Physical activity, diet and BMI in children aged 6–8 years: a cross-sectional analysis American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Objectively measured physical activity level and sedentary behavior in Norwegian children during a week in preschool☆ Individuals Underestimate Moderate and Vigorous Intensity Physical Activity A randomized trial of a Facebook-based physical activity intervention for young adult cancer survivors Evaluation of policies to promote physical activity in afterschool programs: are we meeting current benchmarks? Exercise for people with cancer: a clinical practice guideline. Association of available parkland, physical activity, and overweight in America's largest cities. A cluster-randomized controlled trial of strategies to increase adolescents’ physical activity and motivation during physical education lessons: the Motivating Active Learning in Physical Education (MALP) trial Adherence to physical activity guidelines in mid-pregnancy does not reduce sedentary time: an observational study A self-regulation-based intervention to increase physical activity in cancer patients Objectively measured physical activity in four-year-old British children: a cross-sectional analysis of activity patterns segmented across the day The effect of a movement-to-music video program on the objectively measured sedentary time and physical activity of preschool-aged children and their mothers: A randomized controlled trial Energy Cost of Single‐Set Resistance Training in Older Adults A randomized trial to promote physical activity among breast cancer patients. Rationale and study protocol for the supporting children’s outcomes using rewards, exercise and skills (SCORES) group randomized controlled trial: A physical activity and fundamental movement skills intervention for primary schools in low-income communities A school-based physical activity program to improve health and fitness in children aged 6–13 years ("Kinder-Sportstudie KISS"): study design of a randomized controlled trial [ISRCTN15360785] Change in energy expenditure and physical activity in response to aerobic and resistance exercise programs The effect of supervised exercise therapy on physical activity and ambulatory activities in patients with intermittent claudication. Home-based physical activity intervention for breast cancer patients. Assessment of a two-year school-based physical activity intervention among 7-9-year-old children Exercise impact on sustained attention of ADHD children, methylphenidate effects A cluster-randomized controlled trial to reduce sedentary behavior and promote physical activity and health of 8-9 year olds: The Transform-Us! Study
Objective To assess relationships between current physical activity ( PA ) , dietary intake and body mass index (  BMI ) in English children . Design and setting Longitudinal birth cohort study in northeast Engl and , cross-sectional analysis . Participants 425 children ( 41 % of the original cohort ) aged 6–8 years ( 49 % boys ) . Main outcome measures  PA  over 7 days was measured objective ly by an accelerometer ; three categories of PA were created : ‘ active ’ ≥60 min/day moderate-to-vigorous-intensity PA ( MVPA ) ; ‘ moderately active ’ 30–59 min/day MVPA ; ‘ inactive ’ < 30 min/day MVPA . Dietary intake  over 4 days was measured using a prospect i ve dietary assessment tool which incorporated elements of the food diary and food frequency methods . Three diet categories were created : ‘ healthy ’ , ‘ unhealthy ’ and ‘ mixed ’ , according to the number of portions of different foods consumed . Adherence to the ‘ 5-a-day ’ recommendations for portions of fruit and vegetables was also assessed . Children were classified as ‘ healthy weight ’ or ‘ overweight or obese ’ ( OW/OB ) according to International Obesity Taskforce cutpoints for BMI . Associations between weight status and PA/diet categories were analysed using logistic regression . Results Few children met the UK-recommended guidelines for either MVPA or fruit and vegetable intake , with just 7 % meeting the recommended amount of MVPA of 60 min/day , and 3 % meeting the 5-a-day fruit and vegetable recommendation .  Higher PA  was associated with a lower OR for OW/OB in boys only ( 0.20 , 95 % CI 0.04 to 0.88 ) . There was no association detected between dietary intake and OW/OB in either sex . Conclusions Increasing MVPA may help to reduce OW/OB in boys ; however , more research is required to examine this relationship in girls . Children are not meeting the UK guidelines for diet and PA , and more needs to be done to improve this situation Overweight and obesity affects more than 66 % of the adult population and is associated with a variety of chronic diseases . Weight reduction reduces health risks associated with chronic diseases and is therefore encouraged by major health agencies . Guidelines of the National Heart , Lung , and Blood Institute ( NHLBI ) encourage a 10 % reduction in weight , although considerable literature indicates reduction in health risk with 3 % to 5 % reduction in weight . Physical activity ( PA ) is recommended as a component of weight management for prevention of weight gain , for weight loss , and for prevention of weight regain after weight loss . In 2001 , the American College of Sports Medicine ( ACSM ) published a Position St and that recommended a minimum of 150 min wk(-1 ) of moderate-intensity PA for overweight and obese adults to improve health ; however , 200 - 300 min wk(-1 ) was recommended for long-term weight loss . More recent evidence has supported this recommendation and has indicated more PA may be necessary to prevent weight regain after weight loss . To this end , we have reexamined the evidence from 1999 to determine whether there is a level at which PA is effective for prevention of weight gain , for weight loss , and prevention of weight regain . Evidence supports moderate-intensity PA between 150 and 250 min wk(-1 ) to be effective to prevent weight gain .  Moderate-intensity PA between 150 and 250 min wk(-1 ) will provide only modest weight loss . Greater amounts of PA ( > 250 min wk(-1 ) ) have been associated with clinical ly significant weight loss .  