ENERGI EXPENDITURE PADA LANSIA

Patients with severe OSA consume greater amounts of cholesterol, protein, and fat as well as have greater caloric expenditure. However, it is not known whether their activity levels or diet change after treatment with CPAP. To investigate this issue, serial assessments of activity and dietary intake were performed in the Apnea Positive Pressure Long-term Efficacy Study (APPLES); a 6-month randomized controlled study of CPAP vs. sham CPAP on neurocognitive outcomes. Subjects were recruited into APPLES at 5 sites through clinic encounters or public advertisement. After undergoing a diagnostic polysomnogram, subjects were randomized to CPAP or sham if their AHI was ≥ 10. Adherence was assessed using data cards from the devices. At the Tucson and Walla Walla sites, subjects were asked to complete validated activity and food frequency questionnaires at baseline and their 4-month visit. Activity and diet data were available at baseline and after 4 months treatment with CPAP or sham in up to 231 subjects (117 CPAP, 114 Sham). Mean age, AHI, BMI, and Epworth Sleepiness Score (ESS) for this cohort were 55 ± 13 [SD] years, 44 ± 27 /h, 33 ± 7.8 kg/m(2), and 10 ± 4, respectively. The participants lacking activity and diet data were younger, had lower AHI and arousal index, and had better sleep efficiency (p < 0.05). The BMI was higher among women in both CPAP and Sham groups. However, compared to women, men had higher AHI only in the CPAP group (50 vs. 34). Similarly, the arousal index was higher among men in CPAP group. Level of adherence defined as hours of device usage per night at 4 months was significantly higher among men in CPAP group (4.0 ± 2.9 vs. 2.6 ± 2.6). No changes in consumption of total calories, protein, carbohydrate or fat were noted after 4 months. Except for a modest increase in recreational activity in women (268 ± 85 vs. 170 ± 47 calories, p < 0.05), there also were no changes in activity patterns. Except for a modest increase in recreational activity in women, OSA patients treated with CPAP do not substantially change their diet or physical activity habits after treatment. .

Empowering sedentary adults to reduce sedentary behaviour: Success with a technology-based physical activity monitor

Using Pedometers to Promote Physical Activity Among Clinical Populations

Physical activity in the prevention and treatment of obesity and its comorbidities: evidence report of independent panel to assess the role of physical activity in the treatment of obesity and its comorbidities.

Purpose：The purpose of this study was to investigate the effects of change in daily physical activity during an exercise intervention on health status and physical fitness.Methods：Participants were 22 obese middle-aged men (BMI : 29.1±2.8 kg/m2, 54.1±11.4 yr). They performed 90-min exercise sessions on a regular basis 3 days per week for 3 months. Physical activity (total energy expenditure, TEE ; activity energy expenditure, AEE ; and step counts) was measured using an accelerometer. Daily physical activity was defined as that which was performed outside of the exercise class. A 3-day food record was used to estimate energy intake. Results：Body weight decreased (-3.0±2.5 kg, P＜0.05). Vital age (VA), an index of comprehensive health status, and physical fitness age (PFA), an index of comprehensive physical fitness, significantly improved (VA : -8.7±5.5 yr, PFA : -8.5±5.1 yr, P＜0.05). Energy intake remained unchanged during the intervention (＋63.7±546.1 kcal/d). Daily physical activity increased (TEE : ＋83.0±130.1 kcal/d, AEE : ＋76.9±103.3 kcal/d, step counts : ＋1789±2819 steps/d, P＜0.05). Change in daily physical activity was correlated with change in VA (AEE : r＝-0.52, step counts : r＝-0.46, P＜0.05), while change in daily physical activity did not correlate with change in PFA. Conclusion：These results suggest that changes in daily physical activity during an exercise intervention are associated with improved health status.

