Lyndsey M Hornbuckle, Ziya Gizlice, Daniel P Heil, Melicia C Whitt-Glover
Purpose: To determine the effects of a 10-month secular (SEC) versus faith-integrated (FI) community-based physical activity (PA) intervention on cardiometabolic risk factors in low active, African-American women.
Methods: Participants (age: 55.4±11.6 years; body mass index (BMI): 36.0±7.9 kg/m2; average baseline steps/day: 3,807±1,250) from a larger study (n=418) participated in a sub-study to measure cardiometabolic disease indicators (primary outcomes) and PA (secondary outcomes) pre- and post-intervention (SEC: n=42; FI: n=43). Height, weight, waist and hip circumferences, resting blood pressure, hemoglobin A1c, average steps/day, sedentary behavior, light-intensity physical activity (LPA), and moderate-to-vigorous-intensity physical activity (MVPA) were acquired at baseline and 10 months. Multivariate generalized linear mixed models that included churches as a random effect were used to compare mean changes in outcomes at 10 months between the two study groups (α=0.05).
Results: The FI group showed significant time effects for weight (93.4±2.4 to 92.2±2.3 kg), BMI (35.7±1.0 to 35.3±1.0 kg/m2), and waist circumference (106.9±2.2 to 103.8±2.5 cm), while the SEC group had a significant time effect for hip circumference (121.6±1.9 to 119.9±1.7 cm). There were no time effects in either group for blood pressure, hemoglobin A1c, steps/day, sedentary time, or MVPA. FI significantly decreased LPA in both 1-minute activity bouts (641±13 to 588±16 minutes/day) and 10-minute bouts (536±11 to 479±15 minutes/day). There were no significant differences between SEC and FI for any variable.
Conclusions: The improvements in body weight, BMI, and waist circumference shown after the FI intervention could have long-term implications on cardiometabolic health, particularly if exercise is continued. Further research is needed to examine the effects of culturally-relevant interventions on chronic disease indicators in African-American women, particularly those established as high risk for cardiometabolic disease.
{"title":"A Faith-Integrated Physical Activity Intervention and Cardiometabolic Risk in African American Women.","authors":"Lyndsey M Hornbuckle, Ziya Gizlice, Daniel P Heil, Melicia C Whitt-Glover","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the effects of a 10-month secular (SEC) versus faith-integrated (FI) community-based physical activity (PA) intervention on cardiometabolic risk factors in low active, African-American women.</p><p><strong>Methods: </strong>Participants (age: 55.4±11.6 years; body mass index (BMI): 36.0±7.9 kg/m<sup>2</sup>; average baseline steps/day: 3,807±1,250) from a larger study (n=418) participated in a sub-study to measure cardiometabolic disease indicators (primary outcomes) and PA (secondary outcomes) pre- and post-intervention (SEC: n=42; FI: n=43). Height, weight, waist and hip circumferences, resting blood pressure, hemoglobin A1c, average steps/day, sedentary behavior, light-intensity physical activity (LPA), and moderate-to-vigorous-intensity physical activity (MVPA) were acquired at baseline and 10 months. Multivariate generalized linear mixed models that included churches as a random effect were used to compare mean changes in outcomes at 10 months between the two study groups (α=0.05).</p><p><strong>Results: </strong>The FI group showed significant time effects for weight (93.4±2.4 to 92.2±2.3 kg), BMI (35.7±1.0 to 35.3±1.0 kg/m<sup>2</sup>), and waist circumference (106.9±2.2 to 103.8±2.5 cm), while the SEC group had a significant time effect for hip circumference (121.6±1.9 to 119.9±1.7 cm). There were no time effects in either group for blood pressure, hemoglobin A1c, steps/day, sedentary time, or MVPA. FI significantly decreased LPA in both 1-minute activity bouts (641±13 to 588±16 minutes/day) and 10-minute bouts (536±11 to 479±15 minutes/day). There were no significant differences between SEC and FI for any variable.</p><p><strong>Conclusions: </strong>The improvements in body weight, BMI, and waist circumference shown after the FI intervention could have long-term implications on cardiometabolic health, particularly if exercise is continued. Further research is needed to examine the effects of culturally-relevant interventions on chronic disease indicators in African-American women, particularly those established as high risk for cardiometabolic disease.</p>","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"4 19","pages":"225-234"},"PeriodicalIF":1.1,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802800/pdf/nihms-1534442.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38750981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.1249/TJX.0000000000000106
Cheryl L Albright, Lynne R Wilkens, Kara Saiki, Kami K White, Alana D Steffen
Purpose: Understanding theoretically derived social and behavioral mediators of long-term increases in physical activity (PA) in a vulnerable population at risk for being underactive is needed to inform future research, clinical applications, and public health efforts. This is an analysis of potential mediators of an intervention that increased long-term (12-month) moderate-to-vigorous physical activity (MVPA) in postpartum (2-12months) women in a randomized trial, using a longitudinal analysis.
