No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Age and exercise: A theoretical and empirical analysis of the effect of age and generation on physical activity
Abstract
Aim
The well-documented association of reductions in physical activity with age is based largely on cross-sectional studies that do not distinguish between prevalence of physical activity and initiation/discontinuation patterns. These studies also fail to consider the changes in physical activity as a function of life stage. We investigated how physical activity evolves over a lifetime. We distinguished between prevalence and initiation/discontinuation patterns and also considered multidirectional age effects.
Subject and methods
The analyses are based on the annual German Socio-Economic Panel survey, which originally involved 6,000 households (>12,000 individuals) from age 16. Our study included 3,487 subjects (West Germany), i.e., 33% of the individuals first interviewed in 1984. A survival analysis model was constructed to assess the simultaneous effect of age and generation, while adjusting for potential confounders.
Results
The results show that the ubiquitous differences in physical activity between age groups are mainly attributable to cohort differences, not age effects. The likelihood of initiating at least weekly physical activity declines with age, as does the likelihood of discontinuing an established exercise habit. Both trends are more readily explained by changes in occupational and family biography than by health and fitness.
Conclusion
The ubiquitous differences in physical activity between age groups are largely due to intergenerational differences.
... PA is also affected by cohort or period effects (eg, generational differences in PA socialization). 121,122 For example, health has become an important PA motive, and in particular, older adults tend to start exercising for health reasons. 121,122 In the current review, few environmental variables were found to be associated with PA of pwMS. ...
... 121,122 For example, health has become an important PA motive, and in particular, older adults tend to start exercising for health reasons. 121,122 In the current review, few environmental variables were found to be associated with PA of pwMS. Only proximity to transit stops was associated with PA, 50 and inconsistent associations were evident for type of residency 82,101 and social support. ...
Diese kumulative Dissertation umfasst vier Manuskripte. Übergeordnetes Thema stellt die Förderung der körperlich-sportlichen Aktivität von Personen mit MS (PmMS) dar. Im Speziellen wurden zwei Forschungsfragestellungen bearbeitet. Forschungsfrage 1 fokussiert auf die Einflussfaktoren der körperlich-sportlichen Aktivität von PmMS. Mittels einer systematischen Übersichtsarbeit wurden Zusammenhänge zwischen krankheitsspezifischen, personbezogenen wie umweltbezogenen Faktoren und dem körperlichen Aktivitätsverhalten von PmMS untersucht. Es wurden wesentliche Einflussfaktoren und Personengruppen identifiziert, bei denen ein spezifischer Handlungsbedarf der Bewegungsförderung besteht. Darüber hinaus wurden Forschungslücken bzw. -bedarfe herausgearbeitet. Forschungsfrage 2 fokussiert auf die Konzeption, Realisation sowie Evaluation der Machbarkeit und Wirksamkeit einer internetbasierten, bewegungstherapeutischen Intervention für erwachsene PmMS. Hierzu wurden drei Manuskripte vorgelegt. Zwei Manuskripte beschreiben die Methodik und die Ergebnisse aus zwei randomisiert-kontrollierten Studien. Das letzte Manuskript beschreibt die konzeptionelle Weiterentwicklung der bisherigen Intervention zu einem Tele-Rehanachsorgeprogramm. Besonders erwähnenswerte Elemente der Weiterentwicklung stellen die Integration des Modells der bewegungsbezogenen Gesundheitskompetenz und der Selbstbestimmungstheorie sowie die Integration evidenzbasierter Techniken der Verhaltensänderung dar. Mit dem vorliegenden Konzept werden aktuelle Empfehlungen zur Bewegungsförderung aufgegriffen, wie sie für Menschen mit chronischen, nicht-übertragbaren Erkrankung in der Lebenswelt der gesundheitlichen Versorgung formuliert wurden. Die entwickelte internetbasierte Intervention bietet sich als geeignetes Medium an, um Zugangsbarrieren zu überwinden sowie eine große Anzahl an PmMS orts- wie zeitunabhängig zu betreuen und stellt eine flexible, individuelle und flächendeckende Lösung dar, um die bestehende Versorgungslücke im Kontext der Rehabilitationsnachsorge wie im ambulanten Setting für PmMS zu schließen.
... PA is also affected by cohort or period effects (eg, generational differences in PA socialization). 121,122 For example, health has become an important PA motive, and in particular, older adults tend to start exercising for health reasons. 121,122 In the current review, few environmental variables were found to be associated with PA of pwMS. ...
... 121,122 For example, health has become an important PA motive, and in particular, older adults tend to start exercising for health reasons. 121,122 In the current review, few environmental variables were found to be associated with PA of pwMS. Only proximity to transit stops was associated with PA, 50 and inconsistent associations were evident for type of residency 82,101 and social support. ...
Objective:
To review the current evidence regarding correlates and determinants of physical activity (PA) in persons with multiple sclerosis (pwMS).
Data sources:
Pubmed and Scopus (1980 to January 2015) and reference lists of eligible studies.
Study selection:
Eligible studies (i) include adults with MS, (ii) have a cross-sectional or prospective observational design or (iii) examine the effect of a theory-based intervention trial on PA including a mediation analysis, (iv) apply a quantitative assessment of PA and correlates or proposed mediators and (v) are published in English or German.
Data extraction:
Two reviewers independently evaluated the risk of bias, extracted data and categorized variables according to the International Classification of Functioning, Disability and Health (ICF).
Data synthesis:
Consistency and the direction of associations were evaluated with a semi-quantitative approach. Fifty-six publications with data from observational studies and two interventional studies provided evidence for 86 different variables. Consistent correlates of PA were the disability level, walking limitations in particular, PA-related self-efficacy and self-regulation constructs as well as employment status and educational level. One interventional study provided evidence for a causal relationship between self-regulation and PA. However, 59 of 86 of all investigated variables in observational studies are based on one or two study findings, and the majority of results stem from cross-sectional designs.
Conclusions:
Beside the importance of the general disability level and walking limitations, the results highlight the importance of personal factors, such as PA-related self-efficacy, self-regulatory constructs and sociodemographic factors. Limitations and implications of the current review are discussed. Research that is more rigorous is needed to better understand what affects PA in pwMS.
... PA is also affected by cohort or period effects (eg, generational differences in PA socialization). 121,122 For example, health has become an important PA motive, and in particular, older adults tend to start exercising for health reasons. 121,122 In the current review, few environmental variables were found to be associated with PA of pwMS. ...
... 121,122 For example, health has become an important PA motive, and in particular, older adults tend to start exercising for health reasons. 121,122 In the current review, few environmental variables were found to be associated with PA of pwMS. Only proximity to transit stops was associated with PA, 50 and inconsistent associations were evident for type of residency 82,101 and social support. ...
In recent years various positive effects of physical activity have been reported for physical functions, activities and quality of life in persons with multiple sclerosis (pwMS). Thus, physical activity respectively exercise interventions are becoming more important in rehabilitation. To profit from the induced health effects in the long-term, adherence to regular physical activity is of utmost importance. But pwMS are even less physically active than healthy persons. This, in turn, has negative consequences for their functional capacity and is a risk factor for the development of chronic diseases related to physical inactivity. In the recent past, research activities about determinants of physical activity in pwMS have increased. Thus, disease-related impairments of physical function and activities have been identified as relevant barriers. This especially applies to persons with fatigue and heat sensitivity as well as those with disorders of balance, muscle strength, muscle tone and gait; and depressions are also associated with lower physical activity. Just as much important are personal context factors such as personal beliefs, fear, expectation of negative consequences, missing knowledge and skills and low self-efficacy referring to physical activity. In addition, lack of time and motivation as well as familiar, social, and vocational duties are relevant. Barriers of the material and social environment comprise problems in transportation, a lack of specific offers for physical activity and exercise, restricted access to facilities, missing competences of health and fitness service providers in dealing with the disease as well as a lack of social support. Based on this, important facilitators can be described, which build the basis for the development of adequate interventions for physical activity promotion in pwMS.
... Literature [14] evaluates the body composition, health awareness, and cardiopulmonary health of female college students after compulsory physical education class. Literature [15] studies the theoretical and empirical analysis of the influence of age and exercise on physical activity. e article introduces the image processing technology to carry on the movement recognition to the volleyball movement; the human body physique characteristic and the scientific movement training through the high recognition rate can be scientifically analyzed. ...
