Lifestyle Physical Activity Intervention Research Articles

TRACking health behavior in people with multiple sclerosis: Effects of a randomized trial on physical activity and working memory.

Multiple sclerosis is associated with impairments in working memory functioning. Lifestyle physical activity interventions show promise in improving cognitive functioning; however, the evidence is limited. We examined the efficacy of a lifestyle physical activity intervention, involving step tracking and psychoeducational materials, on improving step counts, working memory functioning, and network strength in a whole-brain network of working memory. Participants (n = 75) were randomly assigned to a group tracking steps with a pedometer (step-track), or a group tracking water intake with a smart water bottle (water-track), for 6 months. At baseline, mid, and postintervention, we assessed weekly physical activity (GT3X+ accelerometer), weekly water intake (H20 Pal Smart Bottle), and working memory functioning. Additionally, the combined network strength of a validated working memory connectome was calculated. We ran random intercept linear mixed models to examine differences between the groups, over time. A significant Group × Time interaction effect with steps and water intake indicated that the step-track group increased their steps, and the water-track group increased their water intake, in comparison to each other, from baseline to postintervention (p < .05). Both groups improved in behavioral working memory over time (p < .05). No significant differences were found on the network strength. Our 6-month randomized controlled trial involving physical activity tracking showed increased step count in the intervention group. Behavioral working memory improved in both groups, potentially due to practice effects. Future studies should include both active and passive control groups to discern practice effects from intervention impact. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Design and rationale for a randomized clinical trial testing the efficacy of a lifestyle physical activity intervention for people with HIV and engaged in unhealthy drinking

BackgroundAmong people living with HIV (PLWH), unhealthy drinking presents an increased risk for negative outcomes. Physical inactivity and sedentariness raise additional health risks. Despite evidence that physical activity (PA) is associated with improved physical and mental functioning and reduced alcohol cravings, there have been no PA studies conducted with PLWH engaged in unhealthy drinking. We describe a study protocol of a remote lifestyle physical activity (LPA) intervention to increase PA and reduce alcohol consumption among PLWH. MethodsUsing online advertisements, 220 low-active PLWH engaged in unhealthy drinking will be recruited and randomized nationwide. After providing informed consent and completing a baseline interview, participants will receive a Fitbit. Participants will complete 15 days of ecologic momentary assessment through a phone application and up to 15 days of Fitbit wear time. Following this period, participants will be randomly assigned to a Fitbit-only control condition or a LPA and Fitbit intervention condition. Health counselors meet with control participants once (and have 6 subsequent brief check ins on Fibit use) and with intervention participants 7 times for PA counseling over a 12-week period. Follow-up assessments will be conducted at 3- and 6-months post-randomization. We hypothesize that individuals in the LPA and Fitbit condition will have lower rates of alcohol consumption and higher rates of PA at 6-month follow-up. ConclusionThe randomized controlled trial described in this paper investigates remote methods to influence multimorbidity among PLWH using a LPA approach for increasing PA and reducing alcohol consumption.

A lifestyle physical activity intervention for women in alcohol treatment: A pilot randomized controlled trial

IntroductionCompared to men, women with alcohol use disorder (AUD) are more likely to drink to manage stress and negative affect. Given women's risk for poor drinking outcomes, it is critical to develop and test interventions that target these affective factors. Physical activity improves negative affect and has emerged as a promising adjunct to AUD treatment and, thus, may be especially valuable for women. MethodsFifty women with AUD (49.9 ± 12.0 years of age) participated in either a 12-week telephone-delivered lifestyle physical activity plus Fitbit (LPA + Fitbit) or a health education contact (HEC) control intervention following a partial hospital addictions treatment program. The study examined changes in drinking behaviors, mental health outcomes, and physical activity engagement post-intervention using both conventional test statistics and standard effect sizes. ResultsHigher rates of continuous abstinence during the 12-week period were observed in the LPA + Fitbit condition (55.6 %) than in the HEC condition (33.6 %); odds ratio = 2.97. However, among women who drank any alcohol during the 12-weeks, slightly higher rates of heavy drinking and drinks/day were observed among women in the LPA + Fitbit condition. Significant differences for improved mental health outcomes (including depression, anxiety, negative affect, positive affect, perceived stress, and behavioral activation) and increased self-reported physical activity were consistently observed among participants in the LPA + Fitbit condition, relative to HEC. ConclusionsThe LPA + Fitbit program had a positive impact on alcohol abstinence, mental health, and physical activity in adult women receiving treatment for AUD. Future research should continue to investigate the optimal implementation strategies, duration, and intensity of LPA interventions in the context of a fully-powered RCT.

