher education (primary, OR: 1.30, 95% CI: 1.16–1.46; secondary, OR: 2.00, 95% CI: 1.79–2.25; college or higher, OR: 3.21, 95% CI: 2.77–3.72), occupation (manual work, OR: 1.52, 95% CI: 1.33–1.73; non-manual work, OR: 1.69, 95% CI: 1.54–1.85; not working, OR: 1.22, 95% CI: 1.03–1.44; retired, OR: 2.94, 95% CI: 2.61–3.30), higher income (¥30,000– < ¥60,000, OR: 1.16, 95% CI: 1.06–1.28; ≥¥60,000, OR: 1.20, 95% CI: 1.10–1.32), higher BMI (overweight, OR: 1.12, 95% CI: 1.05–1.20), self-reported chronic disease at baseline (OR: 1.24, 95% CI:1.16–1.33), former smoking (OR: 1.15, 95% CI: 1.01–1.31) and ever (30 days ago) drinking (OR: 1.20, 95% CI: 1.11–1.29).
Conclusion
The rate of regular exercise among adults in Jiangsu Province was low, but this rate increased by 9.17% from 2010 to 2018, showing an upward trend. There were differences in the rate of regular exercise among different sociodemographic factors.
Background
Disabilities may play a different role in determining people’s physical activity (PA) and physical inactivity (PI) levels when they go through multiple lifetime transitions (e.g., graduation, marriage) between adolescence and young adulthood. This study investigates how disability severity is associated with changes in PA and PI engagement levels, focusing on adolescence and young adulthood, when the patterns of PA and PI are usually formed.
Methods
The study employed data from Waves 1 (adolescence) and 4 (young adulthood) of the National Longitudinal Study of Adolescent Health, which covers a total of 15,701 subjects. We first categorized subjects into 4 disability groups: no, minimal, mild, or moderate/severe disability and/or limitation. We then calculated the differences in PA and PI engagement levels between Waves 1 and 4 at the individual level to measure how much the PA and PI levels of individuals changed between adolescence and young adulthood. Finally, we used two separate multinomial logistic regression models for PA and PI to investigate the relationships between disability severity and the changes in PA and PI engagement levels between the two periods after controlling for multiple demographic (age, race, sex) and socioeconomic (household income level, education level) variables.
Results
We showed that individuals with minimal disabilities were more likely to decrease their PA levels during transitions from adolescence to young adulthood than those without disabilities.
Our findings also revealed that individuals with moderate to severe disabilities tended to have higher PI levels than individuals without disabilities when they were young adults. Furthermore, we found that people above the poverty level were more likely to increase their PA levels to a certain degree compared to people in the group below or near the poverty level.
Conclusions
Our study partially indicates that individuals with disabilities are more vulnerable to unhealthy lifestyles due to a lack of PA engagement and increased PI time compared to people without disabilities. We recommend that health agencies at the state and federal levels allocate more resources for individuals with disabilities to mitigate health disparities between those with and without disabilities.
Background: Disabilities may play a different role in determining people’s physical activity (PA) and physical inactivity (PI) levels when they go through multiple lifetime transitions (e.g., graduation, marriage) between adolescence and young adulthood. This study investigates how disability severity (i.e., no, minimal, mild, and moderate/severe disability and/or limitation) is associated with changes in PA and PI engagement levels, focusing on adolescence and young adulthood, when the patterns of PA and PI are usually formed.
Methods: The study employed data from Waves 1 and 4 of the National Longitudinal Study of Adolescent Health, which covers a total of 15,701 subjects. We first categorized subjects into 4 disability groups: no, minimal, mild, or moderate/severe disability and/or limitation. We then calculated the differences in PA and PI engagement levels between Waves 1 and 4 at the individual level to measure how much the PA and PI levels of individuals changed between adolescence and young adulthood. Finally, we used two separate multinomial logistic regression models for PA and PI to investigate the relationships between disability severity and the changes in PA and PI engagement levels between the two periods after controlling for multiple demographic (age, race, sex) and socioeconomic (income level, education level) variables.
Results: We showed that individuals with minimal disabilities were more likely to decrease their PA levels than those without disabilities during transitions from adolescence to young adulthood. Our findings also revealed that individuals with moderate to severe disabilities tended to have higher PI levels than individuals without disabilities when they were young adults. Furthermore, we found that people above the poverty level were more likely to increase their PA levels to a certain degree compared to people in the group below or near the poverty level.
Conclusions: Our study partially indicates that individuals with disabilities are more vulnerable to unhealthy lifestyles due to a lack of PA engagement and increased PI time compared to people without disabilities. We recommend that health agencies at the state and federal levels allocate more resources for individuals with disabilities to mitigate health disparities between those with and without disabilities.
Despite social acceptance of some leisure activities as healthy or unhealthy, individual behaviour suggests the story is more complex as individuals engage in leisure in both healthy and unhealthy ways. To better understand how leisure behaviour is perceived, we assessed American college students’ perception of their own leisure activities’ healthiness, as well as their perception of healthy and unhealthy leisure activities in general. Three groups were observed: students who viewed all of their leisure as healthy, students who viewed their leisure as a mix of healthy and unhealthy activities, and students who viewed most of their leisure as unhealthy. Across groups, students participated in the same activities but categorised the healthiness of these activities differently. However, students shared an understanding of the types of leisure they considered to be generally healthy and unhealthy. Interventions should therefore promote healthy ways of engaging in leisure, rather than particular “healthy’ leisure activities.
