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OBJECTIVES To document physical activity patterns and perceptions about active transport to school. METHODS Children's activity was measured. Children and parents were surveyed about active transport to school. RESULTS Children were most active after (465 ± 20 cpm) and least active before (379 ± 18 cpm) and during school (351 ± 13 cpm). Weight was not related to activity. Boys were more confident than girls, whereas parents felt more confident than children did about active transport. CONCLUSIONS Active transport programs will likely have a greater impact on before-school activity than after school. Perceptions concerning active transport should be assessed, and parent/child discrepancies rectified prior to program implementation.

The United States Department of Agriculture (USDA) describes a food desert as an urban neighborhood or rural town without ready access to fresh, healthy, and affordable food. An estimated 2.3 million rural Americans live in food deserts. One goal of the USDA is to eliminate food deserts. However, at a time when some food deserts are being eliminated, hundreds of grocery stores are closing, causing other food deserts to arise. The literature is scarce on how a community adapts to an impending food desert. Alderson, West Virginia, USA (population 1184) rallied to face an impending food desert when the only grocery store in town closed in December 2014. This study investigated how this small rural community adapted to its oncoming food desert.A community member survey was administered to 155 Alderson families (49%) to determine how the new food desert affected family food acquisition and storage behaviors. A restaurant survey was given to the town's four restaurants to determine how the food desert affected their businesses. Sales data for a new food hub (Green Grocer) was obtained to see if this new initiative offset the negative effects of the food desert. ANOVA andit/i-tests were used to compare group numerical data. Two group response rates were compared by testing the equality of two proportions. Categorical data were analyzed with the#967;2 or frequency distribution analysis. Group averages are reported as mean ± standard error of the mean. Significance for all analyses was set atip/i0.05.Even though 86% of the population shopped at the new Green Grocer, 77% did most of their shopping at a store at least 17.7 km (11 miles) from home. The number of long-distance monthly shopping trips made after the food desert (3.3±0.4) did not change significantly (ip/i=0.16) from the number before the food desert (2.8±0.3). Price comparisons among the Green Grocer and three distant supermarkets showed a 30% savings by traveling to distant supermarkets. Frequency of monthly restaurant visits did not change after the emergence of the food desert (2.98±0.54 vs 3.05±0.51,ip/i=0.85). However, restaurant patrons requested to buy fresh produce and dairy from the restaurants to use for their own home cooking. Food pantry use increased by 43%, with community members requesting more fresh produce, meat, and dairy. The food desert triggered a 21% increase in home gardening and an 11% increase in home food preservation.Opening a Green Grocer offset only some of the effects of the food desert, because community members use it as a convenience store to purchase fresh produce and dairy products that families may lack before their next long-distance trip to a supermarket. Alderson's low-income residents now rely more heavily on food pantry assistance, while a small number of other residents have started gardening and food preservation. The first factor governing food acquisition behavior in rural Appalachia is food pricing, with the proximity of food access coming in second. How to overcome these two major barriers to food security in the midst of current economics and marketing remains to be answered.

Introduction The United States Department of Agriculture (USDA) describes a food desert as an urban neighborhood or rural town without ready access to fresh, healthy, and affordable food. An estimated 2.3 million rural Americans live in food deserts. One goal of the USDA is to eliminate food deserts. However, at a time when some food deserts are being eliminated, hundreds of grocery stores are closing, causing other food deserts to arise. The literature is scarce on how a community adapts to an impending food desert. Alderson, West Virginia, USA (population 1184) rallied to face an impending food desert when the only grocery store in town closed in December 2014. This study investigated how this small rural community adapted to its oncoming food desert. Methods A community member survey was administered to 155 Alderson families (49%) to determine how the new food desert affected family food acquisition and storage behaviors. A restaurant survey was given to the town's four restaurants to determine how the food desert affected their businesses. Sales data for a new food hub (Green Grocer) was obtained to see if this new initiative offset the negative effects of the food desert. ANOVA and t-tests were used to compare group numerical data. Two group response rates were compared by testing the equality of two proportions. Categorical data were analyzed with the χ2 or frequency distribution analysis. Group averages are reported as mean ± standard error of the mean. Significance for all analyses was set at p Results Even though 86% of the population shopped at the new Green Grocer, 77% did most of their shopping at a store at least 17.7 km (11 miles) from home. The number of long-distance monthly shopping trips made after the food desert (3.3±0.4) did not change significantly (p=0.16) from the number before the food desert (2.8±0.3). Price comparisons among the Green Grocer and three distant supermarkets showed a 30% savings by traveling to distant supermarkets. Frequency of monthly restaurant visits did not change after the emergence of the food desert (2.98±0.54 vs 3.05±0.51, p=0.85). However, restaurant patrons requested to buy fresh produce and dairy from the restaurants to use for their own home cooking. Food pantry use increased by 43%, with community members requesting more fresh produce, meat, and dairy. The food desert triggered a 21% increase in home gardening and an 11% increase in home food preservation. Conclusions Opening a Green Grocer offset only some of the effects of the food desert, because community members use it as a convenience store to purchase fresh produce and dairy products that families may lack before their next long-distance trip to a supermarket. Alderson's low-income residents now rely more heavily on food pantry assistance, while a small number of other residents have started gardening and food preservation. The first factor governing food acquisition behavior in rural Appalachia is food pricing, with the proximity of food access coming in second. How to overcome these two major barriers to food security in the midst of current economics and marketing remains to be answered.