Physical Activity Intervention for Urban Black Women With Asthma: Protocol for a Randomized Controlled Efficacy Study.

Black women experience a higher prevalence of poor asthma outcomes and physical inactivity than their White counterparts. Black women comprise a particularly vulnerable group of patients with asthma, with some of the highest rates of asthma in adults, high health care use (emergency department visits and hospitalizations), and the highest crude asthma mortality rate of all race or ethnicity groups. Despite recommendations to engage in regular physical activity, fewer than 15% of Black women meet the 2008 National Physical Activity Guidelines, the lowest of all racial subgroups of adults. Given the connection between physical inactivity and poor asthma outcomes, addressing physical activity among Black women with asthma is imperative. This 2-arm randomized controlled trial aims to (1) determine the efficacy of a lifestyle walking intervention on asthma control compared to an education (control) group over 24 weeks, (2) examine the maintenance effects of the lifestyle walking intervention on asthma control at 48 weeks, (3) explore the behavioral mediators (eg, self-efficacy, social support, self-regulation, and daily physical activity levels) and contextual moderators (eg, baseline asthma severity, neighborhood environment, comorbid conditions, and social determinants of health) that contribute to treatment responsiveness, and (4) assess the reach and implementation potential of the intervention. The proposed study (ACTION [A Lifestyle Physical Activity Intervention for Minority Women with Asthma]) delivers a 24-week lifestyle walking intervention designed for and by urban Black women with asthma. Participants (n=224) will be recruited through 2 urban health care systems that care for a diverse Black population. Patients will be randomized to one of two groups: (1) ACTION intervention (group sessions, physical activity self-monitoring-Fitbit, and text-based support for step goal setting) or (2) education control (an individual asthma education session and SMS text messages related to asthma education). Outcome assessments will take place at baseline, 12, 24, and 48 weeks. The primary outcome is a change in asthma control from baseline to week 24 as assessed by the asthma control questionnaire-6 (ACQ-6). Secondary outcomes include asthma-related quality of life, health care use, and asthma exacerbations and behavioral outcomes such as self-efficacy, self-regulation, social support, and physical activity. This study was funded by the National Institute of Minority Health Disparities in August 2022. We pilot-tested our recruitment and intervention procedures and began recruitment in April 2023, with the enrollment of our first participant in May 2023. The anticipated completion of the study is April 2027. This study will deliver a new approach to physical activity interventions in Black women with asthma and help to provide guidance for addressing physical activity within this subgroup. This study will also provide a potential framework for future studies in minoritized populations with other disease conditions associated with low levels of physical activity. ClinicalTrials.gov NCT05726487; https://clinicaltrials.gov/study/NCT05726487. DERR1-10.2196/55700.

Internet-delivered lifestyle physical activity intervention for cognitive processing speed in multiple sclerosis

BackgroundWe propose a randomized controlled trial(RCT) of a Social Cognitive Theory-based(SCT), Internet-delivered behavioral intervention targeting lifestyle physical activity(LPA) for yielding improvements in cognitive processing speed(CPS), learning and memory(L/M), symptoms, and quality of life(QOL) among persons with mild multiple sclerosis(MS)-related ambulatory impairment who have impaired CPS. Methods/designThe study involves a Phase-II, parallel group, RCT design. Participants with MS(N = 300) will be randomly assigned on an equal basis(1:1) into behavioral intervention(n = 150) or attention and social contact control(n = 150) conditions. The conditions will be administered over 6-months by trained behavior coaches who will be uninvolved in screening, recruitment, random assignment, and outcome assessment. We will collect outcome data remotely every 6-months over the 12-month period(baseline, immediate follow-up, and 6-month follow-up) using a treatment blinded assessor. The primary outcome is the raw, oral Symbol Digit Modalities Test as a neuropsychological measure of CPS. The secondary outcomes include the California Verbal Learning Test-II as an objective measure of L/M, and patient-reported outcomes of fatigue, depressive symptoms, anxiety, pain, and QOL. The tertiary outcome is accelerometry as an objective, device-based measure of steps/day for generating a minimal clinically important difference(MCID) value that guides the prescription of LPA for improving CPS in clinical practice. The primary data analyses will involve intent-to-treat principles, and mixed-effects models and logistic regression. DiscussionIf successful, the proposed study will provide Class I evidence for the efficacy of a theory-based, Internet-delivered behavioral intervention focusing on LPA for improving CPS and mitigating its negative impact on other outcomes in persons with MS.Clinicaltrials.gov: NCT04518657