Understanding metabolic and immune regulation inherent to patient populations is key to improving the radiation response for our patients. To date, radiation therapy regimens are prescribed based on tumor type and stage. Patient populations who are noted to have a poor response to radiation such as those of African American descent, those who have obesity or metabolic syndrome, or senior adult oncology patients, should be considered for concurrent therapies with radiation that will improve response. Here, we explore these populations of breast cancer patients, who frequently display radiation resistance and increased mortality rates, and identify the molecular underpinnings that are, in part, responsible for the radiation response and that result in an immune-suppressive tumor microenvironment. The resulting immune phenotype is discussed to understand how antitumor immunity could be improved. Correcting nutrient deficiencies observed in these populations should be considered as a means to improve the therapeutic index of radiation therapy.
A large amount of waste is generated within the different steps of the food supply chain, representing a significant loss of natural resources, plant material, and economic value for producers and consumers. During harvesting and processing, many parts of edible plants are not sold for consumption and end up as massive waste, adding environmental hazards to the list of concerns regarding food wastage. An example is Brassica oleracea var. Italica (broccoli) by-products, which represent 75% of the plant mass-generated. A growing concern in the Western world is obesity, which results from incorrect lifestyles and comprises an extensive array of co-morbidities. Several studies have linked these co-morbidities to increased oxidative stress, thus, naturally occurring and readily available antioxidant compounds are an attractive way to mitigate metabolic diseases. The idea of by-products selected for their biomedical value is not novel. However, there is innovation underlying the use of Brassica by-products in the context of obesity. For this reason, Brassica by-products are prime candidates suggested to be used in the treatment of obesity due to its bioactive compounds, such as sulforaphane, with antioxidant activity. Here, we review the economic and health potential of Brassica bioactive compounds in the context of obesity.
Dopamine (DA) neurons in the ventral tegmental area (VTA) modulate physical activity and feeding behaviors that are disrupted in obesity. Yet, the heterogeneity of VTA DA neurons has hindered determination of which ones might be leveraged to support weight loss. We hypothesized that increased activity in the subset of VTA DA neurons expressing neurotensin receptor-1 (NtsR1) might promote weight loss behaviors. To test this, we used Designer Receptors Exclusively Activated by Designer Drugs (DREADDs) to activate VTA NtsR1 neurons in normal weight and diet-induced obese mice. Acute activation of VTA NtsR1 neurons (24hr) significantly decreased body weight in normal weight and obese mice by reducing food intake and increasing physical activity. Moreover, daily activation of VTA NtsR1 neurons in obese mice sustained weight loss over 7 days. Activating VTA NtsR1 neurons also suppressed how much mice worked to obtain sucrose rewards, even when there was high motivation to consume. However, VTA NtsR1 neural activation was not reinforcing, nor did it invoke liabilities associated with whole-body NtsR1 agonism such as anxiety, vasodepressor response or hypothermia. Activating VTA NtsR1 neurons therefore promotes dual behaviors that support weight loss without causing adverse effects, and is worth further exploration for managing obesity.
Background
Hispanic women have increased risk of gestational diabetes mellitus (GDM), which carries an increased risk for future type 2 diabetes, compared to non-Hispanic women. In addition, Hispanic women are less likely to engage in healthy eating and physical activity, which are both risk factors for type 2 diabetes. Supporting patients to engage in healthy lifestyle behaviors through mobile health (mHealth) interventions is increasingly recognized as a viable, underused tool for disease prevention, as they reduce barriers to access frequently experienced in face-to-face interventions. Despite the high percentage of smartphone ownership among Hispanics, mHealth programs to reduce risk factors for type 2 diabetes in Hispanic women with prior GDM are lacking.
Objective
This study aimed to (1) develop a mobile app (¡Hola Bebé, Adiós Diabetes!) to pilot test a culturally tailored, bilingual (Spanish/English) lifestyle program to reduce risk factors for type 2 diabetes in Hispanic women with GDM in the prior 5 years; (2) examine the acceptability and usability of the app; and (3) assess the short-term effectiveness of the app in increasing self-efficacy for both healthy eating and physical activity, and in decreasing weight.
Methods
Social cognitive theory provided the framework for the study. A prototype app was developed based on prior research and cultural tailoring of content. Features included educational audiovisual modules on healthy eating and physical activity; personal action plans; motivational text messages; weight tracking; user-friendly, easy-to-follow recipes; directions on building a balanced plate; and tiered badges to reward achievements. Perceptions of the app’s acceptability and usability were explored through four focus groups. Short-term effectiveness of the app was tested in an 8-week single group pilot study.
Results
In total, 11 Hispanic women, receiving care at a federally qualified community health center, aged 18-45 years, and with GDM in the last 5 years, participated in four focus groups to evaluate the app’s acceptability and usability. Participants found the following sections most useful: audiovisual modules, badges for completion of activities, weight-tracking graphics, and recipes. Suggested modifications included adjustments in phrasing, graphics, and a tiering system of badges. After app modifications, we conducted usability testing with 4 Hispanic women, with the key result being the suggestion for a “how-to tutorial.” To assess short-term effectiveness, 21 Hispanic women with prior GDM participated in the pilot. There was a statistically significant improvement in both self-efficacy for physical activity (P=.003) and self-efficacy for healthy eating (P=.007). Weight decreased but not significantly. Backend process data revealed a high level of user engagement.
