Leisure-time physical exercise: prevalence, attitudinal correlates, and behavioral correlates among young Europeans from 21 countries

The influence of a health education programme on healthy lifestyles and practices among university students

This study aimed at exploring the lifestyles of university students, the relationship between specific demographical variables and health practices and the role of training in improving these practices. An experimental and a comparison group were selected using the convenient sampling method. Two 5-day training programmes on healthy lifestyles were conducted. Self-reported behaviours of both groups were assessed before and after the programme. The results reflected slightly positive health practices related to the three behavioural categories with the type of diet being the highest and physical activity being the lowest. No significant differences were reflected in relation to the selected variables. A positive influence of training on improving health behaviours of university students related to the three behavioural categories was observed. Results suggest a similar course to be included as a university elective and students' involvement in available extra curricular activities be encouraged.

Psychological distress is independently associated with physical inactivity in Israeli adults

OBJECTIVES

Limited data exist on the link between psychological distress and regular physical activity in the general population. We examined the association of psychological distress with physical inactivity, independently of sociodemographic and behavioral factors in a large community sample. We also examined whether psychological distress is related to limitations in day-to-day activities due to emotional problems.

METHODS

Information on physical activity, sociodemographic, and behavioral factors was obtained through telephone interviews of 5708 subjects aged > or = 21 years from a cross-sectional study-the first Israeli National Health Interview Survey (2003-2004). Psychological distress and limitations due to emotional problems were measured using the five-item Mental Health scale (MHI-5) and role emotional scales derived from the SF-36 questionnaire.

RESULTS

In multivariate analyses, high psychological distress level was associated with increased odds of physical inactivity among both men (adjusted OR=1.30, 95% CI=1.09-1.55) and women (adjusted OR=1.31, 95% CI=1.11-1.53). Psychological distress was strongly associated with limitations in day-to-day activities due to emotional problems.

CONCLUSIONS

In this cross-sectional study of adult men and women, psychological distress was independently associated with physical inactivity. Psychological distress may limit day-to-day activities in general and reduce the success of health promotion activities. These findings could help in identifying subjects facing difficulties in initiation and adherence to these activities.

Evaluation of the relationship between hyperinsulinaemia and myocardial ischaemia/reperfusion injury in a rat model of depression

Major depression is associated with medical co-morbidity, such as ischaemic heart disease and diabetes, but the underlying pathophysiological mechanisms remain unclear. The FSL (Flinders Sensitive Line) rat is a genetic animal model of depression exhibiting features similar to those of depressed individuals. The aim of the present study was to compare the myocardial responsiveness to I/R (ischaemia/reperfusion) injury and the effects of IPC (ischaemic preconditioning) in hearts from FSL rats using SD (Sprague-Dawley) rats as controls and to characterize differences in glucose metabolism and insulin sensitivity between FSL and SD rats. Hearts were perfused in a Langendorff model and were subjected or not to IPC before 40 min of global ischaemia, followed by 120 min of reperfusion. Myocardial infarct size was found to be significantly larger in the FSL rats than in the SD rats following I/R injury (62.4+/-4.2 compared with 46.9+/-2.9%; P<0.05). IPC reduced the infarct size (P<0.01) and improved haemodynamic function (P<0.01) in both FSL and SD rats. No significant difference was found in blood glucose levels between the two groups measured after 12 h of fasting, but fasting plasma insulin (70.1+/-8.9 compared with 40.9+/-4.7 pmol/l; P<0.05) and the HOMA (homoeostatic model assessment) index (P<0.01) were significantly higher in FSL rats compared with SD rats. In conclusion, FSL rats had larger infarct sizes following I/R injury and were found to be hyperinsulinaemic compared with SD rats, but appeared to have a maintained cardioprotective mechanism against I/R injury, as IPC reduced infarct size in these rats. This animal model may be useful in future studies when examining the mechanisms that contribute to the cardiovascular complications associated with depression.

Review article: do exercise and fitness protect against stress-induced health complaints? A review of the literature

BACKGROUND

Understanding how exercise influences health is important in designing public health interventions. At present, evidence suggests that there is a positive relationship between exercise and health. However, whether this relationship is partly due to the stress-moderating impact of exercise has been less frequently investigated although more and more people are taxed by stressful life circumstances.

METHODS

A comprehensive review of studies testing the potential of exercise as a stress-buffer was conducted (including literature from 1982 to 2008). The findings are based on a narrative review method. Specific criteria were taken into account to evaluate causality of the evidence.

RESULTS

About half of the studies reported at least partly supportive results in the sense that people with high exercise levels exhibit less health problems when they encounter stress. The causality analyses show that stress-moderation effects were consistently found in different samples and with different methodological approaches. Although more support results from cross-sectional studies, exercise-based stress-buffer effects were also found in prospective, longitudinal and quasi-experimental investigations.

CONCLUSIONS

This review underscores the relevance of exercise as a public health resource. Recommendations are provided for future research. More prospective and experimental studies are needed to provide insight into how much exercise is necessary to trigger stress-buffer effects. Furthermore, more information is warranted to conclude which sort of exercise has the strongest impact on the stress-illness-relationship.

Personal Meanings, Values and Feelings Relating to Physical Activity and Exercise Participation in Female Undergraduates

Understanding was sought of the ways that female students understand and feel about physical activity and exercise participation, to inform effective and ethical intervention. Sixteen women participated in semi-structured interviews which were analysed thematically, using QSR NUD*IST 4. Physical activity and exercise proved emotive topics and meant different things to different people. Some women associated physical activity and exercise with enjoyment, or achieving their goals. Others saw exercise in particular as a duty, associated with feelings of guilt and inadequacy. Findings supported the value of promoting realistic goals, and careful choice of activities according to individual preferences.

