Effect of calorie restriction on the free-living physical activity levels of nonobese humans: results of three randomized trials. The influence of physical activity-induced energy expenditure on the variance in body weight change among individuals during a diet intervention. Weight-Loss Induced Changes in Physical Activity and Activity Energy Expenditure in Overweight and Obese Subjects before and after Energy Restriction Accelerometer prediction of energy expenditure: vector magnitude versus vertical axis. Role of physical activity and sleep duration in growth and body composition of preschool-aged children. Relationships between physical activity, physical fitness, muscle strength and nutritional state in 5- to 11-year-old children Validity of physical activity monitors during daily life in patients with COPD Wrist-worn accelerometers in assessment of energy expenditure during intensive training. Determinants of physical activity after hospitalization for coronary artery disease: the Tracking Exercise After Cardiac Hospitalization (TEACH) Study Weight loss-induced reduction in physical activity recovers during weight maintenance. Measurement of physical activity to assess health effects in free-living populations. Feasibility of heart-rate monitoring to estimate total level and pattern of energy expenditure in a population-based epidemiological study: the Ely Young Cohort Feasibility Study 1994-5. Validity and repeatability of the EPIC-Norfolk Physical Activity Questionnaire. Does school-based physical activity decrease overweight and obesity in children aged 6–9 years? A two-year non-randomized longitudinal intervention study in the Czech Republic Accuracy of a combined heart rate and motion sensor for assessing energy expenditure in free-living adults during a double-blind crossover caffeine trial using doubly labeled water as the reference method Feasibility and Impact of a Function Focused Care Intervention for Parkinson's Disease in the Community Effects of a life skills intervention for increasing physical activity in adolescent girls. Total free living energy expenditure in patients with severe chronic obstructive pulmonary disease. One-year changes in physical activity and sedentary behavior among adolescents: the Croatian Physical Activity in Adolescence Longitudinal Study (CRO-PALS). Etiology of overactive bladder: a diet and lifestyle model for diabetes and obesity in older women. The ProActive trial protocol – a randomised controlled trial of the efficacy of a family-based, domiciliary intervention programme to increase physical activity among individuals at high risk of diabetes [ISRCTN61323766] Physical activity monitor for recording energy expenditure in pregnancy Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments.
The objective of this study was to evaluate the influence of calorie restriction ( CR ) on free-living physical activity levels among humans . Data were from three CALERIE phase I site-specific protocol s. Participants were nonobese ( body mass index = 23.5 - 29.9 kg/m² adults r and omly assigned to 25 % CR , low-calorie diet ( LCD , 890 kcal/day supplement diet until 15 % weight loss , then weight maintenance ) , or control at Pennington Biomedical Research Center ( PBRC ) ; 30 % or 10 % CR  at Tufts University ; and 20 % CR or control  at Washington University School of Medicine ( WUSM )  . Activity was measured at months 0 , 3 , and 6 ( PBRC ) and at months 0 , 3 , 6 , 9 , and 12 ( WUSM and Tufts ) . Total daily energy expenditure ( TEE ) by doubly labeled water and resting metabolic rate ( RMR ) were used to compute activity energy expenditure : AEE = TEE - RMR - 0.1 * TEE . Accelerometry and 7-day recall categorized activities by intensity . At Tufts , the 10 % and 30 % CR groups experienced significant decreases in AEE at months 6 , 9 , and 12 . At month 6 , a larger decrease in AEE was observed in the CR than the control group at WUSM . At months 3 and 6 , larger decreases in AEE were observed in the CR and LCD groups than the control group at PBRC . Accelerometry and 7-day PAR did not consistently detect changes in activity categories . CR-associated changes in AEE were variable but , generally , reduced the energy deficit , which would reduce the expected rate of weight loss . Accelerometry and recall did not consistently explain reduced AEE , suggesting that increased muscle efficiency and /or decreased fidgeting accounted for decreased AEE . Inaccuracy of accelerometry and recall also likely negatively affected sensitivity SUMMARY OBJECTIVE We investigated the relationship between the variability in body weight change among individuals and diet restriction or physical activity during a 14-week intervention . DESIGN A prospect i ve clinical trial with a 14-week weight reduction intervention design . In total , 90 middle aged , Japanese , obese women enrolled as subjects . MEASUREMENTS The outcome variable was the change in body weight during the intervention period . Other primary variables were total energy intake , carbohydrate intake , fat intake , protein intake , total energy expenditure ( TEE ) , and activity energy expenditure ( AEE ) . Diet intake  was assessed by 3 days , weighed dietary records and dietary recall interviews . Physical activity  was assessed by a uniaxial accelerometry sensor and a diary of exercise . RESULTS Significant reductions were observed in body weight ( -8.5 kg ) as a result of intervention . When the subjects were assigned to three categories depending on AEE during intervention , the loss of body weight was significantly greater for subjects within the upper ( -9.6 kg ) AEE category than for those in the middle ( -8.5 kg ) or lower AEE ( -7.5 