In recent years, due to the continuous improvement of the national economic level and the increasing academic burden of students’ main courses, students’ physical health problems (e.g., obesity, vision, and lumbar spine) have become more and more serious, which urgently needs the attention of relevant departments of national education and parents. This paper will use digital image technology to create a physical parameter measurement system and use literature, comparative analysis, and other research methods to analyze the impact of volleyball elective courses on students’ physical health. Firstly, this paper explains the theory of image processing technology and analyzes the parameters of human body scientifically; secondly, it detects the physical parameters of human body in digital images and also designs an image recognition system; finally, through experimental analysis, the accuracy of identifying key points of images is relatively high. After the system is adopted, the error of the measurement index is small. After the training of human body indexes, the effect of volleyball can be effectively improved.
... Age, measurement period and having children were considered as potential confounders. Age and having children are commonly related to relationship status as well as to physical activity (Engberg et al., 2012;Klein & Becker, 2011). Age was a continuous variable. ...
Despite the increasing number of non-marital romantic relationships in developed countries, little is known about their effects on health-related behaviors. This paper examined the impact of relationship status (single, dating, cohabiting or married) on physical activity. Three possible mechanisms underlying this association were discussed: social control and support by the partner, time restrictions and the release from the marriage market. Data were obtained from the German Socio-Economic Panel (GSOEP), a random sample of individuals living in private households in Germany. Both random-effects and fixed-effects logit models were estimated. The random-effects analyses referred to 30,201 individuals and the fixed-effects analyses referred to 11,568 individuals who were observed for up to 19 years. After adjusting for age, measurement period and the presence of children, fixed-effects estimates showed reduced physical activity for each type of relationship for both men and women. The effects were strongest for married couples and weakest for dating couples, and remained similar after controlling for discretionary time. However, the effects found partly depended on age: for men, the negative impacts of cohabitation and marriage on physical activity became weaker with increasing age and shifted to positive impacts. For women, the negative effect of marriage on physical activity also decreased but stayed negative into old age. The results suggest that the release from the marriage market may cause the negative effects of relationships on physical activity. Social support and social control may play a role in older age, whereas the amount of discretionary time seems to be of minor importance for explaining relationship effects on physical activity. If the results will be validated by other studies there will be valuable implications for health promotion programs.
Background
Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents.
Methods
This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. ‘Unhealthy weight control behaviors’ were subcategorized into ‘extreme weight control behaviors’ and ‘less extreme weight control behaviors.’
Results
The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls.
Conclusion
Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors.
An intergenerational pickleball tournament was designed to create a setting wherein older adults interact with undergraduate students, generating an intergenerational learning experience. Teams of older adults were recruited through the local Area Agency on Aging and paired with undergraduate students to provide an opportunity for older adults to share their love and knowledge of pickleball with a younger generation. The students interacted with active, older adults in an activity that connected the generations. An informal evaluation, completed by students, and process-evaluative measures revealed the successes of the tournament. Interdisciplinary approaches to this intergenerational experience brought both academic and community partners together for the creation and implementation of the event. This practice-based paper includes a rationale for tournament implementation, describes program goals and implementation details, and includes a theoretical framework for application. Additionally, the authors utilize student feedback and process-evaluation measures to discuss implications for practice and relevance to other locales.
Introduction:
E-cigarettes are popular in the United States, but psychometrically sound measures of vaping beliefs and behaviors are lacking.
Methods:
We evaluated the psychometrics of the Short Form Vaping Consequences Questionnaire (S-VCQ), a modified version of the Short Form Smoking Consequences Questionnaire that assesses expectancies for negative consequences, positive reinforcement, negative reinforcement, and appetite/weight control associated with vaping. Adult, past-month e-cigarette users completed an anonymous survey in Fall 2015 (N = 522, 50.4% female; 71.5% white; 34.10 [SD = 9.66] years). Psychometric analyses included confirmatory factor analysis, internal consistency, measurement invariance, t tests, correlations, and test-criterion relationships with vaping outcomes.
Results:
The S-VCQ evidenced a four-factor latent structure (Bentler's Comparative Fit Index = .95, Root Mean Square Error of Approximation = .05, Standardized Root Mean Square Residual = .06), and subscales evidenced internal consistency (mean α = 0.89). S-VCQ scores were scalar invariant for sex and smoking status; women reported stronger appetite/weight control than men and dual cigarette/e-cigarette users (n = 309) reported stronger negative vaping consequences and negative reinforcement than nonsmokers. Among dual users, vaping and smoking expectancies also were scalar invariant; dual users reported stronger positive reinforcement associated with vaping than smoking but stronger negative consequences, negative reinforcement, and appetite/weight control associated with smoking than vaping. Correlations indicated that vaping and smoking expectancies were related, yet distinct constructs. Univariate general linear models indicated that vaping frequency and dependence were associated with positive reinforcement (ηp2 = .02/.02), negative reinforcement (ηp2 = .02/.08), and appetite/weight control (ηp2 = .02/.02) from vaping.
Conclusions:
The S-VCQ evidences solid psychometrics as a measure of adult e-cigarette users' vaping expectancies.
Implications:
The current study provides evidence for the reliability and validity of the S-VCQ, the first measure of vaping expectancies that has been validated for use with adult e-cigarette users. Results indicated that the S-VCQ comprises four subscales that evidence internal consistency, scalar measurement invariance for important groups of interest, and test-criterion relationships with vaping outcomes. Researchers are encouraged to consider using this measure for assessing vaping expectancies in adult e-cigarette users.
Background:
We investigated whether maternal smoking in the first year of life or any current parental smoking is associated with childhood or adolescent body mass index (BMI).
Methods:
Secondary analysis of data from a multi-centre, multi-country, cross-sectional study (ISAAC Phase Three). Parents/guardians of children aged 6-7 years completed questionnaires about their children's current height and weight, whether their mother smoked in the first year of the child's life and current smoking habits of both parents. Adolescents aged 13-14 years completed questionnaires about their height, weight and current parental smoking habits. A general linear mixed model was used to determine the association between BMI and parental smoking.
Results:
77,192 children (18 countries) and 194 727 adolescents (35 countries) were included. The BMI of children exposed to maternal smoking during their first year of life was 0.11 kg/m(2) greater than those who were not (P = 0.0033). The BMI of children of currently smoking parents was greater than those with non-smoking parents (maternal smoking: +0.08 kg/m(2) (P = 0.0131), paternal smoking: +0.10 kg/m(2) (P < 0.0001)). The BMI of female adolescents exposed to maternal or paternal smoking was 0.23 kg/m(2) and 0.09 kg/m(2) greater respectively than those who were not exposed (P < 0.0001). The BMI of male adolescents was greater with maternal smoking exposure, but not paternal smoking (0.19 kg/m(2), P < 0.0001 and 0.03 kg/m(2), P = 0.14 respectively).
Conclusion:
Parental smoking is associated with higher BMI values in children and adolescents. Whether this is due to a direct effect of parental smoking or to confounding cannot be established from this observational study.
Objective
This longitudinal study aimed to investigate the characteristics and predictive risk factors of overweight among adolescents. The hypothesis was that baseline overweight predicted most overweight over time compared to other factors, especially excessive Internet use.SubjectsA sample of 621 youths were followed from age 14 (T0 Spring 2012) to age 16 (T1 Spring 2014) in Switzerland. Participants were divided into two groups according to their weight at the final assessment: overweight and non-overweight. At T0, participants reported demographic, health, substance use and Internet use data. A logistic regression was performed to assess the explanatory variables of overweight at T1. Data are presented as adjusted odds ratios (aOR) with 95% confidence interval.ResultsThe 2 year-evolution showed a net BMI increase of 4.8%. Overweight adolescents were significantly more likely to be male, to live in an urban area, to be on a diet and to report using the Internet more than 2 hours per day on weekends at T0. However, with the addition of baseline overweight, only the excessive use of Internet on weekends remained as an explanatory variable. An adolescent who was already overweight at T0 had a more than 20-fold risk (aOR 21.04) of being overweight two years later. Moreover, among adolescents becoming overweight between T0 and T1, Internet use did not show any significant effect.Conclusion
The risk of being overweight is mostly influenced by weight status at baseline compared to excessive Internet use. Thus, our results do not confirm the negative effect of Internet on healthier activities. Internet use could at most reinforce an already existing risk of being overweight.International Journal of Obesity accepted article preview online, 07 August 2015. doi:10.1038/ijo.2015.146.