Socio-economic inequalities in physical activity practice among Italian children and adolescents: a cross-sectional study

Aim

The aim of the study was to evaluate whether socio-economic inequalities in the practice of physical activity existed among children and adolescents, using different indicators of socio-economic status (SES).

Subjects and methods

Data were derived from the Italian National Health Interview Survey carried out in 2004–2005, which examined a large random sample of the Italian population using both an interviewer-administered and a self-compiled questionnaire. This study was based on a sample of 15,216 individuals aged 6–17 years. The practice of physical activity was measured on the basis of questions regarding frequency and intensity of activity during leisure time over the past 12 months. Parents’ educational and occupational level, as well as family’s availability of material resource, were used as indicators of SES. Multivariable logistic regression analyses were performed to estimate the contribution of each SES indicator to the practice of physical activity, adjusting for potential confounding factors. The results of the regression models are expressed as odds ratio (OR) with 95% confidence intervals (95% CI).

Results

About 64% of children and adolescents in the sample declared that they participated in moderate or vigorous physical activity at least once a week. After adjustment for gender, age, parental attitudes towards physical activity and geographical area, the practice of physical activity increased with higher parental educational and occupational level and greater availability of material resources. Children and adolescents whose parents held a middle or high educational title were 80% more likely to practice moderate or vigorous physical activity than subjects whose parents had a lower level of education (OR = 1.80, 95% CI: 1.40–2.33), while subjects with unemployed parents had an odds of practicing moderate or vigorous physical activity 0.43 times that of those children whose parents belonged to the top job occupation category (administrative/professionals). Socio-economic differences were about the same when the practice of vigorous physical activity only was considered instead of that of moderate or vigorous physical activity.

Conclusion

Interventions that promote the practice of physical activity, and especially those aimed at the wider physical and social environment, are strongly needed to contrast socio-economic differences in physical activity among children and adolescents.

Exercise Stages of Change in Turkish University Students by Sex, Residence, and Department

To examine the exercise behavior of 953 Turkish university students (496 men, 457 women) by sex, residence, and department of study, a stratified sampling method, based on the total number of students in each department, was used to select participants. The mean age of the participants was 21.3 yr. ( SD = 1.9). For completed Physical Activity Stages of Change Questionnaire and the International Physical Activity Questionnaire, descriptive statistics and chi-squared tests indicated that most students were at the lower stages of change in exercise habits: Precontemplation (15.2%), Contemplation (31.4%), and Preparation (25.3%), compared with the later stages of Action (7.5%) and Maintenance (20.6%). Women and students from the Department of Architecture were at lower stages of change than men and students from other departments ( p < .05), but there were no significant differences between students who were living on or off campus. Stage-based interventions would be appropriate, with focus on the physical activity of women and students in architecture.

Does leisure-time physical activity in early adulthood predict later physical activity? Pro-Saude Study

INTRODUCTION: Leisure-Time Physical Activity (LTPA) is a health behavior that is considered relatively stable over the course of life; this life-long habit seems to be shaped during youth and early adulthood. LTPA is one of the few healthy behaviors more prevalent among men than among women. METHODS:Data from 3,199 participants of the Pro-Saude Study were analyzed - a cohort of employees of a university in Rio de Janeiro, collected with a self-reported multidimensional questionnaire. The association between LTPA in early adulthood and later was investigated using multinomial logistic regression, with estimated odds ratios (OR), considering three outcome categories: inactive, insufficiently active, and active. Past LTPA was grouped into three categories: never/rarely (reference category), sometimes and frequently/always. Estimates were adjusted for: age; participants' schooling, their father's and mother's schooling, and color/race. RESULTS:Analysis shows men who engaged in LTPA sometimes and almost always/always in early adulthood had an OR= 1.42 (95% CI: 0.70-2.89) and OR= 3.33 (95% CI: 1.82-6.10), respectively, of being physically active in later adulthood than those who did not engage in LTPA. Among women, the corresponding odds ratios were lower: OR = 1.19 (95% CI: 0.79-1.79) and OR =1.42 (95% CI: 1.00-2.04). CONCLUSION:LTPA during early adulthood is associated with physical activity later in adulthood, and this association is stronger in men than in women. Public policies that encourage LTPA among youth, with specific efforts directed at women, could increase the proportion of physically active adults.

Does sports participation during adolescence prevent later alcohol, tobacco and cannabis use?

AIMS

To study whether participation in organized sports during adolescence predicts increased smoking of tobacco, alcohol intoxication and cannabis use from late adolescence to adulthood when controlling for potential confounders. Moreover, to study whether such increased drug use varies according to type of sport (team versus individual), main skills needed (endurance, strength or technical) and level of competition.

DESIGN, SETTING AND PARTICIPANTS

Survey of national sample of Norwegian high school students (aged 13-19 years) in 1992 (T1) followed-up in 1994 (T2), 1999 (T3) and 2006 (T4) (n = 3251).

MEASUREMENTS

Outcome measures included smoking of tobacco and 12-month prevalences of alcohol intoxication and cannabis use, respectively. Confounders included pubertal timing, friends' drug use, perceived social acceptance, grades and parental socio-economic status.

FINDINGS

Latent growth curve analyses showed that initial level of participation in organized sports predicted growth in alcohol intoxication. Those involved initially in team sports had greater growth in alcohol intoxication, but lower growth in tobacco use and cannabis use, during the adolescent and early adult years compared to those involved in technical or strength sports. Practising endurance sports, as opposed to technical or strength sports, predicted reduced growth in alcohol intoxication and tobacco use.

CONCLUSIONS

Sports participation in adolescence, and participation in team sports in particular, may increase the growth in alcohol intoxication during late adolescent and early adult years, whereas participation in team sports and endurance sports may reduce later increase in tobacco and cannabis use.