kg ) categories . In addition , a significant correlation ( r = 0.57 , p < 0.0001 ) was observed between a subject 's AEE before and during the intervention . On the other h and , no significant correlation was observed between body weight reduction and energy intake , indicating that strict diet restriction does not always result in a large weight loss . CONCLUSION Activity energy expenditure , not only through voluntary exercise but also through spontaneous , daily , physical activities can have a positive effect on reducing body weight Activity energy expenditure ( AEE ) is the component of daily energy expenditure that is mainly influenced by the amount of physical activity ( PA ) and by the weight of the body displaced . This study aim ed at analyzing the effect of weight loss on PA and AEE . The body weight and PA of 66 overweight and obese subjects were measured at baseline and after 12 weeks of 67 % energy restriction .  PA was measured using a tri-axial accelerometer for movement registration ( Tracmor ) and quantified in activity counts . Tracmor recordings were also processed using a classification algorithm to recognize 6 common activity types engaged in during the day . A doubly-labeled water vali date d equation based on Tracmor output was used to estimate AEE . After weight loss , body weight decreased by 13±4 % , daily activity counts augmented by 9 % ( 95 % CI : + 2 % , + 15 % ) , and this increase was weakly associated with the decrease in body weight ( R(2 ) = 7 % ; P<0.05 ) . After weight loss subjects were significantly ( P<0.05 ) less sedentary ( -26 min/d ) , and increased the time spent walking ( + 11 min/d ) and bicycling ( + 4 min/d ) . However , AEE decreased by 0.6±0.4 MJ/d after weight loss . On average , a 2-hour/day reduction of sedentary time by increasing ambulatory and generic activities was required to restore baseline levels of AEE . In conclusion , after weight loss PA increased but the related metabolic dem and did not offset the reduction in AEE due to the lower body weight . Promoting physical activity according to the extent of weight loss might increase successfulness of weight maintenance UNLABELLED It is suggested that triaxial accelerometers ( RT3 ) are superior to single-plane accelerometers for predicting energy expenditure ( EE ) . PURPOSE To compare the RT3 uniaxial and triaxial prediction of activity EE ( AEE ) during treadmill activities ( TM ) and activities of daily living ( ADL ) . METHODS Two hundred and twelve subjects ( aged 20 - 60 yr ) completed TM speeds of 1.34 , 1.56 , and 2.23 m x s(-1 ) at 0 % and 3 % grade s , stair ascent/descent , moving a box , and two r and omly assigned ADL . Subjects wore a portable indirect calorimeter to measure EE  to calculate AEE by subtracting resting metabolic rate . Acceleration counts in the vertical ( V ) , medial-lateral , and anterior-posterior planes were collected in a single RT3 secured to the hip . Predicted AEE ( RT3AEE ) was estimated from vector magnitude ( VM ) counts using a proprietary algorithm . A paired t-test compared RT3AEE versus AEE . The relationship among V and VM counts and AEE was examined using linear regression analyses . RESULTS RT3 overestimated AEE for all activities combined , overestimated for TM ( 9.0 % ) , and underestimated for ADL ( 34.3 % ; P < 0.001 ) . The R2 values between RT3AEE and AEE for TM and ADL were R2 = 0.78 and R2 = 0.15 , respectively . The RT3 underestimated activity with greater upper body movements by 24.4%-64.5 % ( P < 0.001 ) . V and VM counts were similarly related to AEE ( R2 = 0.35 ) and RT3AEE ( R2 = 0.83 - 0.89 ) . CONCLUSIONS Although the RT3 did not accurately predict AEE from accelerometer counts , stronger relationships existed between predicted and measured AEE for TM compared with ADL . Compared with V counts , using VM counts to predict AEE did not significantly improve the relationship between counts and AEE . Analytic techniques beyond linear regression with VM as a covariate or with counts from each axis entering the model separately may improve estimates of AEE from triaxial accelerometers OBJECTIVE The impact of physical activity patterns and sleep duration on growth and body composition of preschool-aged children remains unresolved . Aims were ( 1 ) to delineate cross-sectional associations among physical activity components , sleep , total energy expenditure ( TEE ) , and body size and composition ; and ( 2 ) to determine whether physical activity components , sleep , and TEE predict 1-year changes in body size and composition in healthy preschool-aged children . METHODS Anthropometry , body composition , accelerometry , and TEE by doubly labeled water were measured at baseline ; anthropometry and body composition were repeated 1 year later ( n = 111 ) . RESULTS Cross-sectionally , positive associations between sedentary activity and weight and fat-free mass ( FFM ) ( P = 0.009 - 0.047 ) , and a negative association between moderate-vigorous physical activity ( MVPA ) and percent fat mass ( FM ) ( P = 0.015 ) were observed . TEE and activity energy expenditure ( AEE ) were positively associated with weight , body mass index ( BMI ) , FFM , and FM ( P = 0.0001 - 0.046 ) . Prospect ively , TEE , AEE , physical activity level , and MVPA , but not sedentary activity , were positively associated with changes in BMI ( P = 0.0001 - 0.051 ) and FFM ( P = 0.0001 - 0.037 ) , but not percent FM . Sleep duration inversely predicted changes in FM ( P = 0.005 ) and percent FM ( P = 0.006 ) . CONCLUSIONS Prospect ively , MVPA , TEE , AEE , and physical activity level promote normal growth and accretion of FFM , whereas sleep duration inversely predicts changes in adiposity in preschool-aged children Abstract The purpose of the present study was to assess different aspects of physical activity and fitness in order to develop a basis for sport programmes for overweight and obese children . Eighty-eight prepubertal children ( 49 boys , 39 girls , 4.8–11.4 years old , 61 % obese , 14 % overweight and 25 % normal weight ) were examined . Body composition was assessed by combined use of anthropometrics and bioelectrical impedance analysis . Resting energy expenditure ( REE ) and total energy expenditure ( TEE ) were measured by indirect calorimetry ( IC ) and individually calibrated 24-h heart rate ( HR ) monitoring , respectively . Activity-related energy expenditure ( AEE ) and physical activity level ( PAL )  were calculated from TEE and REE .  