Energy cost of physical activity in patients with anorexia nervosa

To assess the amount of energy cost for a standardized physical activity, activity‐induced thermogenesis (AIT) was measured in eight hyperactive and eight sedentary patients with anorexia nervosa as well as in 14 sport students and 14 sedentary controls. Resting metabolic rate (RMR) and AIT were measured by indirect calorimetry. RMR was measured after an overnight fast and began 20 min after the placement of the hood and lasted for 20 min. For the next 10 min subjects had to ride a recumbent bicycle ergometer (25 W) and AIT was measured. Absolute RMR in both anorectic groups was significantly lower than in both normal weight groups, but after adjusting for lean body mass (LBM) RMR did not differ among the groups. Absolute AIT was significantly lower in hyperactive anorectic patients and in sport students compared to the controls. After adjusting for LBM AIT was still significantly lower in the hyperactive anorectic group and in the group of sport students compared to the control group. These results indicate that despite severe underweight and biological changes in muscles anorectic patients still have an energy sparing metabolism during moderate physical activity. Copyright © 2000 John Wiley & Sons, Ltd and Eating Disorders Association.     

The effects of breaking sedentary time with different intensity exercise bouts on energy metabolism: A randomized cross-over controlled trial

Background and aimsBreaking up sedentary periods, particularly with light activity, increases total energy expenditure (EE), and helps provide better glycemic control. However, the effects of activities of various intensities to interrupt prolonged sedentary time are unclear. The purpose of the present study was to examine potential differences in glycemic control and EE from breaking up sedentary time with short exercise bouts of different intensities.Methods and resultsNine overweight/obesity young men underwent whole body indirect calorimetry at 19:00 on day 1 and stayed overnight. After awakening on day 2, they performed short duration jogging every 30 min over 8 h (16-time bouts in total) under 3 different conditions with the same running distance: (1) lactate threshold (LT) for 2 min, (2) 60% LT for 200 s, and (3) onset of blood lactate accumulation (OBLA) for 75 s. The 24-h EE and interstitial glucose concentration (from 8:00 to 19:00 on day 2) was continuously measured throughout the trials. The standard deviation during intervention and indexes of postprandial of the interstitial glucose concentration was significantly lower at LT and OBLA than at 60% LT (p < 0.05). The 24-h EE was not significantly different among conditions, but EE at OBLA during intervention was slightly but significantly higher than at 60% LT and LT.ConclusionBreaking up sedentary time with short-duration jogging at LT and with OBLA intensities may have better glycemic control and increased use of carbohydrate as a fuel, while short-duration a jogging at OBLA intensity may increase EE.Trial registrationUMIN000041361.     

Physical exercise and prevention of falls. Effects of a Pilates training method compared with a general physical activity program: A randomized controlled trial

Introduction:Falls are the leading cause of injury-related mortality and morbidity in the elderly. Physical activity plays a key role in the prevention of falls and stimulates postural control. The aim of this study was to compare a general physical activity program for the elderly with a Pilates program to evaluate the effects on balance and on reducing the risk of falling.Materials and Methods:Forty-six subjects were enrolled in this study, but only 41 were included in the study. The subjects were divided into 2 groups: Pilates group (P-G) and a group following a nonspecific program of physical activity (Pa-G). Each subject underwent the hand grip test, Berg balance scale test, and posturographic analysis.Results:Spearman correlation coefficient showed correlations between the following parameters: BBS versus hand grip test (r = 0.68); BBS versus ellipse surface area (r = −0.75). There were significant differences between groups after the exercise program: both groups showed an improvement in performance but the P-G recorded significantly better results than the Pa-G.Discussion and conclusions:This study confirmed that physical activity improves both balance and strength. However, our data show that Pilates has a greater effect on these physical abilities than a general physical activity program.     

The association of intensity and overall level of physical activity energy expenditure with a marker of insulin resistance

AIMS/HYPOTHESIS: Physical activity is important in preventing insulin resistance, but it is unclear which dimension of activity confers this benefit. We examined the association of overall level and intensity of physical activity with fasting insulin level, a marker of insulin resistance. METHODS: This was a cross-sectional analysis of the Medical Research Council Ely population-based cohort study (2000--2002). Physical activity energy expenditure (PAEE) in kJ kg(-1) min(-1) was measured by heart rate monitoring with individual calibration over a period of 4 days. The percentage of time spent above 1.5, 1.75 and 2 times resting heart rate (RHR) represented all light-to-vigorous, moderate-to-vigorous and vigorous activity, respectively. RESULTS: Data from a total of 643 non-diabetic individuals (319 men, 324 women) aged 50 to 75 years were analysed. In multivariate linear regression analyses, adjusting for age, sex and body fat percentage, PAEE was significantly associated with fasting insulin (pmol/l) (beta = -0.875, p = 0.006). Time (% of total) spent above 1.75 x RHR and also time spent above 2 x RHR were both significantly associated with fasting insulin (beta = -0.0109, p = 0.007 and beta = -0.0365, p = 0.001 respectively), after adjusting for PAEE, age, sex and body fat percentage. Time spent above 1.5 x RHR was not significantly associated with fasting insulin in a similar model (beta = -0.0026, p = 0.137). CONCLUSIONS/INTERPRETATION: The association between PAEE and fasting insulin level, a marker of insulin resistance, may be attributable to the time spent in moderate-to-vigorous and vigorous activity, but not to time spent in light-intensity physical activity.     