Previous researchers have evaluated the influence of physical exercise or physical activity on pregnancy outcome, but the influence of daily physical activities in details including energy expenditure, biomechanical load and exercise before and during pregnancy have remained unclear. This study evaluates the relationship between daily physical activities as a biomechanical load and energy expenditure and physical exercise during household activities with birth weight, type of delivery and Apgar score. The participants of this study were household, first parity women who referred to a prenatal care center in southern Iran. 132 volunteer women were eligible to be enrolled according to their general health and not having any absolute or relative limitation for participating in any kind of activity. Information about daily physical activity was collected through a personal interview using a structured questionnaire during two separate days of ninth month of pregnancy. Data on delivery were recorded from recorded documents of mothers in the hospital. There was no relationship between biomechanical and energy load and birth weight. There was a significant correlation between Apgar score and biomechanical and energy load. Infants of mothers who exercised before or during pregnancy had a significant higher weight than the non-exercise group. Apgar score indicated no significant difference among those having exercise and those without before and during pregnancy. There was no significant difference in the biomechanical load and energy expenditure in the two types of delivery. Daily activities in normal range do not induce any harmful effect on birth weight; increasing biomechanical load as a result of some maternal body postures that may be harmful for infant health at birth time. Physical exercise before and during pregnancy may have a positive effect on birth weight.

A low level of physical activity, typical of Western society, is deemed conducive to weight gain, while an increase in physical activity tends to promote weight loss, suggesting an imperfect coupling between energy expenditure and intake. Conversely, individuals with high levels of habitual activity tend to be in energy balance over the long-term suggesting that intake is adjusted to match expenditure. There are four interactions to consider between energy intake and expenditure in the development and treatment of obesity. Does exercise drive energy intake upwards and undermine its contribution to weight management? Does sedentariness alter levels of energy intake or subsequent energy expenditure? Do high levels of energy intake alter physical activity or exercise? And does dieting elevate or decrease energy expenditure? Cross talk between elevated energy expenditure and intake is initially too weak and takes too long to activate, to seriously threaten dietary approaches to weight management. It appears that substantial fat loss is possible before intake begins to track a sustained elevation in expenditure. There is little evidence that sedentariness produces compensatory reductions in energy intake. This lack of cross talk between altered expenditure and intake tends to promote a positive energy balance. Sizeable, compensatory changes in nonexercise activity in response to overfeeding are feasible, but have yet to be clearly demonstrated. There is more evidence that energy intake restriction does lower physical activity levels (PALs) – at least when it is more severe and for longer than is recommended for normal dieting and weight loss. A higher level or duration of physical activity is needed to prevent weight regain after dieting than is needed to prevent weight gain in the first place. Even more is needed to achieve weight loss through exercise alone. Individuals who are regularly physically active tend to be leaner and have a lower body weight than those who are sedentary. Taking up regular exercise results in weight loss or maintenance, while stopping results in weight gain. However, individuals vary in their ability to adjust or regulate the various components of energy balance, and therefore in their resistance to lose or gain weight in response to increases or decreases in energy expenditure respectively.

Although several cross-sectional studies have assessed the daily physical activity in children with asthma, the impact of the level of asthma control remains unknown. To assess the influence of asthma treatment-induced changes in asthma control on daily physical activity, cardiovascular fitness and body composition in children with asthma. Daily accelerometer-measured physical activity, cardiovascular fitness, body composition (percent fat, percent lean tissue and bone mineral density) and a variety of asthma outcomes (to assess the level of asthma control) were measured over 4 weeks in 55 children with newly diagnosed untreated asthma and 154 healthy, sex and age-matched controls. Treatment with inhaled corticosteroids was initiated after the baseline period. All outcome measurements were repeated after 1 year and some also during the year of treatment. Asthma control improved markedly during the year of treatment. The improvement in control was associated with a significant increase in total daily activity of 2.8 h/week compared with the healthy controls (P < 0.001). In addition, significant increases were seen in moderate-vigorous activity (33 min/week; P = 0.01) and in cardiovascular fitness (1.2 ml O₂/min*kg) compared with the healthy controls. The improvement in activity was mainly seen during the last 6 month of the study. No difference was seen between the two groups in changes in percent body fat. Poorly controlled asthma is associated with reduced physical activity and cardiovascular fitness. Improvement in asthma control is associated with a clinically relevant increase in daily physical activity and cardiovascular fitness.

Background and AimsPhysical activity is essential for healthy growth and development. Being active is an important tool for the prevention and treatment of childhood obesity. Physical activity can benefit children...

Malnutrition in children with cystic fibrosis: the energy-balance equation.