Fitness [ assessed by O2-pulse , respiratory exchange ratio ( RER ) at submaximal work intensities ] was determined by ergometry . The maximal isometric muscle strength of the legs ( m. quadriceps , Fa max , m. ischiocruralis , Fb max ) was measured by computer tensiometry .  Children were grouped according to their nutritional state , AEE , O2-pulse and muscle strength . When compared with normal weight children , obese and overweight children had increased fat mass ( FM ) , fat-free mass ( FFM ) , waist-to-hip ratio and REE , but no group differences were observed for TEE , AEE , and PAL . Obese and overweight children spent more hours per day watching TV  . After correction for body weight and FFM , no group differences in REE were observed , but normal weight children had a higher O2-pulse than overweight and obese children . By contrast , RER was increased in the latter group . The fittest group had the lowest body weight , BMI , FM and FFM . Children with a low O2-pulse spent more hours per day watching TV . Grouping children according to their degree of muscle strength , younger children ( 4–7.5 years ) did not show group differences in nutritional state , energy expenditure , physical activity and fitness . However , in the group of 7.6- to 11-year-old children , those with the greatest muscle strength and FFM had reduced BMI , skin folds , FM and FFM . FM correlated inversely with O2-pulse , but was not associated with TEE , AEE , PAL or muscle strength . By contrast TV consumption was positively associated with FM . To summarize , overweight and obese children were less fit and watched more TV than their normal weight counterparts . FM did not correspond to TEE , AEE or PAL . Muscle strength was not associated with FM in young children , but was inversely associated with FM in older children . Our cross-sectional data are consistent with the idea that increased fitness and reduced physical inactivity may prevent children from being overweight Symptoms during physical activity and physical inactivity are hallmarks of chronic obstructive pulmonary disease ( COPD ) . Our aim was to evaluate the validity and usability of six activity monitors in patients with COPD against the doubly labelled water ( DLW ) indirect calorimetry method . 80 COPD patients ( mean±sd age 68±6 years and forced expiratory volume in 1 s 57±19 % predicted ) recruited in four centres each wore simultaneously three or four out of six commercially available monitors vali date d in chronic conditions for 14 consecutive days . A priori validity criteria were defined . These included the ability to explain total energy expenditure ( TEE ) variance through multiple regression analysis , using TEE as the dependent variable with total body water ( TBW ) plus several physical activity monitor outputs as independent variables ; and correlation with activity energy expenditure ( AEE ) measured by DLW . The Actigraph GT3X ( Actigraph LLC , Pensacola , FL , USA ) , and DynaPort MoveMonitor ( McRoberts BV , The Hague , the Netherl and s ) best explained the majority of the TEE variance not explained by TBW ( 53 % and 70 % , respectively ) and showed the most significant correlations with AEE ( r=0.71 , p<0.001 and r=0.70 , p<0.0001 , respectively ) . The results of this study should guide users in choosing valid activity monitors for research or for clinical use in patients with chronic diseases such as COPD . This study vali date s six activity monitors in the field against indirect calorimetry ( DLW ) in patients with COPD We assessed the ability of the Polar activity recorder ( AR ) to measure energy expenditure ( EE ) during military training . Twenty-four voluntary male conscripts participated in the study and wore an AR on the non-dominant wrist 24 h a day for 7 d. The AR analyzed and stored the frequency of h and movements ( f_h and ) into memory at 1 min intervals . The relationship between f_h and and EE was studied over a 7 d period of military training using the doubly labeled water ( DLW ) technique . In addition , the relationship between f_h and and EE was analyzed during walking and running on a treadmill with an indirect calorimeter ( IC ) , and f_h and was measured during a supervised 45 min field march test where the conscripts carried combat gear .  