Background: Appalachia is one of the unhealthiest regions in the United States due to poor disease prevention behaviors. Objective: Determine if self-perceived health of rural Appalachians is related to participation in disease prevention behaviors. Methods: Rural Appalachian adults (n=437) were surveyed regarding their self-perceived health and disease prevention behaviors. Healthy behaviors included: moderate (? 90 min/wk) and vigorous (? 45 min/wk) physical activity, sugared drink consumption (? 1 sugared drink/d), smoking (non-smoker), alcohol consumption (? 1 drink/d), blood pressure (? 120/80 mm Hg), and fast food consumption (? 1 time/wk). Participants were grouped where healthy = (self-health rating > 5 on a 0-10 scale), BMI < 25, and blood pressure (? 120/80 mm Hg). Jaccard Binary Similarity (JBS) coefficients and Russell and Rao (RR) dichotomy coefficients determined the association and predictability of self-health ratings and disease prevention behaviors. T-tests determined group differences in the number of disease prevention behaviors. Results: Individuals who reported being healthy had high JBS coefficients for having healthy sugared drink consumption (0.552), not smoking (0.704), low alcohol consumption (0.742), and low fast food consumption (0.481). RR results were similar to JBS results. Not smoking and low alcohol consumption were highly correlated (r=0.87). Those with a good health perception practiced more disease prevention behaviors (meanSEM, 2.840.06) than those with a poor health perception (2.190.10, p

Objective Examine after-school activity patterns, eating behaviors, and social environment of overweight and normal weight middle school students. Design Eating and physical activity behaviors of 141 students, ages 10–14, were monitored. Students completed a diary documenting type of activity, location, adult supervision, accompanying participants, and eating habits from 3:00 pm–12:00 am. Setting Three middle schools, grades 6–8. Main Outcome Measures Body mass index, estimated energy expenditure, eating behavior, active time, sedentary time, supervised time. Analysis t tests, ANOVA, chi-square, correlation coefficients. Significance set at P Results Children spent 76% of time sedentary, and 85% of sedentary time was under adult supervision ( r = 0.76). Active time related to time with friends ( r = 0.64) and family ( r = 0.46). Children spent 40% of eating time consuming unhealthful food, and adults supervised 86% of children's eating. Overweight and normal weight children were similarly active (335 ± 156 vs 373 ± 194 counts per minute). Overweight girls spent more eating time (77%) eating healthfully than overweight boys (57%). Conclusions and Implications Children should be given access to healthful food and encouraged to eat healthfully when alone and with friends. Adults should be more physically engaged with children. Children should be encouraged to eat under adult supervision and with their families.

Objective To compare attitudes of overweight (OW) and normal weight (NW) adults regarding health club exercise. Design A 46-item survey (23 pairs of attitude/value statements) measured attitudes toward exercising at a health club 30 minutes, twice a week, for a month. Setting Survey posted on surveymonkey.com. Respondents (men = 730, women = 822). Main Outcome Measures Attitudes toward exercise, exercise intent. Analysis t tests, Mann-Whitney rank sum, 2-way analysis of variance, Pearson rank correlations. Significance set at P < .05. Results More than NW, OW believe exercise improves appearance (P < .001) and self image (P < .03). OW feel more embarrassed and intimidated about exercising, exercising around young people, exercising around fit people, and about health club salespeople than NW (P < .001). OW and NW feel the same about exercising with the opposite sex, complicated exercise equipment, exercise boredom, and intention to exercise. Age rather than weight affects exercise intent. OW Caucasians (C) have less exercise intent than OW non-C. OW women are more embarrassed about exercising than NW women and OW men. The heavier the subject's weight, the lower his or her perception of health (r = -0.53, P < .001). Conclusions and Implications Increasing the OW person's positive beliefs while decreasing negative beliefs about health club exercise will improve his or her intent to exercise at a health club.

Objective A quantitative method for evaluating weight loss using the body mass index (BMI) standard 25, during part or the entire weight loss continuum, was designed and tested. Design Weight Loss Index (WLI) represents the area under the curve of the graphical representation of the weight loss attempt; x-axis=time, y-axis=BMI, BMI standard=25.0. Setting Reliability of the WLI for 1-5 years of weight loss efforts in 50 overweight (BMI=39.1±7.6) patients was evaluated by comparing their calculated WLI to a weight loss ratio, derived using a traditional 2-point comparison. Weight Loss Index sensitivity was tested by sending weight loss scenarios to obesity experts, who were asked to rank success of each weight loss attempt within a scenario. Expert rankings were compared to WLI rankings. Variables Measured Age, weight, height, BMI, WLI. Analysis Dependent t-test for WLI versus pre-post BMI values. Spearman's correlation coefficients for WLI versus expert rankings. Significance, P Results Weight Loss Index better described weight loss attempts for overweight adults than did traditional 2-point comparisons. Obesity experts could not distinguish differences in weight loss success among patients with fluctuating weights, but the WLI categorically ranked these individuals. Conclusions and Implications Using the WLI, researchers and clinicians can compare the weight loss attempts within an individual, among individuals, and among groups of individuals against the standard BMI reference of 25.0.

The rate of cardiovascular diseases (CVD) mortality has decreased over the last few years. However, in rural areas, this reduction is less substantial compared to urban areas despite the effort to ...