Adolescent smoking problem has still remained as a public health concern, but factors that attributing to the initiation of adolescent smoking are not well known in Iran.
The aim of this study is to estimate the prevalence of smoking, and its associations among high school male adolescents in Iran, in the context of the theory of planned behavior (TPB).
This was a cross-sectional study involving male adolescent students (high school) in the city of Zarandieh, Iran. A multiple-stage sampling protocol was used. The participants completed an anonymous, voluntary, and self-report questionnaire. Prevalence was estimated, and demographic variables, psychological factors, and the theory of planned behavior components were used to indicate factors contributing to adolescents' cigarette smoking.
In all, 365 students were entered the study. The mean age of respondents was 16.49 ± 1.11 years. The prevalence of current smoking was 15.1%. The result obtained from logistic regression analysis revealed that all theory of planned behavior (TPB) components [knowledge (OR = 0.75; 95% CI: (0.59-0.97), attitude (OR = 0.75; 95% CI: (0.65-0.86), self-efficacy (OR = 0.82; 95% CI: (0.71-0.95), subjective norms (OR = 0.84; 95% CI: (0.72-0.98)] were significant predating factors for adolescents smoking habits. In addition, having parents who smoke (OR = 4.75; 95% CI: (1.38-12.35), smoking friends (OR = 3.76; 95% CI: (1.20-11.76), and smoking siblings (OR = 4.21; 95% CI: (1.17-11.16) were significant contributing factors to adolescents' cigarette smoking behavior.
The results showed that the prevalence of cigarette smoking in adolescents was high, and the theory of planned behavior (TPB) components were significant predictors of cigarette smoking. It seems that interventions targeting adolescents' smoking habits might benefit using the TPB model.
This study aimed to assess the extent, patterns, and predictors of feelings of body dissatisfaction experienced by female German adolescents. Using 3D-avatar software, a sample population of 144 girls between 14 and 17 years of age was asked to estimate their actual body image, their desired body image (individual ideal), and the body image they believed their parents and their best female friend considered to be the ideal body image for them. The participants estimated their actual body mass index (BMI) to be 18.82 ± 3.01. The individual ideal body shape reported was significantly thinner, with a BMI score of 16.84 ± 2.51. Given a girl who stands 1.65 m and weighs 55 kg, this corresponds to a difference in weight of about 5.5 kg. After adjustment for the participant's self-reported BMI, participating in an esthetic sport was correlated with a significantly lower body dissatisfaction. Conversely, low socio-economic status and the amount of time spent watching TV was correlated with a significantly higher body dissatisfaction. Negative body image-related comments made by parents were significantly associated with body dissatisfaction. The girls who participated in this study would like to be an average of 1.97 BMI units thinner. The findings presented here suggest that future intervention measures should focus on the risk groups of physically inactive girls, those who smoke, and those with a lower social status and high rates of TV consumption. Intervention measures would be especially effective in German schools which offer lower education levels and should include the pupils' parents, who should be informed about the negative effects weight- and diet-related comments have on their children's body images.
Es gilt als erwiesen, dass Frauen im Vergleich zu Männern weniger gesund sind, obwohl sie länger leben. Allerdings sind viele Maße, an denen die höhere Morbidität der Frauen festgemacht wird, keine Indikatoren von Gesundheit bzw. Krankheit, sondern Indikatoren des Gesundheits- bzw. Krankheitsverhaltens, beispielsweise die Inanspruchnahme medizinischer Hilfe. Es wird ein Überblick über neuere Befunde zur physischen Gesundheit im Geschlechtervergleich gegeben, wobei subjektive und objektive Indikatoren der Gesundheit berücksichtigt werden (Selbsteinschätzungen der Gesundheit; Angaben zu körperlichen Beschwerden und Krankheiten; die in Deutschland 1993 eingeführten Krankenhausdiagnosestatistiken). Es finden sich keine überzeugenden Belege, die dafür sprechen, dass Männer gesünder sind als Frauen. Vielmehr könnten manche Gesundheitsindikatoren bei Männern durch geschlechtstypische Selbstwahrnehmungs- oder Selbstdarstellungstendenzen in positiver Richtung verfälscht sein. Dies scheint für ostdeutsche Männer in stärkerem Ausmaß als für westdeutsche Männer zuzutreffen.
Marked age-dependent physical inactivity is generally assumed in the health science literature. On the basis of cross-sectional studies it is assumed that the probable physical inactivity increases linearly with increasing age. Health economical analyses based on this assumption result automatically in the conclusion that an aging society and the associated increasing inactivity will lead to higher health-care costs. The object of this paper was to check the validity of this underlying assumption. The data records of the German Socio-Economic Panel Study (GSOEP) for the years 1985–2001 served as a basis. With the aid of longitudinal and cohort sequence analyses, it was shown that not only the effects of age, but also those of period and cohort effects always influence health behaviour. The effects of age can be absolutely compensated for, or in part even overcompensated, by the period and cohort effects. For this reason, the aging of society itself does not necessarily lead to higher health-care costs owing to certain parameters of health behaviour, even if cross-sectional studies show an increasing incidence with age.
rary, they are sex-specific?This question stimulated us to conductthis study on the sex specificity of theeffects of early-life conditions on adultlifespan.177ANNALES DE DMOGRAPHIE HISTORIQUE 2003 n 2 p. 177 198EARLY-LIFE PREDICTORS OF HUMAN LONGEVITY:ANALYSIS OF THE XIXby Natalia S. GAVRILOVA, Leonid A. GAVRILOV,Galina N. EVDOKUSHKINA, Victoria G. SEMYONOVAAcknowledgmentsThe results of this study were presented at the2001 Annual meeting of the Social Science andHistory...
Data from insurance portfolios and pension schemes lend themselves particularly well to the application of survival models. In addition to the traditional actuarial risk-rating factors of age, gender and policy size, we find that using geodemographic models based on postcode provides a major boost in explaining risk variation. Geodemographic models can be better than models based on pension size in explaining socio-economic variation, but a model using both is usually better still. Models acknowledging heterogeneity tend to fit better than models which do not. Finally, bootstrapping techniques can be used to test the financial applicability of a model, while weighting the model fit can be used to address concentration risk.
Mit den Daten des Sozio-ökonomischen Panel (SOEP) und der Panel Study of Income Dynamics (PSID) wird die aktive Lebenserwartung für Deutschland und die USA anhand von Mehrzustands-Sterbetafeln berechnet. Dabei wird erstmals auf einzelne Geburtsjahrgänge Bezug genommen. Diese Längsschnittbetrachtung hat gegenüber Periodenuntersuchungen den Vorteil, die tatsächlichen Sterblichkeits-, Erkrankungs- und Gesundungsprozesse von Geburtskohorten zu erfassen. Zu den Ergebnissen gehört, dass für Deutschland insgesamt eine deutliche Verbesserung des Gesundheitszustands festgestellt werden kann, während für die USA tendenziell eher von einer Verschlechterung auszugehen ist.
Using the method of multistate life-tables, the article presents results on active life expectancy on the basis of the GermanSocio-Economic Panel (GSOEP) and the Panel Study of Income Dynamics (PSID). The transitions into and out of active life are based on event-history analysis and are calculated for different cohorts. Compared to cross-sectional analysis, the longitudinal analysis carried out here describes active life expectancy with reference to single birth cohorts. Results show that in Germany there has been substantial improvement in active life expectancy while in the USA there has been some deterioration.
This study examined changes in involvement in physical exercise and the motives for and obstacles to participation over an 8-year period in a representative sample of senior residents of Jyvaskyla, Finland. The participants were noninstitutionalized seniors age 65-84 years at baseline in 1988. The most common form of physical exercise was walking for fitness. In men, participation in supervised exercise classes and performing calisthenic exercises at home increased over the follow-up. In women, physical exercise generally declined. The most important reason quoted for nonparticipation at both baseline and follow-up was poor health (65-88%). Among those who reported participation in supervised physical exercise, the most important motives were health promotion (80%) and social reasons (40-50%). The main obstacles were poor health (19-38%) and lack of interest (28-26%). It is an important challenge to remove obstacles to participation in physical activity in old age and to give older people every opportunity to get involved.
