[The role of regular physical activity in the prevention and intervention of symptoms of anxiety and anxiety disorders]. Volume and intensity of physical activity in a large population-based cohort of middle-aged and older Australians: prospective relationships with weight gain, and physical function. Predictors of weight gain in the Pound of Prevention study Study protocol: fit for delivery - can a lifestyle intervention in pregnancy result in measurable health benefits for mothers and newborns? A randomized controlled trial Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews Physical Activity/Exercise and Type 2 Diabetes Will older sedentary people with non-insulin-dependent diabetes mellitus start exercising? A health promotion model. A high-intensity functional weight-bearing exercise program for older people dependent in activities of daily living and living in residential care facilities: evaluation of the applicability with focus on cognitive function. Maintaining vigorous activity attenuates 7-yr weight gain in 8340 runners. The effect of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women: a systematic review protocol Joint effects of adiposity and physical activity on incident mobility limitation in older adults. The effect of a high-intensity functional exercise program on activities of daily living: a randomized controlled trial in residential care facilities. Exercise: effects on physical functional performance in independent older adults. Community-based group exercise improves balance and reduces falls in at-risk older people: a randomised controlled trial. The Sydney Diabetes Prevention Program: A community-based translational study Randomized controlled trial of physical activity counseling as an aid to smoking cessation: 12 month follow-up. Can physical activity attenuate aging-related weight loss in older people? The Yale Health and Aging Study, 1982-1994. Mental disorder prevention and physical activity in Iranian elderly Effects of physical activity on strength and skeletal muscle fat infiltration in older adults: a randomized controlled trial. What are the factors that influence physical activity participation in individuals with depression? A review of physical activity correlates from 59 studies. Qualitative outcomes of progressive resistance exercise for people with COPD Impact of aerobic exercise on neurobehavioral outcomes. The impact of a home-based walking programme on falls in older people: the Easy Steps randomised controlled trial.
Anxiety disorders are the most common mental illness , but are not uniform , many clinical diagnoses include the symptoms of anxiety . That is the reason why there are relatively small numbers of population surveys and r and omized-controlled trials which have examined the relationship between exercise and the various anxiety symptoms/ disorders . In our review we summarize meta-analytic studies , epidemiological surveys and r and omized controlled studies which examine the role of regular physical activity in the prevention and treatment of sub clinical anxiety/anxiety symptoms and anxiety disorders .  The meta-analytic studies and r and omized-controlled trials examining the relationship between sub clinical anxiety disorders and anxiety symptoms demonstrated small to moderate effect of exercise in the decrease of anxiety symptoms , especially for moderate-intensity exercise . This relationship was confirmed for both acute and chronic exercise , for state and trait anxiety in different sex , age and state of health groups . In the case of the anxiety disorders based on review ed studies , we can conclude that there is a potential association between decreased symptoms of anxiety and exercise .  The regular , moderate-intensity exercise can reduce and alleviate the symptoms of anxiety - at least in panic , agoraphobia and generalized anxiety disorders . The review ed studies have been highlighted the fact , that exercise can be effective in psychiatric practice as an alternative or adjuvant therapy . Physically healthy people with anxiety symptoms , or patients with anxiety disorders can perform exercise , there are no contraindications . Although based on previous studies , we can not assume that the relationship is causal , but we can not ignore the evidence s that are already available OBJECTIVES To examine prospect ively whether higher proportions of vigorous physical activity ( VPA ) , independent of total activity volume , are associated with better outcomes in weight maintenance and physical function . METHODS We used three-year longitudinal data ( 2006/07 - 2009/10 ) of adults 45 and older ( n=32,087 ; 59.5±9.3years ) from New South Wales , Australia . Logistic regression models examined odds of weight gain and functional decline by volume and intensity of physical activity . RESULTS On average , body weight increased by 0.66 kg ( SD=5.83 , p<0.001 ) ; a vali date d physical function score ( MOS-PF ) decreased by 4.79 ( SD=12.56 , p<0.001 ) . There was a 10 % reduction in the odds of weight gain for participants who reported 300min/week or more of moderate to vigorous physical activity ( MVPA ) compared to less than 150min of MVPA . The proportion of MVPA that was vigorous was not associated with weight change . With the physical functioning outcome , there were independent protective effects from volume and intensity of physical activity . Independent of total MVPA , each 1 % increase in the proportion of total activity that was vigorous was associated with a 0.3 % decrease in the odds of decline in physical function . CONCLUSION These prospect i ve findings indicate that VPA per se plays an important role in the prevention of functional decline OBJECTIVES : This study examined cross-sectional and prospect i ve relationships between macronutrient intake , behaviors intended to limit fat intake , physical activity and body weight . DESIGN : The overall goal was to identify diet and exercise behaviors that predict and /or accompany weight gain or loss over time . Specific questions addressed included : ( a ) are habitual levels of diet or exercise predictive of weight change ; ( b ) are habitual diet and exercise levels associated cross-sectionally with body weight ; and ( c ) are changes in diet and exercise associated with changes in body weight over time ? PARTICIPANTS : Subjects were a sample of community volunteers ( n=826 women , n=218 men ) taking part in a weight gain prevention project over a 3-year period . MEASURES : Body weight was measured at baseline and annually over the study period . Self-report measures of diet and exercise behavior  were also