Although scientists are supposed to be objective and unbiased, and science itself is held as the epitome of objectivity, scientists often force data to fit their preexisting paradigm or deny the existence of data that fall outside their paradigm. The Health At Every Size (HAES) paradigm lies outside the traditional obesity treatment paradigm. However, there are ample data to support the notion that people can be healthy at every size and that weight loss is not necessary for improved health. This article explains how each of us who remains surrounded by the weight-loss-at-any-cost environment can implement HAES practices into our work without additional investment of resources. Techniques are discussed as to how we can incorporate measures other than weight and size into our treatment outcomes, how we can be open-minded to research and clinical practices that are outside our preconceived notions of how things should be, how we can rid ourselves of the assumption that everyone responds to treatment in the same manner, how we can explore clients' feelings to discover the root of their behaviors, and how we can go beyond teaching clients how to behave and teach them how to change behavior.

Background. This paper presents reliability and validity analyses of physical activity-related psychosocial questionnaires completed by 8- to 10-year-old African-American girls at baseline and follow-up assessments of pilot intervention studies in the Girls health Enrichment Multi-site Study (GEMS). Methods. Two hundred ten girls participated in the GEMS 12-week pilot studies and had their height and weight measured, wore an accelerometer for 3 days and completed a measure of their usual physical activity (PA) at baseline and after the 12-week intervention. Subgroups of girls also completed physical activity-related psychosocial measures at these two time points including: (a) self-concept; (b) self-efficacy; (c) outcome expectancies; and d) preferences. Principal components analysis was conducted on the psychosocial measures obtained at baseline. Cronbach's alpha and test–retest reliability were computed. Convergent validity was assessed by correlating the baseline psychosocial measures with baseline physical activity measures and body mass index (BMI). Results. The following sub-scales were derived: Activity Preference, Positive Expectancies and Negative Expectancies for physical activity. Physical Performance Self-Concept and Self-Efficacy for physical activity were kept as single dimensional scales. Sub-scales, derived from principal components analyses, were Activity Preference, Positive Expectancies, and Negative Expectancies for physical activity. Internal consistency estimates for the various scales were substantial to excellent (0.67–0.85), while test–retest reliability estimates were fair to moderate (0.22–0.56). Correlations between the PA psychosocial sub-scales and measured levels of activity measures showed evidence of convergent validity for the Activity Preference sub-scale, although social desirability may have influenced the significant associations observed. Conclusions. The Activity Preference was a fairly reliable and valid measure. Further studies are needed to examine the utility of activity-related psychosocial measures in interventions to increase physical activity among preadolescent African-American girls.

The purpose of this investigation was to examine the accuracy of percent body fat (%BF) estimates obtained by air displacement plethysmography (ADP) using the BOD POD Body Composition System compared with hydrostatic weighing (HW) in a group of female college athletes (n = 80). In addition, %BF estimates by skinfold measures (SF) were also obtained for comparison. A lean subset (n = 39) of the sample was also examined. Mean %BF estimated for the entire sample by ADP (21.2 +/- 5.9%) was significantly greater than that determined by HW (19.4 +/- 6.4%) and SF (18.8 +/- 5.5%). Results from the lean subset also revealed that %BF determined by ADP (17.1 +/- 3.7%) was significantly higher than %BF estimates by HW (14.3 +/- 2.8%) and SF (15.2 +/- 3.2%). The regression equation for the entire sample (%BF HW = 0.937%BF ADP - 0.452, r(2) = 0.73, standard error of estimates (SEE) = 3.34) did not differ from the line of identity. In contrast, the line of identity differed significantly from the regression equation for the lean subset of female athletes (%BF HW = 0.48%BF ADP + 6.115, r(2) = 0.41, SEE = 2.18). The results of this investigation indicate that ADP significantly overestimated %BF by 8% in female athletes and by 16% for a leaner subset of the sample compared with HW. It appears that %BF estimates by SF may be more accurate than those obtained by ADP for female college athletes, regardless of body composition. Coaches and trainers evaluating body composition should consider the use of SF before ADP when measuring %BF in female college athletes. Sports scientists should continue to examine the possible gender and body composition bias for ADP.

Traditional diet and exercise treatments for obesity have been ineffective in reducing the prevalence of overweight in the population. Treatment outcomes for overweight can be measured in terms of physical parameters (e.g. bodyweight, percentage body fat, body mass index), medical terms (e.g. blood pressure, blood glucose control, blood lipid levels), psychological terms (e.g. eating pathology, self-esteem, mood state) and behavioural terms (e.g. frequency of exercise, eating patterns, self healthcare). Regardless of the specific outcome measures used to define successful treatment, the desired outcome must be maintained for several years to be considered effective. Energy restrictive diets cause significant initial bodyweight loss, but are plagued with high dropout- and relapse-rate. Low-fat diets have met with minimal success for bodyweight control, but nonetheless can significantly lower blood lipid levels. High-protein/low-carbohydrate diets are claimed to be the most effective in reducing bodyweight, but there are no scientific data to support these claims. Persons on these types of diets are also at the greatest risk for metabolic adverse effects. Nondieting approaches and programmes that stress 'health at any size' have not been researched rigorously, but preliminary data show minimal bodyweight loss with significant improvements in psychological state, eating pathology and well-being. Exercise is the only variable that consistently shows effectiveness in physiological, medical, psychological and behavioural outcomes. A treatment programme that has the greatest potential for success, regardless of outcome measure, is a programme that consists of 4 key components. These components are: (i) pre-evaluation, where historical information is gathered and used to set programme goals, objectives and outcome measures; (ii) exercise, wherein enjoyable exercise is encouraged for health, bodyweight control and well being; (iii) a behavioural plan, which is based on patterns of eating and activity that will lead to the desired outcome measures; and (iv) a maintenance plan, that helps the individual develop skills for maintaining newly developed behaviours.