Effects of lifestyle physical activity and sedentary behaviour interventions on disease activity and patient- and clinician- important health outcomes in rheumatoid arthritis: a systematic review with meta-analysis

BackgroundLifestyle physical activity (PA) is defined as any type of PA undertaken as part of daily life. It can include engagement in activities of daily living (i.e., household chores, gardening, walking to work), incidental PA, walking and/or reducing sedentary or sitting behaviours (SB). Regular PA is recommended for people with Rheumatoid Arthritis (RA) to reduce disease activity and systemic inflammation, as well as to improve patient- and clinician-important health outcomes. However, there is no summarised evidence of the effectiveness of interventions specifically targeting lifestyle PA and SB in this population. The aims of this systematic review with meta-analysis were to evaluate interventions targeting lifestyle PA and/or SB on 1) disease activity; 2) PA, SB and 3) patient- and clinician-important outcomes in people with RA.MethodsEight databases [Medline, Cochrane Library CENTRAL, Web of Science, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Scopus, Excerpta Medica database and Physiotherapy Evidence Database] were searched from inception-August 2022. Inclusion criteria required interventions to target lifestyle PA and/or SB, conducted in adults with RA, assessing patient- and/or clinician-important outcomes.ResultsOf 880 relevant articles, 16 interventions met the inclusion criteria. Meta-analyses showed statistically significant effects of interventions on disease activity (standardised mean difference = -0.12 (95% confidence interval = -0.23 to -0.01, I2 = 6%, z = 2.19, p = .03), moderate-to-vigorous PA, light/leisure PA, steps, functional ability, and fatigue. Whereas, no intervention effects were visualised for total PA, pain, anxiety or quality of life.ConclusionsLifestyle PA interventions led to increased PA, reductions in SB and improvements in disease activity and other patient- and/or clinician-important health outcomes in people with RA. Future interventions should be less heterogenous in content, structure, focus and outcome measures used to aid understanding of the most effective intervention components for improving health. More SB interventions are needed to determine their effectiveness at producing clinical benefits.

Effectiveness of Lifestyle Nutrition and Physical Activity Interventions for Childhood Obesity and Associated Comorbidities among Children from Minority Ethnic Groups: A Systematic Review and Meta-Analysis.

Lifestyle physical activity (PA) and nutrition are known to be effective interventions in preventing and managing obesity-related comorbidities among adult populations but less so among children and adolescents. We examined the effectiveness of lifestyle interventions in children from minority ethnic populations in Western high-income countries (HICs). Our systematic review included 53 studies, involving 26,045 children from minority ethnic populations who followed lifestyle intervention programmes lasting between 8 weeks and 5 years with the aim of preventing and/or managing childhood obesity and associated comorbidities, including adiposity and cardiometabolic risks. The studies were heterogenous in terms of lifestyle intervention components (nutrition, PA, behavioural counselling) and settings (community vs. schools and after-school settings). Our meta-analysis included 31 eligible studies and showed no significant effects of lifestyle interventions when they focused on body mass index (BMI) outcomes (pooled BMI mean change = -0.09 (95% CI = -0.19, 0.01); p = 0.09). This was irrespective of the intervention programme duration (<6 months vs. ≥6 months), type (PA vs. nutrition/combined intervention) and weight status (overweight or obese vs. normal weight) as all showed nonsignificant effects in the sensitivity analysis. Nonetheless, 19 of the 53 studies reported reductions in BMI, BMI z-score and body fat percentage. However, the majority of lifestyle interventions adopting a quasi-design with combined primary and secondary obesity measures (11 out of 15 studies) were effective in reducing the obesity comorbidities of cardiometabolic risks, including metabolic syndrome, insulin sensitivity and blood pressure, in overweight and obese children. Preventing childhood obesity in high-risk ethnic minority groups is best achieved using combined PA and nutrition intervention approaches, which jointly target preventing obesity and its comorbidities, especially the outcomes of diabetes, hypertension and cardiovascular disease. Therefore, public health stakeholders should integrate cultural and lifestyle factors and contextualise obesity prevention strategies among minority ethnic groups in Western HICs.