Moderate-intensity PA between 150 and 250 min wk(-1 ) will improve weight loss in studies that use moderate diet restriction but not severe diet restriction . Cross-sectional and prospect i ve studies indicate that after weight loss , weight maintenance is improved with PA > 250 min wk(-1 ) . However , no evidence from well- design ed r and omized controlled trials exists to judge the effectiveness of PA for prevention of weight regain after weight loss .  Resistance training does not enhance weight loss but may increase fat-free mass and increase loss of fat mass and is associated with reductions in health risk . Existing evidence indicates that endurance PA or resistance training without weight loss improves health risk . There is inadequate evidence to determine whether PA prevents or attenuates detrimental changes in chronic disease risk during weight gain Although many studies have reported on  physical activity ( PA ) levels using accelerometers , a thorough description of the PA pattern in preschool children during their stay in the preschool , is lacking in the current literature . Furthermore , there remains a lack of underst and ing of the PA level and pattern in children in the lower end of the PA continuum . The first aim of this study was therefore to describe the PA pattern during a week-long stay in a preschool in all children born in 2011 ( either three or four-year-olds ) attending public preschools in a municipality in Norway . The second aim was to describe the PA level and pattern of the children who are the least physically active . This cross-sectional study included baseline data from 95 % of children ( N = 111 ) participating in a r and omized controlled physical activity intervention ( Active Kindergarten – Active Children study ) . The participants wore an Actigraph accelerometer , in week 39 in 2015 , from when they arrived at the preschool on Monday morning and throughout their stay of five consecutive days . The amount of moderate- to vigorous-intensity PA ( MVPA ) per day ranged from 16 min to 116 min , and sedentary time ranged from 2.7 h to 6.5 h per day in the least and most sedentary child , respectively . The least physically active 25 % of children were less active throughout the entire day , and only a few of them managed to achieve the recommended level of MVPA on any weekday . The physical activity levels and patterns among the least active children described in this study may help to inform interventions targeting this group Background It is unclear whether the common physical activity ( PA ) intensity descriptors used in PA guidelines worldwide align with the associated percent heart rate maximum method used for prescribing relative PA intensities consistently between sexes , ethnicities , age categories and across body mass index ( BMI ) classifications . Objectives The objectives of this study were to determine whether individuals properly select light , moderate and vigorous intensity PA using the intensity descriptions in PA guidelines and determine if there are differences in estimation across sex , ethnicity , age and BMI classifications . Methods 129 adults were instructed to walk/jog at a “ light , ” “ moderate ” and “ vigorous effort ” in a r and omized order . The PA intensities were categorized as being below , at or above the following % HRmax ranges of : 50–63 % for light , 64–76 % for moderate and 77–93 % for vigorous effort . Results On average , people correctly estimated light effort as 51.5±8.3%HRmax but underestimated moderate effort as 58.7±10.7%HRmax and vigorous effort as 69.9±11.9%HRmax . Participants walked at a light intensity ( 57.4±10.5%HRmax ) when asked to walk at a pace that provided health benefits , wherein 52 % of participants walked at a light effort pace , 19 % walked at a moderate effort and 5 % walked at a vigorous effort pace . These results did not differ by sex , ethnicity or BMI class . However , younger adults  underestimated moderate and vigorous intensity more so than middle-aged adults ( P<0.05 ) . Conclusion When the common PA guideline descriptors were aligned with the associated % HRmax ranges , the majority of participants underestimated the intensity of PA that is needed to obtain health benefits . Thus , new subjective descriptions for moderate and vigorous intensity may be warranted to aid individuals in correctly interpreting PA intensities Purpose Over half of young adult cancer survivors do not meet physical activity ( PA ) guidelines . PA interventions can enhance health and quality of life among young adult cancer survivors . However , few exercise interventions have been design ed and tested in this population . This study evaluated the feasibility and preliminary efficacy of a 12-week , Facebook-based intervention ( FITNET ) aim ed at increasing moderate-to-vigorous intensity PA  compared with a Facebook-based self-help comparison ( SC ) condition . Methods Young adult cancer survivors ( n = 86 ) were r and omly assigned to the FITNET or SC group . All participants were asked to complete self-administered online question naires at baseline and after 12 weeks . Results Seventy-seven percent of participants completed postintervention assessment s , and most participants reported using intervention components as intended . Participants in both groups would recommend the program to other young adult cancer survivors ( FITNET , 46.9 vs. SC , 61.8 % ; p = 0.225 ) . Over 12 weeks , both groups increased self-reported weekly minutes of moderate-to-vigorous PA ( FITNET , 67 min/week ( p = 0.009 ) vs. SC , 46 min/week ( p = 0.045 ) ) , with no significant difference between groups . Increases in light PA were 135 min/week greater in the FITNET group relative to the SC group ( p = 0.032 ) , and the FITNET group reported significant weight loss over time ( −2.1 kg , p = 0.004 ; p = 0.083 between groups ) . Conclusion Facebook-based intervention approaches demonstrated potential for increasing PA in young adult cancer survivors . Implication s for Cancer SurvivorsSocial networking sites may be a feasible way for young adult cancer survivors to receive health information and support to promote PA and healthy behaviors BACKGROUND Policies now recommend afterschool programs ( ASP , 3 - 6 pm ) provide children a minimum amount of physical activity daily . We examined the extent to which children attending