This study examines the prevalence of physical inactivity during leisure time in a national representative sample of U.S. adults.
Data were obtained from the Third National Health and Nutrition Examination Survey, conducted between 1988 and 1994. A total of 18,825 adults aged 20 yr and older participated in a home interview where information about physical activity, education, income, occupation, employment, and labor force participation was obtained.
The prevalence of physical inactivity among U.S. adults was 23%, with more women (28%) than men (17%) reporting being inactive during their leisure time. Additionally, inactivity is more common among in social class such as persons who are less educated, living below the poverty line, living in households with income below 20,000 dollars, and who are retired. In every category of social class, women experienced a higher prevalence of physical inactivity than men.
We conclude that social class is associated with physical inactivity and that more research is needed to better understand the effect that other social and environmental factors have on sedentary behaviors in our society.
In neun Thesen skizziert der Artikel aus soziologischer Perspektive die spezifische Rationalität und die Technologien vorbeugenden Handelns. Prävention wird dabei beschrieben als übergreifender Modus des Zukunftsmanagements zeitgenössischer Gesellschaften.
This study assessed how and why the social stratification of leisure-time physical activity changes as adults at different points in the life course, and from different birth cohorts, grow older.
A series of multilevel models were estimated using longitudinal data from a national sample of more than 3,000 adults from the Americans' Changing Lives study.
On average, rates of leisure-time physical activity increased within younger adults and decreased within middle-aged and older adults, throughout the study period. Initial Black-White differences in activity converged over time, whereas initial men advantages over women widened, particularly among older adults. Gender-based differences did not remain after accounting for differences in health; however, significant age and race differences in the trajectories of physical activity persisted, even after accounting for the effects of health and social relationships on leisure-time physical activity.
American adults appear to be reducing their levels of physical activity relatively early in the life course and at increasingly steep rates among older age groups. The changing patterns of stratification in physical activity, as well as the associations between several time-varying predictors and physical activity, provide insight into the forces that may be responsible for these declines.
Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/67001/2/10.1177_109019819001700404.pdf
To examine how change in level of physical activity after middle age influences mortality and to compare it with the effect of smoking cessation.
Population based cohort study with follow-up over 35 years.
Municipality of Uppsala, Sweden.
2205 men aged 50 in 1970-3 who were reexamined at ages 60, 70, 77, and 82 years.
Total (all cause) mortality.
The absolute mortality rate was 27.1, 23.6, and 18.4 per 1000 person years in the groups with low, medium, and high physical activity, respectively. The relative rate reduction attributable to high physical activity was 32% for low and 22% for medium physical activity. Men who increased their physical activity level between the ages of 50 and 60 continued to have a higher mortality rate during the first five years of follow-up (adjusted hazard ratio 2.64, 95% confidence interval 1.32 to 5.27, compared with unchanged high physical activity). After 10 years of follow-up their increased physical activity was associated with reduced mortality to the level of men with unchanged high physical activity (1.10, 0.87 to 1.38). The reduction in mortality associated with increased physical activity (0.51, 0.26 to 0.97, compared with unchanged low physical activity) was similar to that associated with smoking cessation (0.64, 0.53 to 0.78, compared with continued smoking).
Increased physical activity in middle age is eventually followed by a reduction in mortality to the same level as seen among men with constantly high physical activity. This reduction is comparable with that associated with smoking cessation.
Although worksite health promotion programs have proliferated, little is known about the population they reach. This study of employees of a large utility company compared whether the same characteristics which predict recruitment also predict extended participation. The study also prospectively assessed how risk factors are related to employees' on-going extended participation. The findings demonstrate that sociodemographic predictors of recruitment are almost mirror images of the predictors of extended participation. Over time employees who are at higher risk for cardiovascular disease participated in on-going sessions less frequently. Data suggest that referral to targeted sessions does not result in higher rates of attendance by employees with a particular risk factor, although there is no evidence of selective avoidance. Organizational influences on participation evident from the beginning are sustained through four sessions. Programs targeting higher risk employees nested within worksite-wide programs may be useful to increase the extended participation of individuals at elevated risk for heart disease.
This study examines cross-sectional age differences, longitudinal age changes, and secular changes in obligatory, committed, and discretionary activities, using activity questionnaire completed by men and women participants in the Baltimore Longitudinal Study of Aging between 1958 and 1992. (1) Time spent, on obligatory activities and passive leisure is greatest, and on committed activities and active leisure least, for older adults. (2) Longitudinal patterns usually mirror cross-sectional ones. There are pronounced exceptions for women whose paid work time has been increasing and housework decreasing, while cross-sectional patterns show the reverse. (3) Over recent decades, time in committed activities shifted in opposite ways for men and women. Men decreased paid work and increased housework, repairs and yardwork, shopping, and child-care, while women increased paid work and decreased housework. In sum, the age structure of activities has persisted in the midst of new social opportunities; gender roles have proven more malleable than age roles.
Data regarding the nature of change in physical activity as elderly people become progressively older are scarce. The present study describes changes in the physical activity pattern of a cohort of elderly Dutch men between 1985 and 1995.
Self-reported physical activity was assessed with a reliable and valid questionnaire designed for retired men. In 1985, 863 men (aged 65-84 years) were examined, in 1990, 520 surviving men, and in 1995, 343 men. Three analytical perspectives (cross-sectional, longitudinal, and time-series) were used concurrently to untangle effects of aging, period, and birth cohort on the 10-year change in physical activity.
Mean total time spent on physical activity decreased by 33% (28 min/day) during 10 years of follow-up. Time spent on bicycling, gardening, and total activity decreased with aging. A period effect was observed for time spent on bicycling and total activity in 1990 (increase) and gardening in 1995 (decrease). No differences in physical activity between birth cohorts were observed. Time spent on walking remained stable during follow-up, but its relative contribution to total time spent on physical activity increased with aging. The pattern of change in total activity was not affected by functional status.
Mean total time spent on physical activity by elderly men clearly decreased during follow-up. This could not be fully explained by declining functional status, but was partly explained by aging. In contrast to other physical activity parameters, time spent on walking was not affected by aging. These results suggest an increasingly restrictive physical activity pattern with aging.
In conclusion, the findings of most recent studies show that moderate-intensity aerobic exercise training can lower BP in patients with stage 1 and 2 essential hypertension. The average reduction in BP is 10.5 mm Hg for systolic and 7.6 mm Hg for diastolic BP. The reductions do not appear to be gender- or age-specific. Significant reductions in BP and LVH regression in patients with stage 3 hypertension have also been reported following aerobic exercise training. Resistance training exercise has not consistently shown to significantly lower BP and is not recommended as the only form of exercise for hypertensive patients. The exercise training program for optimal benefits should consist of 3 to 5 times per week, 30 to 60 minutes per session, at 50% to 80% of PMHR. However, exercise programs should be individualized to meet the patient's needs and abilities. Exercise intensity and duration should be manipulated to promote a safe and effective antihypertensive program. Initially, the exercise intensity should be low and the duration short. Both intensity and duration should progressive increase over a period of weeks until the desired goal, is achieved. The rate of progression must be tailored to meet individual patient needs and abilities. The exercise program for overweight or obese hypertensive patients should aim to promote a caloric expenditure of 300 to 500 Kcal per day and 1000 to 2000 Kcal per week. Such an approach, combined with a prudent diet, is likely to reduce body weight. The mechanisms mediating exercise-induced BP reduction are poorly understood. BP reductions appear to be independent of changes in body weight or body composition. There are also no indications of age- or gender-related differences in BP response to exercise. The use of ambulatory blood pressure measuring devices in exercise studies is not extensive. The few studies available indicate a more moderate reduction in BP than that reported by casual observations.
To investigate the effect of changes in physical activity on changes in metabolic cardiovascular risk factors and to investigate what factors affect the association between physical activity and cardiovascular mortality.