Study protocol: BRInging the Diabetes prevention program to GEriatric Populations.

In the Diabetes Prevention Program (DPP) randomized, controlled clinical trial, participants who were ≥ 60 years of age in the intensive lifestyle (diet and physical activity) intervention had a 71% reduction in incident diabetes over the 3-year trial. However, few of the 26.4 million American adults age ≥65 years with prediabetes are participating in the National DPP. The BRInging the Diabetes prevention program to GEriatric Populations (BRIDGE) randomized trial compares an in-person DPP program Tailored for Older AdulTs (DPP-TOAT) to a DPP-TOAT delivered via group virtual sessions (V-DPP-TOAT) in a randomized, controlled trial design (N = 230). Eligible patients are recruited through electronic health records (EHRs) and randomized to the DPP-TOAT or V-DPP-TOAT arm. The primary effectiveness outcome is 6-month weight loss and the primary implementation outcome is intervention session attendance with a non-inferiority design. Findings will inform best practices in the delivery of an evidence-based intervention.

Acceptability, feasibility, and preliminary efficacy of a prenatal walking program for depressed pregnant women

Depression is common during pregnancy, yet pregnant women often do not engage in standard mental health treatments, which is concerning due to negative consequences associated with untreated maternal depression. Given that exercise can help to decrease depressive symptoms, and most pregnant women are able to safely engage in mild to moderate physical activity, physical activity interventions may be helpful in improving mood among pregnant women, even those with clinical levels of depression. In an open trial, we piloted a 10-week prenatal walking intervention in 18 depressed pregnant women (mean age=28.7 years). Participants wore a pedometer daily to track activity and attended 6 brief counseling sessions over the 10-week period. Indicators of acceptability and feasibility were assessed, as were changes in depression, physical activity, and other clinical outcomes. Results suggest that the prenatal walking intervention is feasible and acceptable. No adverse events were observed, and most women (83%) completed the intervention, attending on average 5.5 of 6 intervention sessions. Findings also support preliminary efficacy of the intervention: depression scores were reduced by endpoint, and physical activity levels increased based on self-report and objective measurement. Women also reported lower anxiety, and positive changes in affect at endpoint. Participants reported high satisfaction on a questionnaire. Though preliminary, findings suggest that a lifestyle physical activity intervention could be a valuable strategy to improve mood during pregnancy. Further research is needed to evaluate the intervention in a more rigorous randomized trial. If proven efficacious, this simple, low-cost intervention could be implemented in prenatal care settings.

PLIS: A metabolomic response monitor to a lifestyle intervention study in older adults.

The response to lifestyle intervention studies is often heterogeneous, especially in older adults. Subtle responses that may represent a health gain for individuals are not always detected by classical health variables, stressing the need for novel biomarkers that detect intermediate changes in metabolic, inflammatory, and immunity-related health. Here, our aim was to develop and validate a molecular multivariate biomarker maximally sensitive to the individual effect of a lifestyle intervention; the Personalized Lifestyle Intervention Status (PLIS). We used 1 H-NMR fasting blood metabolite measurements from before and after the 13-week combined physical and nutritional Growing Old TOgether (GOTO) lifestyle intervention study in combination with a fivefold cross-validation and a bootstrapping method to train a separate PLIS score for men and women. The PLIS scores consisted of 14 and four metabolites for females and males, respectively. Performance of the PLIS score in tracking health gain was illustrated by association of the sex-specific PLIS scores with several classical metabolic health markers, such as BMI, trunk fat%, fasting HDL cholesterol, and fasting insulin, the primary outcome of the GOTO study. We also showed that the baseline PLIS score indicated which participants respond positively to the intervention. Finally, we explored PLIS in an independent physical activity lifestyle intervention study, showing similar, albeit remarkably weaker, associations of PLIS with classical metabolic health markers. To conclude, we found that the sex-specific PLIS score was able to track the individual short-term metabolic health gain of the GOTO lifestyle intervention study. The methodology used to train the PLIS score potentially provides a useful instrument to track personal responses and predict the participant's health benefit in lifestyle interventions similar to the GOTO study.

Association of protein-energy partitioning with body weight and body composition changes in adolescents with severe obesity.