Methods: Healthy, underactive (i.e., not meeting national guidelines for MVPA) women (n = 311; mean age = 32 ± 5.6 years, 85% minorities) with infants (mean age: 5.7 ± 2.8 months) were randomly assigned to either a tailored eHealth condition consisting of personalized telephone counseling plus access to a website tailored to new mothers' MVPA issues or to a standard MVPA materials-only website. MVPA was assessed via surveys completed at baseline, then 6 and 12 months later. Theoretically derived mediators included social support for MVPA, self-efficacy to increase MVPA, barriers to increasing MVPA, and benefits of increasing MVPA.
Results: All mediators, except benefits, improved over the 12 months in the tailored eHealth condition. The tailored condition's effect on increasing MVPA from 6 months to 12 months was mediated by an increase in social support from baseline to six months. No other hypothesized mediators were significant.
Conclusion: Our results demonstrated that learning strategies to increase social support for MVPA was instrumental in new mothers' increase in MVPA over a 12 month intervention. During this brief but impactful life-stage, where the focus can understandably be on her baby, being able to elicit support from friends and family may facilitate women's efforts to focus on their own needs with respect to MVPA.
{"title":"Mediators of a 12-month change in physical activity in ethnically diverse sample of postpartum women.","authors":"Cheryl L Albright, Lynne R Wilkens, Kara Saiki, Kami K White, Alana D Steffen","doi":"10.1249/TJX.0000000000000106","DOIUrl":"https://doi.org/10.1249/TJX.0000000000000106","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding theoretically derived social and behavioral mediators of long-term increases in physical activity (PA) in a vulnerable population at risk for being underactive is needed to inform future research, clinical applications, and public health efforts. This is an analysis of potential mediators of an intervention that increased long-term (12-month) moderate-to-vigorous physical activity (MVPA) in postpartum (2-12months) women in a randomized trial, using a longitudinal analysis.</p><p><strong>Methods: </strong>Healthy, underactive (i.e., not meeting national guidelines for MVPA) women (n = 311; mean age = 32 ± 5.6 years, 85% minorities) with infants (mean age: 5.7 ± 2.8 months) were randomly assigned to either a tailored eHealth condition consisting of personalized telephone counseling plus access to a website tailored to new mothers' MVPA issues or to a standard MVPA materials-only website. MVPA was assessed via surveys completed at baseline, then 6 and 12 months later. Theoretically derived mediators included social support for MVPA, self-efficacy to increase MVPA, barriers to increasing MVPA, and benefits of increasing MVPA.</p><p><strong>Results: </strong>All mediators, except benefits, improved over the 12 months in the tailored eHealth condition. The tailored condition's effect on increasing MVPA from 6 months to 12 months was mediated by an increase in social support from baseline to six months. No other hypothesized mediators were significant.</p><p><strong>Conclusion: </strong>Our results demonstrated that learning strategies to increase social support for MVPA was instrumental in new mothers' increase in MVPA over a 12 month intervention. During this brief but impactful life-stage, where the focus can understandably be on her baby, being able to elicit support from friends and family may facilitate women's efforts to focus on their own needs with respect to MVPA.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov number.</p>","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"4 19","pages":"215-224"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6980416/pdf/nihms-1530278.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37581555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.1249/TJX.0000000000000105
G. Weir, J. Alderson, B. Elliott, Shina (née: Lee) Leow, D. Devaprakash, K. Starre, C. Goodman, J. Cooke, C. Rechichi, J. Armstrong, B. Jackson, C. Donnelly
Anterior cruciate ligament (ACL) injury prevention programs have been shown to have mixed success in reducing injury rates, raising the question whether these programs are effectively targeting biomechanical mechanisms of injury. The current study examined the efficacy of a biomechanically informed ACL injury prevention training program in reducing injury risk and injury incidence and investigated its effect on athletic performance. Twenty-six elite female field hockey players participated in this study. Athletes participated in a 2-yr injury prevention training program. Injury incidence (i.e., lower limb and ACL) and athletic performance (i.e., strength, speed, and aerobic power) were measured during a control season and after two intervention seasons. Biomechanical ACL injury risk factors were recorded during unplanned sidestepping at baseline and after intensive (9 wk: 4 × 20 min·wk−1) and maintenance (16 wk: 3 × 10 min·wk−1) training phases for a subset of athletes (n = 17). Training was effective in reducing ACL and lower limb injury incidence after the 2-yr program, where zero