Contribution Of Exercise Research Articles

Combined training in addition to cortisol reduction can improve the mental health of girls with precocious puberty and obesity.

Obesity and central precocious puberty (CPP) are associated with increased anxiety, depression, and anger in girls. The contribution of exercise as an efficacious component in decreasing anxiety, depression, and anger has been increasingly recognized. This study aims to evaluate the effects of combined training on cortisol, anxiety, depression, and anger in overweight and obese girls with CPP. The study involved 30 girls aged 7-9 years diagnosed with CPP (undergoing triptorelin treatment) and dealing with obesity. In addition, these girls scored higher than the cut-off line for anxiety, depression, and anger. The participants were divided into two groups, with 15 individuals in each group. The exercise group engaged in 60 min of combined aerobic and resistance training three times per week for a duration of 12 weeks. On the other hand, the control group did not receive any training. Throughout the study, the serum cortisol levels were measured in both groups. Anxiety, anger, and depression questionnaires were also completed at three different stages, namely, baseline, 12 weeks, and 16 weeks (after a 4-week period of detraining). In the exercise group, there was a significant decrease (P < 0.05) in cortisol serum levels and anxiety, depression, and anger scores. These changes were observed consistently during detraining (P > 0.05). However, in the control group, only the depression score significantly decreased (P < 0.05). Based on the results, it can be concluded that combined training is a method to improve the mental health of CPP girls. https://en.irct.ir/trial/61990, identifier IRCT20170411033378N10.

The Contribution of Exercise in Telemedicine Monitoring in Reducing the Modifiable Factors of Hypertension-A Multidisciplinary Approach.

The aim of this review was to explore the contribution of physical activity and exercise in the control and reduction of modifiable factors of arterial hypertension in telemedicine programs, assuming a multidisciplinary perspective. Searches were carried out following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses), and the research question defined using the PICOS approach (Population, Intervention, Comparator, Outcomes, Study design). The search strategy applied the following terms: blood pressure OR hypertension AND exercise OR physical activity AND telemedicine. The initial search identified 2190 records, but only 19 studies were considered eligible after checking for the inclusion and exclusion criteria. The following training variables were generally included: heart rate and heart rate reserve, respiratory rate, rate of perceived exertion and oxygen consumption, but no resistance training variables were found. The significant improvements on blood pressure parameters of participants diagnosed with hypertension tended to be transient. The exercise prescription was commonly based on general instructions and recommendations for exercise and hypertension. On the other hand, most of the studies including patients in cardiac rehabilitation programs used a personalized training program based on a baseline assessment, particularly following a cardiopulmonary exercise test. The inclusion of exercise professionals in multidisciplinary teams could provide a more person-oriented approach and the long-term maintenance of a healthy lifestyle.

Exploring Direct and Indirect Associations of Exercise and Sport Participation with Employment among Individuals with Disabilities: A Scoping Review.

Purpose Exercise and sports have many positive benefits for persons with or without a disability. Despite this, the contribution of exercise and sport participation to employment is less documented. The purpose of this scoping review was to provide insight into the direct and indirect associations of exercise and sport participation with employment among persons with disabilities. Methods Six databases were searched (MEDLINE, Embase, Scopus, PsychINFO, CINAHL, and HealthStar) from their inception date to March 20, 2020. Peer-reviewed English and French articles were included if at least one outcome measure on employment or work-related outcomes as a result of participation in, or benefits of exercise and sport participation was the focus of the study. Results The research identified 2796 hits. Of which, 23 published between 1992 and 2019 met eligibility criteria. Seven studies identified a direct association between exercise and sport participation with employment and full-time positions. Sixteen studies reported on improved health/work-related outcomes such as occupational performance (i.e., self-care, functional independence), physical fitness (i.e., upper extremity strength, endurance) and psychological well-being (i.e., self-efficacy). Conclusions This scoping review highlights that exercise and sport participation have associations with employment and work-related outcomes. Benefits of exercise and sports may be considered to a greater extent, than in the past, in programs that facilitate employment for persons with disabilities. Additional research using longitudinal design should be conducted to further understand the strength of these associations and evaluate whether exercise and sport participation should be incorporated more intensely in vocational programs.

Interindividual variation in cardiometabolic health outcomes following 6months of endurance training in youth at risk of type 2 diabetes mellitus.

