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Ye M, Robson PJ, Eurich DT, Vena JE, Xu JY, Johnson JA. Cohort Profile: Alberta’s Tomorrow Project. Int J Epidemiol 2016; 46:1097-1098l. [DOI: 10.1093/ije/dyw256] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 11/14/2022] Open
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Middlekauff M, Lee W, Egger MJ, Nygaard IE, Shaw JM. Physical activity patterns in healthy middle-aged women. J Women Aging 2016; 28:469-476. [PMID: 27399884 DOI: 10.1080/08952841.2015.1018067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Exercise in healthy female adults around the menopausal transition has been routinely examined in leisure activities alone, potentially discounting the physical activity (PA) that is accumulated in household and outdoor domains. The purpose of this study was to quantify PA in healthy middle-aged women and to examine the extent to which the Center for Disease Control (CDC) PA guidelines were met through leisure, household, and outdoor activities. METHODS 440 healthy women, 51-64 years old, BMI ≥18.5 or < 40 kg/m2, participated in the study using the Lifetime Physical Activity Questionnaire (LPAQ) to quantify PA. RESULTS 25.91% met the CDC PA guidelines if leisure time alone was examined. When multiple domains were included, 73.41% of the women met the PA guidelines. This percentage is much higher than the reported 20.6% of U.S. adults who met the guidelines in 2011. PA in women may be underrepresented in data limited to leisure time PA.
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Affiliation(s)
- Monique Middlekauff
- a Department of Exercise and Sport Science , University of Utah , Salt Lake City , Utah , USA
| | - Woonghee Lee
- b Department of Mathematics , University of Utah , Salt Lake City , Utah , USA
| | - Marlene J Egger
- c Department of Family and Preventive Medicine , DFPM/Education and Research, University of Utah , Salt Lake City , Utah , USA
| | - Ingrid E Nygaard
- d Department of Obstetrics & Gynecology , University Hospital, University of Utah , Salt Lake City , Utah , USA
| | - Janet M Shaw
- a Department of Exercise and Sport Science , University of Utah , Salt Lake City , Utah , USA
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Boisvert-Vigneault K, Payette H, Audet M, Gaudreau P, Bélanger M, Dionne IJ. Relationships between physical activity across lifetime and health outcomes in older adults: Results from the NuAge cohort. Prev Med 2016; 91:37-42. [PMID: 27471024 DOI: 10.1016/j.ypmed.2016.07.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 07/13/2016] [Accepted: 07/23/2016] [Indexed: 11/18/2022]
Abstract
This study aims to (1) describe participation in four physical activity (PA) domains across life and (2) examine the influence of PA during adolescence, early, middle, and later adulthood on health variables at older age. This observational study was conducted in 1378 generally healthy older adults (age 67-84 at baseline in 2003-2005; 52% women) in Quebec, Canada. Using a modified version of the interviewer-administered Lifetime Total Physical Activity Questionnaire (LTPAQ) and life events calendar to facilitate the recall, participants reported the frequency, duration, and intensity of occupational (OPA), commuting (CPA), household (HPA), and leisure time (LTPA) they participated in at age 15, 25, 45, and 65, and at the first follow-up (age 68-85 in 2005-2006). Fat mass, lean body mass, body mass index, waist-to-hip ratio, fasting glucose, systolic and diastolic blood pressures, self-reported chronic diseases, and socio-demographic data were assessed at baseline. Changes in PA over time differed by sex in each domain. However, there was a general decline in all PA domains in both sexes after age 65. In multiple regression analyses, LTPA at first-follow-up was associated with more favourable waist-to-hip ratio in both sexes, fat mass in women and fat mass percentage in men, whereas CPA, OPA, and HPA across life were not consistently associated with health variables. Older adults' LTPA at first follow-up was related to health variables, but PA recalled during adolescence, early adulthood, and mid-life was not. Results support the idea that current PA is positively related to better health outcomes.
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Affiliation(s)
- Katherine Boisvert-Vigneault
- Faculty of Physical Activity Sciences, University of Sherbrooke, 2500 boul. de l'Université, Sherbrooke, Quebec J1K 2R1, Canada; Research Centre on Aging, CIUSS de l'Estrie-CHUS, 1036 rue Belvédère Sud, Sherbrooke, Quebec J1H 4C4, Canada.
| | - Hélène Payette
- Research Centre on Aging, CIUSS de l'Estrie-CHUS, 1036 rue Belvédère Sud, Sherbrooke, Quebec J1H 4C4, Canada; Faculty of Medicine & Health Sciences, University of Sherbrooke, 3001, 12e avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada.
| | - Mélisa Audet
- Faculty of Physical Activity Sciences, University of Sherbrooke, 2500 boul. de l'Université, Sherbrooke, Quebec J1K 2R1, Canada; Research Centre on Aging, CIUSS de l'Estrie-CHUS, 1036 rue Belvédère Sud, Sherbrooke, Quebec J1H 4C4, Canada.
| | - Pierrette Gaudreau
- Department of medicine, University of Montreal, Pavillon Roger-Gaudry (local S-759), 2900 boul. Édouard-Montpetit, Montréal, Québec H3T 1J4, Canada; Centre hospitalier de l'Université de Montréal Research Center, Pavillon R, 900 rue St-Denis, Montreal, Quebec H2X 0A9, Canada.
| | - Mathieu Bélanger
- Department of Family Medicine, Université de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke, Quebec J1H 5N4, Canada; Centre de formation médicale du Nouveau-Brunswick, Pavillon J.-Raymond-Frenette, 18 rue Antonine Maillet, Moncton, New Brunswick E1A 3E9, Canada; Office of research services, Vitalité Health Network, 275, rue Main Bureau 600, Bathurst, New Brunswick E2A 1A9, Canada.
| | - Isabelle J Dionne
- Faculty of Physical Activity Sciences, University of Sherbrooke, 2500 boul. de l'Université, Sherbrooke, Quebec J1K 2R1, Canada; Research Centre on Aging, CIUSS de l'Estrie-CHUS, 1036 rue Belvédère Sud, Sherbrooke, Quebec J1H 4C4, Canada.
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Associations of Postdiagnosis Physical Activity and Change from Prediagnosis Physical Activity with Quality of Life in Prostate Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2016; 26:179-187. [DOI: 10.1158/1055-9965.epi-16-0465] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/31/2016] [Accepted: 09/15/2016] [Indexed: 11/16/2022] Open
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Boyle T, Fritschi L, Kobayashi LC, Heyworth JS, Lee DG, Si S, Aronson KJ, Spinelli JJ. Sedentary work and the risk of breast cancer in premenopausal and postmenopausal women: a pooled analysis of two case-control studies. Occup Environ Med 2016; 73:735-741. [PMID: 27540104 DOI: 10.1136/oemed-2015-103537] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 08/01/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVES There is limited research on the association between sedentary behaviour and breast cancer risk, particularly whether sedentary behaviour is differentially associated with premenopausal and postmenopausal breast cancer. We pooled data from 2 case-control studies from Australia and Canada to investigate this association. METHODS This pooled analysis included 1762 incident breast cancer cases and 2532 controls. Participants in both studies completed a lifetime occupational history and self-rated occupational physical activity level. A job-exposure matrix (JEM) was also applied to job titles to assess sedentary work. Logistic regression analyses (6 pooled and 12 study-specific) were conducted to estimate associations between both self-reported and JEM-assessed sedentary work and breast cancer risk among premenopausal and postmenopausal women. RESULTS No association was observed in the 6 pooled analyses, and 10 of the study-specific analyses also showed null results. 2 study-specific analyses provided inconsistent and contradictory results, with 1 showing statistically significant increased risk of breast cancer for self-reported sedentary work among premenopausal women cancer in the Canadian study, and the other a non-significant inverse association between JEM-assessed sedentary work and breast cancer risk among postmenopausal women in the Australian study. CONCLUSIONS While a suggestion of increased risk was seen for premenopausal women in the Canadian study when using the self-reported measure, overall this pooled study does not provide evidence that sedentary work is associated with breast cancer risk.
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Affiliation(s)
- Terry Boyle
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Lindsay C Kobayashi
- Department of Epidemiology and Public Health, University College London, London, UK Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Jane S Heyworth
- School of Population Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Derrick G Lee
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Si Si
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Kristan J Aronson
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - John J Spinelli
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
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Boyle T, Gallagher RP, Gascoyne RD, Connors JM, Le ND, Spinelli JJ. Lifetime physical activity and the risk of non-Hodgkin lymphoma. Cancer Epidemiol Biomarkers Prev 2016; 24:873-7. [PMID: 25934832 DOI: 10.1158/1055-9965.epi-14-1303] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Research regarding the association between physical activity and the risk of non-Hodgkin lymphoma (NHL) is limited and inconsistent, and few studies have investigated whether the intensity and timing of physical activity influence the association. A case-control study of NHL was conducted in British Columbia, Canada, in 2000 to 2004. Data were collected on various NHL risk factors, including moderate-intensity and vigorous-intensity physical activity performed over the lifetime. Logistic regression was used to estimate the association between physical activity and the risk of NHL. This analysis included 818 controls and 749 cases. Lifetime vigorous-intensity physical activity was inversely associated with NHL risk. Participants in the second, third, and fourth quartiles of lifetime vigorous-intensity physical activity had an approximately 25% to 30% lower risk of NHL than those in the lowest quartile [adjusted odds ratios, 0.69 (95% confidence interval [CI], 0.52-0.93); 0.68 (95% CI, 0.50-0.92); and 0.75 (95% CI, 0.55-1.01), respectively]. No consistent associations were observed for total or moderate-intensity physical activity. There were no apparent age periods in which physical activity appeared to confer a greater risk reduction. In this study, we found that lifetime vigorous-intensity physical activity was associated with a significantly reduced risk of NHL. Given this finding, more research on physical activity intensity and timing in relation to NHL risk is warranted.