ACL injuries occurred after implementation (vs 0.4 per 1000 player hours in the control year). High-risk athletes reduced their peak knee valgus moments by 30% (P = 0.045) and demonstrated improvements in desirable muscle activation strategies after intensive training. The majority of benefits elicited in intensive training were retained during the maintenance phase. One-repetition max strength, beep test scores, and sprint times improved or were maintained over the 2-yr intervention period. Biomechanically informed injury prevention training was successful in reducing both biomechanical ACL injury risk factors and ACL injury incidence while maintaining and/or improving athletic performance. It is important to consider the biomechanical mechanisms of injury when designing injury prevention programs.
{"title":"A 2-yr Biomechanically Informed ACL Injury Prevention Training Intervention in Female Field Hockey Players","authors":"G. Weir, J. Alderson, B. Elliott, Shina (née: Lee) Leow, D. Devaprakash, K. Starre, C. Goodman, J. Cooke, C. Rechichi, J. Armstrong, B. Jackson, C. Donnelly","doi":"10.1249/TJX.0000000000000105","DOIUrl":"https://doi.org/10.1249/TJX.0000000000000105","url":null,"abstract":"\u0000 \u0000 \u0000 Anterior cruciate ligament (ACL) injury prevention programs have been shown to have mixed success in reducing injury rates, raising the question whether these programs are effectively targeting biomechanical mechanisms of injury. The current study examined the efficacy of a biomechanically informed ACL injury prevention training program in reducing injury risk and injury incidence and investigated its effect on athletic performance.\u0000 \u0000 \u0000 \u0000 Twenty-six elite female field hockey players participated in this study.\u0000 \u0000 \u0000 \u0000 Athletes participated in a 2-yr injury prevention training program. Injury incidence (i.e., lower limb and ACL) and athletic performance (i.e., strength, speed, and aerobic power) were measured during a control season and after two intervention seasons. Biomechanical ACL injury risk factors were recorded during unplanned sidestepping at baseline and after intensive (9 wk: 4 × 20 min·wk−1) and maintenance (16 wk: 3 × 10 min·wk−1) training phases for a subset of athletes (n = 17).\u0000 \u0000 \u0000 \u0000 Training was effective in reducing ACL and lower limb injury incidence after the 2-yr program, where zero ACL injuries occurred after implementation (vs 0.4 per 1000 player hours in the control year). High-risk athletes reduced their peak knee valgus moments by 30% (P = 0.045) and demonstrated improvements in desirable muscle activation strategies after intensive training. The majority of benefits elicited in intensive training were retained during the maintenance phase. One-repetition max strength, beep test scores, and sprint times improved or were maintained over the 2-yr intervention period.\u0000 \u0000 \u0000 \u0000 Biomechanically informed injury prevention training was successful in reducing both biomechanical ACL injury risk factors and ACL injury incidence while maintaining and/or improving athletic performance. It is important to consider the biomechanical mechanisms of injury when designing injury prevention programs.\u0000","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1249/TJX.0000000000000105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47013289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.1249/tjx.0000000000000094
B. Melton, T. K. Kessinger, G. Ryan, A. Riggs
The U.S. Department of Health and Human Services recommends that employers create healthy worksites through promotion wellness programs that included routine exercise, daily physical activity, and nutritional education among other initiatives. This study aimed to identify barriers and incentives of routine exercise in varying occupations among rural municipal workers in Southeast Georgia. A cross-sectional research design was used to evaluate the barriers and incentives for exercise among rural municipal workers in a rural setting. The four occupational departments used for analysis were as follows: fire, police, public works, and administration/other. An electronic survey was sent to all 309 workers on November 2016. The survey asked for participants to rank 10 common exercise barriers and incentives. One-hundred and twenty-three (~40%) complete responses were used for analysis. Based on a personal ranking, lack of time to exercise (mean = 2.2), inconvenient time/location of a facility (2.5), and no motivation (5.3) were found to be the top three barriers across all employees. No significant differences (P > 0.05) between departments were found for nine of the exercise barrier rankings. “Cost is too much” was only significantly different result found (P = 0.019) between departments, with fire department reporting lower than the other departments. Another barrier approaching significance was “feel awkward exercising” (P = 0.054). The results suggest that a variation of motivators and incentives, depending on occupational responses, could be a successful means of improving exercise in all employees, instead of implementing a single motivating tactic based on the raw majority.