ASPs meet existing national and state-level policies that specify expected levels of physical activity ( PA ) . METHODS Accelerometer-derived physical activity ( light and moderate-to-vigorous , MVPA ) of 253 children ( 5 - 13 years ) was compared to policies that recommend varying amounts of PA children should achieve during an ASP . RESULTS The proportion of children achieving a policy ranged from 0.0 % ( California 60 min MVPA and North Carolina 20 % of daily program time devoted to MVPA ) , 1.2 % ( California 30 min MVPA ) , to 48.2 % ( National Afterschool Association 30 min light plus MVPA ) . R and om effects logistic models indicated boys ( odds ratio [ OR ] range 2.0 to 6.27 ) and children from a minority background ( Black/Hispanic , OR range 1.87 to 3.98 ) were more likely to achieve a recommended level of physical activity , in comparison to girls and White children . Neither age nor BMI were related to achieving a policy . CONCLUSIONS The PA of children attending ASP falls below policy recommended levels ; however , these policies were developed in absence of data on expected PA levels during ASPs . Thus , concerted effort towards building a stronger ASP evidence -base for policy refinement is required BACKGROUND Development of this guideline was undertaken by the Exercise for People with Cancer Guideline Development Group , a group organized by Cancer Care Ontario 's Program in Evidence -Based Care ( pebc ) . The purpose of the guideline was to provide guidance for clinicians with respect to exercise for patients living with cancer , focusing on the benefits of specific types of exercise , recommendations about screening requirements for new referrals , and safety concerns . METHODS Consistent with the pebc 's st and ardized approach , a systematic search was conducted for existing guidelines , and systematic literature search es were performed in medline and embase for both systematic review s and primary literature . Content and methodology experts performed an internal review , which was followed by an external review by targeted experts and intended users . RESULTS The search identified three guidelines , eighteen systematic review s , and twenty-nine r and omized controlled trials with relevance to the topic . The present guideline provides recommendations for the duration , frequency , and intensity of exercise appropriate for people living with cancer . It also provides recommendations for pre-exercise assessment , safety concerns , and delivery models . CONCLUSIONS There is sufficient evidence to show that exercise provides benefits in quality of life and muscular and aerobic fitness for people with cancer both during and after treatment , and that it does not cause harm . The present guideline is intended to support the Canadian Society for Exercise Physiology 's Canadian physical activity guidelines . The recommendations are intended for clinicians and institutions treating cancer patients in Ontario , and for policymakers and program planners involved in the delivery of exercise programs for cancer patients OBJECTIVE To examine associations between the densities of available parkl and , parkl and provided per capita , and levels of  physical activity ( PA ) and overweight in urban United States . DESIGN Cross-sectional correlation research using data drawn from the Trust for Public L and 's 2010 City Park Facts and The Behavioral Risk Factor Surveillance System ( BRFSS ) . City Park Facts is a report containing " basic information on urban park systems -- from acreage , to facilities , to staffing , to budgets , to usership , and more " for America 's 85 largest cities . The Behavioral Risk Factor Surveillance System is a state-based surveillance system that collects information on health risk behaviors , preventive health practice s , and health care access primarily related to chronic disease and injury . SETTING Sixty-seven metropolitan statistical areas in the United States that provided data for both reports . PARTICIPANTS R and omly selected adults aged 18 years and older who participated in the 2009 Behavioral Risk Factor Surveillance Survey in the 67 metropolitan statistical areas . MAIN OUTCOME MEASURE(S ) Total parkl and per acre of metropolitan area was correlated to inactivity , engaging in recommended levels of moderate or vigorous PA , engaging in recommended levels of vigorous PA , and body weight . Parkl and acreage per 1000 residents was correlated to these same variables . Multilevel models considered these relationships while controlling for race , family income , and age of respondents and accounting for clustering by metropolitan statistical area . RESULTS There were significant , positive correlations between park density and PA ( r(s ) = 0.37 , n = 67 , P < .01 ) and between park density and exercise ( r(s ) = 0.35 , n = 67 , P < .01 ) , and a negative correlation between park density and being above normal weight ( r(s ) = -0.32 , n = 67 , P < .01 ) . Adjusted multilevel models showed that parkl and density in the highest versus lowest quartile was associated with significantly higher odds of meeting PA guidelines ( aOR = 1.19 , 95 % CI : 1.08 - 1.30 ) and reduced odds of being overweight/obese ( aOR = 0.85 , 95 % CI : 0.76 - 0.95 ) . CONCLUSIONS Each of these findings substantiates the need for providing parkl and in a community . As such , this research helps to support the notion that the development of a strong park system may lead to positive PA and health outcomes for that community Background The physical activity ( PA ) levels of many children and adolescents in Australia are currently insufficient to promote health benefits . Physical education ( PE ) programs aim to promote PA and reach nearly all school-aged children , but PA levels within PE lessons are often low . PE teachers may influence children ’s motivation to be physically active in PE lessons , but little is known about teacher strategies that effectively motivate children to participate in PA , and few intervention studies have examined motivational strategies in PE . The purpose of this study was to compare the effect of three motivational strategies , each based on Self-Determination Theory ( SDT ) , on PA levels , and their hypothesized antecedents , during year 8 PE lessons . Methods / design This study employed a cluster-r and omized controlled trial design . Following a familiarization session , PA levels and hypothesized PA antecedents were measured during a baseline lesson and a post-intervention or control lesson .  