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Affiliation(s)
- Terry Boyle
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada. School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada. Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.
| | - Richard P Gallagher
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Randy D Gascoyne
- Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Joseph M Connors
- Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Nhu D Le
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - John J Spinelli
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
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Friedenreich CM, Wang Q, Neilson HK, Kopciuk KA, McGregor SE, Courneya KS. Physical Activity and Survival After Prostate Cancer. Eur Urol 2016; 70:576-585. [PMID: 26774959 DOI: 10.1016/j.eururo.2015.12.032] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 12/16/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Despite the high global prevalence of prostate cancer (PCa), few epidemiologic studies have assessed physical activity in relation to PCa survival. OBJECTIVE To evaluate different types, intensities, and timing of physical activity relative to PCa survival. DESIGN, SETTING, AND PARTICIPANTS A prospective study was conducted in Alberta, Canada, in a cohort of 830 stage II-IV incident PCa cases diagnosed between 1997 and 2000 with follow-up to 2014 (up to 17 yr). Prediagnosis lifetime activity was self-reported at diagnosis. Postdiagnosis activity was self-reported up to three times during follow-up. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Cox proportional hazards models related physical activity to all-cause and PCa-specific deaths and to first recurrence/progression of PCa. RESULTS AND LIMITATIONS A total of 458 deaths, 170 PCa-specific deaths, and, after first follow-up, 239 first recurrences/progressions occurred. Postdiagnosis total activity (>119 vs ≤42 metabolic equivalent [MET]-hours/week per year) was associated with a significantly lower all-cause mortality risk (hazard ratio [HR]: 0.58; 95% confidence interval [CI], 0.42-0.79; p value for trend <0.01). Postdiagnosis recreational activity (>26 vs ≤4 MET-hours/week per year) was associated with a significantly lower PCa-specific mortality risk (HR: 0.56; 95% CI, 0.35-0.90; p value for trend = 0.01). Sustained recreational activity before and after diagnosis (>18-20 vs <7-8 MET-hours/week per year) was associated with a lower risk of all-cause mortality (HR: 0.66; 95% CI, 0.49-0.88). Limitations included generalisability to healthier cases and an observational study design. CONCLUSIONS These findings support emerging recommendations to increase physical activity after the diagnosis of PCa and would inform a future exercise intervention trial examining PCa outcomes. PATIENT SUMMARY In a 17-yr prostate cancer (PCa) survival study, men who survived at least 2 yr who were more physically active postdiagnosis or performed more recreational physical activity before and after diagnosis survived longer. Recreational physical activity after diagnosis was associated with a lower risk of PCa death.
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Affiliation(s)
- Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Qinggang Wang
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Heather K Neilson
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Karen A Kopciuk
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Mathematics and Statistics, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - S Elizabeth McGregor
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Population, Public and Aboriginal Health, Alberta Health Services, Calgary, Alberta, Canada
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
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Antiretroviral Therapy, Especially Efavirenz, Is Associated with Low Bone Mineral Density in HIV-Infected South Africans. PLoS One 2015; 10:e0144286. [PMID: 26633015 PMCID: PMC4669137 DOI: 10.1371/journal.pone.0144286] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 11/15/2015] [Indexed: 12/12/2022] Open
Abstract
Purpose We determined the prevalence and correlates of low bone mineral density (BMD) in HIV-infected South Africans as there is a paucity of such data from Africa. Methods BMD and serum 25-hydroxyvitamin D were measured in HIV-positive participants on antiretroviral therapy (ART) and in those not yet on ART (ART-naïve). Results We enrolled 444 participants [median age 35(IQR: 30, 40) years; 77% women]. BMD was low (z score <-2SD) in 17% and 5% of participants at the lumbar spine and total hip, respectively. Total hip [0.909 (SD 0.123) vs 0.956 (SD 0.124) g/cm2, p = 0.0001] and neck of femur BMD [0.796 (SD 0.130) vs 0.844 (SD 0.120) g/cm2, p = 0.0001] were lower in the ART, compared to the ART-naïve group. Vitamin D deficiency was present in 15% of participants and was associated with efavirenz use [adjusted OR 2.04 (95% CI 1.01 to 4.13)]. In a multivariate linear regression, exposure to efavirenz or lopinavir-based ART was associated with lower total hip BMD, whereas higher weight, being male and higher vitamin D concentration were associated with higher total hip BMD (adjusted R2 = 0.28). Age, weight, sex, and the use of efavirenz-based ART were independently associated with lumbar spine BMD (adjusted R2 = 0.13). Conclusions Vitamin D status, use of efavirenz or lopinavir/ritonavir, weight, age and sex are significantly associated with lower BMD in this young cohort of HIV-infected South Africans.
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Association between Lifetime Physical Activity and Cognitive Functioning in Middle-Aged and Older Community Dwelling Adults: Results from the Brain in Motion Study. J Int Neuropsychol Soc 2015; 21:816-30. [PMID: 26581793 DOI: 10.1017/s1355617715000880] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
To determine if total lifetime physical activity (PA) is associated with better cognitive functioning with aging and if cerebrovascular function mediates this association. A sample of 226 (52.2% female) community dwelling middle-aged and older adults (66.5 ± 6.4 years) in the Brain in Motion Study, completed the Lifetime Total Physical Activity Questionnaire and underwent neuropsychological and cerebrovascular blood flow testing. Multiple robust linear regressions were used to model the associations between lifetime PA and global cognition after adjusting for age, sex, North American Adult Reading Test results (i.e., an estimate of premorbid intellectual ability), maximal aerobic capacity, body mass index and interactions between age, sex, and lifetime PA. Mediation analysis assessed the effect of cerebrovascular measures on the association between lifetime PA and global cognition. Post hoc analyses assessed past year PA and current fitness levels relation to global cognition and cerebrovascular measures. Better global cognitive performance was associated with higher lifetime PA (p=.045), recreational PA (p=.021), and vigorous intensity PA (p=.004), PA between the ages of 0 and 20 years (p=.036), and between the ages of 21 and 35 years (p.5), but partially mediated the relation between current fitness and global cognition. This study revealed significant associations between higher levels of PA (i.e., total lifetime, recreational, vigorous PA, and past year) and better cognitive function in later life. Current fitness levels relation to cognitive function may be partially mediated through current cerebrovascular function.
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Tabung FK, Steck SE, Burch JB, Chen CF, Zhang H, Hurley TG, Cavicchia P, Alexander M, Shivappa N, Creek KE, Lloyd SC, Hebert JR. A healthy lifestyle index is associated with reduced risk of colorectal adenomatous polyps among non-users of non-steroidal anti-inflammatory drugs. J Prim Prev 2015; 36:21-31. [PMID: 25331980 DOI: 10.1007/s10935-014-0372-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In a Columbia, South Carolina-based case-control study, we developed a healthy lifestyle index from five modifiable lifestyle factors (smoking, alcohol intake, physical activity, diet, and body mass index), and examined the association between this lifestyle index and the risk of colorectal adenomatous polyps (adenoma). Participants were recruited from a local endoscopy center and completed questionnaires related to lifestyle behaviors prior to colonoscopy. We scored responses on each of five lifestyle factors as unhealthy (0 point) or healthy (1 point) based on current evidence and recommendations. We added the five scores to produce a combined lifestyle index for each participant ranging from 0 (least healthy) to 5 (healthiest), which was dichotomized into unhealthy (0-2) and healthy (3-5) lifestyle scores. We used logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI) for adenoma with adjustment for multiple covariates. We identified 47 adenoma cases and 91 controls. In the main analyses, there was a statistically nonsignificant inverse association between the dichotomous (OR 0.54; 95% CI 0.22, 1.29) and continuous (OR 0.75; 95% CI 0.51, 1.10) lifestyle index and adenoma. Odds of adenoma were significantly modified by the use of non-steroidal anti-inflammatory drugs (NSAIDs) (p(interaction) = 0.04). For participants who reported no use of NSAIDs, those in the healthy lifestyle category had a 72% lower odds of adenoma as compared to those in the unhealthy category (OR 0.28; 95% CI 0.08, 0.98), whereas a one-unit increase in the index significantly reduced odds of adenoma by 53% (OR 0.47; 95% CI 0.26, 0.88). Although these findings should be interpreted cautiously given our small sample size, our results suggest that higher scores from this index are associated with reduced odds of adenomas, especially in non-users of NSAIDs. Lifestyle interventions are required to test this approach as a strategy to prevent colorectal adenomatous polyps.
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Affiliation(s)
- Fred K Tabung
- Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, 4th Floor, Columbia, SC, 29208, USA,
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Nygaard IE, Shaw JM, Bardsley T, Egger MJ. Lifetime physical activity and female stress urinary incontinence. Am J Obstet Gynecol 2015; 213:40.e1-40.e10. [PMID: 25640047 DOI: 10.1016/j.ajog.2015.01.044] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We sought to estimate whether moderate/severe stress urinary incontinence (SUI) in middle-aged women is associated with overall lifetime physical activity (including leisure, household, outdoor, and occupational), as well as lifetime leisure (recreational), lifetime strenuous, and strenuous activity during the teen years. STUDY DESIGN Recruitment for this case-control study was conducted in primary-care-level family medicine and gynecology clinics. A total of 1538 enrolled women ages 39-65 years underwent a Pelvic Organ Prolapse Quantification examination to assess vaginal support. Based on Incontinence Severity Index scores, cases had moderate/severe and controls had no/mild SUI. We excluded 349 with vaginal descent at/below the hymen (pelvic organ prolapse), 194 who did not return questionnaires, and 110 with insufficient activity data for analysis. In all, 213 cases were frequency matched 1:1 by age group to controls. Physical activity was measured using the Lifetime Physical Activity Questionnaire, in which women recall activity from menarche to present. We created separate multivariable logistic regression models for activity measures. RESULTS SUI odds increased slightly with overall lifetime activity (odds ratio [OR], 1.20 per 70 additional metabolic equivalent of task-h/wk; 95% confidence interval [CI], 1.02-1.41), and were not associated with lifetime strenuous activity (OR, 1.11; 95% CI, 0.99-1.25). In quintile analysis of lifetime leisure activity, which demonstrated a nonlinear pattern, all quintiles incurred about half the odds of SUI compared to reference (second quintile; P = .009). Greater strenuous activity in teen years modestly increased SUI odds (OR, 1.37 per 7 additional h/wk; 95% CI, 1.09-1.71); OR, 1.75; 95% CI, 1.15-2.66 in sensitivity analysis adjusting for measurement error. The predicted probability of SUI rose linearly in women exceeding 7.5 hours of strenuous activity/wk during teen years. Teen strenuous activity had a similar effect on SUI odds when adjusted for subsequent strenuous activity during ages 21-65 years. CONCLUSION In middle-aged women, a slight increased odds of SUI was noted only after substantially increased overall lifetime physical activity. Increased lifetime leisure activity decreased and lifetime strenuous activity appeared unrelated to SUI odds. Greater strenuous activity during teen years modestly increased SUI odds.