{"title":"Occupational Differences in Barriers and Incentives for Routine Exercise among Municipal Workers","authors":"B. Melton, T. K. Kessinger, G. Ryan, A. Riggs","doi":"10.1249/tjx.0000000000000094","DOIUrl":"https://doi.org/10.1249/tjx.0000000000000094","url":null,"abstract":"\u0000 The U.S. Department of Health and Human Services recommends that employers create healthy worksites through promotion wellness programs that included routine exercise, daily physical activity, and nutritional education among other initiatives.\u0000 \u0000 \u0000 This study aimed to identify barriers and incentives of routine exercise in varying occupations among rural municipal workers in Southeast Georgia.\u0000 \u0000 \u0000 \u0000 A cross-sectional research design was used to evaluate the barriers and incentives for exercise among rural municipal workers in a rural setting. The four occupational departments used for analysis were as follows: fire, police, public works, and administration/other. An electronic survey was sent to all 309 workers on November 2016. The survey asked for participants to rank 10 common exercise barriers and incentives. One-hundred and twenty-three (~40%) complete responses were used for analysis.\u0000 \u0000 \u0000 \u0000 Based on a personal ranking, lack of time to exercise (mean = 2.2), inconvenient time/location of a facility (2.5), and no motivation (5.3) were found to be the top three barriers across all employees. No significant differences (P > 0.05) between departments were found for nine of the exercise barrier rankings. “Cost is too much” was only significantly different result found (P = 0.019) between departments, with fire department reporting lower than the other departments. Another barrier approaching significance was “feel awkward exercising” (P = 0.054).\u0000 \u0000 \u0000 \u0000 The results suggest that a variation of motivators and incentives, depending on occupational responses, could be a successful means of improving exercise in all employees, instead of implementing a single motivating tactic based on the raw majority.\u0000","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44549261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.1249/tjx.0000000000000110
Lyndsey M. Hornbuckle, Z. Gizlice, D. Heil, M. Whitt-Glover
PURPOSE To determine the effects of a 10-month secular (SEC) versus faith-integrated (FI) community-based physical activity (PA) intervention on cardiometabolic risk factors in low active, African-American women. METHODS Participants (age: 55.4±11.6 years; body mass index (BMI): 36.0±7.9 kg/m2; average baseline steps/day: 3,807±1,250) from a larger study (n=418) participated in a sub-study to measure cardiometabolic disease indicators (primary outcomes) and PA (secondary outcomes) pre- and post-intervention (SEC: n=42; FI: n=43). Height, weight, waist and hip circumferences, resting blood pressure, hemoglobin A1c, average steps/day, sedentary behavior, light-intensity physical activity (LPA), and moderate-to-vigorous-intensity physical activity (MVPA) were acquired at baseline and 10 months. Multivariate generalized linear mixed models that included churches as a random effect were used to compare mean changes in outcomes at 10 months between the two study groups (α=0.05). RESULTS The FI group showed significant time effects for weight (93.4±2.4 to 92.2±2.3 kg), BMI (35.7±1.0 to 35.3±1.0 kg/m2), and waist circumference (106.9±2.2 to 103.8±2.5 cm), while the SEC group had a significant time effect for hip circumference (121.6±1.9 to 119.9±1.7 cm). There were no time effects in either group for blood pressure, hemoglobin A1c, steps/day, sedentary time, or MVPA. FI significantly decreased LPA in both 1-minute activity bouts (641±13 to 588±16 minutes/day) and 10-minute bouts (536±11 to 479±15 minutes/day). There were no significant differences between SEC and FI for any variable. CONCLUSIONS The improvements in body weight, BMI, and waist circumference shown after the FI intervention could have long-term implications on cardiometabolic health, particularly if exercise is continued. Further research is needed to examine the effects of culturally-relevant interventions on chronic disease indicators in African-American women, particularly those established as high risk for cardiometabolic disease.