EE was expressed as physical activity level ( PAL ) , total energy expenditure ( TEE ) , and activity-induced energy expenditure adjusted for body mass ( AEE/BM ) . Over the 7 d period , f_h and alone explained 46 % of inter-individual variation in PAL(DLW ) . After inclusion of body height and mass in the model used to predict PAL(DLW ) from f_h and , a very high positive correlation and a low st and ard error of estimate ( SEE ) were observed between the AR and DLW techniques : for TEE r = 0.86 ( p < 0.001 ) , the SEE was 6.3 % , and for AEE/BM r = 0.84 ( p < 0.001 ) , the SEE was 12.8 % . In the treadmill exercise , f_h and correlated highly with PAL(IC ) ( r = 0.97 ± 0.02 ) . In the 45 min field march test , the AR measured similar f_h and as on the treadmill at the same speed . In conclusion , the wrist-worn AR can be regarded as a reliable and valid method for assessing EE during intensive training Background Little is known about  physical activity levels in patients with coronary artery disease ( CAD ) who are not engaged in cardiac rehabilitation . We explored the trajectory of physical activity after hospitalization for CAD , and examined the effects of demographic , medical , and activity-related factors on the trajectory . Design A prospect i ve cohort study . Methods A total of 782 patients were recruited during CAD-related hospitalization .  Leisure-time activity energy expenditure ( AEE ) was measured 2 , 6 and 12 months later . Sex , age , education , reason for hospitalization , congestive heart failure ( CHF ) , diabetes , and physical activity before hospitalization were assessed at recruitment . Participation in cardiac rehabilitation was measured at follow-up .  Results AEE was 1948 ± 1450 , 1676 ± 1290 , and 1637 ± 1486 kcal/week at 2 , 6 and 12 months , respectively . There was a negative effect of time from 2 months post-hospitalization on physical activity ( P<0.001 ) . Interactions were found between age and time ( P = 0.012 ) and education and time ( P = 0.001 ) . Main effects were noted for sex ( men more active than women ; P<0.001 ) , CHF ( those without CHF more active ; P<0.01 ) , diabetes ( those without diabetes more active ; P<0.05 ) , and previous level of physical activity ( those active before hospitalization more active after ; P<0.001 ) . Coronary artery bypass graft patients were more active than percutaneous coronary intervention ( PCI ) patients ( P = 0.033 ) . Conclusions Physical activity levels declined from 2 months after hospitalization . Specific subgroups ( e.g. less educated , younger ) were at greater risk of decline and other subgroups ( e.g. women , and PCI , CHF , and diabetic patients ) demonstrated lower physical activity . These groups need tailored interventions BACKGROUND Weight loss due to a negative energy balance is considered to be accompanied by a decrease in physical activity . OBJECTIVE The aim of this study was to investigate whether a decrease in physical activity is sustained during weight maintenance . DESIGN Subjects were 20 men and 31 women [ mean ( ±SD ) age : 42 ± 8 y ; BMI ( in kg/m(2 ) ) : 31.4 ± 2.8 ] . Weight loss was achieved by an 8-wk very-low-energy diet period , followed by 44 wk of weight maintenance . Physical activity measures were total energy expenditure expressed as a multiple of sleeping metabolic rate ( PALSMR ) and resting metabolic rate ( PALRMR ) , activity-induced energy expenditure divided by body weight ( AEE/kg ) , and activity counts measured by a triaxial accelerometer . Measurements took place at 0 , 8 , and 52 wk . RESULTS Body mass decreased significantly during the diet period ( 10.5 ± 3.8 % , P < 0.001 ) , and this reduction was sustained after 52 wk ( 6.0 ± 5.1 % , P < 0.001 ) . PALSMR and PALRMR decreased from 1.81 ± 0.23 and 1.70 ± 0.22 , respectively , before the diet to 1.69 ± 0.20 and 1.55 ± 0.19 after the diet ( P < 0.001 ) and increased again after weight maintenance to 1.85 ± 0.27 and 1.71 ± 0.23 , respectively , compared with 8-wk measurements ( P < 0.001 ) . AEE/kg decreased from 0.043 ± 0.015 MJ/kg at baseline to 0.037 ± 0.014 MJ/kg after the diet ( P < 0.001 ) and was higher after 52 wk ( 0.044 ± 0.17 MJ/kg ) compared with after 8 wk ( P < 0.001 ) . Activity counts decreased from 1.64 ± 0.37 megacounts/d at baseline to 1.54 ± 0.35 megacounts/d after the diet ( P < 0.05 ) and were higher after 52 wk ( 1.73 ± 0.49 megacounts/d ) compared with 8 wk ( P < 0.01 ) . CONCLUSION A weight loss-induced reduction in physical activity returns to baseline values when weight loss is maintained . This trial was registered at clinical trials.gov as NCT01015508 For physical activity surveys that would identify relations to chronic diseases , quality of life , and longevity , the method of choice remains the question naire , especially if it can be st and ardized and administered in uniform fashion to large population s. A sample question naire derived largely from epidemiological experience with the Harvard Alumni Health Study is presented that requests anthropometric estimates ; physician-diagnosed diseases by year of onset ; contemporary physical activities including walking , stair-climbing , and recreational pursuits ; food-frequency data that estimate nutrient values and caloric intakes ; and social habits affecting health . The question naire presents opportunities for cross-sectional , retrospective , and prospect i ve studies . Personal characteristics , physical activities , and other elements of lifestyle may be used as predictor or outcome variables in testing specific hypotheses . Representative surveys are described that have vali date d and used question naires of various complexities , some complemented by measures of physiological fitness . The epidemiological survey question naire , when properly design ed and administered , can measure effectively energy intake , energy retention , energy expenditure , physiological fitness , quality of life , and health maintenance Increasing the precision of measurements of total energy expenditure in population -based epidemiological studies is important for accurately quantifying the relationship between this exposure and disease . Current question naire-based methods can not accurately quantify total energy expenditure , although they may provide an estimate of the frequency of vigorous