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Fleckenstein J, Matura S, Engeroff T, Füzéki E, Tesky VA, Pilatus U, Hattingen E, Deichmann R, Vogt L, Banzer W, Pantel J. SMART: physical activity and cerebral metabolism in older people: study protocol for a randomised controlled trial. Trials 2015; 16:155. [PMID: 25872789 PMCID: PMC4403840 DOI: 10.1186/s13063-015-0662-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/18/2015] [Indexed: 11/10/2022] Open
Abstract
Background Physical activity exerts a variety of long-term health benefits in older adults. In particular, it is assumed to be a protective factor against cognitive decline and dementia. Methods/design Randomised controlled assessor blinded 2-armed trial (n = 60) to explore the exercise- induced neuroprotective and metabolic effects on the brain in cognitively healthy older adults. Participants (age ≥ 65), recruited within the setting of assisted living facilities and newspaper advertisements are allocated to a 12-week individualised aerobic exercise programme intervention or a 12-week waiting control group. Total follow-up is 24 weeks. The main outcome is the change in cerebral metabolism as assessed with Magnetic Resonance Spectroscopic Imaging reflecting changes of cerebral N-acetyl-aspartate and of markers of neuronal energy reserve. Imaging also measures changes in cortical grey matter volume. Secondary outcomes include a broad range of psychometric (cognition) and movement-related parameters such as nutrition, history of physical activity, history of pain and functional diagnostics. Participants are allocated to either the intervention or control group using a computer-generated randomisation sequence. The exercise physiologist in charge of training opens sealed and opaque envelopes and informs participants about group allocation. For organisational reasons, he schedules the participants for upcoming assessments and exercise in groups of five. All assessors and study personal other than exercise physiologists are blinded. Discussion Magnetic Resonance Spectroscopic Imaging gives a deeper insight into mechanisms of exercise-induced changes in brain metabolism. As follow-up lasts for 6 months, this study is able to explore the mid-term cerebral metabolic effects of physical activity assuming that an individually tailored aerobic ergometer training has the potential to counteract brain ageing. Trial registration NCT02343029 (clinicaltrials.gov; 12 January 2015).
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Affiliation(s)
- Johannes Fleckenstein
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Ginnheimer Landstrasse 39, Frankfurt am Main, 60487, Germany.
| | - Silke Matura
- Institute of General Practice, Goethe University, Frankfurt/Main, Germany.
| | - Tobias Engeroff
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Ginnheimer Landstrasse 39, Frankfurt am Main, 60487, Germany.
| | - Eszter Füzéki
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Ginnheimer Landstrasse 39, Frankfurt am Main, 60487, Germany.
| | - Valentina A Tesky
- Institute of General Practice, Goethe University, Frankfurt/Main, Germany.
| | - Ulrich Pilatus
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt, Germany.
| | - Elke Hattingen
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt, Germany.
| | | | - Lutz Vogt
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Ginnheimer Landstrasse 39, Frankfurt am Main, 60487, Germany.
| | - Winfried Banzer
- Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Ginnheimer Landstrasse 39, Frankfurt am Main, 60487, Germany.
| | - Johannes Pantel
- Institute of General Practice, Goethe University, Frankfurt/Main, Germany.
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Thomson MD, Siminoff LA. Perspectives on mammography after receipt of secondary screening owing to a false positive. Womens Health Issues 2015; 25:128-33. [PMID: 25648490 PMCID: PMC4355242 DOI: 10.1016/j.whi.2014.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 11/04/2014] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND The utility of mammography screening as an efficacious tool for early detection is being contested owing to the risk of potential harms, including psychological distress and exposure to unnecessary procedures associated with false-positive (FPs) results and overdiagnosis. However, there is little research regarding women's experiences, values, or preferences for participating in mammography programs. Our aim was to explore women's actual experiences of a FP mammography screen and their perceptions of the value, risks and benefits given their recent experience. METHODS We conducted semistructured interviews with 40 women who experienced a recent FP mammogram. Interviews were recorded and transcribed verbatim. A directed content analysis was used to identify and explore primary themes. Knowledge of breast cancer risk was also assessed. FINDINGS Receiving a FP mammography screen generated significant worry among 60% (n=24) of women. Yet 70% maintained that mammography screening was necessary despite the worry incurred. Women also described the experience as stimulating greater interest in additional cancer prevention activities (32.5%; n=13) and one-third discussed needing more information about the risks and benefits of mammography screening. Less than one-quarter of women (22.5%; n=9) correctly identified a women's lifetime risk of developing breast cancer; 20% (n=8) overestimated, and 57.5% (n=23) underestimated this risk. CONCLUSION Women reported needing more information about the risks and benefits of mammography screening, but also considered FP results an acceptable risk. Further, our results suggest that breast cancer screening programs may provide a unique opportunity to deliver additional breast cancer prevention interventions.
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Affiliation(s)
- Maria D. Thomson
- Department of Social and Behavioral Health, Virginia Commonwealth University, P.O. Box 980149, Richmond, VA, 23219, U.S.A., Telephone: 804-628-2640, Fax: 804-828-5440
| | - Laura A. Siminoff
- Dean and Laura H Carnell Professor of Public Health in the College of Health Professions and Social Work, Temple University, 3307 N. Broad Street, 300 jones Hall, Philadelphia, PA, 19140, U.S.A., Telephone: 215-707-4800, Fax: 215-707-7819
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Crandall CJ, Karlamangla AS, Merkin SS, Binkley N, Carr D, Greendale GA, Seeman TE. Adult bone strength of children from single-parent families: the Midlife in the United States Study. Osteoporos Int 2015; 26:931-42. [PMID: 25510582 PMCID: PMC4344315 DOI: 10.1007/s00198-014-2990-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 12/05/2014] [Indexed: 11/30/2022]
Abstract
UNLABELLED Bone health may be negatively impacted by childhood socio-environmental circumstances. We examined the independent associations of single-parent childhood and parental death or divorce in childhood with adult bone strength indices. Longer exposure to a single-parent household in childhood was associated with lower bone strength in adulthood. INTRODUCTION Because peak bone mass is acquired during childhood, bone health may be negatively impacted by childhood socio-environmental disadvantage. The goal of this study was to determine whether being raised in a single-parent household is associated with lower bone strength in adulthood. METHODS Using dual-energy X-ray absorptiometry data from 708 participants (mean age 57 years) in the Midlife in the United States Biomarker Project, we examined the independent associations of composite indices of femoral neck bone strength relative to load (in three failure modes: compression, bending, and impact) in adulthood with the experience of single-parent childhood and parental death or divorce in childhood. RESULTS After adjustment for gender, race, menopause transition stage, age, and body mass index, each additional year of single-parent childhood was associated with 0.02 to 0.03 SD lower indices of adult femoral neck strength. In those with 9-16 years of single-parent childhood, the compression strength index was 0.41 SD lower, bending strength index was 0.31 SD lower, and impact strength index was 0.25 SD lower (all p values < 0.05). In contrast, parental death or divorce during childhood was not by itself independently associated with adult bone strength indices. The magnitudes of these associations were unaltered by additional adjustment for lifestyle factors and socioeconomic status in childhood and adulthood. CONCLUSIONS Independent of parental death or divorce, growing up in a single-parent household is associated with lower femoral neck bone strength in adulthood, and this association is not entirely explained by childhood or adult socioeconomic conditions or lifestyle choices.
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Affiliation(s)
- Carolyn J. Crandall
- Dept. of Medicine, David Geffen School of Medicine at University of California, Los Angeles, UCLA Medicine/GIM, 911 Broxton Ave., 1 floor, Los Angeles, CA, 90024
| | - Arun S. Karlamangla
- Division of Geriatrics, Dept. of Medicine, David Geffen School of Medicine at University of California, Los Angeles, 10945 Le Conte. Ave., Ste 2339, Los Angeles, CA, 90095,
| | - Sharon Stein Merkin
- Division of Geriatrics, Dept. of Medicine, David Geffen School of Medicine at University of California, Los Angeles, 10945 Le Conte. Ave., Ste 2339, Los Angeles, CA, 90095,
| | - Neil Binkley
- Osteoporosis Clinical Center and Research Program and, University of Wisconsin, 2870 University Ave., Suite 100, Madison, Wisconsin, 53705
| | - Deborah Carr
- Department of Sociology, Rutgers University, 112 Paterson Street New Brunswick, NJ 08901,
| | - Gail A. Greendale
- Division of Geriatrics, Dept. of Medicine, David Geffen School of Medicine at University of California, Los Angeles, 10945 Le Conte. Ave., Ste 2339, Los Angeles, CA, 90095,
| | - Teresa E. Seeman
- Division of Geriatrics, Dept. of Medicine, David Geffen School of Medicine at University of California, Los Angeles, 10945 Le Conte. Ave., Ste 2339, Los Angeles, CA, 90095,
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Does bracing affect bone health in women with adolescent idiopathic scoliosis? SCOLIOSIS 2015; 10:5. [PMID: 25729407 PMCID: PMC4343046 DOI: 10.1186/s13013-015-0031-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 02/03/2015] [Indexed: 11/10/2022]
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) is often associated with low bone mineral content and density (BMC, BMD). Bracing, used to manage spine curvature, may interfere with the growth-related BMC accrual, resulting in reduced bone strength into adulthood. The purpose of this study was to assess the effects of brace treatment on BMC in adult women, diagnosed with AIS and braced in early adolescence. METHODS Participants included women with AIS who: (i) underwent brace treatment (AIS-B, n = 15, 25.6 ± 5.8 yrs), (ii) underwent no treatment (AIS, n = 15, 24.0 ± 4.0 yrs), and (iii) a healthy comparison group (CON, n = 19, 23.5 ± 3.8 yrs). BMC and body composition were assessed using dual-energy X-ray absorptiometry. Differences between groups were examined using a oneway ANOVA or ANCOVA, as appropriate. RESULTS AIS-B underwent brace treatment 27.9 ± 21.6 months, for 18.0 ± 5.4 h/d. Femoral neck BMC was lower (p = 0.06) in AIS-B (4.54 ± 0.10 g) compared with AIS (4.89 ± 0.61 g) and CON (5.07 ± 0.58 g). Controlling for lean body mass, calcium and vitamin D daily intake, and strenuous physical activity, femoral neck BMC was statistically different (p = 0.02) between groups. A similar pattern was observed at other lower extremity sites (p < 0.05), but not in the spine or upper extremities. BMC and BMD did not correlate with duration of brace treatment, duration of daily brace wear, or overall physical activity. CONCLUSION Young women with AIS, especially those who were treated with a brace, have significantly lower BMC in their lower limbs compared to women without AIS. However, the lack of a relationship between brace treatment duration during adolescence and BMC during young adulthood, suggests that the brace treatment is not the likely mechanism of the low BMC.