{"title":"A Faith-Integrated Physical Activity Intervention and Cardiometabolic Risk in African American Women.","authors":"Lyndsey M. Hornbuckle, Z. Gizlice, D. Heil, M. Whitt-Glover","doi":"10.1249/tjx.0000000000000110","DOIUrl":"https://doi.org/10.1249/tjx.0000000000000110","url":null,"abstract":"PURPOSE\u0000To determine the effects of a 10-month secular (SEC) versus faith-integrated (FI) community-based physical activity (PA) intervention on cardiometabolic risk factors in low active, African-American women.\u0000\u0000\u0000METHODS\u0000Participants (age: 55.4±11.6 years; body mass index (BMI): 36.0±7.9 kg/m2; average baseline steps/day: 3,807±1,250) from a larger study (n=418) participated in a sub-study to measure cardiometabolic disease indicators (primary outcomes) and PA (secondary outcomes) pre- and post-intervention (SEC: n=42; FI: n=43). Height, weight, waist and hip circumferences, resting blood pressure, hemoglobin A1c, average steps/day, sedentary behavior, light-intensity physical activity (LPA), and moderate-to-vigorous-intensity physical activity (MVPA) were acquired at baseline and 10 months. Multivariate generalized linear mixed models that included churches as a random effect were used to compare mean changes in outcomes at 10 months between the two study groups (α=0.05).\u0000\u0000\u0000RESULTS\u0000The FI group showed significant time effects for weight (93.4±2.4 to 92.2±2.3 kg), BMI (35.7±1.0 to 35.3±1.0 kg/m2), and waist circumference (106.9±2.2 to 103.8±2.5 cm), while the SEC group had a significant time effect for hip circumference (121.6±1.9 to 119.9±1.7 cm). There were no time effects in either group for blood pressure, hemoglobin A1c, steps/day, sedentary time, or MVPA. FI significantly decreased LPA in both 1-minute activity bouts (641±13 to 588±16 minutes/day) and 10-minute bouts (536±11 to 479±15 minutes/day). There were no significant differences between SEC and FI for any variable.\u0000\u0000\u0000CONCLUSIONS\u0000The improvements in body weight, BMI, and waist circumference shown after the FI intervention could have long-term implications on cardiometabolic health, particularly if exercise is continued. Further research is needed to examine the effects of culturally-relevant interventions on chronic disease indicators in African-American women, particularly those established as high risk for cardiometabolic disease.","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":"4 19 1","pages":"225-234"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45589837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-15DOI: 10.1249/TJX.0000000000000093
C. Ozemek, L. Kaminsky, P. Brubaker, C. Lavie, R. Arena
The increasing prevalence of noncommunicable diseases and multimorbidity negatively affects an individual’s quality of life and health trajectory; this trend and resultant personal and clinical outcomes are of significant concern. Healthy living (HL) behaviors (physical activity, dietary modification, smoking cessation, and medication compliance) are known to provide substantial health benefits that slow the progression or in some cases reverse the deleterious effects associated with inactivity and consumption of a diet high in sodium, fat content, added sugars, and energy-dense foods. However, it is becoming increasingly clear that a one-size-fits-all approach to HL interventions in populations at risk for or diagnosed with noncommunicable diseases is inadequate to promote optimization of health outcomes. Practitioners implementing HL interventions, such as clinical exercise physiologists (CEP), must instead understand the complexity or multimorbidity phenotypes and be able to effectively tailor programs for each condition. Although CEP may receive master’s level training in this area, the rise in patients with complex multimorbidity warrants consideration of elevating the professional expectations to better prepare CEP in training to deliver highly effective primary and secondary prevention HL interventions. Many licensed allied health professions (i.e., physical therapy, pharmacy, occupational therapy, nursing, nutrition, etc.) have recognized the call to move toward professional doctoral degree programs to better prepare practitioners within their field. This article proposes a professional doctorate degree program aimed at enhancing the training of CEP to become highly effective practitioners.