Use of a Social Cognitive Theory-Based Physical-Activity Intervention on Health-Promoting Behaviors of University Students

The purpose of this study was to examine the effects of a 12-wk. physical activity intervention, based on conceptual discussions and practices of a social cognitive theory on health-promoting behaviors of 62 university students. The intervention mainly focused on development of self-regulatory skills, social support, and self-assessment of health-related fitness. The Adolescent Health Promotion Scale and International Physical Activity Questionnaire were given. Analysis of self-reports indicated improved nutrition, health responsibility, social support, exercise, stress management, and overall health from pre- to postintervention. Also, participants' postintervention reports of moderate, vigorous, and total physical activity were higher than at preintervention.

International prevalence of physical activity in youth and adults

Understanding population prevalences of physical activity is important to develop benchmarks for current baseline levels to monitor future changes, and for making country/regional comparisons. The purpose was to review the global prevalence of physical activity levels among youth and adults. Standardized literature searches for articles about national prevalences of physical activity were conducted in PubMed. A total of 34 studies in adults and 28 studies in youth were deemed contemporary (1996 - present) and met the inclusion criteria for this review. Wide variability was present between countries in the prevalence of physical activity (as measured and defined by individual studies). Studies with the highest reported prevalences of physical activity were for men in Sweden (77%), women in Denmark (81%), 12- to 15-year-old boys in Australia (74%) and <12-year-old girls (75%) in China. The countries with the lowest reported prevalences of physical activity were men in Brazil (4%), women in Saudi Arabia (2%) and Thailand (2%), and 17- to 18-year-old boys (0%) and 17- to 18-year-old girls (0%) in Russia. The ranges of prevalence of physical activity, mode of data collection, and determination of meeting the physical activity threshold vary greatly between countries. However, the aggregation of these data can be a useful resource to practitioners, interventionists and epidemiologists.

Psychosocial and environmental factors associated with cycling for transport among a working population

The aim of this study was to examine psychosocial and environmental predictors of cycling for transportation. A sample of 343 Flemish adults (43% men) living at maximum 10 km from their workplace was surveyed. Self-report measures of cycling, demographic variables, psychosocial variables, self-efficacy, perceived benefits and barriers and environmental attributes (destination, traffic variables and facilities at the workplace) of cycling for transport were obtained by means of a mailing questionnaire. Modeling and social support by accompanying, external self-efficacy, ecological-economic awareness and lack of time and interest were positively associated with the likelihood of cycling for transport and varied in importance between cyclists and non-cyclists. Cyclists estimate the time to destination shorter than non-cyclists and indicate to have more facilities for cyclists at the workplace. The results suggest that when people live in a setting with adequate bicycle infrastructure, individual determinants (psychosocial, self-efficacy, perceived benefits and barriers) outperform the role of environmental determinants in this sample. Promotion campaigns aimed at increasing cycling for transportation should focus on creating social support by encouraging cycling with partners, increasing self-efficacy, raising ecological and economic awareness, decreasing lack of time and interest barriers and providing facilities for cyclists at the workplace.

Sleep duration and obesity-related risk factors in the rural Midwest

OBJECTIVE

Habitual short sleep duration is a common practice linked to weight gain and risk of obesity. Our objective was to examine the association between sleep duration with other behaviors, such as physical activity and nutrition, which are important for obesity prevention efforts.

METHODS

We used cross-sectional data from rural communities in Missouri, Tennessee, and Arkansas (N=1203). Controlling for covariates, we assessed the association between short sleep duration (<7 h vs. 7-8 h) and obesity, not meeting vigorous physical activity requirements, low fruit and vegetable consumption, high fat consumption, and frequently eating at fast food restaurants.

RESULTS

The proportion of participants with habitual sleep duration of <7 h, 7-8 h, and > or =9 h was 36.2%, 57.3%, and 6.4%, respectively. After multivariable adjustment, short sleep duration was associated with certain obesity-related behaviors, particularly lower physical activity and lower fruit and vegetable consumption.

CONCLUSIONS

Short sleep duration is associated with risk behaviors that are known to promote weight gain and obesity. Interventions aimed at promoting physical activity and improved nutrition may benefit by considering adequate sleep duration as a potentially modifiable behavior that may impact the effectiveness of efforts to prevent obesity.

Depression and perceived behavioral control are independent predictors of future activity and fitness after coronary syndrome events

OBJECTIVE

Physical inactivity increases the risk of recurrent coronary events, and both depression and perceived behavioral control (PBC) have been shown to influence levels of physical activity. However, it is not known whether depression and PBC affect activity levels independently of one another. The present study investigates whether depression and PBC exert independent effects on future exercise and fitness in patients hospitalized for coronary syndrome events.

METHODS

Five hundred and two patients (hospitalized for myocardial infarction or newly diagnosed angina) reported their levels of depression, PBC, and current regular exercise prior to discharge from hospital, and leisure activities, fitness, regular exercise, and depression 12 months later. The ability of depression and PBC to predict patient's reported levels of activity (n=388) and fitness (n=361) was determined with regression analyses.

RESULTS

Depression prior to discharge from hospital reliably predicted fitness (P<.005), self-reported leisure activities (P<.005), and taking regular exercise (P<.005) 12 months after hospitalization for coronary syndrome events when controlling for age, gender, socio-economic status, illness severity, and reported activity prior to hospitalization. Depression at 12 months explained the variance in all outcome measures previously explained by depression at discharge, but PBC during hospitalization independently predicted leisure activities (P<.005) and taking regular exercise (P<.005) 12 months later.