Of the 1860 men who were 50 years of age and who were without pre-existing cardiovascular disease participating in a population-based study, 898 were re-examined 20 years later. Altogether 231 died from cardiovascular diseases during the follow-up (mean = 22.6 years). The examinations which the men underwent at 50 and 70 years of age included assessment of physical activity (self-reported at four alternative levels), anthropometry, measurements of fasting concentrations of glucose, specific insulin, proinsulin, split proinsulin and lipids.
During the 20 years, 31 % increased their amount of physical activity while 51 % continued the same amount of exercise. Increased physical activity was associated with significant changes in several important metabolic variables, including fasting glucose, proinsulin and HDL cholesterol, independent of body weight changes. The risk of cardiovascular disease for men performing moderate, regular and athletic physical activity was 25 % (p = 0.127), 34 % (p = 0.022) and 71 % (p = 0.009) lower, respectively, compared with sedentary men. The association was attenuated by adjustment for baseline measurements of insulin, proinsulin and split proinsulin. Additional adjustment for other cardiovascular risk factors did not further attenuate the association.
Increased leisure time physical activity between the ages of 50 and 70 years, in the absence of active intervention, is associated with improved glucose, insulin and lipid metabolism in men. The concentrations of insulin, proinsulin and split proinsulin could mediate much of the association between a sedentary lifestyle and increased risk of cardiovascular mortality.
There has been much debate regarding the degree to which healthy lifestyles can increase longevity and whether added years will be offset by increased morbidity at older ages. This study was designed to test the compression of morbidity hypothesis, proposing that healthy lifestyles can reduce and compress disability into a shorter period toward the end of life.
Functional status in 418 deceased members of an aging cohort was observed between 1986 and 1998 in relationship to lifestyle-related risk factors, including cigarette smoking, physical inactivity, and under- or overweight. Three risk groups were created based on the number of these factors at study entry. Disability scores prior to death were modeled for each risk group to compare levels and rates of change, as well as to determine if and when acceleration in functional decline occurred.
The risk-factor-free group showed average disability scores near zero 10-12 years before death, rising slowly over time, without evidence of accelerated functional decline. In contrast, those with two or more factors maintained a greater level of disability throughout follow-up and experienced an increase in the rate of decline 1.5 years prior to death. For those at moderate risk, the rate of decline increased significantly only in the last 3 months of life. Other differences between groups provided no alternative explanations for the findings.
These results make a compelling argument for the reduction and postponement of disability with healthier lifestyles as proposed by the compression of morbidity hypothesis.
Self-rated health has been related to functional status, disability, and mortality in a variety of populations. This study examined whether self-rated health was related to physical activity levels independent of functional status in a population of older women. For this study, 9,704 women aged 65-99 rated their health on a scale ranging from excellent to very poor. Physical activity and functional status questionnaires and physical function tests were administered to evaluate levels of physical activity, strength, and function. Comparisons between women in three groups of self-rated health (good and excellent; fair; poor and very poor) indicated that higher self-rated health was strongly related to physical activity independent of physical strength, functional status, and co-morbidity. These findings suggest that physical activity is an important determinant of self-rated health in older women regardless of functional status.
This study used a qualitative, feminist perspective to examine issues pertaining to exercise constraints among older adults. Participants were 8 male and 9 female older adults (mean age = 76.7) who chose not to engage in structured exercise classes. Twenty-six self-identified constraints were elicited (mean = four per person). Additionally, four constraints per person from previous research were selected. The most frequently cited self-reported constraints were "get enough exercise elsewhere," health-related items, and issues related to time. From the constraints most frequently cited in past studies, inconvenience, time, and type of activity were selected most often. Gender differences were apparent in the constraints chosen as well as reasons why a particular constraint inhibited or prohibited activity. Specific suggestions for strategies included having programs with a purpose, building in flexibility, and encouraging men to participate. The influence of gender is explored, especially how expanding our understanding of gender issues might improve program planning.
It is taken for granted, that women in comparison to men have a poorer health, although they live longer. This statement, however, is partly based on measures which do not represent indicators of health (or illness), but indicators of health (or illness) behavior (i.e. utilization of medical services). This article reviews some new findings regarding physical health comparing men and women, considering subjective and objective indicators of health: self-assessments of health, self-reports of symptoms and diseases, and statistics of hospital diagnoses, which exist for Germany since 1993. Altogether, no convincing evidence is found that men should have a better physical health than women. Rather, some indicators of health could be positively biased through tendencies of self-perception or self-presentation in men. This seems to be true especially for East-German than for West-German men.
Die demographische Entwicklung und der Gesundheitszustand sind auf vielfache Weise miteinander verknüpft, was angesichts des knappen zur Verfügung stehenden Raums zwangsläufig eine starke Eingrenzung der Themenstellung bedingt. Besonders eng ist naturgemäß der Zusammenhang zwischen der Mortalität und der Morbidität. Aus den vielen in diesem Zusammenhang relevanten Fragen wird im weiteren zur detaillierten Behandlung ein Teilaspekt ausgewählt, der einerseits theoretisch und politisch relevant ist und andererseits zugleich mit konkreten empirischen Daten der Bundesrepublik beantwortet werden kann.
Exercise is associated with positive health habits: Findings from the populations survey of the Swiss MONICA-project. Relatively little is known on population-wide relations of habitual exercise to relevant health factors such as diet, cigarette smoking and overweight. Data from a population-based sample of approximately 800 men and women each, aged 25-64, collected in western Switzerland as a part of an international WHO-project, were used to examine cross-sectionally the interrelationships between different lifestyle factors. Men and women training regularly (i.e. greater than or equal to 2 times/wk) exhibited consistently and highly significantly more favourable health habits, regarding diet (i.e. trimming visible fat, higher intake of fruits, salad and vegetables, yogurt and cottage cheese), nonsmoking, and weight control. Men and women with at least some regular physical activity during leisure-time had in turn more favourable health habits than their sedentary counterparts. In both sexes, educational level was directly related to exercise and a healthy diet, and inversely related to smoking and relative weight. Regularly training men and women also had a significantly improved lipid profile compared to inactive ones. It is concluded from this study that leisure-time physical activity and exercise are related to a positive health behaviour including diet, nonsmoking and efficient weight control. This may suggest that exercise should possibly be integrated into any population-wide attempts and efforts to promote health to enhance primary prevention.
A secondary analysis of data from the 1990 Health Promotion and Disease Prevention Supplement to the National Health Interview Survey was conducted to estimate the prevalence of exercise among adults aged 55 and older and identify correlates of exercise in this population. Walking and participation in other exercises were the exercise variables, and the explanatory variables included sociodemographic measures, self-reported health status and medical conditions, and health belief measures. For both exercise measures, physical activity declined with advanced age. Age, gender, education, and the health beliefs that smoking causes heart disease and cancer were the most important correlates of walking and playing sports. Additional interventions are needed to increase participation in regular walking, the most prevalent form of physical activity among older adults. In developing and testing these strategies, investigators should place emphasis on an approach that incorporates health education rather than simple prescriptive advice regarding regular exercise.
An abstract is unavailable. This article is available as HTML full text and PDF.
In Switzerland lack of exercise is common. To improve physical exercise in both women and men, campaigns should consider the motivation for physical activity with respect to gender. This study explores the patterns of self-reported sport activity, habitual physical activity and physical fitness, and associated indicators of self-reported health, health-relevant attitudes, and resources in an urban Swiss population. Using the Bern Lifestyle Panel questionnaire, 511 women and 413 men, aged 55–65years, in the German-speaking capital of Switzerland were assessed. From the three surveys carried out from 1996 to 1998, this study used the data from the 1997 survey for a cross-sectional analysis. Women demonstrated a lower prevalence of sport activity than men but a higher prevalence of habitual physical activity. Forty-six percent of the women but 80% of the men reported a high level of fitness. In the logistic regression analysis, sport activity in the women was significantly associated with indicators of health, health-relevant attitudes such as internal and external health locus of control, and social class. Among the men, no association with health-relevant orientation could be found. The probability of habitual physical activity among the women was associated with perceived good health, health-relevant orientation and social class, while related factors among the men were indicators of health. In both women and men, perceived good health was strongly associated with self-reported physical fitness. Additionally, womens fitness was related to perceived disease-related limitation and indicators of health status. The findings indicate a gender-specific distribution of sport activity, habitual physical activity and fitness. Compared to men, physical activity in women is associated more with health-relevant orientation. Along with indicators of health, attention should be paid to both female and male perception of health and self-reported attitudes when there is an attempt to improve physical activity. Since self-reported health status, disease-related limitations, and habitual physical activity, among others, are strongly affected by sociocultural and structural influences, caution should be kept in drawing general conclusions from the findings.