{"title":"Time to Elevate the Education of Clinical Exercise Physiologists: A Professional Doctorate Model","authors":"C. Ozemek, L. Kaminsky, P. Brubaker, C. Lavie, R. Arena","doi":"10.1249/TJX.0000000000000093","DOIUrl":"https://doi.org/10.1249/TJX.0000000000000093","url":null,"abstract":"\u0000 The increasing prevalence of noncommunicable diseases and multimorbidity negatively affects an individual’s quality of life and health trajectory; this trend and resultant personal and clinical outcomes are of significant concern. Healthy living (HL) behaviors (physical activity, dietary modification, smoking cessation, and medication compliance) are known to provide substantial health benefits that slow the progression or in some cases reverse the deleterious effects associated with inactivity and consumption of a diet high in sodium, fat content, added sugars, and energy-dense foods. However, it is becoming increasingly clear that a one-size-fits-all approach to HL interventions in populations at risk for or diagnosed with noncommunicable diseases is inadequate to promote optimization of health outcomes. Practitioners implementing HL interventions, such as clinical exercise physiologists (CEP), must instead understand the complexity or multimorbidity phenotypes and be able to effectively tailor programs for each condition. Although CEP may receive master’s level training in this area, the rise in patients with complex multimorbidity warrants consideration of elevating the professional expectations to better prepare CEP in training to deliver highly effective primary and secondary prevention HL interventions. Many licensed allied health professions (i.e., physical therapy, pharmacy, occupational therapy, nursing, nutrition, etc.) have recognized the call to move toward professional doctoral degree programs to better prepare practitioners within their field. This article proposes a professional doctorate degree program aimed at enhancing the training of CEP to become highly effective practitioners.","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44344896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-15DOI: 10.1249/TJX.0000000000000092
Gerald C. Dembrowski, Jessica W. Barnes
With the complex role of the thyroid in metabolism and conflicting evidence of weight gain or loss as a result of prescription thyroid hormone replacement (THR), it is important to understand how THR affects weight loss beyond the standard measures of body weight % and body mass index (BMI). We examined differences in body composition improvement in individuals taking and not taking THR over 60 d of an intensive weight loss program. The 20Lighter Program (T20LP), a doctor-supervised weight loss and metabolic health program, included 6 wk of patent-pending very low calorie meal plans and a 3-wk customized transition back to a normal dietary intake. Of 2200 participants completing T20LP by December 31, 2017, ~10% reported taking prescription THR. From initial baseline to 60 d, T20LP participants from both groups showed statistically significant and clinically meaningful reductions in body weight, BMI, % body fat, visceral fat, metabolic age, and increases in % body water. To our knowledge, our study is the first large-scale analysis comparing weight loss outcomes in participants who take THR and participants who do not. Our data show both groups do equally well with respect to % body weight lost, BMI reduction, body fat and visceral fat reduction, and improvement in tissue hydration, and we found no disadvantage in any physiologic or metabolic outcome in weight loss participants on THR. Weight loss participants requiring prescription THR are capable of achieving body composition and metabolic improvements on par with those who do not require prescription THR.
