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Comparison in outcomes at two-years of age of very preterm infants born in 2000, 2005 and 2010.
Abily-Donval, L, Pinto-Cardoso, G, Chadie, A, Guerrot, AM, Torre, S, Rondeau, S, Marret, S, ,
PloS one. 2015;(2):e0114567
Abstract
OBJECTIVE To investigate alteration in 2-year neurological/behavioral outcomes of very preterm infants born in a French level three neonatal intensive care unit. METHODS We conducted a prospective, comparative study of very preterm infants born before 33 weeks' gestation at 5-year intervals in 2000, 2005 and 2010 at Rouen University Hospital. Neonatal mortality/morbidities, ante- and neonatal treatments, and at age 2 years motor, cognitive and behavioral data were collected by standardized questionnaires. RESULTS We included 536 very preterm infants. Follow-up rates at two years old were 78% in 2000, 93% in 2005 and 92% in 2010 respectively. No difference in gestational age, birthweight, neonatal mortality/morbidities was observed except a decrease in low grade subependymal/intraventricular hemorrhages. Care modifications concerned use of antenatal magnesium sulfate, breast-feeding and post-natal corticosteroid therapy. Significant improvement in motor outcome and dramatic decrease in cerebral palsy rates (12% in 2000, 6% in 2005, 1% in 2010, p<0.001) were observed, as were improvements in feeding behavior. Although a non significant difference to better psychosocial behavior was reported, there was no difference in cognitive outcome. CONCLUSIONS Improvement in neuromotor outcome and behavior was reported. This could be due to multiple modifications in care: including administration of magnesium sulfate to women at risk of preterm birth, increase in breast-feeding, decrease in low grade subependymal/intraventricular hemorrhages, and decrease in post-natal corticosteroid therapy, all of which require further investigation in other studies. Extended follow-up until school age is mandatory for better detection of cognitive, learning and behavioral disorders.
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Short-term weight loss with diet and physical activity in young adults: The IDEA study.
Jakicic, JM, King, WC, Marcus, MD, Davis, KK, Helsel, D, Rickman, AD, Gibbs, BB, Rogers, RJ, Wahed, A, Belle, SH
Obesity (Silver Spring, Md.). 2015;(12):2385-97
Abstract
OBJECTIVE This study examined the effect of a behavioral weight loss intervention (BWLI) on young adults (age = 18-35 years). METHODS Participants (N = 470) enrolled in a 6-month BWLI that included weekly group sessions, a prescribed energy-restricted diet, and moderate to vigorous physical activity (MVPA). Assessments included weight, body composition, fitness, lipids, glucose, insulin, resting blood pressure and heart rate, physical activity, and dietary intake. Data are presented as median [25th, 75th percentiles]. RESULTS Retention was 90% (N = 424; age: 30.9 [27.8, 33.7] years; BMI: 31.2 [28.4, 34.3] kg m(-2) ). Participants completed 87.5% [76.1%, 95.5%] of scheduled intervention contacts. Weight and body fat decreased while fitness increased (P < 0.0001). MVPA in bouts ≥10 min increased (P < 0.0001), though total MVPA did not change significantly. Sedentary time decreased (P = 0.03). Energy and percent fat intake decreased, while percent carbohydrate and protein intake increased (P < 0.0001). Systolic and diastolic blood pressure, total cholesterol, LDL cholesterol, triglycerides, glucose, and insulin decreased (P < 0.0001). CONCLUSIONS A 6-month BWLI produced favorable changes in dietary intake and physical activity and elicited favorable changes in weight and other health outcomes in young adults. MVPA performed in bouts of ≥10 min was associated with greater weight loss, but sedentary behavior was not.
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Functional Impairments Mediate Association Between Clinical Fracture Risk and Type 2 Diabetes Mellitus in Older Women.