CONCLUSIONS

Perceived behavioral control and depression independently predict activity and fitness in patients 12 months after hospitalization for coronary syndrome events. Consequently, interventions aiming to increase activity and fitness in these patients should take account of both patients' perceptions of control and their level of depression.

Explaining the effect of a 1-year intervention promoting physical activity in middle schools: a mediation analysis

Objective

The aim of the present study was to examine the mediation effects of changes in psychosocial determinants of physical activity (attitude, social support, self-efficacy, perceived benefits and barriers) on changes in physical activity.

Design

One-year intervention study with baseline and 1-year post measures of physical activity habits and psychosocial correlates.

Setting

Fifteen middle schools.

Subjects

Boys and girls (n = 2840) aged 11–15 years completed the validated questionnaires during class hours.

Results

The product-of-coefficients test was used to asses the mediating effects. Self-efficacy for physical activity at school was found to be the only significant mediator of physical activity change. Specifically, self-efficacy for physical activity at school partly mediated the effect of the intervention on total and school-related physical activity change in the intervention group with parental support (P < 0.05). None of the other potential mediators, attitudes, social support, perceived benefits and perceived barriers, seemed to have had a positive effect. Even a suppressor effect was found for attitudes. Given that the effects of self-efficacy and attitudes were of opposite direction, the total mediated/suppressed effects of the intervention were not statistically significant.

Conclusions

Positive changes in total and school-related physical activity in adolescents could be partly explained by increases in self-efficacy for physical activity at school through a physical activity intervention in middle schools with parental support. However, the suppressor effect of attitudes decreased this effect. As this is one of the first true mediation analyses in this age group, further research is needed to replicate the importance of these mediators.

Relations between physical activity and behavioral and perceptual correlates among midwestern college students

OBJECTIVE

Given the inconsistent findings in the literature, the authors' purpose in this study was to examine the associations between physical activity and behavioral and perceptional correlates, such as binge drinking, cigarette smoking, fruit or vegetable consumption, and weight perceptions, among midwestern college students.

PARTICIPANTS AND METHODS

The authors invited a convenience sample of 1,200 undergraduate college students enrolled in the 2004-2005 academic year in 4 different midwestern universities to participate in a survey. Of the 1,163 students who participated in the survey, a total of 1,134 usable surveys were received (response rate of 94.5%).

RESULTS

Hierarchical multiple logistic regression analyses indicated that smoking, perceived weight, and consumption of fruit were independent predictors of physical activity when controlling for other variables.

CONCLUSIONS

Physical activity promotion requires tailored approaches that are dependent on the target segment of the college student populations.

Health behaviors and depressive symptoms in testicular cancer survivors

OBJECTIVES

Testicular cancer has one of the highest 5-year survival rates of all cancer sites. The survival period is marked by an increased risk of secondary cancer and cardiovascular events owing to treatment-related toxicities. The purposes of this cross-sectional study were to determine the prevalence of health behaviors and depressive symptoms and to assess the relationship between depression and health behaviors in survivors of testicular cancer.

METHODS

A total of 162 survivors of testicular cancer 2 to 10 years after their diagnosis completed a one-time telephone interview. The interview included a battery of questions from the Behavioral Risk Factor Surveillance System assessing health behaviors (smoking, physical activity, cholesterol screening, colorectal cancer screening, alcohol consumption, and fruit and vegetable intake) and the Centers for Epidemiological Studies-Depression (CES-D) questionnaire assessing depressive symptoms.

RESULTS

The interviews revealed a low prevalence of positive health behaviors among survivors of testicular cancer. The percentage (17.5%) of survivors of testicular cancer who scored above the cutoff on the CES-D was greater than that (11%) of large-scale population-based estimates in men aged 19 to 44 years. Smoking was significantly related to depression. Depressive symptoms (CES-D score) differed significantly depending on smoking status (current smokers, mean = 15.2; former smokers, mean = 6.2, P <0.001; and never smokers, mean = 8.7, P <0.001).

CONCLUSIONS

Given the increased risk of cancer and treatment-related morbidities of these survivors, the findings of this study suggest that healthcare professionals should encourage survivors of testicular cancer to engage in positive health behaviors and check for depressive symptoms.

Relationship between attitudes towards healthy eating and dietary behaviour, lifestyle and demographic factors in a representative sample of Irish adults

Attitudes towards healthy eating were explored according to dietary, lifestyle and socio-demographic correlates in a random sample of 1256 Irish adults. Data were obtained from an Irish cross-sectional survey (1997-1999). A self-administered questionnaire was used to obtain attitudinal information. Food consumption was estimated using a 7-d food diary. A majority of the sample had a positive attitude or motivation towards their healthy eating behaviour. Those who perceived their own eating habits to be healthy were more likely to comply with current dietary guidelines than those who did not. Females, increasing age, higher social class, tertiary education, non-smokers, lower body-weights and increased recreational activity were associated with a lower odds ratio (OR) for having a negative attitude towards their healthy eating behaviour. An increased intake (g/d) of breakfast cereals, vegetables, fruit and poultry dishes were associated with decreased OR for negative attitudes towards their healthy eating behaviour, while an increased intake of high-calorie beverages (g/d) was associated with an increased OR. It can be concluded that attitudes or motivation towards eating healthily was related to measured dietary and lifestyle behaviour in this sample. Future research is warranted to devise appropriate methods of instituting attitude change towards dietary behaviour in certain subgroups of the population.

Regular exercise, anxiety, depression and personality: a population-based study

OBJECTIVES

To examine whether regular exercise is associated with anxiety, depression and personality in a large population-based sample as a function of gender and age.

METHODS

The sample consisted of adolescent and adult twins and their families (N=19,288) who participated in the study on lifestyle and health from The Netherlands Twin Registry (1991-2002). Exercise participation, anxiety, depression and personality were assessed with self-report questionnaires.