Body composition and protein-energy partitioning changes are important factors of body weight regulation, but have not been studied in the context of clinical obesity treatment setting. Thus, the aim of the present study was to investigate the pattern of body weight loss, body composition, and energy partitioning changes during a 9-month multidisciplinary weight loss program and 4-month follow up and to test the associations among these changes in adolescents with severe obesity. Twenty-five adolescents (14.1 ± 1.5 years old; 13 girls) with severe obesity joined a pediatric obesity center for a 9-month inpatient multidisciplinary weight loss program. All participants performed body composition assessment (i.e. fat mass-FM, and fat-free mass-FFM) and completed a 36-h session in indirect calorimetric chamber before the start (T0), at the end of the intervention (T1) and 4 months follow-up to the intervention (T2). The protein-energy partitioning (P ratio) was calculated as urinary nitrogen loss/total energy expenditure over 24 hours. 9-month individualized multidisciplinary weight loss program consisting of lifestyle education, psychological support, physical activity, and dietary intervention. Initial P ratio was positively associated with changes in body weight from T0 to T1 (p = 0.038). The changes in FFM/FM were negatively associated with body weight changes in boys (p = 0.006) from T0 to T1 and in girls (p < 0.001) from T1 to T2. Urinary nitrogen excretion (p < 0.001) and total energy expenditure (p < 0.001) significantly decreased during the weight loss program while the P ratio did not significantly change. The present results suggest that baseline and changes in energy partitioning may be associated with changes in body weight in adolescents with severe obesity. In addition, sexual dimorphism in these patterns of change suggest the need for specific dietary and physical activity strategies in boys and girls to optimize body weight loss and to prevent or slow weight regain.

Supervised Aerobic Exercise Training and Increased Lifestyle Physical Activity to Reduce Cardiovascular Disease Risk for Women With Polycystic Ovary Syndrome: A Randomized Controlled Feasibility Trial.

Polycystic ovary syndrome (PCOS) is a complex, heterogeneous endocrinopathy. Women with PCOS often present with cardiovascular disease risk factors. Physical activity (PA) interventions reduce cardiovascular disease risk factors in women with PCOS. However, sedentary behaviors have a distinct deleterious effect on cardiometabolic health. Increasing PA and reducing sedentary behaviors may be a worthwhile therapeutic target to improve cardiovascular health in this population. This study investigated the feasibility of 2 PA interventions to decrease cardiovascular disease risk in women with PCOS. This was a feasibility randomized controlled trial of 2 PA interventions in 36 women with PCOS. Participants were randomized to a supervised exercise intervention (n = 12), a lifestyle physical activity group intervention aimed at reducing sedentary behaviors (n = 12), or a control group (n = 12), for 12weeks. Primary outcomes included the feasibility and acceptability of the interventions and procedures. Recruitment rate was 56%. Adherence rate was 53% and 100% to the exercise intervention and lifestyle PA intervention, respectively. Secondary outcome data indicate a reduction in oxidized low-density lipoprotein concentrations in the exercise group, and weight loss in both intervention groups. The procedures for recruitment, allocation, and outcome measurements were acceptable. However, before progression to a full-scale trial, adherence to the exercise program should be addressed.

A Randomized Clinical Trial Demonstrating Feasibility and Preliminary Efficacy of a Videoconference-Delivered Physical Activity Lifestyle Intervention Among Adolescents With a Congenital Heart Defect.

Individuals with congenital heart defects are at increased risk for developing further cardiovascular complications, which can be mitigated by increasing physical activity. Given that positive health behaviors begin declining during older adolescence, it is vital to promote lifestyle changes in this population. The current study aims to (a) determine the feasibility/acceptability of the Congenital Heart Disease Physical Activity Lifestyle (CHD-PAL) intervention among adolescents (ages 15-18) with moderate and complex congenital heart defects, and (b) estimate the preliminary efficacy of CHD-PAL for increasing time spent in moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness and decreasing sedentary behavior. Eligible participants were randomized into either CHD-PAL (eight 30-min videoconferencing sessions over 20 weeks with an interventionist + Fitbit + exercise prescription) or a comparator (Fitbit + exercise prescription). Sixty adolescents were randomized (76% recruitment rate; 94% of participants were retained from baseline to follow-up). Most adolescents (73%) and their parents/guardians (76%) reported that the trial was enjoyable. While there was no effect of arm on change in MVPA, sedentary behavior, or cardiorespiratory fitness for the entire sample, among those who engaged in <21 min of MVPA on average at baseline, adolescents in the CHD-PAL intervention had an increase of 16 min/day of MVPA more than comparators (d = 0.90). The CHD-PAL intervention warrants examination in a larger trial to establish efficacy among those adolescents with a congenital heart defect who engage in <21 min of MVPA/day and should include follow-up assessments to examine effect durability. NCT03335475.