Lee, RH, Pieper, CF, Colón-Emeric, C
Journal of the American Geriatrics Society. 2015;(8):1546-51
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Abstract
OBJECTIVES To examine the effect of functional impairments in older women with diabetes mellitus (DM) on incident clinical fractures. DESIGN Secondary analysis of two large prospective cohort studies. SETTING North Carolina Established Populations for Epidemiologic Studies of the Elderly (EPESE) and Women's Health Initiative (WHI) clinical trials. PARTICIPANTS EPESE included 2,704 community-dwelling women aged 65 and older; WHI clinical trials included 68,125 postmenopausal women. MEASUREMENTS Women with DM at baseline were compared with women without in successive Cox proportional hazards models. Functional limitations were determined according to self-reported difficulties with activities of daily living (ADLs) and physical activities. RESULTS The risk of any clinical fracture during the study period was greater in women with DM, after controlling for age, race and ethnicity, and body mass index, in the EPESE (hazard ratio (HR) = 1.36, 95% confidence interval (CI) = 1.08-1.72) and WHI (HR = 1.29, 95% CI = 1.19-1.39) cohorts. After inclusion of functional limitations, the greater risk of fracture associated with DM decreased in the EPESE (HR = 1.25, 95% CI = 0.98-1.59) and WHI (HR = 1.21, 95% CI = 1.12-1.31) cohorts. In participants with DM, difficulties with moderate physical activities, such as bending or stooping, walking several blocks, and heavy housework, were significantly associated with incident fracture (P < .05). CONCLUSION Older women with DM are at greater risk of clinical fractures than those without, independent of bone mineral density. Greater functional impairment in moderate physical activities mediates this greater fracture risk in part, although there remains an unexplained residual DM-associated risk for fracture.
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The longitudinal effects of physical activity and dietary calcium on bone mass accrual across stages of pubertal development.
Lappe, JM, Watson, P, Gilsanz, V, Hangartner, T, Kalkwarf, HJ, Oberfield, S, Shepherd, J, Winer, KK, Zemel, B
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. 2015;(1):156-64
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Childhood and adolescence are critical periods of bone mineral content (BMC) accrual that may have long-term consequences for osteoporosis in adulthood. Adequate dietary calcium intake and weight-bearing physical activity are important for maximizing BMC accrual. However, the relative effects of physical activity and dietary calcium on BMC accrual throughout the continuum of pubertal development in childhood remains unclear. The purpose of this study was to determine the effects of self-reported dietary calcium intake and weight-bearing physical activity on bone mass accrual across the five stages of pubertal development in a large, diverse cohort of US children and adolescents. The Bone Mineral Density in Childhood study was a mixed longitudinal study with 7393 observations on 1743 subjects. Annually, we measured BMC by dual-energy X-ray absorptiometry (DXA), physical activity and calcium intake by questionnaire, and pubertal development (Tanner stage) by examination for up to 7 years. Mixed-effects regression models were used to assess physical activity and calcium intake effects on BMC accrual at each Tanner stage. We found that self-reported weight-bearing physical activity contributed to significantly greater BMC accrual in both sexes and racial subgroups (black and nonblack). In nonblack males, the magnitude of the activity effect on total body BMC accrual varied among Tanner stages after adjustment for calcium intake; the greatest difference between high- and low-activity boys was in Tanner stage 3. Calcium intake had a significant effect on bone accrual only in nonblack girls. This effect was not significantly different among Tanner stages. Our findings do not support differential effects of physical activity or calcium intake on bone mass accrual according to maturational stage. The study demonstrated significant longitudinal effects of weight-bearing physical activity on bone mass accrual through all stages of pubertal development.
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Associations of physical activity and sedentary behavior with academic skills--a follow-up study among primary school children.
Haapala, EA, Poikkeus, AM, Kukkonen-Harjula, K, Tompuri, T, Lintu, N, Väistö, J, Leppänen, PH, Laaksonen, DE, Lindi, V, Lakka, TA
PloS one. 2014;(9):e107031
Abstract
BACKGROUND There are no prospective studies that would have compared the relationships of different types of physical activity (PA) and sedentary behavior (SB) with academic skills among children. We therefore investigated the associations of different types of PA and SB with reading and arithmetic skills in a follow-up study among children. METHODS The participants were 186 children (107 boys, 79 girls, 6-8 yr) who were followed-up in Grades 1-3. PA and SB were assessed using a questionnaire in Grade 1. Reading fluency, reading comprehension and arithmetic skills were assessed using standardized tests at the end of Grades 1-3. RESULTS Among all children more recess PA and more time spent in SB related to academic skills were associated with a better reading fluency across Grades 1-3. In boys, higher levels of total PA, physically active school transportation and more time spent in SB related to academic skills were associated with a better reading fluency across the Grades 1-3. Among girls, higher levels of total PA were related to worse arithmetic skills across Grades 1-3. Moreover, total PA was directly associated with reading fluency and arithmetic skills in Grades 1-3 among girls whose parents had a university degree, whereas these relationships were inverse in girls of less educated parents. CONCLUSIONS Total PA, physically active school transportation and SB related to academic skills may be beneficial for the development of reading skills in boys, whereas factors that are independent of PA or SB may be more important for academic skills in girls. TRIAL REGISTRATION ClinicalTrials.gov: NCT01803776.