RESULTS

The overall prevalence of exercise participation (with a minimum of 60 min weekly at 4 METs (Metabolic Energy Expenditure Index)) in our sample was 51.4%. Exercise participation strongly declined with age from about 70% in young adolescents to 30% in older adults. Among adolescents, males exercised more, whereas, among older adults, females exercised more. Exercisers were on average less anxious (-0.18 SD), depressed (-0.29 SD) and neurotic (-0.14 SD), more extraverted (+0.32 SD) and were higher in dimensions of sensation seeking (from+0.25 SD to+0.47 SD) than non-exercisers. These differences were modest in size, but very consistent across gender and age.

CONCLUSIONS

This study corroborates and extends previous findings: regular exercise is cross-sectionally associated with lower neuroticism, anxiety and depression and higher extraversion and sensation seeking in the population.

Environmental and psychosocial correlates of physical activity in Portuguese and Belgian adults

OBJECTIVES

To investigate differences in reported physical activity levels and in perceived environmental and psychosocial correlates of activity between Portuguese and Belgian adults; and to analyse the relative contribution of environmental and psychosocial variables in explaining physical activity within different contexts in Portugal and Belgium.

DESIGN

Cross-sectional study.

SETTING

One city in Portugal (Oeiras) and one in Belgium (Ghent).

SUBJECTS

In total 526 participants, 247 from Portugal and 279 from Belgium, completed the long International Physical Activity Questionnaire and a validated questionnaire on environmental and psychosocial correlates.

RESULTS

For the sum of all activities of at least moderate intensity, a significantly higher mean level of activity was found in Belgian adults (P < 0.001). However, comparable percentages of the Belgian (38%) and Portuguese (42%) samples did not meet the recommendation of 30 min per day. The variance explained by environmental factors was lower (1% to 8%) than by psychosocial factors (maximum 42%). Regression analyses showed activity-specific relations with environmental variables which were analogous in both countries. Walking/cycling for transportation and walking for recreation were related to social support from family and/or friends and to walkability and walking facilities in the neighbourhood. Recreational physical activity was mainly determined by social support, self-efficacy, and perceived benefits and barriers.

CONCLUSIONS

Activity campaigns addressing psychosocial determinants are needed to encourage leisure-time activity, while a combination of neighbourhood design changes and encouragement of social support in walking is warranted to increase walking in different contexts.

Physical activity levels in 10- to 11-year-olds: clustering of psychosocial correlates

OBJECTIVES

To evaluate gender differences for levels of physical activity, for sedentary behaviour and for psychosocial correlates in children, to evaluate whether psychosocial correlates cluster in meaningful ways and to examine whether physical activity and sedentary behaviour differ between children of clusters, differentiated by the level of perceived barriers and benefits, attitudes, social support and self-efficacy.

DESIGN

Cross-sectional study using the Flemish Physical Activity Questionnaire.

SETTING

Questionnaires to be filled out by the children and one of their parents, contacted through the school system.

SUBJECTS

A sample of 1124 10- to 11-year-olds (579 boys and 545 girls).

RESULTS

Girls were found to be less active than boys, with boys scoring better for social support, perceived benefits and self-efficacy compared with girls. The way of clustering differed between boys and girls. Boys were allocated to three clusters: one cluster with positive correlates towards physical activity, labelled 'positives'; one with negative correlates, labelled 'negatives'; and one characterised mainly by high perceived barriers, labelled 'hindered'. In both genders the highest levels of physical activity were found in the 'positives', the lowest in the 'negatives'. In girls a fourth cluster was identified, characterised mainly by low perceived barriers and low social support. Physical activity levels in the girls of this cluster, labelled 'indifferents', were the second highest.

CONCLUSIONS

More research is needed to further characterise these clusters. To prevent the physical activity decline during the transition from childhood to adulthood, novel interventions need to be explored that focus on children of the clusters with the most negative correlates.

Physical activity, psychosocial health and life goals among youth

The main goal of the present study is to investigate the relationship between youth's physical activity, their psychosocial health and well-being, and their life goals. Data were collected among students (n = 1109, age range between 14 and 21 years of age, mean: 16.5 years, SD = 1.3 years) enrolled in the secondary schools of the Southern Plain Region (three counties), Hungary. Our findings support previous results that more active students have a better self-perceived health and fitness, lower levels of depressive symptoms and higher levels of life satisfaction. In addition, students who are regularly active prefer less extrinsic values as life goals for their future. However, there are no significant differences by physical activity status in terms of intrinsic values (except for physical health). These findings suggest that physical activity is not per se a beneficial health behavior only through its functions. In community health programs, a health-related physical education approach should be addressed to improve the psychosocial benefits of physical activity.

Efficacy of sequential or simultaneous interactive computer-tailored interventions for increasing physical activity and decreasing fat intake

BACKGROUND

Little evidence exists about the effectiveness of "interactive" computer-tailored interventions and about the combined effectiveness of tailored interventions on physical activity and diet. Furthermore, it is unknown whether they should be executed sequentially or simultaneously.

PURPOSE

The purpose of this study was to examine (a) the effectiveness of interactive computer-tailored interventions for increasing physical activity and decreasing fat intake and (b) which intervening mode, sequential or simultaneous, is most effective in behavior change.

METHODS

Participants (N = 771) were randomly assigned to receive (a) the physical activity and fat intake interventions simultaneously at baseline, (b) the physical activity intervention at baseline and the fat intake intervention 3 months later, (c) the fat intake intervention at baseline and the physical activity intervention 3 months later, or (d) a place in the control group.

RESULTS

Six months postbaseline, the results showed that the tailored interventions produced significantly higher physical activity scores, F(2, 573) = 11.4, p < .001, and lower fat intake scores, F(2, 565) = 31.4, p < .001, in the experimental groups when compared to the control group.