Conclusions
These data support the app’s acceptability, usability, and short-term effectiveness, suggesting that this mHealth program has the potential to fill the gap in care experienced by Hispanic women with prior GDM following pregnancy. Future studies are needed to determine the effectiveness of an enhanced app in a randomized controlled trial.
Trial Registration
ClinicalTrials.gov NCT04149054; https://clinicaltrials.gov/ct2/show/NCT04149054
This cross-sectional study compared weight-related cognitions, behaviors, and home environments of 568 mothers of young children (ages 2 to <9 years) by racial/ethnic group. Maternal health status was good and did not differ by race/ethnicity. Mothers were somewhat confident in their ability to promote healthy physical activity and eating behaviors in their children, with White and Asian mothers having greater confidence than Hispanic mothers. Mothers had low physical activity, with Hispanic mothers getting more sedentary screentime than White and Asian mothers. Mothers’ dietary intake did not differ. Modeling of healthful behaviors was more frequent in White than Hispanic mothers. Asian mothers tended to use non-recommended feeding patterns more than White, Hispanic, and Black mothers. Children’s physical activity and screentime did not differ by race/ethnicity. Asian children tended to drink less sugar-sweetened beverages and more milk than counterparts. All reported frequent family meals, with Hispanic mothers reporting more family meals eaten in less healthful locations. Household food environments did not differ. However, White mothers reported greater access to physical activity space and supports than Hispanic mothers. Race/ethnicity may link with maternal weight-related cognitions, behaviors, and home environments and thus can help inform the development of interventions tailored by race/ethnicity.
The purpose of agricultural policies is to meet the food demand that the society needs. While supports and incentives for agricultural production increase production, they can have negative consequences on climate change. In parallel with the increase in agricultural production and climate change in the world, there has been a serious increase in both food waste and obese numbers recently. While the overproduction effort of agricultural products creates pressure on the environment, it causes obesity and overweight problems. According to the World Health Organization (WHO), Turkey is at the forefront among the countries where there are obese and overweight people. In the 11th Development Plan in Turkey, in 2018 the prevalence of obesity is 30% (for ages 15 and over) in 2023 is targeted to be reduced to 29.1. The aim of this research is to draw attention to the relationship between climate change and obesity and to address the issue within the framework of the 11th Development Plan. Obesity issues for Turkey; since it is important in terms of food security, climate change and agricultural policies, it is necessary to develop political guidance and protection measures in terms of health, economy, education, environment and national security.
Physical inactivity is a significant public health problem among black women. However, there is limited evidence regarding barriers to physical activity and the availability of opportunities to engage in physical activity, specifically for posttreatment black women with a history of cancer.
Purpose:
The purpose of this paper was to systematically review, summarize, and synthesize findings on physical activity-related research including barriers, facilitators, and resources for physical activity among posttreatment black women with a history of breast and endometrial cancer.
Methods:
We developed a comprehensive search strategy and conducted searches in the following databases: PsycINFO, Web of Science, Cochrane, PubMed, and Sociological Abstracts. Summary measures were described qualitatively (e.g., themes) and quantitatively (e.g., frequencies).
Results:
This review identified 35 eligible articles describing 12 intervention and 23 observational studies. We described intervention preferences (e.g., resistance activities), beliefs about physical activity, and benefits of physical activity for quality of life (e.g., improvements in social wellbeing) in black cancer survivors. In addition, very few studies identified barriers to physical activity (n = 7) and focused on increasing physical activity (n = 12) among black women with a history of cancer. The most common reported barriers among the target population were fatigue, lack of social support, weather, illness/health issues, cost, time constraints, living too far away, and inability/unwillingness to obtain physician clearance, whereas the most common facilitators were faith, other health concerns, and social support.
Conclusions/implications:
Future studies should target barriers, facilitators, and culturally adapted strategies for physical activity at all levels of influence to develop multi-level interventions to engage and improve physical activity among black women with a history of breast and endometrial cancer.
Protocol registration number:
CRD42018110008.
There is a compendium of data documenting the increasing number of older adults. This suggests the continued need to understand identified health outcomes across domains of pain and physical activity, particularly among older men. Therefore, the aim of this study was to evaluate race similarities and/or differences in pain and rates of physical activity among White, Black, and Hispanic men 60+ years of age. Data were taken from the Health and Retirement Study, a longitudinal panel study surveying a representative sample of people in the United States. Logistic regression analysis was used to examine associations between race and pain and the odds of regular physical activity. Results showed that Black men were less likely to participate in light or moderate/vigorous physical activity. Similarly, pain increased the odds of physical activity among Hispanics, but decreased the odds of physical activity among White men. Findings may reflect a number of factors that impact the well-being of what it means to experience pain and physical functioning, while also assuming a masculine identity. This perspective may allow for a better understanding of short- and long-term implications of the pain experience and the pain and physical functioning dyad among this group of men.