This study determined the interindividual variation in the cardiometabolic response to 6months of moderate or vigorous intensity exercise training (ET) among youth at risk for type 2 diabetes mellitus. Youth were randomized to moderate intensity ET (45-55% heart rate reserve; n = 31), vigorous intensity ET (70-85% heart rate reserve; n = 37), or control (n = 36). Only those attending ≥70% of ET sessions were included. Cardiometabolic measures included insulin sensitivity, hepatic triglyceride content, visceral adipose area, and cardiorespiratory fitness. The contribution of ET to interindividual variation was determined using the standard deviation of individual responses (SDIR) and considered meaningful if the SDIR surpassed the smallest worthwhile difference (SWD), calculated as 0.2× the standard deviation of the control group baseline values. ET meaningfully contributed to the interindividual variation among changes in peak oxygen uptake following moderate (SDIR: 2.04) and vigorous (SDIR: 3.43) ET (SWD: 1.17 mL·kgfat free mass-1·min-1), body fat percentage and hepatic triglyceride content following moderate-intensity ET (SDIR: 1.64, SWD: 1.05%; SDIR: 10.08, SWD: 1.06%, respectively), and visceral fat mass following vigorous ET (SDIR: 11.06, SWD: 7.13 cm2). Variation in the changes in insulin sensitivity were not influenced by ET. The contribution of ET to interindividual variation appears to be influenced by the desired outcome and prescribed intensity. Trial registration at ClinicalTrials.gov (identifier no.: NCT00755547). Novelty: The contribution of exercise to interindividual variation following training depends on the outcome and exercise intensity. Increasing exercise intensity does not systematically reduce non-response among youth at risk for type 2 diabetes.

The Contribution of Exercise in Multidimensional Successful Aging of Elderly Women

The Contribution of Exercise in Multidimensional Successful Aging of Elderly Women

Contribution Of Exercise, Physical Activity, And Protein To Functional Cross-sectional Area And Intramuscular Adipose Tissue

Muscle cross sectional area (CSA) has historically been used as a measure for skeletal muscle size, however, functional cross sectional area (FCSA), defined as the area of muscle isolated from adipose tissue within the CSA, is more closely associated with muscular health. The visible adipose tissue beneath the muscle fascia, defined as intramuscular adipose tissue (IMAT), has also been linked to metabolic abnormalities at increased levels in clinical populations. In contrast, in some healthy populations IMAT may be used as a fuel source for physical activity (PA) and dietary intake may influence IMAT. PURPOSE: This study examined factors that predicted FCSA and IMAT in the knee extensors (KE) of younger and older men and women. METHODS: Ninety-eight participants (46 male, 52 female) were classified as younger (20-35 yr) and older (50-65 yr) as well as sedentary (< 2 days per week) and active (3+ days per week) based on self-reported age and concurrent resistance and aerobic exercise training status. All participants completed anthropometry measurements, lower body muscle function testing, a 3-day dietary intake log, and wore an accelerometer for seven days. Participants then completed magnetic resonance imaging (MRI) scanning of the lower limbs. Muscle CSA was determined by manually tracing the KE and FCSA and IMAT were derived through color thresholding. Independent samples t-tests were conducted and two separate step- wise regression analyses were performed to predict FCSA and IMAT. RESULTS: IMAT (cm2) was significantly higher in the sedentary (3.74 ± 1.93) vs. active (1.85 ± 0.56) as well as in older (3.14 ± 2.05) vs. younger (2.74 ± 1.25) (P < 0.05). Protein intake (g·kg·day-1) was also significantly higher in active (1.63 ± 0.55) vs. sedentary (1.19 ± 0.40) (P < 0.05). Gender, age, concurrent exercise training status, and protein intake significantly predicted 70% of the variance in FCSA (P < 0.01), while concurrent exercise training status and light PA predicted 33% of the variance in IMAT (P < 0.01). CONCLUSION: Concurrent exercise, protein intake, and light PA are major determinants of skeletal muscle health and may require further investigation to mitigate aging and activity related loss of muscle quality. Funding: Sanford Health/ NDSU Collaborative Research Seed Grant Program

Pharmacological and Nonpharmacological Treatments for Cardiac Hypertrophy

Cardiac hypertrophy is an adaptive response of the heart to a large variety of extrinsic and intrinsic stimuli, including maladaptive remodeling in response to pathological conditions or to a physiological stimulus such as exercise training. In spite of the cardiac remodeling, classical features differ the pathological and physiological cardiac hypertrophy, in which the pathological remodeling has been associated with several cardiovascular diseases such as heart failure, a major cause of morbidity and mortality. However, there is still no consensus regarding therapies for the treatment of cardiac hypertrophy. In line with the imperative need for new strategies for its treatment, this review is focused on the importance of cholinergic signaling regulation by conventional and alternative drug therapies as well as in the beneficial contribution of exercise as a nonpharmacological approach.