Sedentary behavior and physical activity are independently related to functional fitness in older adults

The last decades of life have been traditionally viewed as a time of inevitable disease and frailty. Sedentary living and physical activity may influence capacity to perform activities that are needed to maintain physical independence in daily living. A total of 117 males and 195 females, aged 65–103 years, were assessed for physical activity and sedentary time with accelerometers and for functional fitness with the Senior Fitness Test battery. Based on the individual scores for each fitness item, a Z-score was created. Associations between functional fitness with sedentary time and moderate-to-vigorous physical activity (MVPA) were analyzed. A negative association was found between the composite Z-score for functional fitness and the sedentary time, even adjusting for MVPA and other confounders. On the other hand, MVPA was positively associated with the composite Z-score for functional fitness, independently of the sedentary time. In conclusion elderly who spend more time in physical activity or less time in sedentary behaviors exhibit improved functional fitness and other confounders. The results reinforce the importance of promoting both the reduction of sedentary behaviors and the increase of MVPA in this age group, as it may interfere at older ages in order to preserve functional fitness and performance of daily functioning tasks.     

Promotion of physical activity after hospitalization for COPD exacerbation: A randomized control trial

Background and Objective

Physical activity worsens during exacerbations of chronic obstructive pulmonary disease (COPD) and notably after hospitalizations. Pedometer-based interventions are useful to increase physical activity in stable patients with COPD. However, there is little information concerning the implementation of such programs following severe exacerbation. This study assessed the efficacy of a physical activity program after hospitalization for a COPD exacerbation.

Methods

We performed a prospective, 12-week, parallel group, assessor-blinded, randomized control trial in COPD patients hospitalized for an exacerbation. After discharge, physical activity and other secondary variables were assessed. Patients were allocated (1:1) to a physical activity promotion program (intervention group, IG) or usual care (control group, CG). Based on a motivational interview and accelerometer physical activity assessment, a patient-tailored, pedometer-based, progressive and target-driven program was designed. Linear mixed effect models were used to analyse between-group differences.

Results

Forty-six out of 61 patients recruited were randomized and 43 (IG = 20, CG = 23) completed the study. In-hospital and baseline characteristics were similar in both groups. After 12 weeks of intervention, the mean steps difference between groups was 2093 steps/day, p = 0.018, 95% CI 376–4012, favouring the IG. Only the IG significantly increased the number of steps/day compared to baseline (mean difference [95% CI] 2932 [1069–4795] steps; p = 0.004). There were no other between-group differences.

Conclusion

After hospitalization for a COPD exacerbation, a patient-tailored physical activity program based on a motivational interview and the use of pedometers, with progressive and customized targets, improved the number of steps/day.     

Bidirectional associations of accelerometer-assessed physical activity and sedentary time with physical function among older English adults: the EPIC-Norfolk cohort study

To develop healthy ageing interventions, longitudinal associations between objectively assessed physical behaviours and physical function need to be better understood. We assessed associations between accelerometer-assessed total physical activity (PA), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary time and prolonged sedentary bout time, and clinically assessed physical function (grip strength, usual walking speed (UWS), chair stand speed) at two time-points in 3188 participants (≥ 60 years) of the EPIC-Norfolk study. Bidirectional associations were assessed using multivariable linear regression. Over an average of 6.1 years, baseline physical behaviours (greater total PA, MVPA and LPA, and less sedentary time) were associated with better subsequent walking and chair stand speed. Better baseline physical function was associated with better follow-up physical behaviours. There were no bidirectional associations between changes in physical behaviours and grip strength. Improvements in UWS were associated with improvements in all physical behaviours. Improvements in chair stand speed were associated with improvements in total PA, MVPA, and sedentary bout time. Improvements in physical behaviours were associated with improvements in UWS (3.1 cm/s/yr per 100 cpm/yr  total PA, 3.6 cm/s/yr per hr/day/yr MVPA, 2.5 cm/s/yr per hr/day/yr LPA, − 2.9 cm/s/yr per hour/day/yr sedentary time, and − 1.6 cm/s/yr per hr/day/yr prolonged sedentary bout time). Only improvements in total PA, MVPA and sedentary bout time were associated with improvements in chair stand speed. In conclusion, we found bidirectional associations between changes in some physical behaviours and physical function and between baseline physical behaviours and subsequent physical function, highlighting the importance of considering the full range of physical behaviours to promote healthy ageing.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10433-022-00733-y.     