Teachers ( n = 16 ) and their classes from five secondary schools in Sydney , Australia were r and omly assigned into four blocks and instructed to provide one of four 20-min lesson teaching strategy conditions : ( 1 ) explaining the relevance of activities ; ( 2 ) providing choice from PA options selected by the teacher ; ( 3 ) providing equipment and free choice of activities ; or ( 4 ) usual practice . The primary outcomes were lesson time spent in moderate-to-vigorous PA , and motivation towards the lesson . Secondary outcomes were perceptions of teacher behavior , psychological needs satisfaction , and lesson time spent in sedentary behavior . PA and sedentary behavior were measured during baseline and post-intervention lessons with waist-mounted Actigraph GT3X accelerometers . Teacher behavior , psychological needs satisfaction , and motivation were assessed via question naires at the end of each lesson . Linear mixed-model analyses will be run on all outcomes , with students nested within teachers as a r and om effect . Discussion Study findings will inform the development of effective SDT-based teaching strategy interventions to enhance students ’ psychological needs satisfaction , motivation , and PA levels . More effective teaching strategies may be identified that are capable of improving  adolescents ’ PA levels , and thereby provide beneficial population health outcomes .Trial registration This trial is registered with Current Controlled Trials and is traceable as IS RCT N07038258 Background Physical activity ( PA ) interventions design ed to prevent prenatal complications have focused on increasing moderate PA yielding conflicting results . Minimal attention has focused on the evaluation of sleep , sedentary behavior ( SB ) , light activity or total daily PA during pregnancy . The purpose of this prospect i ve , longitudinal study was to 1 ) objective ly quantify and compare habitual PA and SB during the 2nd and 3rd trimester ; and 2 ) evaluate differences in activity patterns for women meeting prenatal PA guidelines versus those that did not . Methods Forty-six participants wore 2 PA monitors ( SenseWear ® Mini and activPAL ™ ) during week 18 and week 35 of pregnancy . We compared differences in sleep duration , postural allocation , daily steps , and PA between the 2nd and 3rd trimester and for women who met and did not meet PA guidelines . Results During the 2nd trimester , 30 % of the women ’s day ( 24-hours ) was total sleep ; 52 % SB ; 13 % light ; 3 % moderate ; and 0 % vigorous PA . Light ( P = 0.05 ) , vigorous ( P = 0.02 ) , and moderate-vigorous PA ( MET-minutes ; P = 0.02 ) , decreased with a trend in increased SB ( P = 0.07 ) . Activity of other intensities and sleep duration did not significantly change . Only 39 % and 37 % of participants slept between 7–9 hours/night at week 18 and 35 , respectively . Forty-six percent ( n = 21 ) and 28 % ( n = 13 ) of participants met prenatal PA guidelines during the 2nd and 3rd trimester , respectively . At week 18 , no differences in total sleep , SB , or light PA existed for women who met PA guidelines versus those who did not ; total PA was significantly greater for women who met guidelines . At week 35 , women that met PA guidelines had significantly less SB ( P < 0.005 ) than women who did not . Conclusions This study demonstrates that pregnant women spend the majority of their day in SB . Significant reductions in total activity across pregnancy may be attributed , in part to shifts in light PA and increased SB . Based on the lifestyle of our sample , regardless of meeting PA guidelines in mid-pregnancy , no significant difference exists in time spent in SB , however meeting PA recommendations in late pregnancy may reduce SB . Future interventions should target reducing SB by increasing light and moderate PA beyond volitional exercise The study examined whether a behavior-change intervention focusing on self-regulatory strategies and emphasizing role model support increases physical activity ( PA ) among insufficiently active ( not meeting PA guidelines of 150 min/week ) cancer patients . Ambulatory cancer patients [ N = 72 ; 54 % female ; M = 56 years , SD = 12.34 ; most with breast or colon cancer ( 34 , 15 % ) ] were enrolled in the MOTIVACTION- study , a 4-week intervention ( 1-hr counseling , followed by weekly phone calls ) , with pretest ( T1 ) , posttest ( T2 ) and a 10-week follow-up ( T3 ) . Participants were r and omized to either an exercise or to a stress management intervention ( active control ) . The exercise intervention emphasized self-regulatory strategies ( e.g. action- and coping planning and self-monitoring ) ; patients were also encouraged to contact a physically active same-sex role model as a potential exercise partner . The active control condition consisted of coping and relaxation techniques .  Sixty-seven patients remained in the study and completed the SQUASH assessment of PA and a measure of perceived stress . PA was vali date d by Actigraph accelerometry . At T2 , 46 % of the patients in the exercise group and 19 % of stress management patients increased their activity levels to meet PA guidelines ( > 150 min/week ; χ2(1 ) = 5.51 , p = .019 ) . At T3 , participants in the exercise intervention maintained their exercise level ( 46 % ) , but also 31 % of the stress management patients met the guidelines . All patients reported reductions in perceived stress . Additional analyses comparing patients in the exercise group by role model contact ( 63 % realized contact ) revealed that those who had contact with their role model were significantly more likely to adhere to the recommended guidelines ( T2:50 % ; T3:64 % ) compared to those who did not have contact with a role model ( T2:39 % ; T3:15 % ) , suggesting the potential of mobilizing role model support to facilitate PA . In sum , cancer patients may not only benefit from an exercise intervention emphasizing self-regulation , but also from stress management , regarding both reducing stress and increasing