Breast cancer is the most common noncutaneous malignancy and the second most lethal form of cancer among women in the United States. It currently affects more than one in ten women worldwide. The chance for a female to be diagnosed with breast cancer during her lifetime has significantly increased from 1 in 11 women in 1975 to 1 in 8 women (Altekruse, SEER Cancer Statistics Review, 1975–2007. National Cancer Institute, Bethesda, 2010). This chance for a female of being diagnosed with cancer generally increases with age (Howlader et al, SEER Cancer Statistics Review, 1975–2010. National Cancer Institute, Bethesda, 2013). Fortunately, the mortality rate from breast cancer has decreased in recent years due to increased emphasis on early detection and more effective treatments in the White population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic population has continued to grow. The goal of the work presented in this book chapter is to highlight similarities and differences in breast cancer morbidity and mortality rates among non-Hispanic white and non-Hispanic black populations. This book chapter also provides an overview of breast cancer, racial/ethnic disparities in breast cancer, breast cancer incidence and mortality rate linked to hereditary, major risk factors of breast cancer among minority population, breast cancer treatment, and health disparity. A considerable amount of breast cancer treatment research have been conducted, but with limited success for African Americans compared to other ethnic groups. Therefore, new strategies and approaches are needed to promote breast cancer prevention, improve survival rates, reduce breast cancer mortality, and ultimately improve the health outcomes of racial/ethnic minorities. In addition, it is vital that leaders and medical professionals from minority population groups be represented in decision-making in research so that racial disparity in breast cancer can be well-studied, fully addressed, and ultimately eliminated in breast cancer.
Importance
Cardiovascular disease (CVD) is the leading cause of death and disability among women. Achievement of recommended physical activity (PA) levels is an essential component of CVD management.
Objective
To describe trends, sociodemographic factors, and health care expenditures associated with suboptimal PA among a nationally representative sample of US women with CVD.
Design, Setting, and Participants
This cross-sectional study used serial data from the Medical Expenditure Panel Survey from 2006 through 2015. The analyses were conducted in August 2018. Women who had self-reported and/or International Classification of Diseases, Ninth Revision, diagnosis of CVD were included.
Main Outcomes and Measures
Recommended PA was defined as 30 minutes or more of moderate- to vigorous-intensity exercise, 5 or more days per week. Weighted logistic regression was used to examine the associations of various sociodemographic factors with suboptimal PA, adjusted for comorbidities. A 2-part econometric model was used to assess health care expenditures.
Results
A total of 18 027 women were included in this study. The results were weighted to provide estimates for approximately 19.5 million adult women in the United States with CVD (mean [SD] age, 60.4 [16.9] years). More than half of the women with CVD reported suboptimal PA, a trend that increased during the 10-year period, with 58.2% (95% CI, 55.9%-60.5%) of participants reporting suboptimal PA in 2006-2007 vs 61.9% (95% CI, 59.7%-64.2%) in 2014-2015 (P = .004). The proportion of women with suboptimal PA differed by sociodemographic factors. In adjusted models, compared with non-Hispanic white women, African American women (odds ratio, 1.22; 95% CI, 1.08-1.38) and Hispanic women (odds ratio, 1.33; 95% CI, 1.13-1.58) were more likely to have suboptimal PA. Women from low- or very low-income strata (compared with high-income strata), enrolled in public insurance (compared with private insurance), and with less than high school education (compared with at least some college education) were more likely to have suboptimal PA. Health care costs among women with CVD with suboptimal PA were higher compared with those among women who met the recommended PA, and this increased through time, from a mean total health care expenditure of 11 627-14 820 (95% CI, 16 119) in 2014-2015.
Conclusions and Relevance
The proportion of women with CVD not meeting recommended PA is high and increasing, particularly among certain racial/ethnic and socioeconomic groups, and is associated with significant health care costs. More must be done to improve PA for secondary prevention and reduction of expenditures among women with CVD.
Purpose
This paper concerns participation of Poles aged 15+ years in leisure time and transport-related physical activity (PA) with a special focus on the life stages. The purpose of the paper was to analyze types of exercises, current and future behavior concerning PA, availability of sport and recreation facilities, and factors having the strongest relation with undertaking PA at a sufficient level according to pro-health recommendations of World Health Organization (WHO).
Patients and methods
A survey was carried out on the representative sample (n=2,000). Respondents were classified in accordance to their life stages with a two-step cluster analysis. Relationships between meeting the dose of PA required for health recommendations and a membership in groups of life stages were evaluated using log-linear analysis. The strength of this relationship was expressed by the odds ratio. In order to capture relationships between meeting WHO recommendations and a set of explanatory variables, a predictive model was built.
Results
Life stages and various related events have a significant relation with a decrease of PA. Among groups of a particular risk, there are professionally active and unemployed people aged 50–64 years without children as well as retirees aged 65+ years who do not meet WHO recommendations (45.3; 50.4% and 47.6%). The unemployed and retirees more frequently (p<0.0001) do not or cannot practice sport and do not think that a change of their situation is expected soon. However, 35% of professionally active people aged 50–64 years without children and 18.2% of unemployed people declare that they are currently not active but if they had the possibility, they would start practicing sport.