The Feasibility of a Lifestyle Physical Activity Intervention for Black Women with Asthma

Black women are disproportionately affected by both physical inactivity and asthma. Lifestyle physical activity (PA) interventions targeted for Black women with asthma are lacking. To assess the feasibility and acceptability as well as preliminary effects of a lifestyle PA intervention culturally tailored for Black women with asthma. Black women (age 18-70 years) with uncontrolled asthma (Asthma Control Test <20) were recruited. Outcome assessments at baseline and 24 weeks included measures of: feasibility and acceptability, asthma control, quality of life, health care use, and PA levels. Participants were randomized to the intervention (asthma education, Fitbit, monthly group sessions, text messages, individual step goals, and study manual) or enhanced usual care (EUC) (asthma education plus Fitbit) group. Of the 53 women randomized (EUC= 28; intervention= 25), 92% remained in the intervention (23 of 25) and 76% completing the 24-week outcome assessment. Overall intervention satisfaction (mean score, 6.88 of 7) and individual components were high at 24 weeks. Mean change in asthma control questionnaire between groups was not significant at 24 weeks (intervention= -0.41 vs EUC= 0.03 [P= .08]; effect size= -0.38) but approached clinical significance (0.5). At 24 weeks, more women receiving the intervention had controlled asthma compared with EUC (36.84% vs 9.52%; P= .04). Clinically significant improvements (0.5) in quality of life were found in the intervention group (mean change: intervention= 0.58 vs EUC= 0.10; P= .10) at 24 weeks. A culturally tailored lifestyle PA intervention is feasible and demonstrates improvements in asthma control and quality of life among Black women with asthma. These preliminary findings support the need for PA lifestyle interventions in urban Black women with asthma.

A study protocol for MindMoves: A lifestyle physical activity and cognitive training intervention to prevent cognitive impairment in older women with cardiovascular disease

IntroductionCognitive impairment (CI) and cardiovascular disease (CVD) disproportionately affect women compared to men, and CVD increases risk of CI. Physical activity and cognitive training can improve cognition in older adults and may have additive or synergistic effects. However, no combined intervention has targeted women with CVD or utilized a sustainable lifestyle approach. The purpose of the trial is to evaluate efficacy of MindMoves, a 24-week multimodal physical activity and cognitive training intervention, on cognition and serum biomarkers in older women with CVD. Three serum biomarkers (brain-derived neurotrophic factor [BDNF], vascular endothelial growth factor [VEGF], and insulin-like growth factor 1 [IGF-1]) were selected as a priori hypothesized indicators of the effects of physical activity and/or cognitive training on cognition. MethodsThe study design is a randomized controlled trial with a 2 × 2 factorial design, to determine independent and combined efficacies of Mind (tablet-based cognitive training) and Move (lifestyle physical activity with goal-setting and group meetings) on change in cognition (primary outcome) and serum biomarkers (secondary outcomes). We will recruit 254 women aged ≥65 years with CVD and without CI from cardiology clinics. Women will be randomized to one of four conditions: (1) Mind, (2) Move, (3) MindMoves, or (4) usual care. Data will be obtained from participants at baseline, 24, 48, and 72 weeks. DiscussionThis study will test efficacy of a lifestyle-focused intervention to prevent or delay cognitive impairment in older women with CVD and may identify relevant serum biomarkers that could be used as early indicators of intervention response.

The Feasibility of a Combined Lifestyle Physical Activity and Cognitive Training Intervention to Prevent Cognitive Impairment in Older Women With Cardiovascular Disease.