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Two strategies for response to 14 °C cold-water immersion: is there a difference in the response of motor, cognitive, immune and stress markers?
Brazaitis, M, Eimantas, N, Daniuseviciute, L, Mickeviciene, D, Steponaviciute, R, Skurvydas, A
PloS one. 2014;(9):e109020
Abstract
Here, we address the question of why some people have a greater chance of surviving and/or better resistance to cold-related-injuries in prolonged exposure to acute cold environments than do others, despite similar physical characteristics. The main aim of this study was to compare physiological and psychological reactions between people who exhibited fast cooling (FC; n = 20) or slow cooling (SC; n = 20) responses to cold water immersion. Individuals in whom the T(re) decreased to a set point of 35.5 °C before the end of the 170-min cooling time were indicated as the FC group; individuals in whom the T(re) did not decrease to the set point of 35.5 °C before the end of the 170-min cooling time were classified as the SC group. Cold stress was induced using intermittent immersion in bath water at 14 °C. Motor (spinal and supraspinal reflexes, voluntary and electrically induced skeletal muscle contraction force) and cognitive (executive function, short term memory, short term spatial recognition) performance, immune variables (neutrophils, leucocytes, lymphocytes, monocytes, IL-6, TNF-α), markers of hypothalamic-pituitary-adrenal axis activity (cortisol, corticosterone) and autonomic nervous system activity (epinephrine, norepinephrine) were monitored. The data obtained in this study suggest that the response of the FC group to cooling vs the SC group response was more likely an insulative-hypothermic response and that the SC vs the FC group displayed a metabolic-insulative response. The observations that an exposure time to 14 °C cold water--which was nearly twice as short (96-min vs 170-min) with a greater rectal temperature decrease (35.5 °C vs 36.2 °C) in the FC group compared with the SC group--induces similar responses of motor, cognitive, and blood stress markers were novel. The most important finding is that subjects with a lower cold-strain-index (SC group) showed stimulation of some markers of innate immunity and suppression of markers of specific immunity.
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Dietary prescription adherence and non-structured physical activity following weight loss with and without aerobic exercise.
Serra, MC, Treuth, MS, Ryan, AS
The journal of nutrition, health & aging. 2014;(10):888-93
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OBJECTIVES To compare the effects of weight loss with and without exercise on 1) dietary prescription adherence and 2) non-structured activity in postmenopausal women. DESIGN Longitudinal study. SETTING Clinical research setting with facility based exercise and nutrition education. PARTICIPANTS Overweight and obese women, 45-76 years old. INTERVENTION 6 months of weight loss alone (WL; N=38) or with aerobic exercise (AEX+WL; N=41). MEASUREMENTS Cardiorespiratory fitness (VO2max), resting metabolic rate (RMR), seven day food intake, and physical activity (by Actical accelerometers worn in a subset subgroup: WL: N=10; AEX+WL: N=15) were assessed before and after the interventions. RESULTS Both interventions resulted in similar weight loss (~9%) and no significant changes in RMR, while only the AEX+WL group improved VO2max (~10%). At baseline, the AEX+WL group consumed slightly more protein than the WL group (P<0.01). Macronutrient intake did not change following AEX+WL, but the WL group decreased their fat intake and increased their carbohydrates and protein intakes (Ps<0.05), which resulted in similar macronutrient intakes between groups post-intervention. Weekday total activity counts decreased 22% (P<0.05) following WL. This change tended (P=0.07) to be different than the lack of change in non-structured activity observed following AEX+WL. CONCLUSION Although similar dietary adherence was observed, these data suggest that postmenopausal women undergoing weight loss may benefit from the addition of exercise to prevent the decline in non-structured activity observed following weight loss alone.
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Activity related energy expenditure, appetite and energy intake: potential implications for weight management.