Conclusion
Campaigns promoting PA should be targeted at groups of a particular risk. Any attempts of increasing PA or changing tendencies of its decrease should consider life conditions of these persons, as well as their needs, motivations, and barriers.
Purpose of Review
Multiple respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD), display significant socioeconomic and racial/ethnic disparities. The objective of this review is to evaluate the evidence supporting a link between disproportionate environmental exposures and these health disparities.
Recent Findings
Studies suggest that various co-occurring factors related to the home environment, neighborhood environment, non-modifiable individual factors, and individual behaviors and attributes can increase or modify the risk of adverse respiratory outcomes among socioeconomically disadvantaged and racially/ethnically diverse populations. Pollutants in the home environment, including particulate matter, nitrogen dioxide, and pesticides, are elevated among lower socioeconomic status populations and have been implicated in the development or exacerbation of respiratory-related conditions. Neighborhood crime and green space are socioeconomically patterned and linked with asthma outcomes through psychosocial pathways. Non-modifiable individual factors such as genetic predisposition cannot explain environmental health disparities but can increase susceptibility to air pollution and other stressors. Individual behaviors and attributes, including obesity and physical activity, contribute to worse outcomes among those with asthma or COPD.
Summary
The root causes of these multifactorial exposures are complex, but many likely stem from economic forces and racial/ethnic and economic segregation that influence the home environment, neighborhood environment, and access to healthy foods and consumer products. Critical research needs include investigations that characterize exposure to and health implications of numerous stressors simultaneously, both to guard against potential confounding in epidemiological investigations and to consider the cumulative impact of multiple elevated environmental exposures and sociodemographic stressors on health disparities.
Objective:
To determine the association of social support with alcohol abuse, depression, and health care access among Latino immigrant men in an emerging Latino community (an area with a small yet growing Latino population).
Methods:
Cross-sectional baseline data of 140 men prior to a participatory male-to-male community health worker intervention among Latino immigrants were analyzed using logistic regression. Community health workers recruited community participants in Western Pennsylvania between 2011 and 2013.
Results:
Participants constituted a vulnerable group: 47% had not finished high school, 36% had moderate to severe depression, and 30% reported binge drinking in the past month. Health care access was low (insurance = 6%, usual source = 20%). In multivariable logistic regression high social support was associated with less binge drinking (odds ratio [OR] = 0.44; 95% confidence interval [CI] [0.20, 0.98]) and lower depression (OR = 0.22; 95% CI [0.09-0.54]). Social support was associated with having a dentist visit but not with other health care access measures.
Conclusions:
Results indicate that the role of social support seems important for drinking and depression but remains controversial for health care access. It raises the hypothesis that low social support may be one of the mechanisms for the increase in drinking that happens after immigration.
Purpose:
While recreational physical activity (RPA) has been associated with reduced mortality in breast, colorectal, and prostate cancers, evidence for epithelial ovarian cancer (EOC) is limited. Most EOC studies have been in predominantly white populations, although inactivity is more prevalent and survival is poorer among African-American (AA) women. We examined RPA before and after EOC diagnosis and associations with survival among AA women.
Methods:
We analyzed data from 264 EOC survivors enrolled in a population-based, case-control study who completed surveys that included questions about pre- and post-diagnosis RPA. Data were collected on RPA frequency, intensity, and duration before diagnosis and approximately 1 year after the baseline interview. We calculated metabolic equivalent of task (MET)-hours/week for pre- and post-diagnosis RPA, and evaluated associations with risk of mortality using Cox proportional hazards models.
Results:
RPA before diagnosis was not associated with mortality. Hazard ratios (HRs) for post-diagnosis RPA were < 1.0 but not statistically significant after adjustment for covariates; HRs were 0.94 (95% CI 0.58, 1.54) for > 0-9 MET-hours/week and 0.53 (95% CI 0.21, 1.35) for > 9 MET-hours/week.
Conclusions:
Our results suggest that RPA may be inversely associated with mortality among AA women with ovarian cancer, although it is possible that the present study was underpowered to detect an association. There is a clear need for more studies of RPA after diagnosis in EOC survivors with attention to potential differences by race.
Background
Studies evidenced that reduction in cardiovascular disease (CVD) mortality in diabetic patients can be attributed to improvements in major CVD risk factors and evidence-based treatments. Furthermore, studies showed that the relative risk of CVD mortality associated with diabetes compared with non-diabetes is stronger in women than in men. Hence, we aimed to examine trends in CVD risk factors and intervention measures by sex and diabetic status.
Methods
Analysis of 5 distinct cross-sectional National Health and Nutrition Examination Surveys, 1988–1994, 1999–2002, 2003–2006, 2007–2010, and 2010–2014. Since detailed information on nontraditional risk factors such as sleep apnea was not available in each NHANES survey, traditional CVD risk factors including obesity, hypertension, and dyslipidemia were assessed in the study. To assess whether changes throughout the 27-year period differed by diabetes status, a logistic regression analysis was utilized to examine potential interaction effects between survey and diabetes. The similar process was repeated for sex.