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Thomson MD, Siminoff LA. Finding medical care for colorectal cancer symptoms: experiences among those facing financial barriers. HEALTH EDUCATION & BEHAVIOR 2015; 42:46-54. [PMID: 25394821 PMCID: PMC4604569 DOI: 10.1177/1090198114557123] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Financial barriers can substantially delay medical care seeking. Using patient narratives provided by 252 colorectal cancer patients, we explored the experience of financial barriers to care seeking. Of the 252 patients interviewed, 84 identified financial barriers as a significant hurdle to obtaining health care for their colorectal cancer symptoms. Using verbatim transcripts of the narratives collected from patients between 2008 and 2010, three themes were identified: insurance status as a barrier (discussed by n = 84; 100% of subsample), finding medical care (discussed by n = 30; 36% of subsample) and, insurance companies as barriers (discussed by n = 7; 8% of subsample). Our analysis revealed that insurance status is more nuanced than the categories insured/uninsured and differentially affects how patients attempt to secure health care. While barriers to medical care for the uninsured have been well documented, the experiences of those who are underinsured are less well understood. To improve outcomes in these patients it is critical to understand how financial barriers to medical care are manifested. Even with anticipated changes of the Affordable Care Act, it remains important to understand how perceived financial barriers may be influencing patient behaviors, particularly those who have limited health care options due to insufficient health insurance coverage.
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Bolam KA, Beck BR, Adlard KN, Skinner TL, Cormie P, Galvão DA, Spry N, Newton RU, Taaffe DR. The relationship between BPAQ-derived physical activity and bone density of middle-aged and older men. Osteoporos Int 2014; 25:2663-8. [PMID: 24993816 DOI: 10.1007/s00198-014-2797-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED The bone-specific physical activity questionnaire (BPAQ) accounts for activities that affect bone but has not been used in studies with older adults. Relationships exist between the BPAQ-derived physical activity and bone density in healthy middle-aged and older men but not men with prostate cancer. Disease-related treatments detrimental to bone should be considered when administering the BPAQ. INTRODUCTION The bone-specific physical activity questionnaire (BPAQ) was developed to account for bone-specific loading. In this retrospective study, we examined the relationship between BPAQ-derived physical activity and bone mineral density (BMD) in middle-aged and older men with and without prostate cancer. METHODS Two groups, 36 healthy men and 69 men with prostate cancer receiving androgen suppression therapy (AST), completed the BPAQ and had whole body, total hip, femoral (FN) and lumbar spine BMD assessed by dual-energy X-ray absorptiometry. RESULTS Past (pBPAQ), current (cBPAQ) and total BPAQ (tBPAQ) scores for the healthy men were related to FN BMD (pBPAQ r = 0.36, p = 0.030; cBPAQ r s = 0.35, p = 0.034; tBPAQ r = 0.41, p = 0.014), and pBPAQ and tBPAQ were related to total hip (r s = 0.35, p = 0.035 and r s = 0.36, p = 0.029, respectively) and whole body BMD (r s = 0.44, p = 0.007 and r s = 0.45, p = 0.006, respectively). In men with prostate cancer, the BPAQ was not significantly associated with BMD. In stepwise regression analyses, body mass and tBPAQ predicted 30 % of the variance in total hip BMD (p = 0.003), cBPAQ predicted 14 % of the variance in FN BMD (p = 0.002), and body mass, age and tBPAQ predicted 47% of the variance in whole body BMD (p < 0.001) in healthy men. In men with prostate cancer, the BPAQ was not an independent predictor of BMD. CONCLUSIONS Although BPAQ-derived estimates of physical activity are related to bone status in healthy middle-aged and older men, the adverse effect of AST on bone appears to obscure this relationship in men with prostate cancer.
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Affiliation(s)
- K A Bolam
- School of Human Movement Studies, The University of Queensland, Brisbane, QLD, Australia,
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Keegan THM, Shariff-Marco S, Sangaramoorthy M, Koo J, Hertz A, Schupp CW, Yang J, John EM, Gomez SL. Neighborhood influences on recreational physical activity and survival after breast cancer. Cancer Causes Control 2014; 25:1295-308. [PMID: 25088804 PMCID: PMC4194215 DOI: 10.1007/s10552-014-0431-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 07/01/2014] [Indexed: 01/07/2023]
Abstract
PURPOSE Higher levels of physical activity have been associated with improved survival after breast cancer diagnosis. However, no previous studies have considered the influence of the social and built environment on physical activity and survival among breast cancer patients. METHODS Our study included 4,345 women diagnosed with breast cancer (1995-2008) from two population-based studies conducted in the San Francisco Bay Area. We examined questionnaire-based moderate/strenuous recreational physical activity during the 3 years before diagnosis. Neighborhood characteristics were based on data from the 2000 US Census, business listings, parks, farmers' markets, and Department of Transportation. Survival was evaluated using multivariable Cox proportional hazards models, with follow-up through 2009. RESULTS Women residing in neighborhoods with no fast-food restaurants (vs. fewer fast-food restaurants) to other restaurants, high traffic density, and a high percentage of foreign-born residents were less likely to meet physical activity recommendations set by the American Cancer Society. Women who were not recreationally physically active had a 22% higher risk of death from any cause than women that were the most active. Poorer overall survival was associated with lower neighborhood socioeconomic status (SES) (p(trend) = 0.02), whereas better breast cancer-specific survival was associated with a lack of parks, especially among women in high-SES neighborhoods. CONCLUSION Certain aspects of the neighborhood have independent associations with recreational physical activity among breast cancer patients and their survival. Considering neighborhood factors may aide in the design of more effective, tailored physical activity programs for breast cancer survivors.
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Affiliation(s)
- Theresa H M Keegan
- Cancer Prevention Institute of California, 2201 Walnut Ave, Suite 300, Fremont, CA, 94538, USA,
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"How Hard Could it Be?" A Descriptive Analysis of Errors Made on a Validated Lifetime Physical Activity Questionnaire. J Phys Act Health 2014; 12:388-94. [PMID: 24809450 DOI: 10.1123/jpah.2013-0247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Measuring historical physical activity in epidemiologic research depends on self-report. We aimed to describe data reporting errors women made in completing 2 validated questionnaires: Lifetime Physical Activity Questionnaire (LPAQ) and Occupational Questionnaire (OQ). METHODS Participants--229 women aged 38 to 65 years--completed questionnaires on paper (n = 160) or by web interface (n = 69). One research assistant collected questionnaire data, identified potential errors and contacted participants to trouble-shoot errors. RESULTS Women made mean 9.7 (SD 11.2) errors on paper and 7.1 (SD 6.2) errors on electronic versions of the LPAQ and 2.6 (SD 3.8) and 1.1 (SD 1.4) errors on paper and electronic versions of the OQ, respectively. Fewer mistakes were made on electronic versions of both questionnaires combined (8.5 ± 6.1) when compared with the paper versions (12.7 ± 13.1). Only ~2% of the sample completed all questionnaires without detectable errors. The most common errors were reporting activities or frequencies inconsistently between past year survey and the current age epoch, reporting more years than allowed by age epoch and missing information. CONCLUSIONS Despite the implications of "self-report" questionnaires, we recommend researchers provide participants with additional instructions, either verbally or as written tip sheet or both, and follow-up after questionnaire completion to correct mistakes as needed.
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NYGAARD IE, SHAW JM, BARDSLEY T, EGGER MJ. Lifetime physical activity and pelvic organ prolapse in middle-aged women. Am J Obstet Gynecol 2014; 210:477.e1-12. [PMID: 24486225 PMCID: PMC4011990 DOI: 10.1016/j.ajog.2014.01.035] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 12/11/2013] [Accepted: 01/23/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine, in a case-control study, whether pelvic organ prolapse (POP) is associated with overall lifetime physical activity (combined leisure, outdoor, household, occupational), and lifetime leisure, lifetime strenuous, and teen years strenuous activity. STUDY DESIGN One hundred ninety-one POP cases (defined as maximal vaginal descent ≥1 cm below the hymen) and 191 age and recruitment-site matched controls (defined as maximal vaginal descent ≤1 cm above the hymen) between 39-65 years with no or mild urinary incontinence, were recruited chiefly from primary care clinics. Participants completed Lifetime Physical Activity and Occupation Questionnaires, recalling activities during 4 age epochs. We performed separate logistic regression models for physical activity measures. RESULTS Compared with controls, POP cases had greater body mass index and parity. Median overall lifetime activity, expressed in metabolic equivalents-hours/week, did not differ significantly between cases and controls. In adjusted analyses, we observed no associations between odds of POP and overall lifetime physical activity, lifetime leisure activity, or lifetime strenuous activity. There was a marginally significant nonlinear relationship between teen strenuous activity and POP with an increase in the log-odds of POP for women reporting ≥21 hours/week of strenuous activity (P = .046). CONCLUSION Lifetime physical activity does not increase the odds of anatomic POP in middle-aged women not seeking care for POP. Strenuous activity during teenage years may confer higher odds of POP. This relationship and the potential role of physical activity and POP incidence should be evaluated prospectively.