PA Background Little is known about preschool-aged children ’s levels of  physical activity ( PA ) over the course of the day . Using time-stamped data , we describe the levels and patterns of PA in a population -based sample of four-year-old British children . Methods Within the Southampton Women ’s Survey the PA levels of 593 4-year-old children ( 51 % female ) were measured using ( Actiheart ) accelerometry for up to 7 days . Three outcome measures : minutes spent sedentary ( < 20 cpm ) ; in light ( LPA : ≥20 – 399 cpm ) and in moderate-to-vigorous activity ( MVPA : ≥400 cpm ) were derived . Average daily activity levels were calculated and then segmented across the day ( morning , afternoon and evening ) . MVPA was log-transformed . Two-level r and om intercept models were used to analyse associations between activity level and temporal and demographic factors . Results Children were active for 67 % ( mean 568.5 SD 79.5 minutes ) of their daily registered time on average , with 88 % of active time spent in LPA . All children met current UK guidelines of 180 minutes of daily activity . There were no differences in children ’s average daily levels of sedentary activity and LPA by temporal and demographic factors : differences did emerge when activity was segmented across the day . Sex differences were largest in the morning , with girls being more sedentary , spending fewer minutes in LPA and 18 % less time in MVPA than boys . Children were more sedentary and less active ( LPA and MVPA ) in the morning if they attended childcare full-time compared to part-time , and on weekend mornings compared to weekdays . The reverse was true for weekend afternoons and evenings . Children with more educated mothers were less active in the evenings . Children were less sedentary and did more MVPA on summer evenings compared to winter evenings . Conclusions Preschool-aged children meet current physical activity guidelines , but with the majority of their active time spent in LPA , investigation of the importance of activity intensity in younger children is needed . Activity levels over the day differed by demographic and temporal factors , highlighting the need to consider temporality in future interventions . Increasing girls ’ morning activity and providing opportunities for daytime activity in winter months may be worthwhile Regular physical activity ( PA ) and the avoidance of prolonged sitting are essential for children ’s healthy growth , and for the physical and mental wellbeing of both children and adults . In the context of exercise , music may promote behavioral change through increased exercise adherence and participation . The purpose of this study was to determine whether a movement-to-music video program could reduce sedentary behavior ( SB ) and increase PA in mother-child pairs in the home environment . A r and omized controlled trial was conducted in the Pirkanmaa region , Finl and , in 2014–2016 . The participants consisted of 228 mother-child pairs ( child age 5–7 years ) . The primary outcomes of interest were tri-axial accelerometer-derived SB and PA , which were measured in weeks one ( baseline ) , two , and eight in both the intervention and control groups . Further , the mothers and children in the intervention group used a movement-to-music video program from the beginning of week two to the end of week eight . Secondary outcomes included self-reported screen time . The statistical methods employed comprised an intention-to-treat and linear mixed effects model design . No statistically significant differences between groups were found in primary or secondary outcomes . Among the children in the control group  , light PA  decreased significantly over time and screen time increased from 89 ( st and ard deviation , SD 37 ) to 99 ( SD 41 ) min/d . Among mothers and children in the intervention group , no statistical differences were found . In supplementary analysis , the children who stayed at home instead of attending daycare/preschool had on average 25 ( 95 % confidence interval , CI 19–30 ) min/d more sedentary time and 11 ( 95 % CI 8–14 ) min/d less moderate-to-vigorous PA than those who were at daycare/preschool . The higher body mass index of mothers was related with 5 ( 95 % CI 2–7 ) min/d more sedentary time and 1 ( 95 % CI 0–2 ) min/d less moderate-to-vigorous PA . The movement-to-music video program did not change the objective ly measured SB or PA of the mother-child pairs . However , mothers and children seemed to be more sedentary at home , and therefore interventions for decreasing SB and increasing PA should be targeted in the home environment & NA ; Phillips , W.T. , and J.R. Ziuraitis . Energy cost of single‐set resistance training in older adults . J. Strength Cond . Res . 18(3):606–609 . 2004.—The purpose of this study was ( a ) to assess the intensity and energy cost of a single‐set resistance training ( RT ) protocol as recommended by the recent American College of Sports Medicine ( ACSM ) guidelines for older adults and ( b ) to compare obtained values to those recently reported as eliciting health benefits via endurance‐based physical activity ( PA ) . Five males and 5 females ( 73.1 ± 5.5 years ) performed 1 set of 15 repetitions of 8 RT exercises while connected to a portable metabolic unit ( CosMed K4b2 ) . The RT intensity ( metabolic equivalents [ METs ] ) was 3.3 ± 0.7 ( males ) and 3.0 ± 0.6 ( females ) . Energy cost ( kcal ) was 84.2 ± 14.6 ( males ) and 69.7 ± 17.4 ( females ) . We conclude that a single‐set 8‐exercise RT protocol may be a feasible alternative for achieving moderate intensity ( 3–6 METs ) for older adults but that additional sets and /or repetitions appear to be necessary to accumulate moderate amounts ( 150–200 kcal ) of PA OBJECTIVE  Physical activity ( PA ) has been shown to provide health benefits for breast cancer patients . The effects of augmenting oncology health care provider ( HCP ) advice for PA with 3 months of telephone counseling versus contact control were evaluated in a r and omized trial . METHODS After receiving brief HCP advice to become physically active , 192 women ( age in years : M = 60.0 , SD = 9.9 ) who had completed treatment for Stage 0-IV breast cancer were r and omized to telephone counseling to support PA ( n = 