Exercise is associated with positive health habits: Findings from the populations survey of the Swiss MONICA-project. Relatively little is known on population-wide relations of habitual exercise to relevant health factors such as diet, cigarette smoking and overweight. Data from a population-based sample of approximately 800 men and women each, aged 25-64, collected in western Switzerland as a part of an international WHO-project, were used to examine cross-sectionally the interrelationships between different lifestyle factors. Men and women training regularly (i.e. greater than or equal to 2 times/wk) exhibited consistently and highly significantly more favourable health habits, regarding diet (i.e. trimming visible fat, higher intake of fruits, salad and vegetables, yogurt and cottage cheese), nonsmoking, and weight control. Men and women with at least some regular physical activity during leisure-time had in turn more favourable health habits than their sedentary counterparts. In both sexes, educational level was directly related to exercise and a healthy diet, and inversely related to smoking and relative weight. Regularly training men and women also had a significantly improved lipid profile compared to inactive ones. It is concluded from this study that leisure-time physical activity and exercise are related to a positive health behaviour including diet, nonsmoking and efficient weight control. This may suggest that exercise should possibly be integrated into any population-wide attempts and efforts to promote health to enhance primary prevention.
The purpose of this study was to explore the associations between several social learning theory variables and self-reported vigorous exercise and to consider the implications for exercise promotion. A random sample of adults in San Diego, California, was surveyed by mail. The 2,053 respondents (response rate, 43.4%) overrepresented Caucasian, affluent, and well-educated groups. A model of 24 variables accounted for 0.27 of the variance in exercise, and results strongly supported social learning theory. The strongest correlates were self-efficacy (i.e., confidence in the ability to exercise in specific situations), perceived barriers to exercise, modeling, dietary habits, support from friends, and age. Smoking was inversely associated with exercise in men only. We encourage researchers to conduct intervention trials to test the hypotheses generated in this study.
Compliance with exercise programs in the primary and secondary prevention of coronary heart disease is reviewed. The evidence suggests that compliance with health behavior changes such as exercise is necessary for potential benefits to become apparent. However, the compliance rate with exercise programs is low and particular care must be taken in the interpretation of exercise studies as well as clinical trials because of self-selection bias. There appear to be certain characteristics that may help to identify the potential dropout; there are also certain programmatic features which should be considered in designing compliance-improving strategies to reduce dropout. Behavior modification techniques appear to have significant potential in reducing program dropout; however, there is a need to carefully investigate compliance-improving strategies before recommendations for a particular approach can be made.
The interest and participation in health promotion and wellness activities has expanded greatly in the past two decades. The "wellness revolution," especially in terms of diet and exercise, has been affected by both scientific findings and cultural changes. The paper examines how a particular aspect of culture, the moral meanings of health-promoting activities, contribute to the pursuit of wellness. Based on interviews with 54 self-identified wellness participants at a major university, we examine how health can be a moral discourse and the body a site for moral action. The paper suggests that wellness seekers engage in a profoundly moral discourse around health promotion, constructing a moral world of goods, bads and shoulds. Although there are some gender differences in particular wellness goals, engaging in wellness activities, independent of results, becomes seen as a good in itself. Thus, even apart from any health outcomes, the pursuit of virtue and a moral life is fundamentally an aspect of the pursuit of wellness.
Recent trends toward increasing physical exercise, stopping cigarette smoking, and avoiding obesity may increase longevity. We analyzed changes in the lifestyles of Harvard College alumni and the associations of these changes with mortality.
Men who were 45 to 84 years of age in 1977 and who had reported no life-threatening disease on questionnaires completed in 1962 or 1966 and again in 1977 were classified according to changes in lifestyle characteristics between the first and second questionnaires. We analyzed changes in their level of physical activity, cigarette smoking, blood pressure, and body weight, and the relation of these factors to mortality between 1977 and 1985.
Of the 10,269 men, 476 died during this period (which totaled 90,650 man-years of observation). Beginning moderately vigorous sports activity (at an intensity of 4.5 or more metabolic equivalents) was associated with a 23 percent lower risk of death (95 percent confidence interval, 4 to 42 percent; P = 0.015) than not taking up moderately vigorous sports. Quitting cigarette smoking was associated with a 41 percent lower risk (95 percent confidence interval, 20 to 57 percent; P = 0.001) than continuing smoking, but with a 23 percent higher risk than constant nonsmoking. Men with recently diagnosed hypertension had a lower risk of death than those with long-term hypertension (relative risk, 0.75; 95 percent confidence interval, 0.55 to 1.02; P = 0.057), as did men with consistently normal blood pressure (relative risk, 0.52; 95 percent confidence interval, 0.40 to 0.68; P < 0.001). Maintenance of lean body mass was associated with a lower mortality rate than long-term, recent, or previous obesity. The associations between changes in lifestyle and mortality were independent and were largely undiminished by age. Our findings on death from coronary heart disease mirrored those on death from all causes.
Beginning moderately vigorous sports activity, quitting cigarette smoking, maintaining normal blood pressure, and avoiding obesity were separately associated with lower rates of death from all causes and from coronary heart disease among middle-aged and older men.
The paper is concerned with the use of epidemiological methods to measure the rates at which different strata of a defined population participate in community health promotion projects. The specific aim was to estimate the incidence rates of participation in projects sponsored by the Western Australian Health Promotion Foundation (Healthway), separately for sociodemographic and health-related behavioural subgroups.
Data were drawn from Healthway sponsorship projects in 1992. Each sport, arts and racing project was associated with promotion of a health message and creation of a health promoting environment. The study used a two-stage sampling design. Thirteen of 57 large sponsorship projects and 30 of 129 small projects were selected. In the second stage, respondents were randomly surveyed from among project participants. A total of 4060 respondents aged > or = 10 years was sampled from the 43 selected projects. Population-based incident participants were estimated and were related to person-years at risk.
The total participation rate was 4.01 per person-year. The rate was very high at ages 10-14 years and thereafter declined with increasing age. Compared with the least socially disadvantaged 25% of population, the participation rate fell by around one-third in the medium and high disadvantage groups, but exceeded the baseline by a ratio of 1.85 (95% confidence interval: 1.57-2.18) in the most disadvantaged 10% of population. The effect was most pronounced at ages 10-19 years. Participation was higher in those who smoked, drank alcohol unsafely, reported sunburn and reported low consumption of fruit and vegetables. However, participation was reduced in people who were sedentary.
Epidemiological methods can be used to evaluate the distribution of participation of a population in community health promotion projects. The Western Australian Health Promotion Foundation has been successful in reaching disadvantaged youth.
The association of several lifestyle factors with leisure-time physical activity was examined from 1990 to 1991 in a representative sample of 2623 men and 2688 women, ages 25-69, in Germany. Active persons during leisure time were less likely to live in small villages, to smoke and generally had a lower body mass index as compared to sedentary. Men and women with high socioeconomic status were, respectively, four and three times more likely to have an active leisure time than those with low socioeconomic status. After adjustment for age, body mass index, urbanization, socioeconomic status, smoking and average monthly temperature, they less often felt the need to sleep early, consumed more often fruit, salad, whole grain bread and vitamin supplements, less often white bread and meat and a higher amount of fluids as compared to sedentary persons. They were more likely to be single and to eat breakfast regularly. Higher levels of leisure-time physical activity were associated with a general healthier lifestyle.
We studied the relations between physical activity and changes in physical activity, all-cause mortality, and incidence of major coronary-heart-disease events in older men.
In 1978-80 (Q1), 7735 men aged 40-59 were selected from general practices in 24 British towns, and enrolled in a prospective study of cardiovascular disease, which included physical activity data. In 1992 (Q92), 12-14 years later, 5934 of the men (91% of available survivors, mean age 63 years) gave further information on physical activity and were then followed up for a further 4 years. The main endpoints were all-cause mortality during 4 years of follow-up from Q92, and major fatal and non-fatal coronary-heart-disease events during 3 years of follow-up from Q92.