activities . Heart rate monitoring with individual calibration has been advocated as a method for assessing energy expenditure in field studies and has been compared with the ' gold st and ard ' techniques of doubly-labelled water and indirect calorimetry . However the method has previously only been used on small and selected population s. This study was , therefore , established to test the feasibility of using heart rate monitoring in a population -based study of adults . A total of 167 individuals aged 30 - 40 years were r and omly selected and underwent 4 d heart-rate monitoring . Only three individuals could not complete the protocol . The mean physical activity level ( PAL ) measured over 4 d was 1.89 ( SD 0.40 ) in men and 1.76 ( sd 0.31 ) in women . There was no difference between mean PAL on weekend days compared with weekdays ( mean paired difference 0.0008 , 95 % CI -0.06 + 0.06 ) . The estimate of mean PAL was not correlated with BMI , percentage body fat or the waist : hip ratio . It was , however , correlated with cardio-respiratory fitness as measured by VO2(max ) per kg ( Spearman rank correlation coefficient 0.50 in men and 0.42 in women ) . The pattern of energy expenditure was assessed by calculating the percentage of daytime hours in which PAL was greater than five times basal energy expenditure . This measure was strongly correlated with the mean PAL in both men ( Spearman correlation coefficient 0.77 ) and women ( 0.71 ) . We conclude that heart-rate monitoring is a feasible method for assessing the pattern and total level of energy expenditure in medium-sized epidemiological studies . It may also prove useful as the reference technique for calibrating question naires to estimate energy expenditure in larger scale studies BACKGROUND Physical activity is an important lifestyle which is often poorly assessed in epidemiological studies . The European Prospect i ve Investigation into Cancer Study -Norfolk cohort ( EPIC-Norfolk ) , a large population -based cohort study , has developed a comprehensive question naire to assess activity in different domains of life aim ed at assessing total energy expenditure . We report the repeatability of this instrument and its validity against repeated objective measures of fitness and energy expenditure undertaken throughout the time frame of reference of the question naire . METHODS The validity of the instrument was measured in 173 individuals r and omly selected from a continuing population -based cohort study .  Energy expenditure was assessed by four separate episodes of 4-day heart-rate monitoring , a method previously vali date d against whole body calorimetry and doubly-labelled water . Cardio-respiratory fitness was assessed by four repeated measures of sub-maximum oxygen uptake . At the end of the 12-month period , participants completed the physical activity question naire that assesses past-year activity at home , work and in recreation . Repeatability was assessed in a separate group of 399 r and omly selected participants in EPIC who completed the physical activity question naire twice with a 3-month interval . RESULTS The age- and sex-adjusted correlation between the objective measure of daytime energy expenditure and the sum of recreational and occupational reported physical activity ( in MET h per week ) was 0.28 ( P < 0.001 ) . The reported time spent in vigorous activity was correlated with cardio-respiratory fitness ( 0.16 , P < 0.05 ) and with the proportion of time when energy expenditure was more than five times basal ( 0.17 , P < 0.05 ) . The repeatability of the sum of recreational and occupational reported activity was high , r = 0.73 . CONCLUSIONS The indices of physical activity derived from this question naire have levels of validity and repeatability comparable to other physical activity instruments that are used in large epidemiological studies and which have undergone such intense development and testing Background Globally , efforts aim ed at the prevention of childhood obesity have led to the implementation of a range of school-based interventions . This study assessed whether augmenting physical activity ( PA ) within the school setting result ed in increased daily PA and decreased overweight/obesity levels in 6 - 9-year-old children . Methods Across the first to third primary school years , PA of 84 girls and 92 boys was objective ly monitored five times ( each for seven successive days ) using Yamax pedometer ( step counts ) and Caltrac accelerometer ( activity energy expenditure AEE - kcal/kg per day ) . Four schools were selected to participate in the research ( 2 intervention , 2 controls ) , comprising intervention ( 43 girls , 45 boys ) and control children ( 41 girls , 47 boys ) . The study was non-r and omized and the intervention schools were selected on the basis of existing PA-conducive environment . Analyses of variance ( ANOVA ) for repeated measures examined the PA programme and gender effects on the step counts and AEE . Logistic regression ( Enter method ) determined the obesity and overweight occurrence prospect over the course of implementation of the PA intervention . Results There was a significant increase of school-based PA during schooldays in intervention children ( from ≈ 1718 to ≈ 3247 steps per day ; and from 2.1 to ≈ 3.6 Kcal/Kg per day ) in comparison with the control children .  Increased school-based PA  of intervention children during schooldays contributed to them achieving > 10,500 steps and > 10.5 Kcal/Kg per school day across the 2 years of the study , and result ed in a stop of the decline in PA levels that is known to be associated with the increasing age of children .  