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Affiliation(s)
| | - Janet M. SHAW
- Department of Exercise and Sport Science, University of Utah
| | - Tyler BARDSLEY
- Department of Obstetrics and Gynecology, University of Utah
| | - Marlene J. EGGER
- Department of Family and Preventive Medicine, University of Utah
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71
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Williams PT. Significantly greater reduction in breast cancer mortality from post-diagnosis running than walking. Int J Cancer 2014; 135:1195-202. [DOI: 10.1002/ijc.28740] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 01/14/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Paul T. Williams
- Life Sciences Division, Lawrence Berkeley National Laboratory; Berkeley CA
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Siminoff L, Thomson M, Dumenci L. Factors associated with delayed patient appraisal of colorectal cancer symptoms. Psychooncology 2014; 23:981-8. [PMID: 24615789 DOI: 10.1002/pon.3506] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 01/09/2014] [Accepted: 01/27/2014] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate the relationship between symptoms, financial and cognitive barriers with patient delays in seeking evaluation of symptoms. METHODS Data were collected from 252 colorectal cancer patients from academic and community oncology practices in Virginia and Ohio. We used a cross-sectional, mixed methods design collected data through patient interviews and medical record reviews. Structural equation modeling (SEM) tested the hypothesized relationships between symptoms, financial and cognitive barriers and patient care seeking delays. RESULTS In bivariate analyses, patients who reported a financial barrier to accessing health care (t (246) = -2.6, p < 0.01) were more likely to have greater care-seeking delays. Model testing revealed that experiencing cognitive barriers was a significant, positive, direct predictor of appraisal delay (0.35; p < 0.01). Indirect pathways from symptoms (0.07; p < 0.05) and financial barriers (0.09; p < 0.05) to appraisal delay via cognitive barriers were significant. CONCLUSIONS Patient interpretations of symptoms were influenced by financial barriers. Conceptualizing financial barriers as a component of the symptom appraisal process is conceptually different from viewing it as only a structural barrier preventing healthcare access. Implications for practice These findings extend our understanding of why and how patients seemingly ignore serious symptoms, which hamper physician ability to provide curative therapy. In addition to uninsured patients, this may have important implications for the treatment and care of those who are underinsured.
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Affiliation(s)
- Laura Siminoff
- College Health Professions & Social Work, Jones Hall 302, Philadelphia, PA, USA
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Amiri P, Jalali-Farahani S, Zarkesh M, Barzin M, Kaviani R, Ahmadizad S. Reliability and validity of the Iranian version of the QAPACE in adolescents. Qual Life Res 2014; 23:1797-802. [PMID: 24563109 DOI: 10.1007/s11136-014-0625-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to determine the reliability and validity of the Iranian version of the Quantification de l'Activite Physique en Altitude Chez les Enfants (QAPACE) in adolescents. METHODS After linguistic validation, the Iranian version of the QAPACE was completed by 359 (52.4 % girls) schoolchildren, aged 15-18 years. Test-retest reliability of the questionnaire was determined by intraclass correlation coefficients (ICCs). For validation purposes, two methods were used for (1) the correlation between VO2peak and the DEE and (2) known-group validity, which was examined by comparing the normal weight adolescents and those who were overweight/obese. RESULTS ICCs for test-retest ranged from 0.79 to 0.98. The mean scores in test-retest surveys for total score and all of the subscores were significant (p < 0.05). Sex-specific analysis showed a significant correlation between VO2peak and DEE over 12-month, school, and vacation periods in girls (p < 0.05). The mean values for all activities except for transportation, other activities in school, personal artistic activities, sport competition, and home activities were significantly lower in overweight/obese group than normal group. CONCLUSION Our results support the initial reliability and validity of the Iranian version of QAPACE as a daily physical activity measure in adolescents.
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Affiliation(s)
- Parisa Amiri
- Research Center for Social Determinants of Endocrine Health, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Cuevas BT, Hughes DC, Parma DL, Treviño-Whitaker RA, Ghosh S, Li R, Ramirez AG. Motivation, exercise, and stress in breast cancer survivors. Support Care Cancer 2013; 22:911-7. [PMID: 24249424 DOI: 10.1007/s00520-013-2038-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 10/28/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE Reduced stress and reduced risk of cancer recurrence are among the many benefits of physical activity (PA) for cancer survivors. Exercise behaviors are linked to motivational factors. We investigated the associations between motivational profile, self-reported levels of PA and stress, and mental functioning in 94 posttreatment breast cancer survivors who voluntarily enrolled in an exercise program. METHODS Participants completed the Apter Motivational Style Profile (AMSP), Lifetime of Physical Activity (LTPA) Questionnaire, International Physical Activity Questionnaire (IPAQ), Medical Outcomes Short Form SF-36® (SF-36), and Perceived Stress Scale (PSS) and provided 10 saliva specimens (to measure cortisol levels). PA levels were calculated in metabolic equivalent hours per week (MET-hours/week). RESULTS Participants reported high levels of current and historical PA (M = 39.2 MET-h/week, SD = 39.7; M = 14.2 MET-h/week, SD = 15.4, respectively). They also reported high levels of stress (M = 33.6, SD = 4.5) coupled with low mental functionality as measured by SF-36 mental component scale (MCS) (M = 44.4, SD = 8.8). PSS was negatively associated with MCS (r = -0.27, p = 0.009). Salivary cortisol was not associated with any measure. Participants had a conformist ("follow rules") and alloic ("about others") motivational profile. No motivational, exercise history, or stress variables were associated with current PA. CONCLUSIONS As expected, participants reported higher levels of stress and lower mental functioning. Participants presented a unique motivational profile relative to the general population. Further research into the associations of motivation, exercise behaviors, and stress is warranted.
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Affiliation(s)
- Brandi T Cuevas
- Institute for Health Promotion Research, The University of Texas Health Science Center at San Antonio, 7411 John Smith Drive, Suite 1000, San Antonio, TX, 78229, USA,
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Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA, Richardson CR, Smith DT, Swartz AM. Guide to the Assessment of Physical Activity: Clinical and Research Applications. Circulation 2013; 128:2259-79. [DOI: 10.1161/01.cir.0000435708.67487.da] [Citation(s) in RCA: 584] [Impact Index Per Article: 53.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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A case–control study of lifetime light intensity physical activity and breast cancer risk. Cancer Causes Control 2013; 25:133-40. [DOI: 10.1007/s10552-013-0312-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 10/12/2013] [Indexed: 02/01/2023]
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Karlamangla AS, Mori T, Merkin SS, Seeman TE, Greendale GA, Binkley N, Crandall CJ. Childhood socioeconomic status and adult femoral neck bone strength: findings from the Midlife in the United States Study. Bone 2013; 56:320-6. [PMID: 23810840 PMCID: PMC3784306 DOI: 10.1016/j.bone.2013.06.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 05/16/2013] [Accepted: 06/18/2013] [Indexed: 11/22/2022]
Abstract
PURPOSE Bone acquisition in childhood impacts adult bone mass, and can be influenced by childhood socioeconomic conditions. Socioeconomic status is also associated with body weight which affects the load that bone is exposed to in a fall. We hypothesized that socioeconomic advantage in childhood is associated with greater bone strength relative to load in adulthood. METHODS Hip dual x-ray absorptiometry scans from 722 participants in the Midlife in the United States Study were used to measure femoral neck size and bone mineral density, and combined with body weight and height to create composite indices of femoral neck strength relative to load in different failure modes: compression, bending, and impact. A childhood socioeconomic advantage score was created for the same participants from parental education, self-rated financial status relative to others, and not being on welfare. Multiple linear regression was used to determine the association of childhood socioeconomic advantage with femoral neck composite strength indices, stratified by gender and race (white/non-white), and adjusted for study site, age, menopause status in women, education, and current financial advantage. RESULTS Childhood socioeconomic advantage was independently associated with higher indices of all three composite strength indices in white men (adjusted standardized effect sizes, 0.19 to 0.27, all p values<0.01), but not in the other three race/gender groups. Additional adjustment for adult obesity, physical activity in different life stages, smoking, and heavy drinking over the life-course significantly attenuated the associations in white men. CONCLUSIONS Socioeconomic disadvantage in childhood is associated with lower hip strength relative to load in white men, and these influences are dampened by healthy lifestyle choices.
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Affiliation(s)
- Arun S Karlamangla
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, 10945 Le Conte Ave., Suite 2339, Los Angeles, CA 90095, USA.
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Boyle T, Fritschi L, Platell C, Heyworth J. Lifestyle factors associated with survival after colorectal cancer diagnosis. Br J Cancer 2013; 109:814-22. [PMID: 23787918 PMCID: PMC3738138 DOI: 10.1038/bjc.2013.310] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 05/29/2013] [Accepted: 05/30/2013] [Indexed: 12/12/2022] Open
Abstract
Background: Aside from tumour stage and treatment, little is known about potential factors that may influence survival in colorectal cancer patients. The aim of this study was to investigate the associations between physical activity, obesity and smoking and disease-specific and overall mortality after a colorectal cancer diagnosis. Methods: A cohort of 879 colorectal cancer patients, diagnosed in Western Australia between 2005 and 2007, were followed up to 30 June 2012. Cox's regression models were used to estimate the hazard ratios (HR) for colorectal cancer-specific and overall mortality associated with self-reported pre-diagnosis physical activity, body mass index (BMI) and smoking. Results: Significantly lower overall and colorectal cancer-specific mortality was seen in females who reported any level of recent physical activity than in females reporting no activity. The colorectal cancer-specific mortality HR for increasing levels of physical activity in females were 0.34 (95% CI=0.15, 0.75), 0.37 (95% CI=0.17, 0.81) and 0.41 (95% CI=0.18, 0.90). Overweight and obese women had almost twice the risk of dying from any cause or colorectal cancer compared with women of normal weight. Females who were current smokers had worse overall and colorectal cancer-specific mortality than never smokers (overall HR=2.64, 95% CI=1.18, 5.93; colorectal cancer-specific HR=2.70, 95% CI=1.16, 6.29). No significant associations were found in males. Conclusion: Physical activity, BMI and smoking may influence survival after a diagnosis of colorectal cancer, with more pronounced results found for females than for males.
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Affiliation(s)
- T Boyle
- Western Australian Institute for Medical Research, The University of Western Australia, Perth, Australia.