Harrington, DM, Martin, CK, Ravussin, E, Katzmarzyk, PT
Appetite. 2013;:1-7
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The aim was to investigate relationships between activity related energy expenditure (AREE), appetite ratings and energy intake (EI) in a sample of 40 male (26.4years; BMI 23.5kg/m(2)) and 42 female (26.9years; BMI 22.4kg/m(2)) participants. AREE was expressed as the residual value of the regression between total daily EE (by doubly labeled water) and resting EE (by indirect calorimetry). EI was measured using an ad libitum buffet meal and visual analogue scales measured subjective appetite ratings before and after the meal. AREE was divided into low, middle and high sex-specific tertiles. General linear models were used to investigate differences in appetite ratings and EI across AREE tertiles. Before the meal, males in the high AREE tertile had significantly lower desire to eat and lower prospective food consumption and higher feelings of fullness compared to those in the low tertile. Males in the middle tertile had significantly higher satiety quotients after the meal and lower EI compared to the other tertiles. No significant differences across tertiles were found in females. Sex differences in relationships between AREE, appetite ratings and EI may lead to differing patterns of EI and subsequent weight maintenance.
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Physical activity versus sedentary behavior: associations with lipoprotein particle subclass concentrations in healthy adults.
Aadland, E, Andersen, JR, Anderssen, SA, Kvalheim, OM
PloS one. 2013;(12):e85223
Abstract
BACKGROUND Physical activity (PA) and sedentary behavior (SED) may have independent effects on health and disease. This might be due to PA and SED having distinct effects on lipoprotein metabolism. The aim of this study was to determine associations between lipoprotein subclass particle concentrations (-P) and accelerometer-measured SED and moderate-to-vigorous PA (MVPA) in a sample of healthy adult subjects. METHODS Lipoprotein subclass particle concentrations were determined by proton nuclear magnetic resonance spectroscopy, whereas SED and MVPA were measured using Agtigraph GT1M and GT3X+ accelerometers. We obtained valid data in 73 subjects (30 men and 43 women, age 40.5 ± 10.6 years; body mass index 24.0 ± 2.8). Multiple regression analysis was used to determine associations (partial correlations) with lipoproteins. RESULTS Positive associations were detected between SED and small VLDL-P, large LDL-P and TG (partial r = 0.24 to 0.25, p < .047). Corresponding associations were non-significant for MVPA (partial r = -0.12 to 0.04, p > .355). On the contrary, MVPA was positively associated with large HDL-P, average HDL size, Apo A1 and HDL-cholesterol (partial r = 0.28 to 0.50, p < .027), whereas SED was not (partial r = -0.06 to 0.07, p > .607). CONCLUSION There might be a specific effect of SED versus MVPA on lipoprotein metabolism. However, our results must be interpreted carefully due to possible effect-modification by gender and a low sample size. Thus, our findings should be viewed as preliminary.
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Physical activity, sustained sedentary behavior, and pain modulation in women with fibromyalgia.
Ellingson, LD, Shields, MR, Stegner, AJ, Cook, DB
The journal of pain. 2012;(2):195-206
Abstract
UNLABELLED Fibromyalgia (FM) has been conceptualized as a disorder of the central nervous system, characterized by augmented sensory processing and an inability to effectively modulate pain. We previously reported that physical activity is related to brain processing of pain, providing evidence for a potential mechanism of pain management. The purpose of this study was to extend our work by manipulating pain modulation and determining relationships to both physical activity and sustained sedentary behavior. Eleven women with FM completed accelerometer measures of physical activity and underwent functional magnetic resonance imaging of painful heat, administered alone and during distracting cognitive tasks. Results showed that physical activity was significantly (P < .005) and positively related to brain responses during distraction from pain in regions implicated in pain modulation including the dorsolateral prefrontal cortex (DLPFC), the dorsal posterior cingulate, and the periaqueductal grey. A significant negative relationship occurred in the left anterior insula. For sedentary time, significant negative relationships were observed in areas involved in both pain modulation and the sensory-discriminative aspects of pain including the DLPFC, thalamus, and superior frontal and pre- and post-central gyri. These results suggest that physical activity and sedentary behaviors are related to central nervous system regulation of pain in FM. PERSPECTIVE Our results support a promising benefit of physical activity and highlight the potentially deleterious effects of sustained sedentary behavior for pain regulation in FM. Studies aimed at increasing physical activity or reducing sedentary behavior and determining the impact of these on pain regulation are warranted.