Increased school-based PA  had also positive impact on leisure time PA of schooldays and on PA at weekends of intervention children . One year after the start of the PA intervention , the odds of being overweight or obese in the intervention children was almost three times lower than that of control children ( p < 0.005 ) , and these odds steadily decreased with the duration of the intervention . Conclusions The findings suggest that school-based PA ( Physical Education lessons , PA during short breaks and longer recesses , PA at after-school nursery ) in compatible active environments ( child-friendly gym and school playground , corridors with movement and playing around corners and for games ) has a vital role in obesity and overweight reduction among younger pupils Background / Objectives : A combined heart rate ( HR ) and motion sensor ( Actiheart ) has been proposed as an accurate method for assessing total energy expenditure ( TEE ) and physical activity energy expenditure ( PAEE ) . However , the extent to which factors such as caffeine may affect the accuracy by which the estimated HR-related PAEE contribution will affect TEE and PAEE estimates is unknown . Therefore , we examined the validity of Actiheart in estimating TEE and PAEE in free-living adults under a caffeine trial compared with doubly labeled water ( DLW ) as reference criterion . Subjects/ Methods : Using a double-blind crossover trial ( Clinical trials.gov ID : # NCT01477294 ) with two conditions ( 4-day each with a 3-day-washout period ) , r and omly ordered as caffeine ( 5 mg/kg per day ) and placebo ( malt-dextrine ) intake , TEE was measured by DLW in 17 physically active men ( 20–38 years ) who were non-caffeine users . In each condition , resting energy expenditure ( REE ) was assessed by indirect calorimetry and PAEE was calculated as ( TEE−(REE+0.1 TEE ) ) . Simultaneously , PAEE and TEE were estimated by Actiheart using an individual calibration ( ACC+HRstep ) . Results : Under caffeine , ACC+HRstep explained 76 and 64 % of TEE and PAEE from DLW , respectively ; corresponding results for the placebo condition were 82 and 66 % . No mean bias was found between ACC+HRstep and DLW for TEE  ( caffeine:-468 kJ per day ; placebo:-407 kJ per day ) , although PAEE was slightly underestimated ( caffeine:-856 kJ per day ; placebo:-1147 kJ per day ) . Similar limits of agreement were observed in both conditions ranging from −2066 to 3002 and from −3488 to 1776 kJ per day for TEE and PAEE , respectively . Conclusions : Regardless of caffeine intake , the combined HR and motion sensor is valid for estimating free-living energy expenditure in a group of healthy men but is less accurate for an individual assessment Background : Parkinson 's disease ( PD ) results in a progressive loss of function such that family caregivers provide a large percentage of the personal care to PD patients living in the home setting . Objectives : The aim of this study was to test the feasibility and impact of function-focused care for PD ( FFC-PD ) developed to optimize function and physical activity among people with PD who live in the community . Methods : This pilot study was a single-group , 2 pretest , 3 posttest repeated- measures design to investigate the impact of the FFC-PD intervention over a 12-month period . Measurements included the Self-Efficacy and Outcome Expectations for Exercise and Functional Activities , Yale Physical Activity Scale , Unified Parkinson 's Disease Rating Scale , Barthel Index , Schwab & Engl and , Timed Chair Rise , Parkinson 's Disease Question naire-39 , and Geriatric Depression Scale . Results : The impact of FFC-PD on a person with PD showed a statistically significant increase in outcome expectations for exercise , F(3 , 60 ) = 3.09 , p = .034 ; hours a week exercising , F(1 , 24 ) = 4.95 , p = .004 ; mean weekly energy expenditure , F(2,43 ) = 4.32 , p = .017 ; hours spent in overall activities , F(3 , 60 ) = 6.06 , p = .001 ; decreased disability based on the Unified Parkinson 's Disease Rating Scale , F(2 , 40 ) = 9.48 , p < .001 ; improved Parkinson 's Disease Question naire-39 score , F(3 , 60 ) = 3.81 , p = .014 ; and a trend toward significance on Barthel Index , F(1.6 , 31 ) = 3.47 , p = .055 . Discussion : Function-focused care for PD has a significant effect on increasing and on strengthening outcome expectations related to exercise , time spent in exercise , and physical activity and in improving functional performance in people with PD . Further research is needed to explore the use of objective measurements of functional performance and activity and to test FFC-PD in a r and omized controlled trial BACKGROUND Although adolescence is a time when physical activity levels decline , few interventions have targeted high school-aged girls in the school setting . OBJECTIVE To evaluate the effects of a life skills-oriented physical activity intervention for increasing overall physical activity in high school-aged girls . DESIGN R and omized controlled trial . SETTING Baltimore magnet high school . PARTICIPANTS A total of 221 ninth- grade girls , 83.0 % of whom were African American . Intervention Participants were r and omized to an 8-month physical intervention conducted in physical education class or to a st and ard physical education class ( control ) . MAIN OUTCOME MEASURES Self-reported estimated daily energy expenditure ( physical activity ) , self-reported sedentary activities ( television viewing and computer or Internet use ) , cardiorespiratory fitness , and selected cardiovascular disease risk factors . RESULTS Intervention classes spent 46.9 % of physical education class time in moderate to vigorous activity compared with 30.5 % of time for