106 ) or contact control ( n = 86 ) . Their PA , motivational readiness , fatigue , and physical functioning were assessed at baseline ( before receiving HCP advice ) , 3 , 6 , and 12 months . RESULTS Telephone counseling produced significant effects on the primary outcome of moderate-intensity PA of about 30 min/week at both 3 months ( 95 % CI = 0.44 , 57.32 ) and 6 months ( 95 % CI = 3.06 , 61.26 ) . Intervention participants were also more than twice as likely as control participants to report improvements in achieving PA guidelines of at least 150 min/week at 3 ( OR = 2.43 , 95 % CI = 1.18 , 4.98 ) and 6 months ( OR = 2.11 , 95 % CI = 1.00 - 4.48 ) . Telephone counseling was significantly more effective than contact control in increasing motivational readiness for PA at all follow-ups ( ORs = 3.93 - 6.28 , all ps < .003 ) . No between-groups differences were found for fatigue , while differential improvements in physical functioning did not remain significant past 3 months ( p = .01 ) . CONCLUSION HCP advice plus telephone counseling improved PA among breast cancer patients at 3 and 6 months and also differentially improved patients ' motivational readiness at all follow-ups , suggesting the potential for exercise promotion in cancer follow-up care Background Many Australian children are insufficiently active to accrue health benefits and physical activity ( PA ) levels are consistently lower among youth of low socio-economic position .  PA levels decline dramatically during adolescence and evidence suggests that competency in a range of fundamental movement skills ( FMS ) may serve as a protective factor against this trend . Methods / design The Supporting Children ’s Outcomes Using Rewards Exercise and Skills ( SCORES ) intervention is a multi-component PA and FMS intervention for primary schools in low-income communities , which will be evaluated using a group r and omized controlled trial . The socio-ecological model provided a framework for the 12-month intervention , which includes the following components : teacher professional learning , student leadership workshops ( including leadership accreditation and rewards , e.g. , stickers , water bottles ) , PA policy review , PA equipment packs , parental engagement via newsletters , FMS homework and a parent evening , and community partnerships with local sporting organizations . Outcomes will be assessed at baseline , 6- and 12-months . The primary outcomes are PA ( accelerometers ) , FMS ( Test of Gross Motor Development II ) and cardiorespiratory fitness ( multi-stage fitness test ) . Secondary outcomes include body mass index [ using weight (kg)/height ( m2 ) ] , perceived competence , physical self-esteem , and resilience . Individual and environmental mediators of behavior change ( e.g. social support and enjoyment ) will also be assessed . The System for Observing Fitness Instruction Time will be used to assess the impact of the intervention on PA within physical education lessons . Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA behavior change will be explored . Discussion SCORES is an innovative primary school-based PA and FMS intervention design ed to support students attending schools in low-income communities to be more skilled and active . The findings from the study may be used to guide teacher pre-service education , professional learning and school policy in primary schools . Trial registration Australian New Zeal and Clinical Trials Registry No : Background Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure . A major contributing factor is physical inactivity which is closely linked to bone health , cardiovascular disease risk , fitness and psychological factors . The school seems to provide an excellent setting to enhance levels of  physical activity ( PA ) .  However , there is insufficient data from previous school-based intervention trials on how to enhance overall PA . It is also unknown whether an intervention aim ed at increasing PA is effective in improving the children 's health . The purpose of this paper is to outline the design of a school-based r and omized , controlled trial ( RCT ) aim ing to increase overall PA and to improve fitness and health in 6- to 13-year-old children . Methods / Design 15 schools were r and omized to the intervention ( n = 9 ) or the control ( n = 6 ) group , stratified by geographic region ( urban vs. rural ) and by age ( 1st and 5th grade ) . Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum . The intervention during one academic year consisted of : 1 . two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week , 2 . short PA breaks ( 2–5 min each ) during academic lessons , 3 . PA home work , and 4 . adaptation of recreational areas around the school . All children underwent  anthropometric measurements , blood pressure assessment , fitness testing , measurement of PA  and they filled out question naires . At least 70 % of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry . The primary endpoints of the study after one year were an increase in total PA by accelerometry , an increase in aerobic fitness measured by the 20 m shuttle run , a decrease in percent body fat derived from skinfold measurements and an increase in quality of life as assessed by the child health question naire in the intervention group compared to the control group . Secondary outcomes were overall fitness , differences in body composition including body fat distribution , cardiovascular risk factors , psychosocial health , bone mineral content and density of femur , lumbar spine and total body and food intake . Discussion Our preliminary data suggest that the children were representative of Swiss children with respect to sex , socio-demographic status , and body mass index . Short-term results can be expected by the beginning of 2007 . We hypothesized that our intervention will lead to an increase in PA , fitness and overall health . Based on our data , we aim to provide important information regarding the influence of such an intervention on these outcome measures in school-aged children and to provide nationwide guidelines to improve PA in children Exercise is considered an important component of a healthy lifestyle but there remains controversy on effects of exercise on non-exercise  physical activity ( PA ) . The present study examined the prospect i ve association of aerobic and resistance exercise with total daily energy expenditure and PA in previously sedentary , young men . Nine men ( 27.0 ± 3.3 years ) completed two 16-week exercise programs ( 3 exercise sessions per week ) of aerobic and resistance exercise separated by a minimum of 6 weeks in r and om order .  