Restrictive pattern on spirometry: association with cardiovascular risk and level of physical activity in asymptomatic adults

Objective

: To determine whether a restrictive pattern on spirometry is associated with the level of physical activity in daily life (PADL), as well as with cardiovascular disease (CVD) risk factors, in asymptomatic adults.

Methods

: A total of 374 participants (mean age, 41 ± 14 years) underwent spirometry, which included the determination of FVC and FEV₁. A restrictive pattern on spirometry was defined as an FEV₁/FVC ratio > 0.7 and an FVC < 80% of the predicted value. After conducting demographic, anthropometric, and CVD risk assessments, we evaluated body composition, muscle function, and postural balance, as well as performing cardiopulmonary exercise testing and administering the six-minute walk test. The PADL was quantified with a triaxial accelerometer.

Results

: A restrictive pattern on spirometry was found in 10% of the subjects. After multivariate logistic regression, adjusted for confounders (PADL and cardiorespiratory fitness), the following variables retained significance (OR; 95% CI) as predictors of a restrictive pattern: systemic arterial hypertension (17.5; 1.65-184.8), smoking (11.6; 1.56-87.5), physical inactivity (8.1; 1.43-46.4), larger center-of-pressure area while standing on a force platform (1.34; 1.05-1.71); and dyslipidemia (1.89; 1.12-1.98).

Conclusions

: A restrictive pattern on spirometry appears to be common in asymptomatic adults. We found that CVD risk factors, especially systemic arterial hypertension, smoking, and physical inactivity, were directly associated with a restrictive pattern, even when the analysis was adjusted for PADL and cardiorespiratory fitness. Longitudinal studies are needed in order to improve understanding of the etiology of a restrictive pattern as well as to aid in the design of preventive strategies.     

Improving physical function and blood pressure in older adults through cobblestone mat walking: a randomized trial

OBJECTIVES: To determine the relative effects of cobblestone mat walking, in comparison with regular walking, on physical function and blood pressure in older adults. DESIGN: Randomized trial with allocation to cobblestone mat walking or conventional walking. SETTING: General community in Eugene, Oregon. PARTICIPANTS: One hundred eight physically inactive community-dwelling adults aged 60 to 92 (mean age+/-standard deviation=77.5+/-5.0) free of neurological and mobility-limiting orthopedic conditions. INTERVENTION: Participants were randomized to a cobblestone mat walking condition (n=54) or regular walking comparison condition (n=54) and participated in 60-minute group exercise sessions three times per week for 16 consecutive weeks. MEASUREMENTS: Primary endpoint measures were balance (functional reach, static standing), physical performance (chair stands, 50-foot walk, Up and Go), and blood pressure (systolic, diastolic). Secondary endpoint measures were Short Form-12 physical and mental health scores and perceptions of health-related benefits from exercise. RESULTS: At the 16-week posttest, differences between the two exercise groups were found for balance measures (P=.01), chair stands (P<.001), 50-foot walk (P=.01), and blood pressure (P=.01) but not for the Up and Go test (P=.14). Although significant within-group changes were observed in both groups for the secondary outcome measures, there were no differences between intervention groups. CONCLUSION: Cobblestone mat walking improved physical function and reduced blood pressure to a greater extent than conventional walking in older adults. Additional benefits of this walking program included improved health-related quality of life. This new physical activity may provide a therapeutic and health-enhancing exercise alternative for older adults.     

Reducing fear of falling in seniors through education and activity programs: a randomized trial

OBJECTIVES: To determine the relative effect of education and activity programs on fear of falling, balance, strength, and health status. DESIGN: A randomized intervention trial with two groups (education and activity); evaluators were blind to group allocation. SETTING: Motor performance laboratory at Queen's University. PARTICIPANTS: Thirty-eight community-dwelling seniors who reported a fear of falling and activity restriction but were free of neurological and mobility-limiting orthopedic conditions. INTERVENTIONS: Programs designed to reduce fear of falling were delivered weekly to groups of three to five seniors for 8 weeks, each session lasting 1 hour. The activity program included low-resistance exercises and weight-shifting activities. Education focused on identifying and reducing risk factors for falls. MEASUREMENTS: Balance confidence, activity level, limits of stability (LOS), isokinetic strength, and health status were measured twice preintervention (baseline), postintervention, and 6 weeks later. RESULTS: Both programs reduced fear of falling (P <.006) as ascertained from the balance confidence scores. Differential effects were observed in LOS (P <.05); activity improved balance, whereas education led to modest declines. Gains in perception of health status were limited to physical health for the activity group and mental health for the education group. Benefits were generally sustained at follow-up. CONCLUSION: Improved balance confidence is not intervention-specific, but associated changes in physical ability and health status are a function of the composition of the intervention program.