A Study on the Contribution of Exercises, Etudes and Pieces Written in Maqam in Violin Education

The violin is a fretless instrument. Due to this reason, in violin education producing a good quality sound, which is known as “intonation”, is one of the most important elements. In order to have a good intonation, a long and disciplined practicing process is essential. Especially during the beginning of violin education and also in the development phases, being unable to acquire the ability to produce the appropriate sound in the left hand is one of the most significant problems for some students. For this specific reason, it is assumed that during both phases, exercises and etudes written in maqam might facilitate the acquisition of the target behaviours and overcome the mentioned problem.The present study aims to introduce maqams that facilitate the acquisition of some certain behaviour in violin education, and also exercises, etudes and pieces appropriate to these maqams. In addition, it is aimed to discuss the usability of these exercises, etudes and pieces in violin education. In this research, firstly behaviours that are needed to be acquired in the left hand is determined and the musical characteristics of the maqams that are foresight to be used as a material to help students acquire the determined behaviours are analyzed. Maqams that are foreseen to be appropriate and used are also explained. Etudes and exercises that were written with the determined maqams are introduced. Moreover, the degree of the contribution of these behaviours to the development of the students that are will be discussed.The study is considered important in introducing and spreading the traditional music that reflects the rich culture of Turkey and is suggested to be used in violin education.

OT3-02-04: TBCRC 012: ABCDE, a Phase II Randomized Study of Adjuvant Bevacizumab, Metronomic Chemotherapy (CM), Diet and Exercise after Preoperative Chemotherapy for Breast Cancer.

Abstract Background Patients (pts) with residual breast cancer after neoadjuvant chemotherapy are at increased risk of recurrence; no proven risk-reduction strategies exist, supporting exploration of novel therapies in the post-preoperative setting. Bevacizumab (B) combined with chemotherapy is active in metastatic disease; ongoing studies are exploring the efficacy of adjuvant combination chemotherapy and B. DFCI 05–055 (Mayer et al, ASCO 2007, 2008) demonstrated the feasibility of 1 year B after preoperative chemotherapy. Also, increasing data support risk reduction through lifestyle interventions (Segal, Ligibel et al, ASCO 2011). The ABCDE trial was designed to evaluate extended adjuvant B in a high risk post-preoperative cohort, and also assess the contribution of exercise to a dietary intervention. Eligibility Criteria Eligible pts have HER2− breast cancer and have received preoperative anthracycline and/or taxane-based chemotherapy with residual invasive disease at surgery. Acceptable stages include: triple negative if preop stages I-III, or ER+/PR+ if stage III preop or IIB postop. Acceptable organ function and standard B exclusions apply. Registration must occur between 28–180 days after last surgery. Specific Aims Primary endpoint is recurrence-free survival at a median follow-up of 6 years. Secondary endpoints include B pharmacogenomics, evaluation of the impact of exercise on quality of life and biomarkers associated with recurrence, and prospective examination of cardiac toxicity. Residual tissue-based predictors of outcome will be extensively explored, including PAM50, Ki67, and VEGF hypoxia signature. Methods This is a 2 × 2 randomized study with a first randomization to 6 months (mo) B 15 mg/kg every 3 weeks (wks) plus 6 mo CM (C 50 mg daily, M 2.5 mg twice daily days 1, 2 each wk), followed by 2.5 years B 15 mg/kg every 6–8 wks, versus observation. A second randomization is to a 1 year telephone-based lifestyle intervention, offering dietary modification alone, or in combination with a structured exercise program. Statistical Methods and Accrual Total sample size is 660 pts within the Translational Breast Cancer Research Consortium. Overall power is 0.80 to detect a hazard ratio of 0.59−0.68, depending on pt population. Accrual initiated early 2011 and is expected to continue for the next 36 months. Conclusions Patients with residual disease after preoperative chemotherapy are at high risk of recurrence and have unmet medical needs. To our knowledge, this is the only trial testing a prolonged but less intensive adjuvant B schedule in this clinical setting. Results of this study could have critical implications for the management of this patient population and for the design of future clinical trials with anti-angiogenic agents. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr OT3-02-04.