measured annually . RESULTS : Among both men and women , the most consistent results were the positive association between dietary fat intake and weight gain and an inverse association between frequency of physical activity and weight gain . Individuals who weighed more both ate more and exercised less than those who weighed less . Individuals who increased their physical activity level and decreased their food intake over time were protected from weight gain compared to those who did not . Frequency of high-intensity physical activity was particularly important for both men and women . Additionally , women who consistently engaged in higher levels of moderate physical activity gained weight at a slower rate compared to women who were less active . CONCLUSIONS : Overall results indicated that both cross-sectionally and prospect ively , the determinants of weight and weight change are multifactorial . Attention to exercise , fat intake and total energy intake all appear important for successful long term control of body weight Background The global obesity epidemic has led to increased attention on pregnancy , a period when women are at risk of gaining excessive weight . Excessive gestational weight gain is associated with numerous complications , for both mother and child . Though the problem is widespread , few studies have examined the effect of a lifestyle intervention in pregnancy design ed to limit maternal weight gain . The Fit for Delivery study will explore the effectiveness of nutritional counseling coupled with exercise classes compared with st and ard prenatal care . The aims of the study are to examine the effect of the intervention on maternal weight gain , newborn birth weight , glucose regulation , complications of pregnancy and delivery , and maternal weight retention up to 12 months postpartum . Methods / design Fit for Delivery is a r and omized controlled trial that will include 600 women expecting their first child . To be eligible , women must be 18 years of age or older , of less than 20 weeks gestational age , with a singleton pregnancy , and have a Body Mass Index ( BMI ) ≥ 19 kg/m2 . The women will be r and omly allocated to either an intervention group or a control group . The control group will receive st and ard prenatal care . The intervention group will , in addition , receive nutritional counseling by phone , access to twice-weekly exercise sessions , and information on healthy eating and physical activity provided in pamphlets , evening meetings and an interactive website . Both groups will be monitored by weighing ( including bioimpedance measurements of percent body fat ) , blood tests , self-report question naires and hospital record review . Discussion Weight gained in pregnancy affects the health of both the mother and her unborn child , and simple models for efficient intervention are in high dem and . The Fit for Delivery intervention provides concrete advice on limiting energy intake and practical training in increasing physical activity . This lifestyle intervention is simple , reproducible , and inexpensive . The design of the study reflects the realities of clinical practice , where patients are free to choose whether or not they respond to health initiatives . If we find measurable health benefits associated with the intervention , it may be an easily adopted supplement to routine prenatal care , in the prevention of obesity . Trial registration Clinical Trial.gov , Objectives : This umbrella review aim ed to determine the effectiveness of exercise interventions , alone or in combination with other interventions , in improving physical function in community-dwelling older people identified as pre-frail or frail . Introduction : Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty . Several systematic review s discuss the effects of exercise interventions on physical function parameters , such as strength , mobility , gait , balance and physical performance , and indicate that multi-component exercise , including resistance , aerobic , balance and flexibility training , appears to be the best way in which to improve physical function parameters in frail older people . However , there is still uncertainty as to which exercise characteristics ( type , frequency , intensity , duration and combinations ) are the most effective and sustainable over the long-term . Inclusion criteria : Participants were adults , 60 years or over , living in the community and identified as pre-frail or frail . Quantitative systematic review s , with or without meta- analysis that examined the effectiveness of exercise interventions of any form , duration , frequency and intensity , alone or in combination with other interventions design ed to alter physical function parameters in frail older people , were considered . The quantitative outcome measures were physical function , including muscular strength , gait , balance , mobility and physical performance . Methods : An iterative search strategy for ten bibliometric data bases and gray literature was developed . Critical appraisal of seven systematic review s was conducted independently by two review ers using a st and ard Joanna Briggs Institute tool . Data was extracted independently by two review ers using a st and ard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach . Results : Seven systematic review s were included in this umbrella review , with a total of 58 relevant r and omized controlled trials and 6927 participants . Five systematic review s examined the effects of exercise only , while two systematic review s reported on exercise in combination with a nutritional approach , including protein supplementations , as well as fruit and dairy products . The average  exercise frequency was 2–3 times per week ( mean 3.0 ± 1.5 times per week ; range 1–7 weekly ) for 10–90 minutes per session ( mean of 52.0 ± 16.5 mins ) and a total duration of 5–72 weeks with the majority lasting a minimum of 2.5 months ( mean 22.7 ± 17.7 weeks ) . Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength , gait speed , balance and physical performance , including resistance , aerobic , balance and flexibility tasks . Resistance training alone also appeared to be beneficial , in particular for improving muscular strength , gait speed and physical performance . Other types of exercise were not sufficiently studied and their effectiveness is yet to be established . Conclusions : Interventions for pre-frail and frail older adults should include multi-component exercises , including in particular resistance training , as well as aerobic , balance and flexibility tasks . Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made For decades , exercise has been considered a cornerstone of diabetes management , along with diet and medication . However , high- quality evidence on the importance of exercise and fitness in diabetes was lacking until recent years . The present document summarizes the most clinical ly relevant recent advances related to people with type 2 diabetes and the recommendations that follow from these . Our recently published technical review on physical activity/exercise and type 2 diabetes ( 1 ) includes greater detail on individual studies , on prevention of diabetes , and on the physiology of exercise . The present statement focuses on type 2 diabetes . Issues primarily germane to type 1 diabetes will be covered in a subsequent technical review and ADA Statement . The levels of evidence used are defined by the ADA in ref . 2 . Two r and omized trials each found that lifestyle interventions including ∼150 min/week of physical activity and  diet-induced weight loss of 5–7 % reduced the risk of progression from impaired glucose tolerance ( IGT ) to type 2 diabetes by 58 % ( 3,4 ) . A cluster-r and omized trial found that diet alone , exercise alone , and combined diet and exercise were equally effective in reducting the progression from IGT to diabetes ( 5 ) . Therefore , there is firm and consistent evidence that programs of increased physical activity  and modest weight loss reduce the incidence of type 2 diabetes in individuals with IGT . Boule et al. ( 6 ) undertook a systematic review and meta- analysis on the effects of structured exercise interventions in clinical trials of ≥8 weeks duration on HbA1c ( A1C ) and body mass in people with type 2 diabetes . Postintervention A1C was significantly lower in exercise than control groups ( 7.65 vs. 8.31 % , weighted mean difference −0.66 % ; P < 0.001 ) . In contrast , postintervention body weight did not differ between the exercise and control groups . Meta-regression confirmed that the beneficial effect of exercise on A1C Exercise and diet are the cornerstones of management of non-insulin-dependent diabetes mellitus ( NIDDM ) . Many older people have difficulty in exercising , missing benefits on glycaemic control , weight , cardiac disease and mood . We report the outcomes of a 6 month structured exercise and support programme based on a health promotion model , on physical activity , glycaemic control and parameters of cardiovascular risk in non-exercisers , compared with st and ard outpatient clinic education . A total of 26 non-exercising patients were r and omised to an intervention or control group ( ten men , 16 women ; mean age ( + /- S.D. ) 60 + /- 8 years ) . Programme participation was not associated with any significant increase in activity . Glycated hemoglobin ( HbAtc ) levels tended to stabilise in the intervention group during the 6 month programme and to deteriorate in the control group ( P = 0.03 ) ; by 12 months HbA1C levels deteriorated to a similar level in both . Programme participation did not cause significant change in anthropometric or metabolic parameters . Examining the cohort as a whole , increased activity over 6 months was associated with improvements in weight , body mass index ( BMI ) , body fat and fasting insulin . Activity increases over 12 months were associated with improvements in weight and BMI . These changes could not be attributed to changes in energy intake or dietary composition . We conclude that while exercise can benefit older people with NIDDM , a programme based on a model of health promotion was not effective in increasing physical activity BACKGROUND AND PURPOSE Knowledge concerning the applicability and the effect of high-intensity exercise programs is very limited for older people with severe cognitive and physical impairments . The primary aim of this study was to evaluate the applicability of a high-intensity functional weight-bearing exercise program among older people who are dependent in activities of daily living and living in residential care facilities . A second aim was to analyze whether cognitive function was associated with the applicability of the program . SUBJECTS The subjects were 91 older people ( mean age=85.3 years , SD=6.1 , range=68 - 100 ) who were dependent in personal activities of daily living and r and omly assigned to participate in an exercise intervention .  Their mean score for the Mini-Mental State Examination ( MMSE ) was 17.5 ( SD=5.0 , range=10 - 29 ) . METHODS A high-intensity functional weight-bearing exercise program was performed in groups of 3 to 7 participants who were supervised by physical therapists . There were 29 exercise sessions over 13 weeks . Attendance , intensity of lower-limb strength and balance exercises , and occurrence and seriousness of adverse events were the outcome variables in evaluating the applicability of the program . RESULTS The median attendance rate was 76 % .  Lower-limb strength exercises with high intensity were performed in a median of 53 % of the attended exercise sessions , and balance exercises with high intensity were performed in a median of 73 % of the attended exercise sessions . The median rate of sessions with adverse events was 5 % . All except 2 adverse events were assessed as minor and temporary , and none led to manifest injury or disease . No significant differences were observed in applicability when comparing participants with dementia and participants without dementia . In addition , there was no significant correlation between applicability and the MMSE score . DISCUSSION AND CONCLUSION The results suggest that a high-intensity functional weight-bearing exercise program is applicable for use , regardless of cognitive function , among older people who are dependent in activities of daily living , living in residential care facilities , and have an MMSE score of 10 or higher INTRODUCTION / PURPOSE Body weight generally increases with aging in Western societies . Although training studies show that exercise produces acute weight loss , it is unclear whether the long-term maintenance of vigorous exercise attenuates the trajectory of age-related weight gain . Specifically , prior studies have not tested whether the maintenance of physical activity , in the absence of any change in activity , prevents weight gain . METHODS Prospect i ve study of 6119 male and 2221 female runners whose running distances changed < 5 km x wk(-1 ) between baseline and follow-up surveys 7 yr later . RESULTS On average , men who maintained modest ( 0 - 23 km x wk(-1 ) ) , intermediate ( 24 - 47 km x wk(-1 ) ) , or prolonged running distances ( > or = 48 km x wk(-1 ) ) all gained weight through age 64 ; however , those who maintained > or = 48 km x wk(-1 ) had one half the average annual weight gain of those who maintained < 24 km x wk(-1 ) . For example , between the ages of 35 and 44 in men and 30 and 39 yr in women , those who maintained < 24 km x wk(-1 ) gained , on average , 2.1 and 2.9 kg more per decade than those averaging > 48 km x wk(-1 ) . Age-related weight gain , and its attenuation by maintained exercise , were both greater in younger than in older men . Men 's gains in waist circumference with age , and its attenuation by maintaining running , were the same in older and younger men . Regardless of age , women increased their body weight , waist circumference , and hip circumference over time , and these measurements were attenuated in proportion to their maintained running distance . In both sexes , running disproportionately prevented more extreme increases in weight . CONCLUSION As they aged , men and women gained less weight in proportion to their levels of sustained vigorous activity . This long-term beneficial effect is in addition to the acute weight loss that occurs with increased activity Review question / objective What are the effects of weight management interventions that include a diet component on weight‐related outcomes in pregnant and postpartum women ? The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aim ed at limiting gestational weight gain and postpartum weight retention in women . The second objective of this systematic review is to investigate included intervention components with respect to effect on weight‐related outcomes . This may include , but is not limited to : length of intervention , use of face‐to‐face counselling , group or individual consultations , use of other interventions components including exercise , use of goals and use of support tools like food diaries , coaching , including email or text message support . Background Around half of all women of reproductive age are either overweight or obese,1,2,3 with women aged 25‐34 years having a greater risk of substantial weight gain compared with men of all ages.1,4 Excessive gestational weight gain ( GWG ) and postpartum weight retention ( PPWR ) may play a significant role in long term obesity . Having one child doubles the five‐ and 10‐year obesity incidence for women , with many women who gain excessive weight during pregnancy remaining obese permanently.5 Excessive GWG and /or PPWR can also significantly contribute to short‐ and long‐term adverse health outcomes for mother , baby and future pregnancies.6,7 Maternal obesity increases the risk of pregnancy related complications such as pre‐eclampsia , gestational diabetes mellitus , stillbirth and the rate of caesarean section.8 Childhood obesity is a further long term complication of maternal obesity for offspring , which may persist in to adulthood.9 Excess GWG is also a risk factor for PPWR both in the short and long‐term.10,11 Nehring et al. conducted a meta‐ analysis with over 65,000 women showing that , compared to women who gained weight within recommendations during pregnancy , women with GWG above Institute of Medicine weight gain recommendations , 12 retained an additional 3.1 kg and 4.7 kg after three and greater than or equal to 15 years postpartum , respectively.13 The health risk associated with PPWR is highlighted in a study of 151,025 Swedish women followed between 1992 and 2001.The study identified the risk of adverse pregnancy outcomes for those who gained three or more units of Body Mass Index ( kg/m2 ) between consecutive pregnancies ( an average of two years ) was much higher compared with women whose BMI changed from ‐1.0 and 0.9 units.14 Long‐term chronic disease risk may also be affected by PPWR as weight retention at the end of the first year post‐partum has been found to be a predictor of maternal overweight 15 years later.15With around 14‐20 % of women retaining 5 kg or more 12 months postpartum,16,5 the risk of developing conditions like diabetes , metabolic syndrome and cardiovascular disease may be increased.17 It becomes evident that interventions which aim to support attainment of healthy weight both in the antenatal and postpartum periods are key health priorities for women during this life stage . Lifestyle factors of overweight , having poor diet quality , and not undertaking enough moderate‐to‐vigorous physical activity are amongst the top five predictors of mortality in women.18 Additionally it is noted that , for many women , pregnancy and the postpartum period are associated with a reduction in physical activity.19 It is known that a combination of poor dietary choices , an increase in sedentary time and reduction in physical activity are all contributors to the development of overweight and obesity . With this in mind , current research has focused on lifestyle interventions to limit GWG and PPWR . Thangaratinam et al. review ed 44 r and omized controlled trials ( 7278 women ) where interventions including diet , physical activity or both were evaluated for their influence on maternal weight during  pregnancy.20 Results indicate that all were significantly effective in reducing GWG compared with the control group . More specifically , dietary interventions were the most effective in reducing weight gain , with a mean weight loss of ‐3.84 kg compared with ‐0.72 kg and ‐1.06 kg for physical activity and the mixed ( diet plus physical activity ) approach , respectively.20 This finding is supported by Hill and colleagues ' recent systematic review of theory based interventions to limit GWG.21 Included studies in this review reported an underpinning theory base and were classified as adopting a dietary , physical activity or mixed approach . Hill et al. concluded that studies which included a diet intervention were significantly more effective at limiting GWG.21 In 2011 Tanentsapf et al. review ed the effect of dietary interventions alone for reducing GWG in normal weight , overweight and obese pregnant women.22 This review analysed 13 r and omized controlled trials and quasi‐r and omized controlled trials with a dietary intervention to prevent excessive GWG in women . The review concluded that dietary interventions during pregnancy were effective in reducing GWG with an effect of ‐1.92 kg ( n=1434 ) compared with the control group.22 Tanentsapf et al. identified that trials differed in the conduct of the interventions with various diet and non‐diet related components utilised . Dietary approaches were highly variable with some trials focusing only on calorie restriction and others