Health care professionals have used restrictive dieting and exercise intervention strategies in an effort to combat the rising prevalence of obesity in affluent countries. In spite of these efforts, the prevalence of obesity continues to rise. This apparent ineffectiveness of diet and exercise programming to reduce obesity has caused many health care providers, obesity researchers, and lay persons to challenge the further use of diet and exercise for the sole purpose of reducing body weight in the obese. The purposes of this paper were to examine the history and effectiveness of diet and exercise in obesity therapy and to determine the best future approach for health promotion in the obese population. A brief survey of the most popular dieting techniques used over the past 40 yr shows that most techniques cycle in and out of popularity and that many of these techniques may be hazardous to health. Data from the scientific community indicate that a 15-wk diet or diet plus exercise program produces a weight loss of about 11 kg with a 60-80% maintenance after 1 yr. Although long-term follow-up data are meager, the data that do exist suggest almost complete relapse after 3-5 yr. The paucity of data provided by the weight-loss industry has been inadequate or inconclusive. Those who challenge the use of diet and exercise solely for weight control purposes base their position on the absence of weight-loss effectiveness data and on the presence of harmful effects of restrictive dieting. Any intervention strategy for the obese should be one that would promote the development of a healthy lifestyle. The outcome parameters used to evaluate the success of such an intervention should be specific to chronic disease risk and symptomatologies and not limited to medically ambiguous variables like body weight or body composition.

In this study we compared substrate use at submaximal intensities of a maximal graded exercise test (GXT) with that derived from equivalent intensities during continuous submaximal steady-state exercise in obese and normal-weight women. Sedentary obese (n = 20, body fat > 30%) and normal-weight (n = 15, body fat < or =30%) women performed three treadmill tests with concurrent metabolic measurements. Maximal oxygen consumption (VO2max) was determined using the Bruce protocol, followed by two, randomly assigned, continuous 15-min, steady-state exercise bouts, on different days; one bout at 50% and one bout at 75% VO2max. Analysis of variance revealed no significant differences between groups for blood lactate or respiratory exchange ratio (R) values at any point during exercise. Therefore, obese and normal-weight group data were combined for subsequent analyses. The R at 50% VO2max from the GXT [0.83 (0.01)] was significantly (P < 0.05) lower than at 8 min [0.90 (0.01)] and 15 min [0.89 (0.01)] of steady-state exercise, whereas at 75% VO2max, the GXT R [0.96 (0.01)] was similar to that seen at 8 min [0.96 (0.01)] and at 15 min of steady-state exercise [0.93 (0.01)]. Blood lactate values at 50% VO2max were similar between the GXT [1.66 (0.10) mM] and steady-state exercise [1.65 (0.09) mM], but at 75% VO2max the GXT blood lactate values [2.58 (0.21) mM] were lower than after 15 min of steady-state exercise [4.65 (0.46) mM]. Total exercise fat oxidation was greater at 50% compared to 75% VO2max. There was no difference in substrate use between sedentary obese and normal-weight women either at rest or during steady-state exercise at the same relative intensity. Total fat oxidation was greater during low- (50% VO2max) compared to high-intensity (75% VO2max) exercise. Data from a GXT cannot be used to predict R or substrate utilization values for the purpose of exercise prescription.

Health care professionals most often approach health promotion for large persons in the context that health improvement can be attained only through weight loss. Unequivocal acceptance of the notion that thinness equals health and fitness has been the only health intervention strategy available for many large men and women. The apparent ineffectiveness of traditional diet and exercise programming to reduce body weight has caused many health care providers, obesity researchers, and lay persons to challenge the further use of diet and exercise for the sole purpose of reducing body weight in the large person. A brief survey of the most popular dieting techniques used over the past 40 years shows that most techniques cycle in and out of popularity, and that many of these techniques are hazardous to health. Data from the scientific community indicate that diet and exercise programs for weight loss are ineffective in producing reduced weight maintenance after a period of 3 to 5 years. On the other hand, there are data indicating that overweight men and women can become healthy without losing significant amounts of weight. Furthermore, epidemiological studies indicate that fitness, not fatness, is related to disease and mortality. Any intervention strategy for the obese should be one that promotes the development of a healthy lifestyle. The outcome parameters used to evaluate the success of such an intervention should be specific to disease risk and symptomatologies and not limited to medically ambiguous variables like body weight or body composition.

The carotenoid crocetin has been shown to relieve the hypoxic condition caused by many diseases. Since hypoxia is also a limiting factor in endurance performance, this study evaluated the effect of crocetin administration on exercise endurance. Eleven treadmill trained rats were randomly divided into an experimental or control group. Sixty minutes prior to exhaustive exercise, the exercise group received a 0.3 mL intraperitoneal injection of 0.2 mg crocetin/kg body weight, and the control group received a placebo injection. The experimental group improved running time by 18± 3 minutes (t test, p ≤ 0.01) and showed a reduction in postexercise blood lactate concentration by 1.84 ± 0.52 mM (t test, p ≤0.01). The results demonstrate that crocetin increased exercise endurance and decreased blood lactate concentration in trained rats. The mechanism of action may be that, by increasing oxygen diffusion, crocetin enhanced aerobic production of adenosine triphosphate while reducing anaerobic adenosine triphosphate...