Differences in energy expenditure between high- and low-volume training

Several studies have examined energy expenditure in various sports but there is a lack of research on the contribution of exercise and habitual activity during different training periods. This study examined changes in total daily energy expenditure (TDEE) and its components during high- and low-volume training periods. Further, changes in time spent in sedentary, light, moderate and vigorous activity in response to different training volumes were explored. Energy expenditure was measured in 15 male endurance athletes during 2 non-consecutive weeks – 1 week of high volume (>13 hours) training and another week of low volume (<7 hours) training. The SenseWear Pro 3 Armband, individual heart-rate-oxygen consumption regression and indirect calorimetry was used to measure non-exercise activity thermogensis (NEAT), exercise energy expenditure (EEE) and resting metabolic rate, respectively. Time spent at different intensities was assessed using previously established MET cutpoints. TDEE as well as EEE increased significantly with higher training volume, while no difference in NEAT occurred. Further, significantly less time was spent in sedentary activities during the high-volume week. These results suggest that highly trained athletes do not compensate for increased training volume and reduce sedentary activities to allow for more training time.

Could exercise unveil the mystery of non-response to cardiac resynchronization therapy?

Left ventricular mechanical dyssynchrony describes the differences in the timing of contraction between different myocardial segments that are commonly observed in patients with congestive heart failure, particularly in those with depressed LV ejection fraction. Its presence varies with not only the methods of assessment, but also characteristics of the study population including the QRS duration, loading condition, severity of coronary artery disease, LV hypertrophy, and LV remodelling. Therefore, the ECG criteria of QRS width ≥120 ms adopted in the current guidelines may not be optimal for identifying patients who will benefit most from CRT or defining the presence of mechanical dyssynchrony. 6 Analysis of LV dyssynchrony is achieved by different imaging modalities such as echocardiography, from conventional M-mode and Doppler echocardiography to more advanced tissue Doppler imaging (TDI), three-dimensional echocardiography, and speckle tracking imaging, and most of the time, performed at rest. Consequently, lack of mechanical dyssynchrony has been found in about one-third of heart failure patients with QRS duration ≥120 ms. On the other hand, mechanical dyssynchrony occurs in 40‐50% of patients with a narrow QRS complex defined as ,120 ms. 7 Furthermore, numerous studies have suggested that the presence and the extent of LV mechanical dyssynchrony could be a better predictor of response to CRT than QRS duration per se. 5,8 Not until recently, the contribution of exercise to LV mechanical dyssynchrony has been investigated and exercise-induced dyssynchrony has been found to be associated with exacerbation of heart failure symptoms, an increase in mitral regurgitation, and a reduction in exercise capacity. 9‐12 Therefore, it appears that the assessment of LV mechanical dyssynchrony only at rest may not be sufficient in heart failure patients. The landmark study by Lafitte et al. 9 first described how mechanical dyssynchrony was modified by exercise in 65 consecutive patients with LV ejection fraction of ,35% and New York Heart Association class II or III symptoms. Depending on the parameter adopted for assessment and using 20% of change as a cut-off point, LV systolic dyssynchrony increased in 28‐40%, remained the same in 35‐43%, and decreased in 23‐31% of the patients during exercise. On a closer inspection, patients could be categorized into four different groups: patients without dyssynchrony at rest but induced by exercise (exercise-induced dyssynchrony), patients with dyssynchrony at rest which normalized during exercise, patients without dyssynchrony at rest as well as during exercise, and patients with dyssynchrony in both situations. The former two groups warranted further investigation to help understand the relationship with lack of response to CRT, which represented 20‐26% of the study population. In another study in 60 patients with dilated cardiomyopathy and narrow QRS complex (,120 ms), significant mechanical dyssynchrony was observed in 33.3% of patients at rest and in 58.3% during exercise. The dynamic change in standard deviations of the time to peak systolic velocity of the 12 LV segments (Ts-SD or Yu Index) as the dyssynchrony measurement between rest and exercise showed an independent positive association with the change in mitral regurgitation, and an independent inverse correlation with the change in LV stroke volume. 10 Wang et al. 11 reported the occurrence of exercise-evoked systolic dyssynchrony in 11 (33%) of 33 heart failure patients with ejection

The Contribution of Exercise and Sport to Mental Health Promotion in Serious Mental Illness: An Interpretive Project

In this article we synthesise the findings of previous research to explore the question: How can exercise and sport contribute to mental health promotion in the context of serious mental illness? We used an interpretive approach to gain insights into the sport and exercise experiences of 11 men with serious mental illness. Data were gathered through interviews and participant observation, and analysed through a content analysis and a narrative analysis of structure and form. These analyses suggest that exercise and sport contributed in three distinct ways: acting as a vehicle for other outcomes, facilitating recreation of a previous athletic identity, and providing a means to re-story self and identity through adventure experiences. We conclude that the ways in which exercise and sport can help promote mental health in the context of serious mental illness are varied, complex and closely related to the meaning the activity holds for the individual.