Among 4311 men with no history of coronary heart disease, stroke, or "other heart trouble" by Q92 and who did not report "poor health", there were 219 deaths. In the inactive/occasionally active, light, moderate, and moderately vigorous/vigorous activity groups there were 101 (18.5/1000 person-years) 48 (11.4), 23 (7.3), and 47 (9.1) deaths, respectively (adjusted risk ratios 1.00, 0.61 [95% CI 0.48-0.86], 0.50 [0.31-0.79], 0.65 [0.45-0.94]). Men who were sedentary at Q1 and who began at least light activity by Q92 had significantly lower all-cause mortality than those who remained sedentary, even after adjustment for potential confounders (risk ratio=0.55 [0.36-0.84]). Physical activity improved both cardiovascular mortality (0.66 [0.35-1.23]) and non-cardiovascular mortality (0.48 [0.27-0.85]). The relation between physical activity at Q92, changes in physical activity, and mortality were similar for men with pre-existing cardiovascular disease.
Maintaining or taking up light or moderate physical activity reduces mortality and heart attacks in older men with and without diagnosed cardiovascular disease. Our results support public-health recommendations for older sedentary people to increase physical activity, and for active middle-aged people to continue their activity into old age.
Because physical activity may affect risk of certain chronic diseases, we wanted to examine the effects of leisure time physical activity on the metabolic profiles.
In a population-based cohort study, 5220 men and 5869 women, aged 20 to 49 years at entry, took part in 2 surveys (1979-1980 and 1986-1987) with repeated assessments of self-reported leisure time activity. Measurements of body mass index (measured as the weight in kilograms divided by the square of the height in meters [BMI]) and levels of serum triglyceride, total cholesterol (total C), and high-density lipoprotein cholesterol (HDL-C) were studied in relation to 4 levels of physical activity.
There was a dose-response relationship between serum lipid levels and BMI, and levels of physical activity in both sexes after adjustments for potential confounders. Differences in BMI and serum lipid levels between sedentary and sustained exercising groups were consistently more pronounced after 7 years than at baseline, especially in the oldest age group. Men reporting sustained very hard exercising compared with sedentary men had lower total C concentrations (5.65 mmol/L vs 6.21 mmol/L [218 mg/dL vs 240 mg/dL]), triglyceride levels (1.34 mmol/L vs 1.85 mmol/L [118 mg/dL vs 164 mg/dL] ), total C/HDL-C ratios by 19.0%, and BMI (23.9 kg/m2 vs 25.7 kg/m2), and higher HDL-C levels (1.52 mmol/L vs 1.36 mmol/L [59 mg/dL vs 52 mg/dL]). The combined sustained hard and very hard exercising group of women compared with sedentary women had lower total C concentrations (5.70 mmol/L vs 5.90 mmol/L [220 mg/ dL vs 228 mg/dL]), triglyceride levels (1.03 mmol/L vs 1.18 mmol/L [91 mg/dL vs 104 mg/dL]), total C/HDL-C ratios by 7.5%, BMI (23.1 kg/m2 vs 23.6 kg/m2), and higher HDL-C levels (1.73 mmol/L vs 1.66 mmol/L [67 mg/dL vs 64 mg/ dL]). An increase in leisure time activity over the 7 years improved metabolic profiles, whereas a decrease worsened them in both sexes.
Sustained high levels and change from sedentary to higher levels of physical activity relative to sedentary men and women improved the metabolic risk profiles in both sexes. The differences observed are sufficiently large to have a beneficial effect in the prevention of certain chronic diseases.
The purpose of this study was to analyze physical activity in a large, diverse sample of urban women (N = 521; X = 40.5 +/- 10.5 yr) relative to race/ethnicity, income, age, and education, using a sex-specific physical activity questionnaire. We also examined demographic and behavioral predictors of high levels (> or = 2000 kcal.wk-1) of leisure-time physical activity (LTPA; exercise, sports, recreational activities) in this population.
The majority of women were sedentary (0-666 kcal.wk-1 in LTPA), and only 8% of African-American women (N = 6), 11% of Mexican-American women (N = 4), and 13% of white women (N = 55) participated in the level of physical activity recommended by the surgeon general (i.e., moderate to vigorous physical activity most days of the week for at least 30 min). Women of color, women over 40, and women without a college education had the lowest levels of participation in LTPA. Logistic regression analysis indicated that education was the only significant predictor of high LTPA in white women (P < 0.01) and marital status was the only significant predictor of high LTPA in minority women (P < 0.001). Age, body mass index (BMI; kg.m-2), income, self-rated health, alcohol intake, and smoking were not significant predictors of high LTPA for any of the women. Because the majority of adult women from this sample do not participate in adequate amounts of physical activity as recommended by the surgeon general, they may be at increased risk for hypokinetic diseases.
These results indicate that public health efforts to increase physical activity in women should be focused on women of color, women over 40, and women without a college degree. More attention to predictors of physical activity that are specific to race or ethnicity may improve intervention program design and implementation.
In this study we aim to explain educational differences in leisure-time physical inactivity in terms of psychosocial and material factors. Cross-sectional data were obtained from the baseline of the Dutch GLOBE study in 1991, including 2598 men and women, aged 15-74 years. Physical inactivity during leisure time was defined as not participating in any activity, such as sports, gardening, walking or cycling. Psychosocial factors included in the study were coping resources, personality, and stressors. Material factors were financial situation, employment status, and living conditions. Logistic regression models were used to calculate educational differences in physical inactivity. Physical inactivity was more prevalent in lower educational groups. Psychosocial factors related to physical inactivity were locus of control, parochialism, neuroticism, emotional social support, active problem focussing, optimistic and palliative coping styles. Material factors associated with physical inactivity were income, employment status and financial problems. All correlates of physical inactivity were unequally distributed over educational groups, except optimistic and palliative coping. Personality and coping style were the main contributors to the observed educational differences in physical inactivity. That is to say, parochialism, locus of control, neuroticism and active problem focussing explained about half of elevated odds ratios of physical inactivity in the lower educational groups. The material factors, equivalent income and employment status explained about 40% of the elevated odds ratios. Psychosocial and material correlates together reduced the odds ratios of lower educational groups by on average 75%. These results have practical consequences for the design of more effective interventions to promote physical activity. In particular, personality and coping style of risk groups, such as lower educational groups, should be taken into consideration at the future development of these interventions, as well as inequalities in material restrictions related to engaging in physical activity. Supplementary interventions focussing on childhood conditions which, partly, influence both personality and physical inactivity may also contribute to a reduction of socio-economic differences in physical inactivity.
A sustainable pattern of participation in physical activity is important in the maintenance of health and prevention of disease. College students are in transition from an active youth to a more sedentary adult behavior pattern.
We assessed self-reported physical activity and other characteristics in a sample of 2,729 male and female students (median age was 20 years) recruited from representative courses and year levels at four Australian College campuses. They were categorized as sufficiently or insufficiently active, using estimates of energy expenditure (kcal/week) derived from self-reported physical activity. Personal factors (self-efficacy, job status, enjoyment), social factors (social support from family/friends), and environmental factors (awareness of facilities, gym membership) were also assessed.
Forty-seven percent of females and 32% of males were insufficiently active. For females, the significant independent predictors of being insufficiently active were lower social support from family and friends, lower enjoyment of activity, and not working. For males, predictors were lower social support from family and friends, lower enjoyment of activity, and being older.
Factors associated with physical activity participation (particularly social support from family and friends) can inform physical activity strategies directed at young adults in the college setting.
Demographic and psychosocial correlates of activity in domains other than recreational activity have not been well characterized and may be particularly relevant for health promotion efforts aimed at women.
Cross-sectional relationships between recreational, occupational, and household/caregiving physical activity and demographic and psychosocial factors were assessed with a mail survey in a random sample of 2,636 ethnically diverse women members of a large health maintenance organization, ages 20-65. Activity was assessed with a modified Baecke questionnaire that uses categorical responses regarding frequency of domain-specific activities to create four semicontinuous activity indices (sports/exercise, active living, occupational, household/caregiving).