control classes ( P<.001 ) . There were no significant between-treatment group differences for mean daily energy expenditure ( P = .93 ) , moderate-intensity energy expenditure ( P = .77 ) , or hard to very hard energy expenditure ( P = .69 ) . The proportion of participants who spent 3 or more hours viewing television during school days declined from 22.3 % to 17.0 % in the intervention group , but remained at 26.7 % for the control group ( P = .03 ) . Both groups improved their cardiorespiratory fitness ( P<.001 ) . CONCLUSION A life skills-oriented physical education curriculum may need to be combined with other approaches to increase the magnitude of effects on physical activity behavior in predominantly African American high school-aged girls Resting  energy expenditure ( REE )  is often elevated in patients with chronic obstructive pulmonary disease ( COPD ) , but no data are available regarding total energy expenditure in free living conditions . We compared total daily energy expenditure ( TDE ) in eight COPD patients ( FEV1 36 + /- 13 % ) admitted to a pulmonary rehabilitation center and eight independently living healthy subjects , matched for sex , age , and body mass index ( BMI ) .  TDE was measured over a 2-wk interval using doubly labeled water in combination with measurement of REE and body composition .  The COPD patients had a significantly higher TDE than the healthy subjects ( 2,499 + /- 320 kcal/d and 2,107 + /- 88 kcal/d , respectively , p < 0.01 ) . The nonresting component of TDE ( TDE-REE : physical activity and diet-induced thermogenesis [ DIT ] ) was significantly higher in the COPD patients than in the healthy subjects , result ing in a ratio between TDE and REE of 1.7 + /- 0.2 and 1.4 + /- 0.1 , respectively ( p < 0.01 ) . The results indicate that COPD patients exhibit an increased TDE in comparison with healthy subjects . The difference could by attributed to an increase in the nonresting component of TDE , since REE was comparable between the groups Background Little is known about the concurrent change in  physical activity ( PA )  ,  sedentary behavior ( SB ) and  sport participation  ( SP ) during adolescence . The main purpose of this prospect i ve and partly objective study was to simultaneously investigate PA , SBs and SP changes between the 1st and 2nd grade s of high school in urban adolescents . Methods In this 1-year follow-up study , the participants were 81 secondary -school students ( 28 boys and 53 girls ) aged 15.5 years at the baseline .  PA was assessed with the SenseWear Armb and multi-sensor activity monitor , while SBs were assessed by using School Health Action , Planning and Evaluation System ( SHAPES ) PA question naire . The SHAPES question naire was supplemented with two questions inquiring about SP in organized sports in school and outside of school . Results PA decreased markedly in both genders between the 1st and 2nd grade s of high school . Total energy expenditure ( TEE ) was reduced by 13 kcal/kg/day on average in boys and by 10 kcal/kg/day in girls ( p for both < 0.001 ) , while mean daily active energy expenditure ( AEE ) decreased by 7 kcal/kg/day ( p < 0.001 ) and 3 kcal/kg/day ( p = 0.04 ) in boys and girls , respectively . Similarly , the amount of moderate PA declined by 49 min/day in boys and 21 min/day in girls ( p for both < 0.001 ) . At the same time vigorous PA was cut by 14 min/day ( p < 0.001 ) and 3 min/day ( p = 0.003 ) in boys and girls , respectively . Conversely , time spent in SBs did not show any change . Conclusion In conclusion , a decline in PA between the 1st and 2nd grade s of high school was marked but was not accompanied with an increase in SBs . Policies aim ed at increasing PA should be targeting the period of entering secondary school to offset the observed drop in PA OBJECTIVE To evaluate a coherent , evidence -based hypothesis that specific modifiable lifestyle factors implicated in the development of diabetes and associated obesity are related to the onset of OAB . METHODS A hypothetical causative model for OAB involving modifiable lifestyle factors implicated in the development of diabetes and obesity was constructed , based on a systematic literature review . Secondary analysis of data was undertaken in a prospect i ve cohort of women aged 40 and over , living in Leicestershire , UK . Subjects included 3,411 women free from OAB at baseline and 277 incident cases of OAB . Reported diet , lifestyle , morbid , and social factors were measured at baseline and incident cases at 1-year follow-up . Graphical chain modeling was used to estimate the associations between variables and identify likely pathways involved . RESULTS All hypothesized lifestyle factors ( physical activity , high glycemic index , and high energy intake ) plus diabetes and obesity were retained within the graph as potential contributors . However , low physical activity was the only direct risk factor linked prospect ively to the onset of OAB ( RR 2.47 ; 95 % CI 1.82 , 3.36 ) , in addition to older age . CONCLUSIONS Poor lifestyle factors causally linked to diabetes and obesity may contribute to the onset of OAB ; low physical activity appears to be an important modifiable causal factor for OAB operating directly as well as indirectly via pathways involving obesity or diabetes . Further research is needed to demonstrate a causal link between lifestyle and OAB Background Increasing prevalence of obesity and disorders associated with sedentary living constitute a major global public health problem . While previous evaluations of interventions to increase  physical activity  have involved communities or individuals with established disease , less attention has