Results
Means of all risk factors except body mass index and waist circumference decreased and the prevalence of antihypertensive and lipid-lowering medication use increased over time among diabetic and non-diabetic men and women. For both men and women, survey × diabetes status interaction terms for changes in HDL-cholesterol and triglyceride levels were not statistically significant, while the prevalence of antihypertensive and lipid-lowering medication use increased more in diabetic than in non-diabetic persons (all P < 0.001). For women, survey × diabetes status interaction terms indicated that compared with the first survey, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol fallen more in diabetic than in non-diabetic persons (all P < 0.001). In the diabetic state, men experienced similar changes in means of all CVD risk factors and the prevalence of antihypertensive and lipid-lowering medication use as women (all P for interactions between survey and sex were >0.01).
Conclusions
The major traditional CVD risk factors in diabetic men decreased to the same extent that they did for non-diabetic men. The magnitude of changes in the favorable trends in diabetic women was of similar or greater compared with those among non-diabetic women. Diabetic women had as good an improvement in CVD risk factors as diabetic men.
Electronic supplementary material
The online version of this article (10.1186/s12889-017-4921-4) contains supplementary material, which is available to authorized users.
Objective:
The objective of this study was to quantify the impact of crime on physical activity location accessibility, leisure-time physical activity (LTPA), and obesity among African American women.
Methods:
An agent-based model was developed in 2016 to represent resource-limited Washington, DC, communities and their populations to simulate the impact of crime on LTPA and obesity among African American women under different circumstances.
Results:
Data analysis conducted between 2016 and 2017 found that in the baseline scenario, African American women had a 25% probability of exercising. Reducing crime so more physical activity locations were accessible (increasing from 10% to 50%) decreased the annual rise in obesity prevalence by 2.69%. Increasing the probability of African American women to exercise to 37.5% further increased the impact of reducing crime on obesity (2.91% annual decrease in obesity prevalence).
Conclusions:
These simulations showed that crime may serve as a barrier to LTPA. Reducing crime and increasing propensity to exercise through multilevel interventions (i.e., economic development initiatives to increase time available for physical activity and subsidized health care) may promote greater than linear declines in obesity prevalence. Crime prevention strategies alone can help prevent obesity, but combining such efforts with other ways to encourage physical activity can yield even greater benefits.
Breast cancer is the second leading cause of cancer related deaths among women aged 40–55 in the United States and currently affects more than one in ten women worldwide. It is also one of the most diagnosed cancers in women both in wealthy and poor countries. Fortunately, the mortality rate from breast cancer has decreased in recent years due to increased emphasis on early detection and more effective treatments in White population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic populations has continued to grow. The goal of the present review article was to highlight similarities and differences in breast cancer morbidity and mortality rates primarily among African American women compared to White women in the United States. To reach our goal, we conducted a search of articles in journals with a primary focus on minority health, and authors who had published articles on racial/ethnic disparity related to breast cancer patients. A systematic search of original research was conducted using MEDLINE, PUBMED and Google Scholar databases. We found that racial/ethnic disparities in breast cancer may be attributed to a large number of clinical and non-clinical risk factors including lack of medical coverage, barriers to early detection and screening, more advanced stage of disease at diagnosis among minorities, and unequal access to improvements in cancer treatment. Many African American women have frequent unknown or unstaged breast cancers than White women. These risk factors may explain the differences in breast cancer treatment and survival rate between African American women and White women. New strategies and approaches are needed to promote breast cancer prevention, improve survival rate, reduce breast cancer mortality, and ultimately improve the health outcomes of racial/ethnic minorities
Background
Osteoarthritis is one of the leading causes of inactivity worldwide. The recommended level of health enhancing physical activity (HEPA) is at least 150 min of moderate intensity physical activity per week. The purpose of this study was to explore how the proportion of patients, who reached the recommended level of HEPA, changed following a supported osteoarthritis self-management programme in primary care, and to explore how reaching the level of HEPA was influenced by body mass index (BMI), gender, age and comorbidity.
Methods
An observational study was conducted using data from a National Quality Registry in which 6810 patients in primary care with clinically verified hip or knee osteoarthritis with complete data at baseline, 3 and 12 months follow-up before December 31st 2013 were included. HEPA was defined as self-reported physical activity of at least moderate intensity either a) at least 30 min per day on four days or more per week, or b) at least 150 min per week. HEPA was assessed at baseline, and again at 3 and 12 months follow-up. Cochran’s Q test was used to determine change in physical activity over time. The association between reaching the level of HEPA and time, age, BMI, gender, and Charnley classification was investigated using the generalized estimation equation (GEE) model.
Results
The proportion of patients who reached the level of HEPA increased by 345 patients, from 77 to 82%, from baseline to 3 months follow-up. At 12 months, the proportion of patients who reached the level of HEPA decreased to 76%. Not reaching the level of HEPA was associated with overweight, obesity, male gender and Charnley category C, i.e. osteoarthritis in multiple joint sites (hip and knee), or presence of any other disease that affects walking ability.
Conclusions
Following the supported osteoarthritis self-management programme there was a significant increase in the proportion of patients who reached the recommended level of HEPA after 3 months. Improvements were lost after 12 months. To increase physical activity and reach long-lasting changes in levels of physical activity, more follow-up sessions might be needed.
Purpose:
Studies describing prevalence and trends of physical activity among workers in the United States are scarce. We aimed to estimate prevalence and trends of "sufficient" leisure-time physical activity (LTPA) during the 2004-2014 time period among U.S. workers.