Background Appalachia is characterized by poor health behaviors, poor health status, and health disparities. Recent interventions have not demonstrated much success in improving health status or reducing health disparities in the Appalachian region. Since one's perception of personal health precedes his or her health behaviors, the purpose of this project was to evaluate the self-rated health of Appalachian adults in relation to objective health status and current health behaviors. Methods Appalachian adults (n = 1,576) were surveyed regarding health behaviors - soda consumer (drink ≥ 355 ml/d), or non-consumer (drink < 355 ml/d), fast food consumer (eating fast food ≥ 3 times/wk) or healthy food consumer (eating fast food < 3 times/wk), smoking (smoker or non-smoker), exercise (exerciser > 30 min > 1 d/wk) and sedentary (exercise < 30 min 1 d/wk), blood pressure medication (yes, no), and self-rated health. Blood pressure was measured through auscultation and serum cholesterol measured via needle prick. Weight status was based on BMI: normal weight (NW ≥ 18.5 and < 25.0), overweight (OW ≥ 25.0 and < 30.0), and obese (OB ≥ 30.0). Jaccard Binary Similarity coefficients, odds ratios, chi-square, and prevalence ratios were calculated to evaluate the relationships among self-rated health, objective health status, and health behaviors. Significance was set at p < 0.05. Results Respondents reported being healthy, while being sedentary (65%), hypertensive (76%), overweight (73%), or hyperlipidemic (79%). Between 57% and 66% of the respondents who considered themselves healthy had at least two disease conditions or poor health behaviors. Jaccard Binary Similarity coefficients and odds ratios showed the probability of reporting being healthy when having a disease condition or poor health behavior was high. Conclusions The association between self-rated health and poor health indicators in Appalachian adults is distorted. The public health challenge is to formulate messages and programs about health and health needs which take into account the current distortion about health in Appalachia and the cultural context in which this distortion was shaped.

Purpose: Only a small fraction of overweight people get enough exercise to improve health. club environment may cause the overweight person to have low perceived control and low self The objectives of this study were to determine the perceived behavioral control and self weight (NW) adults have toward health club exercise and what individual factors affect their perceived control and self Method: A 17-item survey measured perceived behavioral control, self health club 30 min, twice a week, for the next month, in overweight (OW, n=1159) and normal weight (NW, n=550) adults. ANOVA, t-tests, Mann-Whitney Rank Sum, and correlation coefficients were used for analysis. Results: NW adults have higher overall self ability to exercise, having what is necessary related to perceived control (r=0.56) and self demands or stressful life changes. Conclusions provide support and skills for overcoming these barriers. INTRODUCTION It is well recognized that regular physical activity and associated with the co-morbidities of being overweight. reduced weight maintenance for the previously overweight. themselves recognize the importance of exercise in weight control. reported the reason they regained weight is because they stopped In spite of the acceptance of exercise as the antidote for being overweight, only a small fraction of the overweight population gets enough physical activity to reap any health benefits Health guidelines for exercise and less than one in five trying to lose weight meet the Institute of Medicine exercise recommendations.4 On the other hand, 97% of overweight individuals affirm that they would be 6 days/week (d/wk) in order to lose weight.2 The conflict between what the overweight person perceives as correct (to exercise) and how the overweight person behaves (not exercise) is called ambivalence.5 Health-related ambivalence makes it psychologically difficult to Vol. 9 o. 2 ISS 1540-580X -Efficacy of Overweight and Wayne C. Miller, PhD1 Todd A. Miller, PhD2

Theobromine ingestion (100 mg/kg body weight) did not affect resting plasma fatty acid concentration in untrained rats, whereas fatty acid concentration was higher (p ≤0.001) following exhaustive treadmill exercise in the theobromine group (0.67 ± 0.08 mM, mean ± SEM) than in the controls (0.31 ± 0.10 mM). Run time to exhaustion was also greater (p ≤0.02) for the theobromine rats (44.0 ± 6.9 min) compared with control animals (27.5 ± 3.5 min). Liver glycogen utilization rate was lower (p ≤0.05) for the theobromine animals than the controls (4.58 ± 0.46 vs. 6.75 ± 0.92 μmol/g/min, respectively), as was soleus muscle glycogen use (p ≤0.03; 0.40 ± 0.04 vs. 0.53 ± 0.04 μmol/g/min, respectively). This suggests that theobromine increases exercise performance by reducing glycogen use and enhancing free fatty acid availability to the working muscle.

Objective To determine the social pressure overweight (OW, n=1183) and normal-weight (NW, n=550) adults perceive regarding health club exercise. Methods A 12-item survey, based on the theory of reasoned action and theory of planned behavior, measured subjective norm toward exercising at a health club 30 min, twice a week, for the next month. Results OW feel more social pressure to exercise at a club than do NW, but motivation to comply is the same between groups. Conclusions Exercise interventions for OW should capitalize on individual perceived social pressures to exercise by designing strategies to increase motivation to comply with these pressures.