CONCLUSIONS

For both behaviors, the sequential and simultaneous intervening modes showed to be effective; however, for the fat intake intervention and for the participants who did not meet the recommendation in the physical activity intervention, the simultaneous mode appeared to work better than the sequential mode.

Gender differences in health habits and in motivation for a healthy lifestyle among Swedish university students

The aim of the present study was to investigate gender differences in students' health habits and motivation for a healthy lifestyle. The sample of students comprised a probability systematic stratified sample from each department at a small university in the south-west of Sweden (n = 479). A questionnaire created for this study was used for data collection. Self-rated health was measured by number of health complaints, where good health was defined as having less than three health complaints during the last month. A healthy lifestyle index was computed on habits related to smoking, alcohol consumption, food habits, physical activity and stress. Female students had healthier habits related to alcohol consumption and nutrition but were more stressed. Male students showed a high level of overweight and obesity and were less interested in nutrition advice and health enhancing activities. The gender differences are discussed in relation to the impact of stress on female students' health, and the risk for male students in having unhealthy nutritional habits in combination with being physically inactive and drinking too much alcohol.

Stages of change for physical activity in a community sample of adolescents

The aims of the present study were to investigate (1) the proportion of adolescents in each of the stages of change, (2) the differences in psychosocial factors and in physical activity between the stages, and (3) the classification accuracy using several reference criteria. A random sample of 38 schools from the Flemish community in Belgium resulted in a sample of 5931 adolescents (mean age=14.8, range 12-18, 61% females). All adolescents completed a computerized questionnaire assessing demographic variables, physical activity, physical activity determinants and stages of change. Distribution across the stages was: precontemplation, n=684 (11.5%); contemplation, n=948 (16.0%); preparation, n=818 (13.8%); action, n=492 (8.3%); and maintenance, n=2989 (50.4%). Analyses revealed gender and age differences (P<0.001), with girls and older adolescents being more prevalent in the first three stages. Differences between the stages of change were related to higher levels of physical activity of different intensity and within different contexts (P<0.001), together with more favorable psychosocial determinants related to physical activity (P<0.001). No differences between stages were found for sedentary activities. Three subgroups of adolescents were identified based on psychosocial determinants and physical activity levels. About 71% of the adolescents placed themselves in a stage which was in accordance with their self-reported level of physical activity.

The association between self-reported physical activity and prevalence of depression and anxiety disorder in long-term survivors of testicular cancer and men in a general population sample

GOALS OF WORK

Physical activity is claimed to have a beneficial influence on a person's mental health, though its impact may be different in cancer patients and individuals in the general population. The objective of this cross-sectional study was (1) to estimate the associations between the level of self-reported physical activity as a lifestyle factor (LPA) and the prevalence of depression and anxiety disorder in testicular cancer survivors (TCSs) and in men of similar age from the general population (GenPop), and (2) to examine whether these associations differ in the two groups.

PATIENTS AND METHOD

A total of 1260 TCSs and 20,207 men from the GenPop completed a questionnaire that assessed LPA, and depression and anxiety disorder on the Hospital Anxiety and Depression Scale (HADS).

MAIN RESULTS

The prevalence of HADS-defined depression was lower among those who were physically active than in those who were physically inactive (TCSs 9% vs 17%, P<0.001; GenPop 8% vs 15%, P<0.001). Among physically inactive TCSs there was a trend towards higher a prevalence of HADS-defined anxiety disorder compared to physically active TCSs (P=0.07). In the GenPop this difference was statistically significant (P<0.001). Multivariate analysis confirmed the association between LPA and HADS-defined depression in both the TCSs [adjusted odds ratio (aOR)=0.56; 95% confidence interval (CI) (0.31, 1.02)] and the GenPop [aOR=0.58; 95% CI (0.51, 0.65)], but not the association between LPA and HADS-defined anxiety disorder. The associations between LPA and HADS-defined depression and HADS-defined anxiety disorder did not differ between the TCSs and the GenPop.

CONCLUSION

In both the TCSs and the GenPop, the prevalence of HADS-defined depression was higher among those who were physically inactive than among those who were physically active, with no intergroup difference. There was no association between LPA and prevalence of HADS-defined anxiety disorder in either of the groups after adjusting for background variables. Prospective studies are needed to allow causal inferences to be drawn.

The role of peer social network factors and physical activity in adolescent girls

OBJECTIVE

To study the relationship between peer-related physical activity (PA) social networks and the PA of adolescent girls.

METHODS

Cross-sectional, convenience sample of adolescent girls. Mixed-model linear regression analyses to identify significant correlates of self-reported PA while accounting for correlation of girls in the same school.

RESULTS

Younger girls were more active than older girls. Most activity-related peer social network items were related to PA levels. More PA with friends was significantly related to self-reported PA in multivariate analyses.

CONCLUSIONS

Frequency of PA with friends was an important correlate of PA among the peer network variables for adolescent girls.

Religion, social support, fat intake and physical activity

OBJECTIVE

Most research on diet and exercise has focused on these health behaviours as proximate causes of disease, rather than examine the context of how diet and exercise are developed and maintained. This study examined religion and social support in relationship to fat intake and physical activity.

DESIGN, SETTING AND SUBJECTS

Data from surveys of 546 adults aged 17-91 years, residing in one upstate New York county, were analysed.

RESULTS

Most relationships between the multiple facets of religion, fat intake and physical activity were not statistically significant. After controlling for demographics and social support, Conservative Protestant women and women specifying an "Other" religious affiliation reported higher fat intakes than did Catholic women. There were no relationships between religion and fat intake in men. In women, religious commitment was associated with greater moderate and vigorous physical activity, whereas in men, divine social support was associated with greater moderate physical activity. Social support did not substantially change the magnitude of the relationships between religion, diet and physical activity.