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Moderate-to-vigorous intensity physical activity across the life course and risk of pre- and post-menopausal breast cancer. Breast Cancer Res Treat 2013; 139:851-61. [DOI: 10.1007/s10549-013-2596-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 06/03/2013] [Indexed: 12/11/2022]
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Web versus paper-based completion of the epidemiology of prolapse and incontinence questionnaire. Female Pelvic Med Reconstr Surg 2013; 19:17-22. [PMID: 23321654 DOI: 10.1097/spv.0b013e31827bfd93] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to examine the validity and reliability of a Web-based version of the epidemiology of prolapse and incontinence questionnaire (EPIQ). METHODS Participants included 876 women age 38 to 65 years attending primary care clinics in the Salt Lake Valley. Women completed a single Web- or paper-based version of the symptom bother questions from EPIQ, and a subset repeated the same or opposite method at 2 separate time points. To assess subscales for the Web-based version factor, analysis of the 22 EPIQ items related to pelvic floor disorder symptoms was performed using principal components analysis and varimax rotation. Internal consistency was assessed using coefficient α. Test-retest and intermethod reliability were assessed using intraclass correlation coefficients for domain scores. Correlations above 0.70 were considered acceptable. RESULTS Overall, 384 and 492 women completed at least 1 Web and 1 paper EPIQ and 93% were white with mean age of 50 (7) years. Of these, 63 completed Web-Web, 57 Web-paper, 47 paper-Web, and 109 paper-paper test-retest. Overall, factor analyses were consistent with the 7 domains of the original EPIQ. Cronbach α for the 4 symptomatic pelvic floor disorder domains and range of test-retest reliability for the various administration methods were similar to the original EPIQ instrument. Correlations for domain scores were above 0.70, except the anal incontinence scale (intraclass correlation coefficients, 0.68.) CONCLUSIONS Web administration of the EPIQ has similar psychometric properties with comparable internal consistency and test-retest reliability when administered in the same modality. Reliability between both methods of administration is acceptable.
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81
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A case–control study of lifetime occupational sitting and likelihood of breast cancer. Cancer Causes Control 2013; 24:1257-62. [DOI: 10.1007/s10552-013-0194-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 03/18/2013] [Indexed: 10/27/2022]
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Sutcliffe S, Colditz GA. Prostate cancer: is it time to expand the research focus to early-life exposures? Nat Rev Cancer 2013; 13:208-518. [PMID: 23363989 PMCID: PMC3962783 DOI: 10.1038/nrc3434] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Although the contribution of lifestyle and environment (non-genetic factors) to prostate carcinogenesis is indicated by international variation in prostate cancer occurrence and migration studies, no conclusive modifiable risk factors have yet been identified. One possible reason for this may be the dearth of epidemiological research on exposures experienced early in life, when the immature prostate may be more susceptible to carcinogenic exposures. In this Opinion article, we summarize the rationale for studying early-life exposures, describe the small body of early-life research and its associated challenges, and point to solutions for future research.
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Affiliation(s)
- Siobhan Sutcliffe
- The Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, Missouri 63110, USA.
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Smith AW, Cronin KA, Bowles H, Willis G, Jacobs DR, Ballard-Barbash R, Troiano RP. Reproducibility of physical activity recall over fifteen years: longitudinal evidence from the CARDIA study. BMC Public Health 2013; 13:180. [PMID: 23448132 PMCID: PMC3602096 DOI: 10.1186/1471-2458-13-180] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 02/14/2013] [Indexed: 11/13/2022] Open
Abstract
Background To examine the benefits of physical activity (PA) on diseases with a long developmental period, it is important to determine reliability of long-term PA recall. Methods We investigated 15-year reproducibility of PA recall. Participants were 3605 White and African-American adults in the Coronary Artery Risk Development in Young Adults study, aged 33–45 at the time of recall assessment. Categorical questions assessed PA before and during high school (HS) and overall PA level at Baseline, with the same timeframes recalled 15 years later. Moderate- and vigorous-intensity scores were calculated from reported months of participation in specific activities. Results HS PA recall had higher reproducibility than overall PA recall (weighted kappa = 0.43 vs. 0.21). Correlations between 15-year recall and Baseline reports of PA were r = 0.29 for moderate-intensity scores, and r = 0.50 for vigorous-intensity. Recall of vigorous activities had higher reproducibility than moderate-intensity activities. Regardless of number of months originally reported for specific activities, most participants recalled either no activity or activity during all 12 months. Conclusion PA recall from the distant past is moderately reproducible, but poor at the individual level, among young and middle aged adults.
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Affiliation(s)
- Ashley Wilder Smith
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
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Tyndall AV, Davenport MH, Wilson BJ, Burek GM, Arsenault-Lapierre G, Haley E, Eskes GA, Friedenreich CM, Hill MD, Hogan DB, Longman RS, Anderson TJ, Leigh R, Smith EE, Poulin MJ. The brain-in-motion study: effect of a 6-month aerobic exercise intervention on cerebrovascular regulation and cognitive function in older adults. BMC Geriatr 2013; 13:21. [PMID: 23448504 PMCID: PMC3598522 DOI: 10.1186/1471-2318-13-21] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 02/21/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aging and physical inactivity are associated with declines in some cognitive domains and cerebrovascular function, as well as an elevated risk of cerebrovascular disease and other morbidities. With the increase in the number of sedentary older Canadians, promoting healthy brain aging is becoming an increasingly important population health issue. Emerging research suggests that higher levels of physical fitness at any age are associated with better cognitive functioning and this may be mediated, at least in part, by improvements in cerebrovascular reserve. We are currently conducting a study to determine: if a structured 6-month aerobic exercise program is associated with improvements or maintenance of both cerebrovascular function and cognitive abilities in older individuals; and, the extent to which any changes seen persist 6 months after the completion of the structured exercise program. METHODS/DESIGN Two hundred and fifty men and women aged 55-80 years are being enrolled into an 18-month combined quasi-experimental and prospective cohort study. Participants are eligible for enrollment into the study if they are inactive (i.e., not participating in regular physical activity), non-smokers, have a body mass index <35.0 kg/m(2), are free of significant cognitive impairment (defined as a Montreal Cognitive Assessment score of 24 or more), and do not have clinically significant cardiovascular, cerebrovascular disease, or chronic obstructive pulmonary airway disease. Repeated measurements are done during three sequential six-month phases: 1) pre-intervention; 2) aerobic exercise intervention; and 3) post-intervention. These outcomes include: cardiorespiratory fitness, resting cerebral blood flow, cerebrovascular reserve, and cognitive function. DISCUSSION This is the first study to our knowledge that will examine contemporaneously the effect of an exercise intervention on both cerebrovascular reserve and cognition in an older population. This study will further our understanding of whether cerebrovascular mechanisms might explain how exercise promotes healthy brain aging. In addition our study will address the potential of increasing physical activity to prevent age-associated cognitive decline.
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Affiliation(s)
- Amanda V Tyndall
- Department of Physiology & Pharmacology, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Margie H Davenport
- Department of Physiology & Pharmacology, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Ben J Wilson
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Grazyna M Burek
- Department of Physiology & Pharmacology, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Genevieve Arsenault-Lapierre
- Department of Physiology & Pharmacology, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Eryka Haley
- Department of Physiology & Pharmacology, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
| | - Gail A Eskes
- Department of Physiology & Pharmacology, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, B3H 2E2, Canada
- Department of Psychology, Faculty of Science, Dalhousie University, Halifax, Nova Scotia, B3H 4R2, Canada
- Department of Medicine (Neurology), Dalhousie University, Halifax, Nova Scotia, B3H 3A7, Canada
| | - Christine M Friedenreich
- Department of Population Health Research, Alberta Health Services-Cancer Care, Calgary, Alberta, T2S 3C3, Canada
- Department of Oncology, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Department of Community Health Sciences, Faculty of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, T2N 1N4, Canada
| | - Michael D Hill
- Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Department of Community Health Sciences, Faculty of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Department of Radiology, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - David B Hogan
- Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Department of Community Health Sciences, Faculty of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Brenda Stafford Foundation Chair in Geriatric Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - R Stewart Longman
- Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Psychology Service, Alberta Health Services, Foothills Hospital, Calgary, Alberta, T2N 2T9, Canada
| | - Todd J Anderson
- University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Department of Cardiac Science, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Richard Leigh
- Department of Physiology & Pharmacology, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Airway Inflammation Research Group, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Snyder Institute for Chronic Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Eric E Smith
- Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Department of Community Health Sciences, Faculty of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Department of Radiology, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Marc J Poulin
- Department of Physiology & Pharmacology, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada
- Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, T2N 1N4, Canada
- University of Calgary, Calgary, Alberta, T2N 4N1, Canada
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Intensity of recreational physical activity in different life periods in relation to breast cancer among women in the region of Western Pomerania. Contemp Oncol (Pozn) 2013; 16:576-81. [PMID: 23788947 PMCID: PMC3687462 DOI: 10.5114/wo.2012.32493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2009] [Revised: 08/10/2012] [Accepted: 09/20/2012] [Indexed: 01/01/2023] Open
Abstract
Background Recreational physical activity has been consistently associated with lower breast cancer risk, but there is a need to study the intensity and duration of activity that are critical to reduce the risk. The aim of this study was to examine the influence of moderate and vigorous intensity of recreational physical activity performed at different age periods on breast cancer risk. Material and methods The case-control study included 858 women with histological confirmation of invasive breast cancer and 1085 women free of any cancer diagnosis, residents of the region of Western Pomerania, aged 28–79 years. The frequency, duration and intensity of lifetime household, occupational and recreational physical activity, sociodemographic characteristics, reproductive factors, family history of breast cancer, current weight and height, and lifestyle habits were measured using a self-administered questionnaire. Unconditional logistic regression analyses were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The risk estimates were controlled for potential risk factors and lifetime household and occupational activities. Results We found a risk reduction for recreational activity done early in life (age periods 14–20, 21–34, 35–50 years), particularly at ages 14–20 and 21–34 years, regardless of intensity. Active women engaging in more than 4.5 hours per week of moderate activity during ages 14–20 years had, on average, a 36% lower risk (OR = 0.64, 95% CI: 0.45–0.89) than women who were never or rarely active. For the women who reported 4.5 hours per week of vigorous activity during this period we found about 64% risk reduction (OR = 0.36, 95% CI: 0.26–0.51). For the period after 50 years of age, recreational activity of moderate or vigorous intensity was not significantly associated with the risk. Conclusions Recreational physical activity of moderate or vigorous intensity done during adolescence, early and middle adulthood, particularly at ages 14–20 and 21–34 years, is associated with significantly decreased breast cancer risk.