been given to interventions for individuals at risk of disease . Methods / design ProActive aims to evaluate the efficacy of a theoretical , evidence - and family-based intervention programme to increase physical activity  in a sedentary population , defined as being at-risk through having a parental family history of diabetes . Primary care diabetes or family history registers were used to recruit 365 individuals aged 30–50 years , screened for activity level . Participants were assigned by central r and omisation to three intervention programmes : brief written advice ( comparison group ) , or a psychologically based behavioural change programme , delivered either by telephone ( distance group ) or face-to-face in the family home over one year . The protocol -driven intervention programme is delivered by trained facilitators , and aims to support increases in physical activity through the introduction and facilitation of a range of self-regulatory skills ( e.g. goal setting ) . The primary outcome is daytime energy expenditure and its ratio to resting energy expenditure , measured at baseline and one year using individually calibrated heart rate monitoring . Secondary measures include self-report of individual and family activity , psychological mediators of behaviour change , physiological and biochemical correlates , acceptability , and costs , measured at baseline , six months and one year . The primary intention to treat analysis will compare groups at one-year post r and omisation . Estimation of the impact on diabetes incidence will be modelled using data from a parallel ten-year cohort study using similar measures . Discussion ProActiveis the first efficacy trial of an intervention programme to promote physical activity in a defined high-risk group accessible through primary care . The intervention programme is based on psychological theory and evidence ; it introduces and facilitates the use of self-regulatory skills to support behaviour change and maintenance . The trial addresses a range of method ological weaknesses in the field by careful specification and quality assurance of the intervention programme , precise characterisation of participants , year-long follow-up and objective measurement of physical activity . Due to report in 2005 , ProActivewill provide estimates of the extent to which this approach could assist at-risk groups who could benefit from changes in behaviours affecting health , and inform future pragmatic trials Objective . To determine whether the energy expenditure recorded with the physical activity monitor SenseWear ™ Pro2 Armb and differs from that recorded with indirect calorimetry . Design . Cross‐sectional comparison of measures of energy expenditure . Setting . A convenient sample recruited from a r and omized controlled trial . Population . Twenty‐nine pregnant women ( 24–43years old ) . Methods . Energy expenditure was recorded with SenseWear ™ Pro2 Armb and and a portable oxygen analyzer for 90minutes while carrying out a variety of activities of different intensities . Main Outcome Measures . Energy expenditure recorded with the physical activity monitor SenseWear ™ Pro2 Armb and . Results . Comparing energy expenditure during free‐living activities , the mean differences and limits of agreements from Bl and –Altman plots was −136±343kJ , giving an underestimation of energy expenditure by 9 % . The intraclass correlation coefficient was 0.85 ( 95 % confidence interval 0.71–0.93 ; p<0.001 ) , giving 85 % of the variance explained by differences among individuals . Conclusions . SenseWear ™ Pro2 Armb and is a valid measure of energy expenditure during pregnancy Assessment of habitual physical activity in epidemiologic and health education studies has been difficult . A seven-day physical activity recall interview was developed and administered in a community health survey , a r and omized clinical trial , and two worksite health promotion programs during 1979 - 1982 . These studies were conducted in several population s in California , Texas , Pennsylvania , and New Jersey . Energy expenditure estimates from the physical activity recall conformed to expected age- and sex-specific values in the cross-sectional community survey . Estimates of energy expenditure were also congruent with other questions on physical activity and job classification . In a r and omized , one-year exercise trial , the physical activity recall detected increases in energy expenditure in the treated group and was positively associated with miles run during training ( p less than 0.05 ) . Changes in energy expenditure were associated with changes in maximal oxygen uptake ( VO2max ( r = 0.33 , p less than 0.05 ) and body fatness ( r = -0.50 , p less than 0.01 ) at six months , and in high density lipoprotein-cholesterol ( r = 0.31 , p less than 0.05 ) and triglyceride ( r = -0.41 , p less than 0.01 ) at one year . The physical activity recall detected significant ( p less than 0.01 ) increases in energy expenditure in treatment groups in two worksite health promotion projects . These data suggest that the physical activity recall provides useful estimates of habitual physical activity for research in epidemiologic and health education studies
Conclusions : We conclude that there is large heterogeneity across studies in the explained variance of AEE when estimated based on accelerometry .
Background / Objectives : Activity-related energy expenditure ( AEE ) might be an important factor in the etiology of chronic diseases .
However , measurement of free-living AEE is usually not feasible in large-scale epidemiological studies but instead has traditionally been estimated based on self-reported physical activity .