In addition to aerobic endurance and anaerobic capacity, high power-to-weight ratio (PWR) is important for cycling performance. Cyclists often try to lose weight before race season to improve body composition and optimize PWR. Research has demonstrated body fat-reducing benefits of exercise after fasting overnight. We hypothesized that fasted-state exercise in calorie-restricted trained cyclists would not result in performance decrements and that their PWR would improve significantly. We also hypothesized that substrate use during fasted-state submaximal endurance cycling would shift to greater reliance on fat. Ten trained, competitive cyclists completed a protocol consisting of baseline testing, 3 weeks of caloric restriction (CR), and post-CR testing. The testing sessions measured pre- and post-CR values for resting metabolic rate (RMR), body composition, VO2, PWR and power-to-lean weight ratio (PLWR), and power output, as well as 2-hour submaximal cycling performance, rating of perceived exertion (RPE), and respiratory exchange ratio (RER). There were no significant differences between baseline and post-CR for submaximal trial RER, power output, VO2, RMR, VO2max, or workload at VO2max. However, RPE was significantly lower, and PWR was significantly higher post-CR, whereas RER did not change. The cyclists' PWR and body composition improved significantly, and their overall weight, fat weight, and body fat percentage decreased. Lean mass was maintained. The cyclists' RPE decreased significantly during 2 hours of submaximal cycling post-CR, and there was no decrement in submaximal or maximal cycling performance after 3 weeks of CR combined with overnight fasting. Caloric restriction (up to 40% for 3 weeks) and exercising after fasting overnight can improve a cyclist's PWR without compromising endurance cycling performance.

Background: Limited support for healthcare services is one reason rural Appalachia is among the unhealthiest regions in the United States.Objective: Evaluate Level 1 of a multi-level community health worker (CHW) training program designed to train CHWs easily so they can affect community health.Methods: 198 CHWs evaluated their training curriculum. CHW activities were tracked for 19 months. Group data were analyzed with t-tests and ANOVA using mean ± SEM comparisons. Correlation coefficients and rank sum difference analyses were used to evaluate ranked variables. Statistical significance was set at p

To determine vasodilatory responsiveness we measured forearm blood flow (FBF) following reactive hyperemia (RH), prior to and following a bout of maximal aerobic exercise in endurance- (n=14) and resistance-trained men (n=10). Both groups were similar in height, body mass, and percentage body fat. Using strain-gauge plethysmography, resting FBF was higher in the resistance-trained group [4.82 (0.84) vs 3.33 (1.17) ml min−1 100 ml−1 of tissue; P

The purpose of this investigation was to quantify the effects of different attire on the accuracy and reliability of estimating percent body fat (%fat) by using air displacement plethysmography (ADP).Fifteen adults were tested four times on four separate occasions. Each session consisted of estimating %fat with ADP wearing a swimsuit (ADP(SS)), a hospital gown (ADP(HG)), and in the nude (ADP(N)), plus assessment by hydrostatic weighing (HW).An ANOVA revealed no significant differences within any of the four methods over the 4 days. Intraclass correlation coefficients revealed a strong relationship for repeated measures in ADP(SS) (r = 0.981), ADP(HG) (r = 0.993), ADP(N) (r = 0.989), and HW (r = 0.976). Mean data for each condition indicated a significant underestimation (P0.05) of %fat while wearing a hospital gown (13.8 +/- 7.7%) compared with ADP(SS) (22.0 +/- 7.8%), ADP(N) (23.5 +/- 7.5%), and HW (22.6 +/- 6.8%).Reliability of ADP does not appear to be compromised by clothing; however, wearing a hospital gown significantly affects accuracy, reducing %fat estimations by approximately 9% compared with the recommended swimsuit. Measurement in the nude does not provide more reliable or accurate measures than wearing a swimsuit.

The primary purpose of this investigation was to compare estimations of percentage body fat (%fat) using air displacement plethysmography (ADP) and hydrostatic weighing (HW) in a heterogeneous (age and %fat) sample of the population. Of secondary importance was to determine whether there were differences between the two methods among lean (n = 32), average (n = 34) and overweight (n = 29) subsets of this sample. A total of 95 adults (men 27, women 68) ranging in age from 18-52 years volunteered for this study. Test-retest reliability for %fat ADP (n = 16) was 0.99 with a technical error of 0.75%fat and a coefficient of variation of 3.4%fat. Mean body density using ADP [1.048 (SD 0.016) g.ml-1] was not significantly different when compared to HW [1.049 (SD 0.017) g.ml-1], which corresponded to a non-significant difference in %fat [22.5 (SD 7.3)% ADP compared to 22.0 (SD 7.6)% HW]. Regression analysis provided the equation: %fat HW = 0.9121%fat ADP + 1.5123; r = 0.88, SEE = 3.6, which did not differ significantly from the line of identity. Data for the subsets revealed a significant overestimation of %fat ADP [16.4 (SD 4.8)%] compared to HW [14.1 (SD 3.2)%] (P = 0.001) for lean individuals while no difference was found in the average [21.9 (SD 4.4)%fat ADP compared to 22.0 (SD 3.4)%fat HW] or overweight [29.9 (SD 5.5)%fat ADP compared to 30.8 (SD 4.1)%fat HW] subsets. Measuring %fat by ADP is a highly reliable method and valid when compared to HW for a heterogeneous sample of adults. The ADP method requires little expertise to operate, is quick to perform, and may be more accommodating for certain individuals compared to HW. However, in this study ADP was less valid for lean individuals. Further investigation is warranted to determine the bias of this method for subsets of the population which may be outside the average range of %fat (men 15.4%-22.0%, women 18.4%-28.5%).