Methods:
Data were collected for U.S. workers in the National Health Interview Survey. LTPA was categorized as sufficiently active (moderate intensity, ≥150 minutes per week), insufficiently active (10-149 minutes per week), and inactive (<10 minutes per week). Prevalence of LTPA was adjusted for age using 2010 U.S. working population as a standardized age distribution.
Results:
Prevalence trends of "sufficient" LTPA significantly increased from 2004 to 2014 (45.6% to 54.8%; P < .001). Among industry groups, the highest prevalence of "sufficient" LTPA was observed among workers in Professional/Scientific/Technical Services (62.1%). The largest increases were observed among workers in Public Administration (51.3%-63.4%). Among occupational groups, "sufficient" LTPA prevalence was lowest in farming/fishing/forestry (30.8%) and highest in life/physical/social science (66.4%). Prevalence of LTPA significantly increased from 2004 to 2014 in most occupational and industry groups.
Conclusions:
Among U.S. workers, trends of "sufficient" LTPA significantly increased between 2004 and 2014. Overall, a larger proportion of white-collar compared to blue-collar workers were engaged in "sufficient" LTPA.
Introduction:
Today, many jobs are associated with the inactivity or sedentary lifestyle. Employees' health will be affected by their depriving of the benefits of physical activity (PA). Therefore, the present study was undertaken to determine the PA among employee women in Isfahan University of Medical Sciences based on the transtheoretical model.
Materials and methods:
This is a cross-sectional study has been performed in Isfahan University of Medical Sciences employee women (2013). A convenience sample of 100 women was selected. Data were collected by validated and reliable questionnaire in three parts (demographics information, PA scale, and TTM constructs). Data were analyzed by SPSS SPSS (version 16.0; SPSS, IBM, Inc, Chicago, IL, USA) and descriptive and analytical statistics such as ANOVA and independent t-test were used. A two-tailed P < 0.05 was considered statistically significant.
Results:
The mean of PA was 21.17 ± 27.30 min in a day. Weekly heavy, moderate, and light exercise mean was 0.72 ± 1.81, 0.89 ± 1.87 and 0.57 ± 1.57 days, respectively. In this study, 26% of women were in contemplation, 22% in contemplation, 20% in preparation, 13% in action, and 19% in the maintenance stage. Furthermore, there were significant differences between consciousness raising, dramatic relief, counter-conditioning, stimulus control, helping relationships, reinforcement management, and self-liberation with stages of change constructs.
Conclusion:
Because of a significant relationship between cognitive and behavioral processes and PA in this group, designing and implementing an educational program based on the transtheoretical model may be useful in promoting PA of a female employee.
Aims:
Type 2 diabetes has grown to epidemic proportions in the U.S. and physical activity levels in the population continues to remain low, although it is one of the primary preventive strategies for diabetes. The objectives of this study were to estimate the direct medical costs of type 2 diabetes attributable to not meeting physical activity Guidelines and to physical inactivity in the U.S. in 2012.
Methods:
This was a cross sectional study that used physical activity prevalence data from the Behavioral Risk Factor Surveillance System to estimate the population attributable risk percentage for type 2 diabetes. These data were combined with the prevalence and cost data of type 2 diabetes to estimate the cost of type 2 diabetes attributable to not meeting physical activity Guidelines and to inactivity in 2012.
Results:
The cost of type 2 diabetes in the U.S. in 2012, attributable to not meeting physical activity guidelines was estimated to be 4.65 billion. Based on sensitivity analyses, these estimates ranged from 27.43 billion for not meeting physical activity guidelines and 6.98 billion for physical inactivity in the year 2012.
Conclusions:
This study shows that billions of dollars could be saved annually just in terms of type 2 diabetes cost in the U.S., if the entire adult population met physical activity guidelines. Physical activity promotion, particularly at the environmental and policy level should be a priority in the population.
Background.
Physical activity (PA) counselling is challenging in primary care. It is unknown whether clinician training on the 5As (Ask, Advise, Agree, Assist, Arrange) improves PA counselling skills.
Objective.
To evaluate the effect of a clinician training intervention on PA counselling for underserved adults using the 5As framework.
Methods.
Pragmatic pilot clinical trial was used in the study. Clinicians (n = 13) were randomly assigned to two groups. Each group received the intervention consisting of four 1-hour training sessions to teach the 5As for PA counselling. Patient–clinician visits (n = 325) were audio recorded at baseline, immediately post-intervention, and at 6 months. Outcomes were the frequency and quality of PA discussions using the 5As, assessed by blinded coders.
Results.
Patients’ mean age was 44 years; 75% were African American. PA was discussed in 37% (n = 119) of visits overall and did not change from baseline to follow-up. When PA discussions occurred, the frequency of 5As increased from baseline to follow-up for Advise (51–54%), Agree (11–26%), and Assist (11–17%); however, none of the 5As had a statistically significant increase. For Agree, exploration of patient willingness to engage in PA increased from 23% at baseline to 50% at follow-up.
Conclusion.
A clinician-directed intervention to improve PA counselling increased the frequency of Advise, Agree and Assist, and the quality of Ask and Agree statements, though the absolute numbers were small and only Agree reached statistical significance. Future research is needed to understand the factors that affect the optimal uptake and approach to 5As counselling.