included additional target macronutrient distribution for intake . Some trials further provided feedback based on maternal weight gain guidelines .12 Interventions also varied in delivery method with a variety of modes used , including face‐to‐face , individual or group consultations and /or written correspondence . The frequency of communication , despite the type or mix , also changed from trial to trial with additional methods via telephone , posted material s , feedback or food diaries utilised . The inclusion of physical activity in addition to diet intervention was also common . Whilst the recent review by Tanentsapf et al.22 identified that dietary interventions are effective in reducing GWG , the review did not investigate the impact that different intervention components , delivery methods or dietary counselling approaches had on gestational weight management . It remains unclear as to which intervention components optimize GWG in women . The impact of lifestyle interventions has also been investigated in the postpartum period . The recent systematic review from van der Pligt et al. reported seven of 11 studies review ed were successful in limiting PPWR.23 As with studies aim ed at limiting GWG , interventions included in van der Pligt et al. 's review differed greatly in their conduct . Six of these seven studies included both dietary and physical activity components for the intervention , with the final successful study including a diet only intervention . Five of the successful studies recruited overweight or obese women only . Intervention time varied considerably in successful studies with some running for as little at ten days , and others up to six months . Bertz et al. demonstrated that their 12‐week behavior modification intervention which targeted diet alone or diet and exercise , including two individual sessions with a dietitian and physical therapist , provision of scales for weight self‐monitoring and bi‐weekly text messages was successful in achieving significant weight loss following the intervention , and sustained at one year.24 The diet intervention and the diet and exercise intervention  yielded significant weight loss compared to the control . Following 12 weeks a reduction of ‐8.3 + /‐ 4.2 kg for diet intervention and ‐6.9 + /‐ 3.0 kg for diet and exercise was observed . Additionally after one year , the diet intervention showed ‐10.2 + /‐ 5.7 kg reduction and ‐7.3 + /‐ 6.3 kg for the diet and exercise intervention (p<0.001).24 Colleran et al. also found significant weight change results by implementing a 16‐week intervention which consisted of weekly individual sessions with a dietitian regarding calorie restriction , two additional home visits regarding exercise , weekly food diary completion and email support.25 The intervention group had greater weight loss compared to the control group ( ‐5.8 kg + /‐ 3.5 kg vs ‐1.6 kg + /‐ 5.4 kg ) . It can be seen that various methods have been utilized in investigating the impact of diet and physical activity interventions on PPWR . The review by van der Pligt et al.23 highlights the impact successful lifestyle interventions can have on postpartum weight change . However , this review did not investigate the different intervention strategies utilized . It remains unclear as to the optimal setting , delivery method , diet strategy , contact frequency or intervention length to limit PPWR . Previous systematic review s for both GWG and PPWR have focused on the effectiveness of lifestyle interventions as a whole for weight management in pregnant and postpartum women.20,23 And despite Tanentsapf et al. 's focus on dietary interventions for GWG,22 much is still unknown about the effectiveness of differing diet interventions over the antenatal and postpartum period . Specifically , the impact of differing diet intervention strategies on maternal weight gain is not known . Firstly , this systematic review will focus on whether  weight management interventions which include a dietary component  are effective in pregnant and postpartum women . In addition to this , this review will investigate the different intervention strategies utilized and their effectiveness in maternal weight management . A search of systematic review protocol data bases has shown that there is no current review underway for this topic OBJECTIVES To examine joint associations of physical activity and adiposity measures ( body mass index ( BMI ) , waist circumference , percentage body fat ) with incident mobility limitation . DESIGN Prospect i ve observational cohort study . SETTING Memphis , Tennessee and Pittsburgh , Pennsylvania . PARTICIPANTS Two thous and nine hundred and eighty-two black and white men and women aged 70 to 79 participating in the Health , Aging and Body Composition ( Health ABC ) study . MEASUREMENTS Mobility limitation was defined as reported difficulty walking one-quarter of a mile or climbing 10 steps during two consecutive semiannual assessment s over 6.5 years . Three measures of adiposity were included in this study : BMI , total percentage body fat , and waist circumference . Physical activity  was assessed using a modified leisure-time physical activity question naire . RESULTS Forty-six percent of the cohort developed mobility limitation .  White and black men with a high BMI ( > or = 30 kg/m(2 ) ) , high total percentage body fat ( > 31.3 % ) , or high waist circumference ( > or = 102 cm ) had an approximately 60 % , 40 % , and 40 % , respectively , higher risk of incident mobility limitation than those with low adiposity . In women , high adiposity was also associated with a significantly higher mobility limitation risk than in those with low adiposity . Low physical activity ( lowest quartile ) was associated with a 70 % higher risk of mobility limitation in all groups . Persons with high adiposity and low physical activity were at particularly high risk of mobility limitation .  