Health and fitness professionals most often approach health care for large people in the context that health improvement can only be attained through weight loss. Unequivocal acceptance of the notion that thinness equals health and fitness presents an obstacle for large people who want to improve their health through lifestyle changes in eating and activity patterns and also weakens the working relationship between the health care professional and the large client. Since the health benefits of exercise and sound nutrition are significant for people of all sizes, the strategy for health care professionals should be to assist people of all sizes in eating healthier and becoming more active. Because large people face even more barriers to exercise than smaller people, we address the special needs of large people trying to become more physically active, outline an approach sensitive to their needs, and suggest how health and fitness professionals can improve their effectiveness with this population.

Previously established normative data for muscular strength, endurance and the flexibility of women have recently been criticized as being unreliable. Furthermore, no normative data for the muscular fitness of women over 70 years of age are established. The purpose of this study was to derive normative data for muscular fitness in women 20-70+ years old, and to compare these data to the most recently published norms of the American College of Sports Medicine (ACSM). A total of 304 independent-living women were evaluated for maximal performance of bench press, leg press, modified push-ups, grip strength, and sit-and-reach. Tables of normative values for each measurement were generated along with percentile rankings. Large discrepancies were found between these new data and those of the ACSM norms. Bench press norms from ACSM are comparatively high so that the average woman in this current sample scored below the 10th percentile of the ACSM rankings. Similarly, the average woman in our sample ranked in either the poor or fair category of the ACSM norms for modified push-ups, and in the poor ACSM category for sit-and-reach. In contrast, leg press scores for the average woman in this study fell within the good or excellent category of the ACSM norms, suggesting that the ACSM norms are too low. Grip strength for the middle-aged women in this study was higher than that in previous norms. These newly established norms are better suited for interpreting women's fitness test results than previously published norms.

The purpose of this research was to derive and compare regression equations for predicting residual volume (RV) in overweight and normal weight adults.RV was determined on land, in 311 men and women, following an overnight fast, using the nitrogen-dilution technique. Subjects were then weighed underwater at RV; 5-10 underwater weights were recorded; and the heaviest 3 measurements were averaged as the underwater weight. Percent body fat was calculated using the Siri equation. Group analyses were performed on overweight men (N = 59, body fat25%) and women (N = 126, body fat30%) compared with normal weight men (N = 68, body fator = 25%) and women (N = 58, body fator = 30%). A stepwise regression was performed for each group using the Systat Statistical Package (Evanston, IL).When RV was regressed on sex, age (yr), body weight (kg), and height (cm), sex was not found to be a significant predictor variable for RV. Subsequent regressions revealed that prediction equations for the overweight (RV = 0.0277 AGE + 0.0048 WT + 0.0138 HT - 2.3967, F = 44.0, P0.0000, SEE = 0.403) were different from those generated for normal weight men and women (RV = 0.0275 AGE + 0.0189 HT - 2.6139, F = 58.6, P0.0000, SEE = 0.405). Similar equations were obtained when a cross validation was performed on a separate sample of normal weight (N = 31) and overweight (N = 46) men and women.These data suggest that prediction equations for RV are separate and distinct for the overweight and normal weight populations.

To study how diet composition affects exercise endurance and body composition, 48 male Sprague-Dawley rats were treadmill trained for 8 wk while consuming either a high-fat (F) diet or high-carbohydrate (C) diet. The diets were switched for one-half the number of rats in each group 3 days before the animals were killed, during which feeding time the rats did not exercise. One-half of rats receiving each of the four diet combinations were taken at rest (R) or exhaustion (E), resulting in eight groups: CCR, CFR, FFR, FCR, CCE CFE, FFE, and FCE. An analysis of variance revealed that resting glycogen in the FCR group was enhanced in muscle (19-33%) and liver (23%) compared with controls. Each F group's exercise time to exhaustion [CFE, 322.9 +/- 25.0; FFE, 356.8 +/- 37.8; FCE, 467.0 +/- 32.6 (SE) min] was different (P < 0.05) from control (CCE, 257.5 +/- 29.2 min). Postexercise glycogen was equivalent among all dietary groups, were muscle triglycerides. The FF and FC groups had higher 3-hydroxyacyl-CoA dehydrogenase activity in soleus muscle than either CC or CF animals. After training, body weights were similar between the two dietary groups; however, percent body fat was 17% greater after the F diet, even though F diet animals voluntarily consumed 12% less energy than did C diet animals. These data suggest that exercise endurance time is optimized in trained rats that receive a carbohydrate load after adaptation to a F diet. However, despite intense exercise training, the F diet promotes body fat deposition, and the health consequences of following such a regimen are still unknown.

An evaluation instrument called the diabetes self-management record has been developed to better document the positive behavioral changes associated with diabetes education programming. This record is a simple behavior monitoring system that awards points for positive behaviors associated with exercise, glucose monitoring, and nutrition management. A group of 39 adults with diabetes monitored their behaviors with the record prior to, immediately after; and 4 to 6 weeks following a diabetes education programming course. Overall diabetes management scores were higher (mean ± SEM=56.2 ± 3.5 vs 66.3 ± 2.9) following the educational intervention, as well as specific behavioral scores for exercise, glucose monitoring, fat consumption, refined sugar/carbohydrate consumption, and eating behavior. These behaviors were maintained for at least 4 to 6 weeks postprogramming. The diabetes self-management record can be used as an adjunct to diabetes education programming, as an evaluator of the educational intervention, and/or as a behavior monitoring tool for diabetes self-management.