Energy expenditure and PA  were measured with the SenseWear Mini Armb and prior to each intervention as well as during week 1 , week 8 and week 16 of the aerobic and resistance exercise program . Body composition was measured via dual x-ray absorptiometry . Body composition did not change in response to either exercise  intervention . Total daily energy expenditure on exercise days increased by 443 ± 126 kcal/d and 239 ± 152 kcal/d for aerobic and resistance exercise , respectively ( p < 0.01 ) . Non-exercise moderate-to-vigorous PA , however , decreased on aerobic exercise days ( −148 ± 161 kcal/d ; p = 0.03 ) . There was no change in total daily energy expenditure and PA on non-exercise days with aerobic exercise while resistance exercise was associated with an increase in moderate-to-vigorous PA during non-exercise days ( 216 ± 178 kcal/d , p = 0.01 ) . Results of the present study suggest a compensatory reduction in PA in response to aerobic exercise . Resistance exercise , on the other h and , appears to facilitate non-exercise PA , particularly on non-exercise days , which may lead to more sustainable adaptations in response to an exercise program OBJECTIVE / BACKGROUND Intermittent claudication ( IC ) is associated with a reduction in physical activity ( PA ) and a more rapid functional decline leading to a higher mortality rate compared with healthy individuals . Supervised exercise therapy ( SET ) is known to increase the walking capacity of patients with IC . However , it is unclear whether SET increases PA . The aim of this study was to investigate the effect of SET on PA levels and ambulatory activities in patients with IC . METHODS Patients newly diagnosed with IC were requested to wear an activity monitor 1 week prior to and 1 week immediately after 3 months of SET . The primary outcome was the percentage of patients meeting the minimum recommendations of PA ( American College of Sports Medicine [ACSM]/American Heart Association [ AHA ] recommendation for public health of ≥ 67 metabolic equivalents [METs]/min/day , in bouts of ≥ 10 min ) at baseline and after 3 months of SET . Additionally , daily PA level ( METs/min ) , duration of ambulatory activities , daily number of steps , pain free walking distance ( PFWD ) , maximal walking distance ( MWD ) , and Short Form Health Survey ( SF-36 ) health surveys were compared before and after SET . RESULTS Data from 41 participants were available for analysis . A higher number of participants met the ACSM minimum recommendation for PA at the 3 month follow up ( baseline : 43 % ; 3 months : 63 % ; p = .003 ) . Despite significant increases in PFWD ( baseline : 210 m ; 3 months : 390 m ; p = .001 ) , MWD ( baseline : 373 m ; 3 months : 555 m ; p = .002 ) and physical functioning score ( SF-36 )  following SET , no increase in the mean daily PA level was found ( 395 ± 220 vs. 411 ± 228 METs/min ; p = .43 ) . Furthermore , the total number of steps and time spent in ambulatory activities did not change following SET . CONCLUSION Three months of SET for IC leads to more patients meeting the ACSM/AHA public health minimum recommendations for PA . Assessment of PA could be incorporated as an outcome parameter in future research comparing different treatment modalities for peripheral arterial disease PURPOSE The efficacy of a home-based physical activity ( PA ) intervention for early-stage breast cancer patients was evaluated in a r and omized controlled trial . PATIENTS AND METHODS Eighty-six sedentary women ( mean age , 53.14 years ; st and ard deviation , 9.70 years ) who had completed treatment for stage 0 to II breast cancer were r and omly assigned to a PA or contact control group . Participants in the PA group received 12 weeks of PA counseling ( based on the Transtheoretical Model ) delivered via telephone , as well as weekly exercise tip sheets . Assessment s were conducted at baseline , after treatment ( 12 weeks ) , and 6 and 9 month after baseline follow-ups . The post-treatment outcomes are reported here . RESULTS Analyses showed that , after treatment , the PA group reported significantly more total minutes of PA , more minutes of moderate-intensity PA , and higher energy expenditure per week than controls . The PA group also out-performed controls on a field test of fitness . Changes in PA were not reflected in objective activity monitoring . The PA group was more likely than controls to progress in motivational readiness for PA and to meet PA guidelines . No significant group differences were found in body mass index and percent body fat . Post-treatment group comparisons revealed significant improvements in vigor and a reduction in fatigue in the PA group . There was a positive trend in intervention effects on overall mood and body esteem . CONCLUSION The intervention successfully increased PA and improved fitness and specific aspects of psychological well-being among early-stage breast cancer patients . The success of a home-based PA intervention has important implication s for promoting recovery in this population Background  Physical activity ( PA )  in children has declined in recent decades , highlighting the need for effective intervention programs for school-aged children . The main objective of this study was to assess to what extent PA during and after school hours changed among children who received a progressive two-year long intervention vs. that of children who only received general curriculum-based PA .  