Cognitive impairment disproportionately affects older women with cardiovascular disease (CVD). Physical activity (PA) and cognitive training (CT) may have synergistic effects in combined interventions. However, no combined intervention has targeted women with CVD or utilized a sustainable and preferable lifestyle approach. The purpose was to test feasibility and acceptability of the 24-week MindMoves program, a lifestyle intervention that combined PA and CT developed for older women with CVD. The PA component included goal setting with Fitbits and 5 behavioral group meetings. The CT component was evidence-based BrainHQ delivered on a tablet in three 30-minute weekly sessions. Participants included 10 women aged ≥65 years with CVD. Exclusion criteria were cognitive impairment, regular PA, and CT use. Measures were feasibility (recruitment, attendance, participation, retention, and acceptability), change in PA (Fitbit min/steps), and change in cognitive function (NIH Toolbox®). Of the 10 participants, 70% attended ≥4/5 group meetings, and overall attendance was 76%. Participants completed 2.3/3 CT sessions weekly. Participant retention was 100%. Over 90% of participants rated MindMoves with the highest levels of satisfaction. Participants had significant improvements in steps, light PA, and moderate PA, and there was a trend for improved cognition. Findings support testing MindMoves in an efficacy trial.

Technology in Exercise Interventions for Older Women: Acceptability, Adherence, and Special Considerations

Women aged 65 years and older participate in less moderate-vigorous physical activity (PA) than men of this age group, which increases the risk for a myriad of chronic health problems. Interventions that utilize a lifestyle approach to increase PA in everyday life are preferred by women compared to structured exercise, but long-term adherence is a challenge. Technology (e.g., wearables, social media, computers) can be efficiently leveraged as motivational tools in lifestyle PA interventions. However, the unique needs of older women must be considered. Thus, the purpose is to examine the: (a) types of technology that were successfully integrated into existing PA intervention studies designed for older women; (b) acceptability and adherence to technological approaches by older women; and (c) additional considerations needed for special populations, including older women with chronic health problems. The efficiency and scalability of technological approaches with clinical and public health implications will also be discussed.

Mental health benefits from lifestyle physical activity interventions: A systematic review.

Lifestyle physical activity (LPA) interventions are a promising alternative to structured exercise interventions for addressing mental health problems. The authors conducted a systematic review of the literature on LPA interventions in any population in order to determine (a) the extent to which mental health outcomes were examined and (b) whether benefits in mental health outcomes were observed. Mental health outcomes were defined as depression, anxiety, perceived stress, health-related quality of life, and psychological well-being. A total of 73 articles were identified as LPA intervention, of which 24.7% (n = 18) reported the effect of LPA intervention on mental health outcomes. The most commonly evaluated mental health outcome was depression, and to a lesser extent anxiety and perceived stress. Overall, findings point to promising effects of LPA interventions across common mental health problems. Key areas for future research are discussed in light of emergent limitations in existing published studies.

Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium

AimsTo examine the effect of lifestyle (diet and physical activity) interventions on the prevalence of GDM, considering the method of GDM ascertainment and its association with early pregnancy characteristics and maternal and neonatal outcomes in the LIFE-Moms consortium. MethodsLIFE-Moms evaluated the effects of lifestyle interventions to optimize gestational weight gain in 1148 pregnant women with BMI ≥ 25 kg/m2 and without known diabetes at enrollment, compared with standard care. GDM was assessed between 24 and 31-weeks gestation by a 2-hour, 75-gram OGTT or by local clinical practice standards. ResultsLifestyle interventions initiated prior to 16 weeks reduced early excess GWG compared with standard care (0.35 ± 0.24 vs 0.43 ± 0.26 kg per week, p=<0.0001) but did not affect GDM diagnosis (11.1% vs 11.6%, p = 0.91). Using the 75-gram, 2-hour OGTT, 13. 0% of standard care and 11.0% of the intervention group had GDM by the IADPSG criteria (p = 0.45). The ‘type of diagnostic test’ did not change the result (p = 0.86). Women who developed GDM were significantly heavier, more likely to have obesity, and more likely to have dysglycemia at baseline. ConclusionModerate-to-high intensity lifestyle interventions grounded in behavior change theory initiated between 9 and 16-weeks gestation did not affect the prevalence of GDM despite reducing early GWG. Clinicaltrials.govNCT01545934, NCT01616147, NCT01771133, NCT01631747, NCT01768793, NCT01610752, NCT01812694.

325 Poster - The effects of lifestyle modification, including dietary and physical activity interventions, on Anthropometric indices and Quality of life of patients with breast cancer: A systematic review and meta-analysis of clinical trials

Background: Lifestyle modifications have been found to strongly reduce the side effects of breast cancer (BC). This is the first systematic review and meta-analysis assessing the effect of lifestyle modification including dietary and physical activity intervention on anthropometric indices and quality of life (QOL) of patients with BC.