Objective:
To determine whether sex modifies the relationship between fitness and mortality.
Patients and methods:
We included 57,284 patients without coronary artery disease or heart failure who completed a routine treadmill exercise test between 1991 and 2009. We determined metabolic equivalent tasks (METs) and linked patient records with mortality data via the Social Security Death Index. Multivariable Cox regression was used to determine the association between sex, fitness, and all-cause mortality.
Results:
There were 29,470 men (51.4%) and 27,814 women (48.6%) with mean ages of 53 and 54 years, respectively. Overall, men achieved 1.7 METs higher than women (P<.001). During median follow-up of 10 years, there were 6402 deaths. The mortality rate for men in each MET group was similar to that for women, who achieved an average of 2.6 METs lower (P=.004). Fitness was inversely associated with mortality in both men (hazard ratio [HR], 0.84 per 1 MET; 95% CI, 0.83-0.85) and women (HR, 0.83 per 1 MET; 95% CI, 0.81-0.84). This relationship did not plateau at high or low MET values.
Conclusion:
Although men demonstrated 1.7 METs higher than women, their survival was equivalent to that of women demonstrating 2.6 METs lower. Furthermore, higher MET values were associated with lower mortality for both men and women across the range of MET values. These findings are useful for tailoring prognostic information and lifestyle guidance to men and women undergoing stress testing.
Background:
Studies have consistently reported associations among depression, cigarette smoking, and fruit and vegetable intake (FVI). This study evaluated FVI as a moderator of the association between depressive symptoms and smoking.
Methods:
We analyzed data from the National Longitudinal Survey of Youth 1979: Child and Young Adult. The study sample was adults aged 19-33 years at baseline in the year 2004 from the Young Adult Survey portion. Moderation analyses were performed using the Johnson-Neyman technique to assess whether baseline FVI moderated the association between depressive symptoms and smoking status cross-sectionally and as a predictor of smoking cessation longitudinally at 4-year follow-up.
Results:
Cross-sectionally, at lower levels of FVI (< 4.9 times/day) there was a significant association between smoking and depressive symptoms (p < .05), but not at higher levels of FVI (≥ 4.9 times/day; p > .05). Longitudinally, there was an inverse association between depressive symptoms and quitting smoking at FVI < 1.2 times/day (p < .05), but there was not a significant association at FVI ≥ 1.2 times/day (p ≥ .05).
Conclusions:
FVI moderated the association between depressive symptoms and cigarette smoking cross-sectionally and longitudinally. The cross-sectional findings might be partially explained by the longitudinal findings paired with prior research; there might be fewer smokers with high FVI because depressive symptoms are removed as an impediment to cessation. Further experimental research is warranted to test the efficacy of increased FVI as an adjunct to smoking cessation with a possible mechanism of action being reduced depressive symptoms during quit attempts.
Background:
Walking among Latinos in US Micropolitan towns may vary by language spoken.
Methods:
In 2011-2012, we collected telephone survey and built environment (BE) data from adults in six towns located within micropolitan counties from two states with sizable Latino populations. We performed mixed-effects logistic regression modeling to examine relationships between ethnicity-language group [Spanish-speaking Latinos (SSLs); English-speaking Latinos (ESLs); and English-speaking non-Latinos (ENLs)] and utilitarian walking and recreational walking, accounting for socio-demographic, lifestyle and BE characteristics.
Results:
Low-income SSLs reported higher amounts of utilitarian walking than ENLs (p = 0.007), but utilitarian walking in this group decreased as income increased. SSLs reported lower amounts of recreational walking than ENLs (p = 0.004). ESL-ENL differences were not significant. We identified no statistically significant interactions between ethnicity-language group and BE characteristics.
Discussion:
Approaches to increase walking in micropolitan towns with sizable SSL populations may need to account for this group's differences in walking behaviors.
Context:
Four major modifiable behavioral risk factors are considered responsible for the current burden of the non-communicable diseases: tobacco use, physical inactivity, unhealthy diet and excessive alcohol consumption. Limited data on the lifestyle habits in Romanian population is currently available.
Objective:
To assess the eating patterns and physical activity habits and other lifestyle components in various age groups in the population included in the ORO study.
Design:
ORO was a cross-sectional, epidemiologic, multicenter non-interventional study conducted from January 2014 until August 2014 in 8 study centers spread in the main historical regions of Romania.
Results:
Eating 3 meals/day every day was more frequently reported in the 60-79 years and ≥ 80 years age groups (53.0% and 51.7%) than in the 18-39 years and 40-59 years age groups (26.8% and 35.8%), p <0.001. The frequency of eating breakfast every day increased with age from 43.5% in the youngest age group to 79.3% in the oldest one (p <0.001). Intense and moderate leisure-time physical activity was more frequent among participants in the 18- 39 years age group. Leisure time physical activities were associated with younger age groups, male sex, rural area, higher educational level and non-smoking status. Regular breakfast and regular consumption of 3 meals/day was associated with older age group, male sex and non-smoking status.
Conclusions:
Our analysis showed a high frequency of unhealthy lifestyle habits among the younger age groups as compared to the older ones, with the highest frequency of these unhealthy behavior reported in the 18-39 years age group.
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