Multivariable logistic regression analysis showed that the likelihood of being in the highest quartile of the sports/exercise and active-living indices, compared with the other three quartiles, was decreased among older, nonwhite, less well educated, heavier women who had young children at home, lacked motivation to exercise, and perceived external obstacles to exercise behavior. The odds ratios (ORs) ranged from 0.38, 95% confidence interval (CI) 0.33-0.45, associated with low motivation, to 0.95, 95% CI 0.93-0.98, associated with increasing body mass index. Social support and confidence in one's ability to continue to exercise, even when faced with other pressures and demands (termed self-efficacy), were associated with increased likelihood of high levels of sports/exercise and active living (OR = 2.34, 95% CI 1. 83-2.98 and OR = 3.96, 95% CI 2.92-5.38, respectively). In contrast, the highest quartile of household/caregiving activity was positively associated with increasing age (OR = 1.28, 95% CI 1.16-1.42), Hispanic ethnicity (OR = 1.58, 95% CI 0.55-1.01), being married (OR = 1.70, 95% CI 1.33-2.18), having young children at home (OR = 6.99, 95% CI 4.33-11), and greater time constraints as a barrier to exercise (OR = 1.55, 95% CI 1.38-1.74) and was negatively associated with employment (OR = 0.38, 95% CI 0.30-0.47). Increased likelihood of the highest quartile of occupational activity was associated with high school education or less (OR = 2.26, 95% CI 1.74-2.94) and current smoking (OR = 1.66, 95% CI 1.23-2.23), while self-efficacy regarding exercise was associated with decreased likelihood (OR = 0. 77, 95% CI 0.61-0.96).
These findings suggest that demographic and psychosocial correlates of physical activity vary by domain and that initiatives to promote physical activity in the population need to take these differences into account.
Coronary artery disease is the most common cause of morbidity and mortality in subjects with type 2 diabetes mellitus. The risk of coronary artery disease, myocardial infarction and mortality from myocardial infarction is markedly increased in type 2 diabetic patients compared with non-diabetics. Diabetic patients with acute myocardial infarction should receive thrombolytic therapy as rapidly as possible and for the same indications as non-diabetics. Diabetic retinopathy is not a contraindication to treatment. The management of diabetic patients should also include medication with aspirin, beta-blockers and ACE-inhibitors. An insulin-glucose infusion during acute myocardial infarction, followed by insulin injections subcutaneously, reduces mortality by about 30% after 12 months and improves long-term prognosis. Thus, insulin-glucose infusion in diabetic patients with acute myocardial infarction, especially in those with a high blood glucose level (> 11 mmol/l), seems advisable. Diabetic patients benefit from secondary prevention by drug therapy (aspirin, lipid lowering with statins, beta-blockers and ACE-inhibitors) to the same extent as, or more than, non-diabetic patients.
The present study examined the associations between leisure-time exercise and a range of health behaviors and reports of illness and injury in a sample of community working adults.
The study population included 4907 women and 4136 men who completed surveys in 24 worksites in the Minneapolis-St. Paul metropolitan area.
Participants in the study were ranked by gender according to their exercise score and grouped into quartiles. Women and men in the highest activity quartiles were more highly educated and were younger. High-activity men were more likely to be unmarried. Higher levels of leisure-time exercise were positively associated with seat belt use and inversely related to smoking, dietary fat intake, reported stress, and obesity. In men only, leisure-time exercise was related to greater reports of injuries resulting in restriction of usual activities. In women only, leisure-time exercise was positively associated with daily alcohol use. Most of the significant associations were seen in the two highest quartiles of exercise.
These findings suggest that associations between leisure-time exercise and health behaviors occur at the higher levels of exercise and interventions may need to promote this higher level of leisure-time exercise to impact overall public health.
The questionnaire data of the German National Health Interview and Examination Survey 1998 were used to determine the actual physical activity level in Germany. With the use of similar data from the National Health Surveys 1990/92 changes in activity level over time were estimated. At present, a large part of the population is sedentary during leisure time. Among men this proportion is larger in the eastern part and among older women in the western part of Germany. The proportion of young sedentary women is, however, smaller in the eastern part of Germany. The proportion of men engaged in sport for two hours per week or more, is larger in the western part of Germany. Among West and East German women this proportion is almost equal, although among younger women more are active in the eastern part. During the last seven years, the proportion of sedentary men younger than 50 years of age has grown, whereas the same proportion has declined among those over 50 years of age. Among women a similar decline is apparent above 30 years of age and more pronounced as it is for men. In general, the proportion of active men and women engaged in sport during leisure time for more than 2 hours per week has increased.
I argue that the shift from manual to white-collar jobs and reduced exposure to infectious disease were important determinants of declines in chronic disease rates among older men from the early 1900s to the 1970s and 1980s. The average decline in chronic respiratory problems, valvular heart disease, arteriosclerosis, and joint and back problems was about 66%. Occupational shifts accounted for 29% of the decline; the decreased prevalence of infectious disease accounted for 18%; the remainder are unexplained. The duration of chronic conditions has remained unchanged since the early 1900s, but when disability is measured by difficulty in walking, men with chronic conditions are less disabled now than they were in the past.
This review of the epidemiological evidence regarding physical activity and cardiovascular disease (CVD) provides substantial evidence from many different populations that leisure time physical activity is associated with reduced risk of coronary heart disease (CHD) and cardiovascular mortality in both men and women and in middle-aged and older individuals. Physical activity appears to be a critical factor in both primary and secondary prevention of CHD. The studies indicate a dose-response relationship between overall physical activity and CVD, which is linear at least up to a certain level of activity. Prospective studies suggest that physical activity is also associated with reduced risk of stroke. The mechanisms underlying the protective effect of physical activity on CVD are still unclear. In recent years. the view that physical activity has to be vigorous to achieve a reduction in risk of CHD has been questioned. Overall, the evidence points to the benefit of continued regular moderate physical activity which does not need to be strenuous or prolonged and includes daily leisure activities such as walking or gardening which are readily attainable by large sections of the population. Taking up regular light or moderate physical activity in middle or older age confers significant benefit for CVD and all-cause mortality.
Several studies have shown socioeconomic differences in leisure-time physical activity. One explanation may be socioeconomic differences in relevant psychosocial conditions. The Malmö Diet and Cancer Study is a prospective cohort study including inhabitants in Malmö, Sweden. The baseline questionnaire used in this cross-sectional study was completed by the 11,837 participants born 1926-1945 in 1992-1994. Leisure-time physical activity was measured by an item presenting a variety of activities. These activities were aggregated into a summary measure of leisure-time physical activity that takes both the intensity and duration of each specific activity into consideration. The effects of the psychosocial variables on the socioeconomic differences in leisure-time physical activity were calculated in a multivariate logistic regression analysis. The quartile with the lowest degree of leisure-time physical activity was not evenly distributed between the socioeconomic groups. Socioeconomic differences were seen as odds ratios 1.5 for skilled and 1.5 for unskilled male manual workers, compared to the high level non-manual employees. An OR 1.6 was observed for female unskilled manual workers. Self-employed men and female pensioners also had a significantly increased risk of low leisure-time physical activity. Adjustment for age, country of origin and previous/current diseases had no effect on these SES differences. Finally, adjusting for social participation almost completely erased the SES differences. Among the psychosocial variables, social participation was the strongest predictor of low physical activity, and a strong predictor for socioeconomic differences in low leisure-time physical activity. Social participation measures the individual's social activities in, for example political parties and organisations. It therefore seems possible that some of the socioeconomic differences in leisure-time physical activity are due to differing social capital between socioeconomic groups.
This paper assesses the importance of early-life conditions relative to the prevailing conditions for mortality by cause of death in later life using historical data for four rural parishes in southern Sweden for which both demographic and economic data are very good. Longitudinal demographic data for individuals are combined with household socio-economic data and community data on food costs and the disease load using a Cox regression framework. We find strong support for the hypothesis that the disease load experienced during the first year of life has a strong impact on mortality in later life, in particular on the outcome of airborne infectious diseases. Hypotheses about the effects of the disease load on mothers during pregnancy and access to nutrition during the first years of life are not supported. Contemporary short-term economic stress on the elderly was generally of limited importance although mortality varied by socio-economic group.