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Bridge MW, Toms MR. The specialising or sampling debate: a retrospective analysis of adolescent sports participation in the UK. J Sports Sci 2013; 31:87-96. [DOI: 10.1080/02640414.2012.721560] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Courneya KS, Vallance JK, Culos-Reed SN, McNeely ML, Bell GJ, Mackey JR, Yasui Y, Yuan Y, Matthews CE, Lau DC, Cook D, Friedenreich CM. The Alberta moving beyond breast cancer (AMBER) cohort study: a prospective study of physical activity and health-related fitness in breast cancer survivors. BMC Cancer 2012; 12:525. [PMID: 23153358 PMCID: PMC3534483 DOI: 10.1186/1471-2407-12-525] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 11/14/2012] [Indexed: 01/24/2023] Open
Abstract
Background Limited research has examined the association between physical activity, health-related fitness, and disease outcomes in breast cancer survivors. Here, we present the rationale and design of the Alberta Moving Beyond Breast Cancer (AMBER) Study, a prospective cohort study designed specifically to examine the role of physical activity and health-related fitness in breast cancer survivorship from the time of diagnosis and for the balance of life. The AMBER Study will examine the role of physical activity and health-related fitness in facilitating treatment completion, alleviating treatment side effects, hastening recovery after treatments, improving long term quality of life, and reducing the risks of disease recurrence, other chronic diseases, and premature death. Methods/Design The AMBER Study will enroll 1500 newly diagnosed, incident, stage I-IIIc breast cancer survivors in Alberta, Canada over a 5 year period. Assessments will be made at baseline (within 90 days of surgery), 1 year, and 3 years consisting of objective and self-reported measurements of physical activity, health-related fitness, blood collection, lymphedema, patient-reported outcomes, and determinants of physical activity. A final assessment at 5 years will measure patient-reported data only. The cohort members will be followed for an additional 5 years for disease outcomes. Discussion The AMBER cohort will answer key questions related to physical activity and health-related fitness in breast cancer survivors including: (1) the independent and interactive associations of physical activity and health-related fitness with disease outcomes (e.g., recurrence, breast cancer-specific mortality, overall survival), treatment completion rates, symptoms and side effects (e.g., pain, lymphedema, fatigue, neuropathy), quality of life, and psychosocial functioning (e.g., anxiety, depression, self-esteem, happiness), (2) the determinants of physical activity and health-related fitness including demographic, medical, social cognitive, and environmental variables, (3) the mediators of any observed associations between physical activity, health-related fitness, and health outcomes including biological, functional, and psychosocial, and (4) the moderators of any observed associations including demographic, medical, and biological/disease factors. Taken together, these data will provide a comprehensive inquiry into the outcomes, determinants, mechanisms, and moderators of physical activity and health-related fitness in breast cancer survivors.
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Affiliation(s)
- Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada.
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Kirk MA, Rhodes RE. Physical activity status of academic professors during their early career transition: An application of the theory of planned behavior. PSYCHOL HEALTH MED 2012; 17:551-64. [DOI: 10.1080/13548506.2011.647700] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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89
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Wolin KY, Stoll C. Physical activity and urologic cancers. Urol Oncol 2012; 30:729-34. [DOI: 10.1016/j.urolonc.2012.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Revised: 08/06/2012] [Accepted: 08/06/2012] [Indexed: 01/06/2023]
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90
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The effect of behavioural risk factors on osteoporosis in Irish women. Ir J Med Sci 2012; 182:97-105. [DOI: 10.1007/s11845-012-0840-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 07/13/2012] [Indexed: 10/28/2022]
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Ratzlaff CR, Koehoorn M, Cibere J, Kopec JA. Is lifelong knee joint force from work, home, and sport related to knee osteoarthritis? Int J Rheumatol 2012; 2012:584193. [PMID: 22848225 PMCID: PMC3405641 DOI: 10.1155/2012/584193] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Revised: 05/14/2012] [Accepted: 05/14/2012] [Indexed: 11/17/2022] Open
Abstract
Purpose. To investigate the association of cumulative lifetime knee joint force on the risk of self-reported medically-diagnosed knee osteoarthritis (OA). Methods. Exposure data on lifetime physical activity type (occupational, household, sport/recreation) and dose (frequency, intensity, duration) were collected from 4,269 Canadian men and women as part of the Physical Activity and Joint Heath cohort study. Subjects were ranked in terms of the "cumulative peak force index", a measure of lifetime mechanical knee force. Multivariable logistic regression was conducted to obtain adjusted effects for mean lifetime knee force on the risk of knee OA. Results. High levels of total lifetime, occupational and household-related force were associated with an increased in risk of OA, with odds ratio's ranging from approximately 1.3 to 2. Joint injury, high BMI and older age were related to risk of knee OA, consistent with previous studies. Conclusions. A newly developed measure of lifetime mechanical knee force from physical activity was employed to estimate the risk of self-reported, medically-diagnosed knee OA. While there are limitations, this paper suggests that high levels of total lifetime force (all domains combined), and occupational force in men and household force in women were risk factors for knee OA.
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Affiliation(s)
- Charles R Ratzlaff
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, 75 Francis Street PBB3, Boston, MA 02115, USA
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Crandall CJ, Merkin SS, Seeman TE, Greendale GA, Binkley N, Karlamangla AS. Socioeconomic status over the life-course and adult bone mineral density: the Midlife in the U.S. Study. Bone 2012; 51:107-13. [PMID: 22543227 PMCID: PMC3371160 DOI: 10.1016/j.bone.2012.04.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 03/06/2012] [Accepted: 04/16/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE Adult bone mass depends on acquisition in childhood and decline in adulthood, and may be influenced by socioeconomic conditions over the entire life course. METHODS We examined associations of bone mineral density (BMD) in adulthood with life course socioeconomic status in 729 participants in the Midlife in the United States Biomarker Project, adjusting for age, menopausal transition stage, race, gender, body weight, smoking, physical activity in several life stages, and research site. Primary predictors were a) childhood socioeconomic advantage score (including parental education, self-rated financial status relative to others, not being on welfare), b) adult education level (no college vs. some college vs. college graduate), and c) adult current financial advantage score (including family-adjusted poverty to income ratio, self-assessed current financial situation, having enough money to meet needs, ease in paying bills). RESULTS Mean age was 56.9 (range 34-85) years. After adjustment for covariates, childhood socioeconomic advantage and adult education level were positively associated with lumbar spine BMD: 0.27 standard deviations (SD) higher at 90th compared to 10th percentile of childhood advantage score (P=0.009), and 0.24 SD higher in college graduates compared to participants without college education (P=0.01). Adult current financial advantage was not associated with lumbar spine BMD. None of the three socioeconomic indicators was significantly associated with femoral neck BMD. CONCLUSIONS Childhood socioeconomic advantage and adult education level were associated with higher adult lumbar spine BMD. Current financial advantage was not associated with BMD. Childhood socioeconomic factors may influence acquisition of lumbar BMD.
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Affiliation(s)
- Carolyn J. Crandall
- Division of General Internal Medicine, David Geffen School of Medicine at University of California, Los Angeles,
| | - Sharon Stein Merkin
- Division of Geriatrics, David Geffen School of Medicine at University of California, Los Angeles,
| | - Teresa E. Seeman
- Division of Geriatrics, David Geffen School of Medicine at University of California, Los Angeles,
| | - Gail A. Greendale
- Division of Geriatrics, David Geffen School of Medicine at University of California, Los Angeles,
| | - Neil Binkley
- University of Wisconsin-Madison Osteoporosis Clinical Center and Research Program, Madison, WI
| | - Arun S. Karlamangla
- Division of Geriatrics, David Geffen School of Medicine at University of California, Los Angeles,
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Nygaard I, Shaw J, Egger MJ. Exploring the association between lifetime physical activity and pelvic floor disorders: study and design challenges. Contemp Clin Trials 2012; 33:819-27. [PMID: 22521947 PMCID: PMC3361559 DOI: 10.1016/j.cct.2012.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 03/11/2012] [Accepted: 04/02/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND One in four women has moderate to severe symptoms of at least one pelvic floor disorder. Lifetime physical activity, a modifiable risk factor, may theoretically predispose women to, or protect them from, developing pelvic floor disorders. It is neither feasible nor ethical to test this association using the most rigorous (level I) study design. PURPOSE The aim of this manuscript is to describe the methods for the PHysical ACtivity Study (PHACTS), which encompasses two case-control studies and the development of a registry, and to describe challenges and solutions to study progress to date. For each of the case-control studies, the primary aims are to determine, compared to controls with neither pelvic organ prolapse nor urinary incontinence, whether 1) pelvic organ prolapse or 2) stress urinary incontinence is associated with a) increased or decreased current leisure activity or b) increased or decreased overall lifetime activity (including leisure, household, outdoor, and occupational) measured in MET-hours per week, as well as in strenuous hours per week. METHODS To obtain 175 pelvic organ prolapse cases, 175 stress urinary incontinence cases, and an equal number of age, body mass index and recruitment site matched controls, we plan to enroll 1500 women from about 20 primary care level clinics. RESULTS We have encountered various challenges leading to lessons learned about minimizing bias, recruitment from community clinics, the lifetime physical activity instrument used, and data management. CONCLUSIONS Our experiences can help guide future investigators studying risk factors, particularly physical activity, and pelvic floor disorders.
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Affiliation(s)
- Ingrid Nygaard
- Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT 84132-0001, USA.
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Boyle T, Bull F, Fritschi L, Heyworth J. Resistance training and the risk of colon and rectal cancers. Cancer Causes Control 2012; 23:1091-7. [PMID: 22562221 DOI: 10.1007/s10552-012-9978-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Although there is convincing evidence that physical activity reduces colon cancer risk, research in this area has focused on aerobic activity. We conducted a case-control study to investigate whether resistance training was associated with the risk of colon and rectal cancers. METHODS Data were collected on various colorectal cancer risk factors, including recreational physical activity performed during three age periods, from 870 cases and 996 controls in Western Australia in 2005-2007. Participants were classified as having never, possibly, or definitely performed resistance training in each age period and over the adult lifetime. The association between resistance training and colon and rectal cancer risk was analyzed using multinomial logistic regression. RESULTS Participants who definitely performed resistance training in their lifetime had a non-significant reduced risk of colon cancer compared with those who did no resistance training (adjusted odds ratio (AOR) = 0.70, 95 % confidence interval (CI) = 0.45-1.11). No association was found for rectal cancer risk (AOR = 1.16, 95 % CI = 0.71-1.87). Performing resistance training was associated with a lower risk of colon cancer in each age period, although none of the relationships were statistically significant. CONCLUSION This study provides some initial evidence, albeit inconclusive, that resistance training may be inversely associated with colon cancer risk.
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Affiliation(s)
- Terry Boyle
- School of Population Health, The University of Western Australia, Crawley, Australia.