Methods A cluster r and omized intervention study was conducted and six elementary schools r and omly assigned to serve as control- or intervention schools . All children attending second grade ( mean age = 7.4 years - born in 1999 ) were invited to participate in the fall of 2006 ( N = 320 , 82 % participated ) , again in 2007 ( midpoint ) and 2008 ( end of intervention ) . The intervention consisted of multi-component PA-intervention during school hours and was conducted by teachers at each intervention school . PA  was assessed by means of accelerometers and subjectively at the intervention schools via teachers ' PA log-books . Results There was no difference in PA intensity ( minutes of moderate-to-vigorous physical activity - min of MVPA ) between the two study groups at baseline , but children in the intervention schools were more physically active at moderate-to-vigorous intensity compared to those in control schools after one year of intervention ( mean difference of MVPAlog-minutes : 0.61 , 95%CI : 0.02 , 1.20 , p = 0.04 ) . Moreover , the model for minutes of MVPA during school hours , showed a significant three-way interaction between time at mid-point , group and gender ( mean difference of MVPAlog-minutes : 1.06 , 95%CI : 0.15 , 1.97 , p = .02 ) , indicating a significantly greater increase among the boys in the intervention schools compared to girls . No difference in PA was detected between the study groups at the end of the study period after two years of intervention . Conclusions The results suggest that the objective of increasing PA at school was met after one year of intervention , and it was more pronounced among boys . The lack of increase at the end of the study period suggested that any increase in  PA  during school may highly depend on both motivation and training of general teachers . Boys may respond better to PA interventions such as the one described in this study Attention deficit hyperactivity disorder ( ADHD ) is related to a deficiency of central catecholamines ( CA ) in cognitive , biochemical , and physical tests , and pharmaceutical intervention may have no effect if it is not accompanied by changes in the environment . The objective of our study was to test the hypothesis that central CA are responsible for the increase in speed reaction seen after physical activity ( PA ) and to measure the impact of high intensity PA on the sustained attention of 25 children diagnosed with ADHD consistent with the Disease Statistical Mental-IV ( DSM-IV ) criteria . It is possible that practicing sports assists in the management of the disorder . The children were divided between users ( US ) and non-users ( NUS ) of methylpheni date ( MTP ) , and the groups were compared to evaluate the effect of the drug on cognition after PA . Post-exercise performance on Conner ’s Continuous Performance Test-II ( CPT ) was not affected by MTP , we observed significant improvements in response time , and we saw normalization in the impulsivity and vigilance measures . These results suggest that the improvements in cognition after physical effort are not CA dependent . Additionally , our results suggest that  children ’s attention deficits can be minimized through PA irrespective of treatment with MTP . Additional studies are necessary to confirm that exercise mitigates the harmful symptoms of ADHD Background Physical activity ( PA ) is associated with positive cardio-metabolic health and emerging evidence suggests sedentary behavior ( SB ) may be detrimental to children 's health independent of PA . The primary aim of the Transform-Us ! study is to determine whether an 18-month , behavioral and environmental intervention in the school and family setting s results in higher levels of PA and lower rates of SB among 8 - 9 year old children compared with usual practice ( post-intervention and 12-months follow-up ) . The secondary aims are to determine the independent and combined effects of PA and SB on  children 's cardio-metabolic health risk factors ; identify the factors that mediate the success of the intervention ; and determine whether the intervention is cost-effective . Methods / design A four-arm cluster-r and omized controlled trial ( RCT ) with a 2 × 2 factorial design , with schools as the unit of r and omization . Twenty schools will be allocated to one of four intervention groups , sedentary behavior ( SB-I ) , physical activity ( PA-I ) , combined SB and PA ( SB+PA-I ) or current practice control ( C ) , which will be evaluated among approximately 600 children aged 8 - 9 years in school year 3 living in Melbourne , Australia . All children in year 3 at intervention schools in 2010 ( 8 - 9 years ) will receive the intervention over an 18-month period with a maintenance ' booster ' delivered in 2012 and children at all schools will be invited to participate in the evaluation assessment s. To maximize the sample and to capture new students arriving at intervention and control schools , recruitment will be on-going up to the post-intervention time point . Primary outcomes are time spent sitting and in PA assessed via accelerometers and inclinometers and survey . Discussion To our knowledge , Transform-Us ! is the first RCT to examine the effectiveness of intervention strategies for reducing children 's overall sedentary time , promoting PA and optimizing health outcomes . The integration of consistent strategies and messages to children from teachers and parents in both school and family setting s is a critical component of this study , and if shown to be effective , may have a significant impact on educational policies as well as on pedagogical and parenting practice s . Trial registration ACTRN12609000715279 ; Current Controlled Trials IS RCT
Results Overall , exercise intolerance is prevalent in pediatric chronic disease .
Background Physical activity ( PA ) is associated with a diverse range of health benefits .
International guidelines suggest that children should be participating in a minimum of 60 min of moderate to vigorous intensity PA per day to achieve these benefits .
However , current guidelines are intended for healthy children , and thus may not be applicable to children with a chronic disease .
Specifically , the dose of PA and disease specific exercise considerations are not included in these guidelines , leaving such children with few , if any , evidence -based informed suggestions pertaining to PA .
Thus , the purpose of this narrative review was to consider current literature in the area of exercise as medicine and provide practical applications for exercise in five prevalent pediatric chronic diseases : respiratory , congenital heart , metabolic , systemic inflammatory/autoimmune , and cancer .