Objective This study was conducted to determine the relationships among the specific components of dietary fat and carbohydrate and body fatness in lean and obese adults. Design Body composition determination was performed on each subject by hydrostatic weighing at residual volume. Subsequently, the individual components of dietary fat and carbohydrate were examined relative to body fatness using a 3-day food diary and a food frequency questionnaire. Subjects Subjects were 23 lean (11.1±2.9% body fat) men, 23 obese (29.2±3.8% body fat) men, 17 lean (16.7±3.3% body fat) women, and 15 obese (42.7±3.9% body fat) women who volunteered for free diet and body composition analyses. Inclusion criteria were 15% body fat for lean men, 25% for obese men, 20% for lean women, and 35% for obese women. Statistical analysis performed Group comparisons for dietary variables were made with a multivariate analysis of variance. Results No differences were found between lean and obese subjects for energy intake or total sugar intake, but obese subjects derived a greater of their energy from fat (33.1±2.6% and 36.3±2.3% for obese men and women, respectively, vs 29.1±1.3% and 29.6±2.0%, lean men and women, respectively). Percent of fat intake for saturated, monounsaturated, and polyunsaturated fats was not different among groups. Obese subjects derived a greater percentage of their sugar intake from added sugars than lean subjects (38.0±3.5% vs 25.2±2.0%, respectively, for men; 47.9±8.0% vs 31.4±3.4%, respectively, for women). Dietary fiber was lower for obese men (20.9±1.8 g) and women (15.7±1.1 g) than for lean men (27.0±1.8 g) and women (22.7±2.1 g). Applications/conclusions Obesity is maintained primarily by a diet that is high in fat and added sugar and relatively low in fiber. Alterations in diet composition rather than energy intake may be a weight control strategy for overweight adults.

A literature review identified 29 anthropometric methods to estimate body fat distribution, but no valid standardized set of criterion values to categorize upper and lower body obesity. The purpose of this investigation was to observe the influence of different anthropometric methods for categorizing upper and lower body obesity. Three common girth methods (waist:iliac crest, iliac crest: hip, and waist:hip) for waist to hip ratios (WHR) and one common skinfold method for trunk to extremity ratio were compared in 119 obese women (38.4 ± 5.3% fat) and 81 obese men (31.3 ± 5.2% fat). Significant differences were found in the WHR among all three girth methods for women, but for only the waist:hip method for men. A significant interaction between method and sex was also apparent. The different WHR methods resulted in a significantly different percentages of the population categorized as having lower, normal, and upper body obesity. Kappa statistics demonstrated significant agreement among the three methods to place subjects into similar fat distribution categories for men (κ = 0.133; z = 4.03), but not for women (κ = 0.059; z = 2.20). There was also no significant correlation between any of the circumference and skinfold methods for men (r = 0.20, 0.10 and 0.15, respectively); yet, significant correlations were found between the iliac crest:hip (r = 0.30) and waist:hip (r = 0.45) methods and the skinfold method for women. In summary, girth methods for estimating body fat distribution in terms of lower and upper body obesity need validation and standardization. © 1994 Wiley-Liss, Inc.

This study examined the relationships among body fat, diet composition, energy intake, and exercise in adults. Male (n = 107) and female (n = 109) adults aged 18-71 y (36.6 +/- 1.0 y, means +/- SEM) were hydrostatically weighed to determine body fat (5.7-49.0% of total weight). Diet and exercise behaviors were determined by use of a questionnaire. As body fat increased, percent of energy intake derived from fat increased (p less than 0.001) whereas the percent from carbohydrate decreased (p less than 0.001). There was no relationship between energy intake and adiposity although leanness and exercise were related (p less than 0.001). When subgroups of lean and obese subjects were compared, the lean subjects derived approximately 29% of their energy from fat and 53% from carbohydrate vs 35% and 46%, respectively, for the obese subjects. No differences were found between groups for energy intake but the lean individuals exercised more often than did the obese individuals. These data suggest that diet composition may play as important a role in fat deposition as do energy intake and lack of exercise.

We performed a randomized exercise training study to assess the effects of traditional Nautilus-style (TR) or superslow (SS) strength training on muscular strength, body composition, aerobic capacity, and cardiovascular endurance. Subjects were 14 healthy, sedentary women, 19-45 years of age (mean +/- SD age, 32.7 +/- 8.9 years), randomized to either the SS or TR training protocols and trained 3 times per week for 10 weeks. Measurements were taken both before and after training, which included a maximal incremental exercise test on a cycle ergometer, body composition, and 1 repetition maximum (1RM) tests on 8 Nautilus machines. Both groups increased their strength significantly on all 8 exercises, whereas the TR group increased significantly more than the SS group on bench press (34% vs. 11%), torso arm (anterior lateral pull-down) (27% vs. 12%), leg press (33% vs. 7%), leg extension (56% vs. 24%), and leg curl (40% vs. 15%). Thus, the TR group's improvement in total exercise weight lifted was significantly greater than that of the SS group after testing (39% vs. 15%). Exercise duration on the cycle ergometer and work rate significantly improved for both groups, but there was no group-by-training interaction. No significant differences were found for body composition or additional aerobic variables measured. Both strength training protocols produced a significant improvement in strength during a 10-week training period, but the TR protocol produced better gains in the absence of changes in percentage of body fat, body mass index, lean body mass, and body weight. In addition, strength training alone did not improve Vo2max, yet short-term endurance increased.