People with high adiposity who were physically active had an equally high risk of mobility limitation as inactive people with low adiposity . CONCLUSION High adiposity and low self-reported physical activity predicted the onset of mobility limitation in well-functioning older persons . Preventing weight gain in old age and promoting physical activity in obese and non-obese older persons may therefore be effective strategies to prevent mobility loss and future disability OBJECTIVES To evaluate whether a high-intensity functional weight-bearing exercise program reduces dependency in activities of daily living ( ADLs ) in older people living in residential care facilities , focusing on people with dementia . DESIGN R and omized , controlled trial . SETTING Nine residential care facilities . PARTICIPANTS One hundred ninety-one older people dependent in ADLs and with a Mini-Mental State Examination score of 10 or greater . One hundred ( 52.4 % ) of the participants had dementia . INTERVENTION A high-intensity functional weight-bearing exercise program or a control activity consisting of 29 sessions over 3 months . MEASUREMENTS The Barthel ADL Index ; follow-up at 3 months ( directly after the intervention ) and 6 months with intention-to-treat analyses . RESULTS There were no statistically significant differences between the groups regarding overall ADL performance . Analyses for each item revealed that a smaller proportion of participants in the exercise group had deteriorated in indoor mobility at 3 months ( exercise 3.5 % vs control 16.0 % , P=.01 ) and 6 months ( 7.7 % vs 19.8 % , P=.03 ) . For people with dementia , there was a significant difference in overall ADL performance in favor of the exercise group at 3 months ( mean difference 1.1 , P=.03 ) but not at 6 months . CONCLUSION A high-intensity functional weight-bearing exercise program seems to reduce ADL decline related to indoor mobility for older people living in residential care facilities . The program does not appear to have an overall effect on ADLs . In people with dementia , the exercise program may prevent decline in overall ADL performance , but continuous training may be needed to maintain that effect BACKGROUND Age-related loss in physiologic capacities contributes to the decline in physical function in the elderly population . Despite the beneficial effects of exercise interventions on maximal physiologic capacity measures , the functional benefits have not been shown in independently living older adults . The objective of this study was to evaluate exercise in independent older adults for significant and meaningful improvements in physical function , not detected by commonly used measures of physical function . METHODS In a r and omized controlled study , 49 independently living men and women were assigned to either a nonexercise control group ( Control ; n = 26 ) or an exercise training group ( Exercise ; n = 23 ) . Participants ( age = 76+/-4 ) in good general health were recruited from retirement communities or apartments . The combined endurance and strength training was performed at 75 % to 80 % intensity ; the groups met 3 times/week for 6 months of supervised sessions . Outcome measures included physical capacity , health status , and physical function using a newly developed performance test -- the Continuous Scale-Physical Functional Performance test ( CS-PFP ) . RESULTS Compared to the Control group , the Exercise group showed significant increases in maximal oxygen consumption ( 11 % ) and muscle strength ( 33 % ) . No significant differences were found between groups for changes in the Sickness Impact Profile , SF-36 scales , or the 6-minute walk . However , the CS-PFP score improved significantly in the Exercise group ( 14 % , effect size 0.80 ) . CONCLUSIONS Independent older adults gain meaningful functional benefits from several months of exercise training . The public health importance of physical activity may relate not just to its role in preventing decline , but also to its role in enhancing physical function BACKGROUND recent studies have found that moderate intensity exercise is an effective intervention strategy for preventing falls  in older people . However , research is required to determine whether supervised group exercise programmes , conducted in community setting s with at-risk older people referred by their health care practitioner are also effective in improving physical functioning and preventing falls in this group . OBJECTIVES to determine whether participation in a weekly group exercise programme with ancillary home exercises over one year improves balance , muscle strength , reaction time , physical functioning , health status and prevents falls in at-risk community-dwelling older people . METHODS the sample comprised 163 people aged over 65 years identified as at risk of falling using a st and ardised assessment screen by their general practitioner or hospital-based physiotherapist , residing in South Western Sydney , Australia . Subjects were r and omised into either an exercise intervention group or a control group .  Physical performance and general health measures were assessed at baseline and repeated 6-months into the trial . Falls were measured over a 12-month follow-up period using monthly postal surveys . RESULTS at baseline both groups were well matched in their physical performance , health and activity levels . The intervention subjects attended a median of 23 exercise classes over the year , and most undertook the home exercise sessions at least weekly . At retest , the exercise group performed significantly better than the controls in three of six balance measures ; postural sway on the floor with eyes open and eyes closed and coordinated stability . The groups did not differ at retest in measures of strength , reaction time and walking speed or on Short-Form 36 , Physical Activity Scale for the Elderly or fear of falling scales . Within the 12-month trial period , the rate of falls in the intervention group was 40 % lower than that of the control group ( IRR=0.60 , 95 % CI 0.36 - 0.99 ) . CONCLUSIONS these findings indicate that participation in a weekly group exercise programme with ancillary home exercises can improve balance and reduce the rate of falling in at-risk community dwelling older people Background Type 2 diabetes is a major public health problem in Australia with prevalence increasing in parallel with increasing obesity . Prevention is an essential component of strategies to reduce the diabetes burden . There is strong and consistent evidence from r and omised controlled trials that type 2 diabetes can be prevented or delayed through lifestyle modification which improves diet , increases physical activity and achieves weight loss in at risk people . The current challenge is to translate this evidence into routine community setting s , determine feasible and effective ways of delivering the intervention and providing on-going support to sustain successful behavioural changes . Methods / Design The Sydney Diabetes Prevention Program ( SDPP ) is a translational study which will be conducted in 1,550 participants aged 50 - 65 years ( including 100 indigenous people aged 18 years and older ) at high risk of future development of diabetes . Participants will be identified through a screening and recruitment