Aging, in conjunction with decreasing physical activity, is associated with a range of health problems. Simple, low-maintenance, population-based means of promoting activity to counteract the age-associated decline are required. We therefore assessed the effect of pedometry and buddy support to increase physical activity. We undertook a clustered randomized trial (HKCTR-346) of 24 community centers involving 399 older Chinese participants (≥ 60 yr). Centers were randomly allocated to 1) pedometry and buddy, 2) pedometry and no buddy, 3) no pedometry and buddy, and 4) no pedometry and no buddy with a 2 × 2 factorial design. The trial simultaneously tested the individual and combined effects of the interventions. The intervention groups also received monthly organized group activities to provide encouragement and support. Outcome measures were assessed at 6 and 12 months, including physical fitness and activity and cardiovascular disease risk factors (anthropometry and blood pressure). From the 24 centers, 356 volunteers (89.2%) completed the study. Those receiving the interventions had higher mean physical activity levels at 12 months of 1820 (95% confidence interval (CI) = 1360-2290) and 1260 (95% CI = 780-1740) MET·min·wk(-1), respectively relative to the decrease in the control groups. The buddy peer support intervention significantly improved mean aerobic fitness (12% [95% CI = 4%-21%]) and reduced both body fat (-0.6% [95% CI = -1.1% to 0.0%]) and time to complete the 2.5-m get-up-and-go test (-0.27 [95% CI = -0.53 to -0.01] s). No other improvements in the cardiovascular disease risk factors were observed. The combination of motivational tools was no better than the individual interventions. Both motivational interventions increased physical activity levels, and the buddy style improved fitness. These tools could be useful adjuncts in the prevention of obesity and age-related complications.

To establish an easy and convenient method for assessing the daily physical activity of workers, validity of a calorie counter combined with an accelerometer (KENZ Calorie Counter) was tested and compared with the method of daily survey and Stanford's interview method for energy consumption of daily physical activity. The subjects of this study were 92 volunteers. Energy expenditure of daily physical activity during 3-4 d was measured in 20 volunteers by means of a calorie counter, and the daily energy consumption was calculated from relative metabolic rates of physical activity. In the remaining 72 volunteers the energy consumption over 4-7 d was measured by means of a calorie counter and calculated from the Stanford's interview method. Correlation of the energy expenditure of daily physical activity measured by calorie counter (y) and that calculated from daily survey (x) was y = 0.74 x + 473 (r = 0.91, n = 56). Correlation of the calorie expenditure over 4-7 d measured by the calorie counter (y) and that predicted by Stanford's interview method (x) was high (y = 0.65 x + 3513, r = 0.86, n = 72). Relationship between the energy expenditure measured by the calorie counter (y) and that calculated by both daily survey and Stanford's interview method (x) showed a high correlation (y = 0.84 x + 518, r = 0.98, n = 128). These results suggest that a calorie counter combined with an accelerometer is valid for assessing the daily physical activity of workers.

Limited evidence exists for the role of parent-child coparticipation in physical activity (joint light, moderate, or vigorous physical activities involving at least 1 child and a parent) in parents' and children's overall physical activity. This study examined the association of parent-child coparticipation in physical activity with parental and children's daily physical activity and explored correlates of coparticipation. Data were from 149 participants (41 families: 67 parents [30-55y, 57% female] and 82 children [4-16y, 40% girls]) in the Families Reporting Every Step to Health pilot study. Families Reporting Every Step to Health was a 3-armed, parallel-group, randomized controlled pilot trial. Participants' physical activity and location were measured simultaneously with accelerometers and Global Positioning System monitors. Data from 3 data collection points (baseline and 2 follow-ups) were analyzed cross-sectionally using multivariable linear mixed models with random intercepts at the family and participant levels. At baseline, children and parents accumulated an average of 70 and 36minutes per day, respectively, of parent-child coparticipation in physical activity, which contributed 33% and 17% of their daily total physical activity, respectively. For both parents and children, coparticipation was positively associated with daily total physical activity (β = 0.37; 95% CI, 0.19-0.55min/d) and daily moderate- to vigorous-intensity physical activity (β = 0.10; 95% CI, 0.03-0.16min/d). Coparticipation in physical activity was on average 28.80 (11.23-46.37)minutes per day lower among parents than among children. Parent-child coparticipation in physical activity might be a promising component of family-based interventions to promote physical activity among children and parents.

Physical Activity in Community‐Dwelling Older Persons With Mild Traumatic Brain Injury

Association of free-living physical activity measures with metabolic phenotypes in type 2 diabetes at the time of diagnosis. The Verona Newly Diagnosed Type 2 Diabetes Study (VNDS)