Can Exercise Contribute to the Goals of Feminist Therapy?

Exercise can contribute to the feminist therapy goals of empowerment and consciousness raising, and it can help to alleviate depression, manage stress, reduce anxiety, improve body image, raise self-esteem and self-efficacy, and aid recovery from physical or sexual abuse. The purposes of this article are to review the potential contributions of exercise to feminist therapy and to encourage therapists to consider how their clients could benefit from engagement in regular physical exercise.

Physiologic regulators of bone turnover in adolescents with anorexia nervosa

s of Research Presentations Presented at the Annual Meeting of The Society for Adolescent Medicine—March 2002 SESSION I NEW INVESTIGATOR AWARD ELIGIBLE SCIENTIFIC RESEARCH PAPERS PHYSIOLOGIC REGULATORS OF BONE TURNOVER IN ADOLESCENTS WITH ANOREXIA NERVOSA Catherine M. Gordon, M.D., M.Sc., Elizabeth Goodman, M.D., S. Jean Emans, M.D., Estherann Grace, M.D., Kelly A. Becker, B.A., Clifford J. Rosen, M.D., Caren M. Gundberg, Ph.D., Meryl S. LeBoff, M.D. Division of Adolescent and Young Adult Medicine, and Division of Endocrinology, Children’s Hospital, Boston; Division of Adolescent Medicine, Children’s Hospital of Cincinnati, Cincinnati, OH; St. Joseph Hospital, Bangor, ME; Department of Orthopedics, Yale-New Haven Hospital, New Haven, CT; Division of Endocrine/Hypertension, Brigham and Women’s Hospital, Boston, MA. Purpose: Profound osteopenia is a frequent and often irreversible complication of anorexia nervosa (AN), but controversy exists around the mechanisms responsible for the bone loss of this disease. The goal of this study was to clarify the role of specific physiologic regulators of bone turnover in adolescents with AN. We sought to determine correlates of bone mineral density (BMD), with a focus on the contributions of exercise, specific indices of body mass, and adrenal androgens. Methods: Sixty-one young women with AN were studied. Anthropometric data were acquired, and BMD and body composition measured by dual energy x-ray absorptiometry (DXA). Serum samples were obtained for adrenal and sex steroids, insulin-like growth factor I (IGF-I), proresorptive cytokines, and bone formation markers (osteocalcin and bone-specific alkaline phosphatase), and urine for bone resorption markers (N-telopeptides, NTx). Results: Forty-seven percent of patients with AN had osteopenia of the lumbar spine, and BMD was positively correlated with weight (r .46, p .001), height (r .33, p .008), and weekly exercise (r .36, p .006), and inversely correlated with duration of AN (r .26, p .041). BMD of the hip was positively correlated with weight (r .39, p .002) and exercise (r .42, p .001), and negatively correlated with duration of amenorrhea (r .27, p .044). Levels of dehydroepiandrosterone sulfate (DHEAS), IGF-I, and bone formation markers were below that expected for age, while NTx levels were elevated. DHEAS levels were inversely correlated with NTx (r .40, p .004). IGF-I was directly correlated with BMI (r .32, p .014), percentage body fat (r .31, p .034), and the bone formation marker, osteocalcin (r .32, p .015). Proresorptive cytokine levels were low or undetectable. Conclusions: These results suggest that exercise, height, and weight are positive predictors of BMD in AN, and duration of disease and amenorrhea are negative predictors. If cautiously prescribed, exercise may be a lifestyle factor that could augment bone density in adolescent girls with AN. DHEAS was inversely correlated with bone resorption markers, suggesting a relationship between this adrenal steroid and increased bone resorption in AN. IGF-I was correlated with body mass and bone formation indices. The unexpected finding of low proresorptive cytokines suggests that other mechanisms contribute to the increased bone resorption seen in AN. A NEW PROBLEM IN PEDIATRIC AND ADOLESCENT MEDICINE: THE PSYCHIATRIC BOARDER Jonathan M. Mansbach, M.D., Elizabeth Wharff, Ph.D., S. Bryn Austin, Sc.D., Katherine Ginnis, M.S.W., Elizabeth R. Woods, M.D., M.P.H. Children’s Hospital Boston, Harvard Medical School, Boston, MA. Purpose: Due to the shortage of pediatric and adolescent mental health services, pediatric patients requiring psychiatric hospitalization may be admitted to a medical service only because there are no available inpatient psychiatric beds. These patients are termed psychiatric ‘boarders.‘ The goals of this study were to describe the extent of the boarder crisis and to compare the characteristics of patients successfully placed into psychiatric facilities from the Emergency Department (ED) to those requiring admission to the medical service as a boarder. A psychiatric facility was considered an inpatient psychiatric unit or acute residential treatment center. Methods: We conducted a retrospective cohort study. The cohort consisted of all patients presenting to a large pediatric ED who required inpatient psychiatric admission between July 1, 1999 and June 30, 2000. Extensive data were collected at the time of ED evaluation by psychiatrists, psychologists, and psychiatric social workers. Patients were excluded if they needed inpatient medical stabilization or treatment prior to psychiatric placement. The outcomes were validated using computerized medical records and an inpatient psychiatric consult log. Multivariate logistic regression was used to estimate the odds of being boarded associated JOURNAL OF ADOLESCENT HEALTH 2002;30:92–105 © Society for Adolescent Medicine, 2002 Published by Elsevier Science Inc., 655 Avenue of the Americas, New York, NY 1001