由于甲状腺在代谢中的复杂作用以及处方甲状腺激素替代(THR)导致体重增加或减少的相互矛盾的证据，了解THR如何影响体重减轻是很重要的，超出了体重百分比和体重指数(BMI)的标准测量。我们研究了在60天的强化减肥计划中，服用和不服用THR的个体在身体成分改善方面的差异。20Lighter Program (T20LP)是一项由医生监督的减肥和代谢健康计划，包括6周正在申请专利的极低卡路里饮食计划和3周的定制过渡到正常饮食摄入量。在截至2017年12月31日完成T20LP的2200名参与者中，约10%的人报告服用处方THR。从初始基线到60 d，两组T20LP参与者的体重、BMI、体脂百分比、内脏脂肪、代谢年龄和体水百分比均有统计学意义和临床意义的降低。据我们所知，我们的研究是第一个比较服用THR和不服用THR的参与者减肥结果的大规模分析。我们的数据显示，两组在体重减轻%、BMI降低、体脂和内脏脂肪减少以及组织水化改善方面都做得很好，而且我们发现，服用THR的减肥参与者在任何生理或代谢结果上都没有不利之处。需要处方THR的减肥参与者能够达到与不需要处方THR的人相同的身体成分和代谢改善。
{"title":"Prescription Thyroid Replacement Does Not Affect Outcomes in an Intensive Weight Reduction Program","authors":"Gerald C. Dembrowski, Jessica W. Barnes","doi":"10.1249/TJX.0000000000000092","DOIUrl":"https://doi.org/10.1249/TJX.0000000000000092","url":null,"abstract":"\u0000 With the complex role of the thyroid in metabolism and conflicting evidence of weight gain or loss as a result of prescription thyroid hormone replacement (THR), it is important to understand how THR affects weight loss beyond the standard measures of body weight % and body mass index (BMI). We examined differences in body composition improvement in individuals taking and not taking THR over 60 d of an intensive weight loss program. The 20Lighter Program (T20LP), a doctor-supervised weight loss and metabolic health program, included 6 wk of patent-pending very low calorie meal plans and a 3-wk customized transition back to a normal dietary intake. Of 2200 participants completing T20LP by December 31, 2017, ~10% reported taking prescription THR. From initial baseline to 60 d, T20LP participants from both groups showed statistically significant and clinically meaningful reductions in body weight, BMI, % body fat, visceral fat, metabolic age, and increases in % body water. To our knowledge, our study is the first large-scale analysis comparing weight loss outcomes in participants who take THR and participants who do not. Our data show both groups do equally well with respect to % body weight lost, BMI reduction, body fat and visceral fat reduction, and improvement in tissue hydration, and we found no disadvantage in any physiologic or metabolic outcome in weight loss participants on THR. Weight loss participants requiring prescription THR are capable of achieving body composition and metabolic improvements on par with those who do not require prescription THR.","PeriodicalId":75243,"journal":{"name":"Translational journal of the American College of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43326284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1249/TJX.0000000000000099
M. Mahar
Schools are valuable locations to promote physical activity becausemost children are in school for large portions of the day and year. However, the main objective of most schools is to teach academic skills. For school personnel to implement classroom-based physical activity programs, they need to be convinced that these programs will help the students learn better. Teachers understand and value the concept of on-task behavior or paying attention. Without attentional focus, students do not learn. Thus, if research demonstrates that participation in classroombased physical activity programs enhances on-task behavior, teachersmay bemore likely to implement these programs. Although on-task behavior in the authentic classroom setting is difficult to measure, the accumulated evidence about the effect of classroom-based physical activity on on-task behavior is convincing. This article presents an overview of measurement issues associated with directly observed on-task behavior in schools and a summary of the key studies that have made a substantial contribution to the literature in this field. Various research designs and statistical comparisons have been used to examine these relationships. Several research studies have included examination of the effect of physical activity on on-task behavior within subgroups of students (e.g., level of attention, sex, fitness, race/ethnicity, and socioeconomic status). In summary, research demonstrates that classroom-based physical activity enhances on-task behavior compared with traditional sedentary learning environments, and this benefit appears to hold for all subgroups of students that have been examined. Specific suggestions to enhance the implementation of classroom-based physical activity and to further develop the research base are provided. INTRODUCTION Health benefits of physical activity are widely known (1,2); however, less is known about the additional benefits or potential limitations of physical activity when it is incorporated into the classroom. Research on the effectiveness of classroombased physical activity began to be published around the mid-2000s. Integrating physical activity into the classroom can help youth meet the U.S. Physical Activity Guidelines (3). Part of the Physical Activity Guidelines recommends that youth School of Exercise and Nutritional Sciences, San Diego State University,
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