program delivered through primary care and will be offered a community-based lifestyle modification intervention . The intervention comprises an initial individual session and three group sessions based on behaviour change principles and focuses on five goals : 5 % weight loss , 210 min/week physical activity ( aerobic and strength training exercise ) , limit dietary fat and saturated fat to less than 30 % and 10 % of energy intake respectively , and at least 15 g/1000 kcal dietary fibre . This is followed by 3-monthly contact with participants to review progress and offer ongoing lifestyle advice for 12 months . The effectiveness and costs of the program on diabetes-related risk factors will be evaluated . Main outcomes include changes in weight , physical activity , and dietary changes ( fat , saturated fat and fibre intake ) . Secondary outcomes include changes in waist circumference , fasting plasma glucose , blood pressure , lipids , quality of life , psychological well being , medication use and health service utilization . Discussion This translational study will ascertain the reach , feasibility , effectiveness and cost-effectiveness of a lifestyle modification program delivered in a community setting through primary health care . If demonstrated to be effective , it will result in recommendations for policy change and practical methods for a wider community program for preventing or delaying the onset of type 2 diabetes in high risk people There is some evidence to suggest that regular supervised physical activity may be useful as an aid to smoking cessation . It is unclear whether less extensive interventions confer similar benefits . This study examined whether physical activity counseling alone increases long-term smoking abstinence and physical activity levels and reduces weight gain .  299 male and female smokers were r and omized to a 7-week smoking cessation program , including nicotine replacement therapy , plus either ( i ) physical activity counseling ( ' exercise ' , N=154 ) , or ( ii ) health education advice ( ' control ' , N=145 ) . There was no significant difference in rates of continuous smoking abstinence between the exercise group and the controls at 12 months following the quit day ( 9.1 % versus 12.4 % ) . Significant increases in physical activity levels observed for the exercise group versus the controls at six weeks were not maintained at 12 months . There was a non-significant tendency for less weight gain in the exercise group versus the controls at 12 months ( P=0.06 ) . Further trials are needed to examine the effect of more extensive physical activity interventions on smoking cessation , physical activity levels and post-cessation weight gain The purpose of this analysis was to determine the longitudinal relation between physical activity and the trajectory of weight change in an older cohort ( > or = 65 years ) living in New Haven , Connecticut , who participated in the Established Population s for the Epidemiologic Study of the Elderly between 1982 and 1994 ( n=2,812 ) . The authors hypothesized that body weight would decline over the follow-up and that physical activity would play an important role in minimizing weight loss over time . Physical activity and other covariables were self-reported at baseline , while body weight was self-reported annually over 12 years . Multivariable r and om effects regression demonstrated a curvilinear trajectory of weight loss per year with an accelerated loss at older ages . Baseline body weight was 155 ( st and ard deviation , 30 ) pounds ( 70 ( st and ard deviation , 14 ) kg ) for those who survived the entire follow-up and was 153 ( st and ard deviation , 32 ) pounds ( 70 ( st and ard deviation , 15 ) kg ) for those who did not . Each 1-unit increase in baseline total activity score minimized this aging-related weight loss , but this relation was most pronounced among those with chronic disease who did not survive the entire follow-up period ( n=973 ; 0.15 pounds ( 0.07 kg ) per year ) . These data suggest that , among frail older people , even modest levels of physical activity can attenuate the rate of aging- and disease-related weight loss Objectives : Mental disorders such as depression , anxiety and dementia are common in elderly . However , physical activity is suggested to be effective in preventing such aging-related disorders . The aim of this study was to investigate the role of physical activity on mental health in later life . Methods : Four hundred elderly people were r and omly divided into the intervention and control groups . The intervention consisted of exercise twice a week for two months .  Mental health status before , just after , and three months after the study was assessed with the 28-item General Health Question naire ( GHQ-28 ) . Results : The mean of the GHQ-28 total scale decreased in the case group and this change remained significant after three months ( before : 8 ± 5.5 , after three months : 5.6 ± 4.6 , p < .001 ) . GHQ subscales including somatization , anxiety , social dysfunction , and depression decreased significantly in the case group just after and three months after the intervention . Conclusions : Physical activity significantly prevents mental disorder in older adults . Although it has effects on anxiety , social dysfunction , and depression , the greatest influence is on improving the somatization symptoms Considerable evidence suggests that the loss of strength and muscle mass appear to be inevitable consequences of aging . Moreover , aging is associated with an increase in body fat . This study examined whether increased physical activity could prevent or reverse the losses of strength and skeletal muscle mass as well as the gain in  fat in older adults . Eleven men and 31 women completed a r and omized trial consisting of either a physical activity ( PA ; n = 22 ) or successful aging health educational control ( SA ; n = 20 ) group . Isokinetic knee extensor strength and computed tomography-derived midthigh skeletal muscle and adipose tissue cross-sectional areas ( CSA ) were assessed at baseline and at 12 mo following r and omization .  