Contributions of exercise, body composition, and age to bone mineral density in premenopausal women

The purpose of this cross-sectional study were to determine whether exercisers have greater bone mineral density (BMD) than nonexercisers, whether aerobic dancers have greater BMD than walkers, and to determine the contributions of energy expenditure, body composition, and dietary factors to spine and femur BMD. Measurements were obtained on 93 eumenorrheic women (walkers N = 28; aerobic dancers, N = 34; nonexercisers, N = 31) ages 25-41 yr; lumbar spine and proximal femur BMD, body composition, physical activity, and nutrient intakes. Mean height, weight, and body mass index and median age and calcium intakes were similar for the three groups. Mean (+/- SD) values of the spine, total femur, and femoral neck BMD, respectively, were: walkers (1.092 (+/- 0.098), 0.947 g.cm-2), dancers (1.070 (+/- 0.124), 0.990 (+/- 0.104), 0.908 (+/- 0.106) g.cm-2), and nonexercisers (1.020 (+/- 0.112), 0.887 (+/- 0.073), 0.792 (+/- 0.089) g.cm-2) multiple regression analyses indicated that exercise contributed to spine (P = 0.018), total femur (P =0.012), and femoral neck (P < 0.0001) BMD, whereas type of exercise (aerobic dance vs walking) did not (P > 0.05). Total femoral BMD was influenced by exercise (P = 0.012) and energy expenditure (P = 0.023), while vertebral BMD was influenced by age (P = 0.0067), body weight (P = 0.017), and exercise (P = 0.018). These findings suggest that walking and aerobic dance exercise may provide physically active premenopausal women with greater lumbar and femoral BMD than sedentary females.

Recent advances in the treatment of childhood obesity.

The multidisciplinary, four-phase approach, which includes PSMF, BEM, and MPE is successful in treating mild, moderate, and severe degrees of childhood and adolescent obesity. The MPE program is appropriate for use with PSMF and BEM due to its progressive nature, variety of options, and moderate intensity level. In addition, the MPE program is of sufficient intensity, duration, and frequency to promote a significant increase in estimated aerobic capacity (VO2max) and to promote the maintenance of lean body mass and resting energy expenditure. The short-term intervention of PSMF, BEM, and MPE also results in an improvement in body composition, lipid profiles, and IGF-1 and T3 levels. The 1200-calorie balanced diet, MPE, and BEM also provide a successful method of weight maintenance in children and adolescents, as indicated by further improvement in body composition at the 26-week measure. Additional studies are needed to assess the contribution of exercise to the maintenance of lean body mass and resting energy expenditure in obese children and adolescents. In addition, it will be important to assess long-term weight maintenance in obese adolescents who effectively lose weight in this multidisciplinary program.

Personal determinants of leisure-time exercise activities.

This study investigated the importance of personal determinants such as self-efficacy, beliefs about the contribution of exercise, health locus of control, and dispositional optimism for leisure-time exercise in a working population. The main predictors of such exercise were beliefs and self-efficacy with the generalization of the latter to eat correctly. Beliefs and efficacy expectations were highly correlated. Neither health locus of control nor dispositional optimism was related to leisure-time exercise; however, optimism was related to the positive belief that exercise contributes to health. Ramifications of the findings were carefully described.