CONCLUSION

Overall, there were few relationships between religion, fat intake and physical activity, suggesting that in contemporary US society religion may play a small role in the context of how diet and exercise are developed and maintained. The limited range of religiosity in the sample, however, may have underestimated the role of religion. Significant relationships between religion and physical activity in women suggest that further research is needed to more clearly delineate religion's relationship with health behaviours.

Cardiac risk factors in patients with diabetes mellitus and major depression

OBJECTIVE

The prevalence of major depression is approximately 2-fold higher in patients with diabetes mellitus compared to medical controls. We explored the association of major depression with 8 cardiac risk factors in diabetic patients with and without evidence of cardiovascular disease (CVD).

DESIGN

A mail survey questionnaire was administered to a population-based sample of 4,225 patients with diabetes to obtain data on depression status, diabetes self-care (diet, exercise, and smoking), diabetes history, and demographics. On the basis of automated data we measured diabetes complications, glycosylated hemoglobin, medical comorbidity, low-density lipid levels, triglyceride levels, diagnosis of hypertension, and evidence of microalbuminuria. Separate analyses were conducted for subgroups according to the presence or absence of CVD.

SETTING

Nine primary care clinics of a nonprofit health maintenance organization.

MAIN RESULTS

Patients with major depression and diabetes were 1.5- to 2-fold more likely to have 3 or more cardiovascular risk factors as patients with diabetes without depression (62.5% vs 38.4% in those without CVD, and 61.3% vs 45% in those with CVD). Patients with diabetes without CVD who met criteria for major depression were significantly more likely to be smokers, to have a body mass index (BMI) > or = 30 kg/m2, to lead a more sedentary lifestyle, and to have HbA1c levels of >8.0% compared to nondepressed patients with diabetes without heart disease. Patients with major depression, diabetes, and evidence of heart disease were significantly more likely to have a BMI > or = 30 kg/m2, a more sedentary lifestyle, and triglyceride levels > 400 mg/dl than nondepressed diabetic patients with evidence of heart disease.

CONCLUSIONS

Patients with major depression and diabetes with or without evidence of heart disease have a higher number of CVD risk factors. Interventions aimed at decreasing these risk factors may need to address treatment for major depression in order to be effective.

Cooccurrence of lifestyle risk factors and the explanation of education inequalities in mortality: results from the GLOBE study

BACKGROUND

To investigate whether the cooccurrence of two lifestyle risk factors (smoking, excessive alcohol consumption, physical inactivity in leisure time) has an additional contribution to the explanation of education inequalities in mortality, over and above the contribution of single risk factors.

METHODS

Prospective cohort study, 1991-1998, in the South East of the Netherlands. Participants were 16,980 men and women aged 15-74 years at baseline.

RESULTS

Education differences in the cooccurrence of risk factors were of a similar magnitude as education inequalities seen for single risk factors. A significant (P = 0.04) interaction effect on mortality was found between smoking and physical inactivity. Adjustment for both smoking and inactivity reduced the mortality hazard ratio of the lowest level of education by 30% (from 1.66 to 1.46). Further adjustment for the interaction between the two risk factors did not change the hazard ratio significantly.

CONCLUSION

The cooccurrence of lifestyle risk factors did not provide any additional contribution to the explanation of education inequalities in mortality, over and above that of single risk factors. However, because risk factors tend to cooccur and have a higher prevalence among lower-educated people, it is still useful to focus interventions on more than one risk factor.

The association between physical exercises and health-related quality of life in subjects with mental disorders: results from a cross-sectional survey

OBJECTIVES

The present study examines the relationship between health-related quality of life and physical activity among adults with affective, anxiety, and substance dependence disorders.

METHODS

Analyses were conducted among participants in the German National Health Interview and Examination Survey (GHS), a nationally representative multistage probability survey, conducted from 1997 to 1999. Multiple linear regression analyses were used to determine the relationship between health-related quality of life and physical activity among subjects with mental disorders.

RESULTS

Affective, anxiety, and substance dependence disorders were associated with substantial impairment in health-related quality of life. Higher levels of physical activity were associated with higher health-related quality of life among persons with mental disorders. Even after controlling for sociodemographic characteristics, physically inactive subjects reported poorer quality of life.

CONCLUSIONS

Physical activity can be considered as beneficial for people suffering from mental disorders. The promotion of a physically active lifestyle is an important public health objective.

Knowledge and lifestyle behaviors of healthy older adults related to modifying the onset of vascular dementia

The purpose of this study was to examine the relationship between knowledge and practice of lifestyle behaviors in healthy older adults related to the prevention of vascular dementia. Data were derived from a convenience sample of 281 Canadian participants 55 years of age and older. Lifestyle was measured using the health-promoting lifestyle profile (HPLP). Seven knowledge sub-scales were developed consistent to the HPLP. Multivariate analysis found that four independent variables accounted for 26% of the variance of a healthy lifestyle score and included those who reported a lower level of stress, indicated a higher knowledge of interpersonal relations, had a better general health self-assessment and higher medical knowledge. These Canadian results were compared with those from a study conducted in Australia and found to be similar. The study argues that health professionals and health education programs can better promote and increase awareness of healthy lifestyle behaviors by assisting older adults to apply this knowledge in their daily lives. Specifically, the study discusses policy and practice implications with regards to lifestyle issues relating to health responsibility, physical activity, spirituality, stress management, interpersonal relationships and nutrition.