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95
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Williams K, Frei A, Vetsch A, Dobbels F, Puhan MA, Rüdell K. Patient-reported physical activity questionnaires: a systematic review of content and format. Health Qual Life Outcomes 2012; 10:28. [PMID: 22414164 PMCID: PMC3349541 DOI: 10.1186/1477-7525-10-28] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 03/13/2012] [Indexed: 01/24/2023] Open
Abstract
Background Many patients with chronic illness are limited in their physical activities. This systematic review evaluates the content and format of patient-reported outcome (PRO) questionnaires that measure physical activity in elderly and chronically ill populations. Methods Questionnaires were identified by a systematic literature search of electronic databases (Medline, Embase, PsychINFO & CINAHL), hand searches (reference sections and PROQOLID database) and expert input. A qualitative analysis was conducted to assess the content and format of the questionnaires and a Venn diagram was produced to illustrate this. Each stage of the review process was conducted by at least two independent reviewers. Results 104 questionnaires fulfilled our criteria. From these, 182 physical activity domains and 1965 items were extracted. Initial qualitative analysis of the domains found 11 categories. Further synthesis of the domains found 4 broad categories: 'physical activity related to general activities and mobility', 'physical activity related to activities of daily living', 'physical activity related to work, social or leisure time activities', and '(disease-specific) symptoms related to physical activity'. The Venn diagram showed that no questionnaires covered all 4 categories and that the '(disease-specific) symptoms related to physical activity' category was often not combined with the other categories. Conclusions A large number of questionnaires with a broad range of physical activity content were identified. Although the content could be broadly organised, there was no consensus on the content and format of physical activity PRO questionnaires in elderly and chronically ill populations. Nevertheless, this systematic review will help investigators to select a physical activity PRO questionnaire that best serves their research question and context.
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Affiliation(s)
- Kate Williams
- Patient Reported Outcomes Centre of Excellence, Global Market Access, Primary Care Business Unit, Pfizer Ltd, Walton Oaks, Surrey, UK
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96
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Wright RL, Robinson P, Peters D. Lifetime adherence to physical activity recommendations and fall occurrence in community-dwelling older adults: A retrospective cohort study. JOURNAL OF HUMAN SPORT AND EXERCISE 2012. [DOI: 10.4100/jhse.2012.71.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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97
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Frei A, Williams K, Vetsch A, Dobbels F, Jacobs L, Rüdell K, Puhan MA. A comprehensive systematic review of the development process of 104 patient-reported outcomes (PROs) for physical activity in chronically ill and elderly people. Health Qual Life Outcomes 2011; 9:116. [PMID: 22185607 PMCID: PMC3311097 DOI: 10.1186/1477-7525-9-116] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 12/20/2011] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Capturing dimensions of physical activity relevant to patients may provide a unique perspective for clinical studies of chronically ill patients. However, the quality of the development of existing instruments is uncertain. The aim of this systematic review was to assess the development process of patient-reported outcome (PRO) instruments including their initial validation to measure physical activity in chronically ill or elderly patient populations. METHODS We conducted a systematic literature search of electronic databases (Medline, Embase, Psychinfo, Cinahl) and hand searches. We included studies describing the original development of fully structured instruments measuring dimensions of physical activity or related constructs in chronically ills or elderly. We broadened the population to elderly because they are likely to share physical activity limitations. At least two reviewers independently conducted title and abstract screening and full text assessment. We evaluated instruments in terms of their aim, items identification and selection, domain development, test-retest reliability, internal consistency, validity and responsiveness. RESULTS Of the 2542 references from the database search and 89 from the hand search, 103 full texts which covered 104 instruments met our inclusion criteria. For almost half of the instruments the authors clearly described the aim of the instruments before the scales were developed. For item identification, patient input was used in 38% of the instruments and in 32% adaptation of existing scales and/or unsystematic literature searches were the only sources for the generation of items. For item reduction, in 56% of the instruments patient input was used and in 33% the item reduction process was not clearly described. Test-retest reliability was assessed for 61%, validity for 85% and responsiveness to change for 19% of the instruments. CONCLUSIONS Many PRO instruments exist to measure dimensions of physical activity in chronically ill and elderly patient populations, which reflects the relevance of this outcome. However, the development processes often lacked definitions of the instruments' aims and patient input. If PROs for physical activity were to be used in clinical trials more attention needs to be paid to the establishment of content validity through patient input and to the assessment of their evaluative measurement properties.
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Affiliation(s)
- Anja Frei
- Horten Centre for Patient-oriented Research, University Hospital of Zurich, Switzerland
- Institute of General Practice and Health Services Research, University Hospital of Zurich, Switzerland
| | - Kate Williams
- Patient Reported Outcomes Centre of Excellence, Global Market Access, Primary Care Business Unit, Pfizer Ltd, Walton Oaks, Surrey, United Kingdom
| | - Anders Vetsch
- Horten Centre for Patient-oriented Research, University Hospital of Zurich, Switzerland
- Institute of General Practice and Health Services Research, University Hospital of Zurich, Switzerland
| | - Fabienne Dobbels
- Centre for Health Services and Nursing Research, post-doctoral researcher FWO Vlaanderen, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Laura Jacobs
- Respiratory Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Katja Rüdell
- Patient Reported Outcomes Centre of Excellence, Global Market Access, Primary Care Business Unit, Pfizer Ltd, Walton Oaks, Surrey, United Kingdom
| | - Milo A Puhan
- Horten Centre for Patient-oriented Research, University Hospital of Zurich, Switzerland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore (MD), USA
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98
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Shephard RJ, Aoyagi Y. Measurement of human energy expenditure, with particular reference to field studies: an historical perspective. Eur J Appl Physiol 2011; 112:2785-815. [PMID: 22160180 DOI: 10.1007/s00421-011-2268-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 11/23/2011] [Indexed: 01/23/2023]
Abstract
Over the years, techniques for the study of human movement have ranged in complexity and precision from direct observation of the subject through activity diaries, questionnaires, and recordings of body movement, to the measurement of physiological responses, studies of metabolism and indirect and direct calorimetry. This article reviews developments in each of these domains. Particular reference is made to their impact upon the continuing search for valid field estimates of activity patterns and energy expenditures, as required by the applied physiologist, ergonomist, sports scientist, nutritionist and epidemiologist. Early observers sought to improve productivity in demanding employment. Direct observation and filming of workers were supplemented by monitoring of heart rates, ventilation and oxygen consumption. Such methods still find application in ergonomics and sport, but many investigators are now interested in relationships between habitual physical activity and chronic disease. Even sophisticated questionnaires still do not provide valid information on the absolute energy expenditures associated with good health. Emphasis has thus shifted to use of sophisticated pedometer/accelerometers, sometimes combining their output with GPS and other data. Some modern pedometer/accelerometers perform well in the laboratory, but show substantial systematic errors relative to laboratory reference criteria such as the metabolism of doubly labeled water when assessing the varied activities of daily life. The challenge remains to develop activity monitors that are sufficiently inexpensive for field use, yet meet required accuracy standards. Possibly, measurements of oxygen consumption by portable respirometers may soon satisfy part of this need, although a need for valid longer term monitoring will remain.
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Affiliation(s)
- Roy J Shephard
- Faculty of Physical Education and Health, University of Toronto, Toronto, ON, Canada.
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99
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Timing and intensity of recreational physical activity and the risk of subsite-specific colorectal cancer. Cancer Causes Control 2011; 22:1647-58. [PMID: 21922204 DOI: 10.1007/s10552-011-9841-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 09/02/2011] [Indexed: 02/07/2023]
Abstract
PURPOSE Although there is convincing evidence that physical activity reduces colon cancer risk, there are important questions that remain unanswered about the association. These include the timing and intensity of activity required to optimally reduce risk, and whether physical activity has a different effect on cancers at different sites within the colon. We conducted a case-control study to investigate these issues. METHODS A case-control study of colorectal cancer was conducted in Western Australia in 2005-2007. Data were collected on various risk factors. The estimated effects of recreational physical activity on the risk of cancers of the distal colon, proximal colon, and rectum were analyzed using multinomial logistic regression. This analysis included 870 cases and 996 controls. RESULTS The risk of distal colon cancer was reduced by performing a high level of vigorous-intensity activity between the ages 19 and 34 years (women), 35 and 50 years (men), after the age of 51 years (men and women), and consistently over the adult lifetime (men and women). The risk of rectal cancer was reduced by performing a high level of vigorous activity between the ages 35 and 50 years (men), and consistently over the adult lifetime (men). Proximal colon cancer risk was not associated with physical activity in any of the age periods or over the adult lifetime. Moderate intensity activity did not reduce the risk of colorectal cancer. CONCLUSION Physical activity may have a greater effect on the risk of distal colon cancer than proximal colon cancer. Vigorous physical activity is required to reduce colorectal cancer risk.
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100
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Boyle T, Fritschi L, Heyworth J, Bull F. Long-term sedentary work and the risk of subsite-specific colorectal cancer. Am J Epidemiol 2011; 173:1183-91. [PMID: 21421743 DOI: 10.1093/aje/kwq513] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Research suggests that sedentary behavior may increase the risk of some chronic diseases. The aims of the study were to examine whether sedentary work is associated with colorectal cancer and to determine whether the association differs by subsite. A total of 918 cases and 1,021 controls participated in a population-based case-control study of colorectal cancer in Western Australia in 2005-2007. Data were collected on lifestyle, physical activity, and lifetime job history. The estimated effects of sedentary work on the risk of cancers of the proximal colon, distal colon, and rectum were analyzed by using multinomial logistic regression. Compared with participants who did not spend any time in sedentary work, participants who spent 10 or more years in sedentary work had almost twice the risk of distal colon cancer (adjusted odds ratio = 1.94, 95% confidence interval: 1.28, 2.93) and a 44% increased risk of rectal cancer (adjusted odds ratio = 1.44, 95% confidence interval: 0.96, 2.18). This association was independent of recreational physical activity and was seen even among the most recreationally active participants. Sedentary work was not associated with the risk of proximal colon cancer. These results suggest that long-term sedentary work may increase the risk of distal colon cancer and rectal cancer.
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Affiliation(s)
- Terry Boyle
- Western Australian Institute for Medical Research, University of Western Australia, B Block, Queen Elizabeth II Medical Centre, Hospital Avenue, Nedlands, Western Australia 6009, Australia.
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