Total body weight and muscle CSA decreased in both groups , but these losses were not different between groups . Strength adjusted for muscle mass decreased ( -20.1 + /- 9.3 % , P < 0.05 ) in SA . The loss of strength was completely prevented in PA ( + 2.5 + /- 8.3 % ) . In addition , there was a significant increase ( 18.4 + /- 6.0 % ) in muscle fat infiltration in SA , but this gain was nearly completely prevented in PA ( 2.3 + /- 5.7 % ) . In conclusion , regular physical activity prevents both the age-associated loss of muscle strength and increase in muscle fat infiltration in older adults with moderate functional limitations BACKGROUND The present review systematic ally evaluates correlates of physical activity across the socio-ecological model for people with depression . SUBJECTS AND METHODS Two independent review ers search ed Embase , PubMed , and CINAHL from their inception until May 2015 , combining the medical subject heading ' depression ' or ' depressive ' with ' physical activity ' or ' exercise ' . Data were extracted by the same independent research ers and summarized according to the socio-ecological model . RESULTS Fifty-nine papers involving 101,539 persons with depression were eligible and enabled us to evaluate 42 correlates . Correlates that were consistently ( n ≥ 4 ) associated with lower physical activity participation in depressed persons were a higher level of depressive symptoms , a higher body mass index , the presence of physical co-morbidity and a lower self-efficacy . The role of social , environmental and policy factors on  physical activity participation is unknown and should be addressed in future research . CONCLUSION In persons with depression  physical activity participation  is a complex behavior that is influenced by many different factors . Significant correlates should be confirmed in prospect i ve studies . Interventions to improve modifiable physical and mental health variables in people with depression should be developed and evaluated The outcomes of quantitative investigations examining the effectiveness of exercise interventions for people with COPD are limited by the small number of measurement tools that can be included . In contrast , qualitative inquiry allows broader exploration of the perceived outcomes of an intervention . The purpose of this investigation is to explore the qualitative outcomes of a progressive resistance exercise ( PRE ) program for people with COPD . People with COPD , enrolled in a r and omized controlled trial of PRE , were invited to participate in two semi-structured interviews conducted at the end ( 12 weeks ) and 12 weeks after the training intervention ( 24 weeks ) . Interviews were audiotaped , transcribed and then coded independently by two research ers . Themes relating to training outcomes were then developed and described . Twenty-two participants were interviewed at 12 weeks , and 19 participants at 24 weeks . After PRE , participants reported a range of physical gains , particularly with regard to improved strength and reduced breathlessness during daily activities . Improved control and confidence during activities of daily living were important psychological benefits perceived by people with COPD , as was the social support experienced during group training sessions . At 24 weeks , confidence persisted despite a perceived plateau or dissipation of physical gains .  People with COPD reported physical , psychological and social benefits after PRE , which had a positive effect on activity performance . Although the perceived physical benefits of training were not prominent at 24 weeks , feelings of increased confidence and control persisted . Chronic Respiratory Disease 2007 ; 4 : Numerous studies have examined the relationship between physical activity and cognitive function , demonstrating that greater physical activity is associated with lower incidence of cognitive impairment in later life . Due to an increasingly large number of older adults at risk for cognitive impairment , the relationship between physical activity and cognition has garnered increasing public health relevance and multiple r and omized trials have demonstrated that exercise interventions among sedentary adults improve cognitive performance in multiple domains of function . This article will examine the relationship between physical activity and cognitive function by review ing several different areas of literature , including the prevalence of cognitive impairment , assessment methods , observational studies examining physical activity and cognition , and intervention studies . The present review is intended to provide a historical tutorial of existing literature linking  physical activity , exercise , and cognitive function among both healthy and clinical population BACKGROUND walking is the most popular form of exercise in older people but the impact of walking on falls is unclear . This study investigated the impact of a 48-week walking programme on  falls in older people . METHODS three hundred and eighty-six physically inactive people aged 65 + years living in the community were r and omised into an intervention or control group . The intervention group received a self-paced , 48-week walking programme that involved three mailed printed manuals and telephone coaching . Coinciding with the walking programme manual control group participants received health information unrelated to falls . Monthly falls calendars were used to monitor falls ( primary outcome ) over 48 weeks . Secondary outcomes were self-reported quality of life , falls efficacy , exercise and walking levels . Mobility , leg strength and choice stepping reaction time were measured in a sub- sample ( n = 178 ) of participants . RESULTS there was no difference in fall rates between the intervention and control groups in the follow-up period ( IRR = 0.88 , 95 % CI : 0.60 - 1.29 ) . By the end of the study , intervention group participants spent significantly more time  exercising in general , and specifically walking for exercise  ( median 1.69 versus 0.75 h/week , P < 0.001 ) . CONCLUSION our finding that a walking programme is ineffective in preventing falls supports previous research and questions the suitability of recommending walking as a fall prevention strategy for older people . Walking , however , increases physical activity levels in previously inactive older people
In sum , exercise and physical activity can effectively prevent weight gain in older adults and postmenopausal women either in terms of weight loss or maintenance .
They can preserve lean body mass and thus are important for the balance between potentially positive and negative effects of weight reduction in later life .
In addition , since all intervention studies were conducted with an overweight sample , it seems that primordial prevention ( in terms of preventing the development of risk factors such as excess weight in the first place ) might be a neglected issue in geriatric and postmenopausal prevention
This review examines the role of exercise and physical activity for preventing  weight gain in older people .