Leisure-time physical activity in university students from 23 countries: associations with health beliefs, risk awareness, and national economic development

BACKGROUND

Physical inactivity has been linked with chronic disease and obesity in most western populations. However, prevalence of inactivity, health beliefs, and knowledge of the risks of inactivity have rarely been assessed across a wide range of developed and developing countries.

METHODS

A cross-sectional survey was carried out with 19,298 university students from 23 countries varying in culture and level of economic development. Data concerning leisure-time physical activity, health beliefs, and health knowledge were collected.

RESULTS

The prevalence of inactivity in leisure time varied with cultural and economic developmental factors, averaging 23% (North-Western Europe and the United States), 30% (Central and Eastern Europe), 39% (Mediterranean), 42% (Pacific Asian), and 44% (developing countries). The likelihood of leisure-time physical activity was positively associated with the strength of beliefs in the health benefits of activity and with national economic development (per capita gross domestic product). Knowledge about activity and health was disappointing, with only 40-60% being aware that physical activity was relevant to risk of heart disease.

CONCLUSIONS

Leisure-time physical activity is below recommended levels in a substantial proportion of students, and is related to cultural factors and stage of national economic development. The relationship between health beliefs and behavior is robust across cultures, but health knowledge remains deficient.

Associations between psychological traits and endothelial function in postmenopausal women

OBJECTIVE

The objective of this study was to determine whether psychosocial risk factors for cardiovascular disease (CVD) are associated with impairments in endothelial function and to determine whether use of hormone replacement therapy (HRT) can moderate observed associations among women without prior CVD.

METHODS

Flow-mediated dilation was assessed by brachial ultrasound after reactive hyperemia in 193 postmenopausal women enrolled in the prospective Healthy Women Study. Measures of psychosocial characteristics had been completed at study entry, when the women were premenopausal (mean = 13.6 years earlier), and at a separate postmenopausal follow-up exam near the time of the ultrasound (mean = 1.5 years earlier).

RESULTS

Factor analyses of the psychosocial characteristics yielded two factors: Type A/anger and anxiety/depression. Anxiety/depression scores at the study entry and follow-up exams and Type A/anger scores at the study entry exam were associated with less vasodilation (p values < 0.05). Type A/anger scores at the follow-up exam were associated with less vasodilation among women not using HRT (p <.05).

CONCLUSIONS

Psychosocial risk factors for CVD are associated with impaired brachial artery dilation among postmenopausal women. HRT use may mask some associations between psychosocial risk factors and endothelial dysfunction among postmenopausal women.

Distribution and determinants of sedentary lifestyles in the European Union

BACKGROUND

Many studies have shown the health burden of a sedentary lifestyle. The main goal of this study was to determine the prevalence of sedentary lifestyles in the 15 Member States of the European Union (EU) and to identify the main correlates of a sedentary lifestyle.

METHODS

Nationally representative samples (n approximately 1000 subjects in each country; >15 years) completed a questionnaire concerning attitudes to physical activity, body weight, and health; in total 15 239 subjects. Sedentary people were defined in two ways: (1) those expending less than 10% of their leisure time expenditure in activities involving >/=4 metabolic equivalents (MET). (2) Those who did not practice any leisure-time physical activity and who also were above the median in the number of hours spent sitting down during leisure time. Logistic regression models were fitted to analyse the association between sedentary lifestyles and gender, age, body mass index (BMI), educational level, weight change in the last 6 months, and marital and smoking status.

RESULTS

Percentages of sedentary lifestyles across European countries ranged between 43.3% (Sweden) and 87.8% (Portugal) according to the first definition. According to both definitions, a lower prevalence of sedentary lifestyle was found in Northern countries (especially Scandinavian countries) as compared with Mediterranean countries, whereas the prevalence was higher among older, obese, less educated, widowed/divorced individuals, and current smokers. Similar relative differences between countries and socio-demographic groups were found independently of the method used to define a sedentary lifestyle.

CONCLUSION

Prevalence of sedentary lifestyle in the EU is high, especially among inhabitants of some Mediterranean countries, obese subjects, less-educated people, and current smokers. This high prevalence involves important public health burdens and preventive strategies are urgently needed.

Beyond the U-curve: the relationship between sport and alcohol, cigarette and cannabis use in adolescents

AIMS

This study aimed at increasing understanding of the relationship between sporting activities and alcohol, cigarette and cannabis use among adolescents, by examining gender, age and the context of sporting practice.

DESIGN, SETTING, SUBJECTS

The study was a national school survey (n=10807; ages 14-19 years) conducted in France in 1999.

MEASURES

Respondents were asked confidentially by self-administered questionnaire (pen and paper) about their use of licit and illicit drugs and life-style (including sporting activities outside school: hours per week, registration in a club, type of sport).

FINDINGS

The U-shaped curve between the intensity of physical activities and licit and illicit drug use appeared not to be systematic. It depended mainly on the product and the level of use. It only remained significant for boys and heavy smoking once gender and age effect were taken into account.

CONCLUSION

The results stress the need to control for age and gender when the survey participants are teenagers. The relationship between drug use and sporting activity also depends on the type of sport.

Age, smoking, and negative affectivity as predictors of sleep patterns among shiftworkers in two environments

Although adaptation to shiftwork has been widely studied, little is known about how individual and environmental factors combine to influence sleep among shiftworkers. This study examined age, smoking, and negative affectivity (NA) as predictors of sleep duration and quality for 3 work phases (day shifts, DS; night shifts, NS; and leave periods, LP). Data were collected from personnel working 12-hr shifts, onshore (n = 330) or offshore (n = 456). Individual factors predicted patterns of sleep measures across the DS, NS, and LP phases onshore, but not offshore; onshore, work phase interacted with smoking and with age to predict sleep duration and with NA to predict sleep quality. The role of the offshore environment in shiftwork adaptation is discussed.