OBJECTIVETo evaluate the impact of an exercise program organized into supervised walking groups in subjects with type 2 diabetes.RESEARCH DESIGN AND METHODSFifty-nine diabetic subjects were randomized to a control group receiving standard lifestyle recommendations or an intervention group assigned to three supervised walking sessions per week and counseling. Changes in metabolic features, weight, 6-min walk test, prescription of antidiabetic medications, and overall physical activity were assessed.RESULTSFunctional capacity and overall physical activity were higher in the intervention group, whereas metabolic changes were not different between groups after 4 months. However, in subjects who attended at least 50% of scheduled walking sessions, changes in A1C and fasting glucose were greater than in control subjects. Discontinuation or reduction of antidiabetic drugs occurred in 33% of these patients versus 5% of control subjects (P < 0.05).CONCLUSIONSSupervised walking may be beneficial in diabetic subjects, but metabolic improvement requires adequate compliance.
To date, only a few studies have evaluated the effect of physical activity on PWVcf in the elderly. In the current study, 21 community-dwelling women, with a mean age of 68.19 ± 5.72 years and a mean BMI of 28.63 ± 4.69 kg m À2 , participated in moderate physical activity sessions for 1 h per day and 2 days each week under the supervision of a qualified physical education instructor for a total of 24 weeks. At the beginning of the study, at 3 months and at 6 months, the study participants' body weight, waist circumference, sagittal abdominal diameter (SAD) and body composition by dual energy X-ray absorptiometry (DEXA) were recorded along with the participants' Physical Activity Scale for the Elderly questionnaire. Total low-density-lipoprotein and high-density lipoprotein cholesterol; triglycerides (TGs) and HbA1c; blood pressure (BP); and arterial stiffness, as determined by carotid-femoral and carotid-radial pulse wave velocity (PWVcf, PWVcr), were also assessed. During the follow-up period, the waist and SAD significantly decreased, whereas fat-free mass, BMI and weight did not decrease. A significant decline in TGs was observed. A significant decline in PWVcf, even after adjusting for mean arterial pressure, heart rate triglycerides and waist diameter changes, was observed. In a sub-analysis that examined the effect of physical activity separately in the hypertensive and normotensive subjects, we observed a significant decline in PWVcf in the hypertensive subjects and a nonsignificant tendency in the normotensive subjects. The data showed an association between light aerobic physical activity in the elderly and decreased PWVcf, even after adjusting for changes in systolic BP (SBP), TGs and central adiposity. These results suggest a beneficial effect of moderate physical activity on subclinical vascular damage, particularly in hypertensive subjects. Keywords: cardiovascular risk factors; elderly; physical activity; pulse wave velocity INTRODUCTION Exercise may reduce cardiovascular (CV) morbidity and mortality 1 and decrease several CV risk factors. The beneficial effect of aerobic physical activity on CV risk factors has been reported even in the elderly. [2][3][4][5][6] Cross-sectional studies have shown that physical activity is associated with lower values of pulse wave velocity carotid-femoral (PWVcf), a surrogate marker of subclinical vascular damage. [7][8][9] To date, only a few studies have evaluated the effect of physical activity on PWVcf in the elderly. Madden et al. 10 showed that aerobic exercise reduced arterial stiffness (that is, PWVcf and pulse wave velocity carotid-radial (PWVcr)) in a group of 36 elderly diabetic patients, whereas non-aerobic exercise did not demonstrate an effect.No studies have supported the efficacy of moderate physical activity in improving arterial stiffness in elderly subjects with hypertension.
The results obtained from the training and follow-up of 189 IDUs who participated in a programme consisting of an audiovisual presentation, pre-/post-testing and individual counselling are presented. Syringe sharing decreased from 35% at initial contact to 12% after 6 months. Sexual behaviour proved more resistant to change. However, condom use in at-risk situations increased from 49% to 70%. IDUs under continuous methadone treatment were less likely to engage high risk drug injecting practices than the other IDUs. Results indicate that an educational programme addressed toward risk reduction may determine relevant behavioural change among IDUs.
Aim: To examine the impact of a 12-week brisk walking program on physical performance and muscle function in community-dwelling healthy elderly women. Methods:The study was conducted in a group of 27 women with mean age 68.6 ± 5.5 years and mean BMI 28.2 ± 4.37 Kg/m 2 . Anthropometric variables (BMI, weight, height, waist circumference), body composition measured by Dual Energy X-ray Absorptiometry (DXA), the 400 meters walking test, the short physical performance battery, the physical activity level with the PASE questionnaire, handgrip, isometric strength and power of the lower limbs with dynamometer were evaluated at baseline and three months follow-up.All subjects were involved in brisk walking sessions, 1 and ½ h per day on 2 days each week under the supervision of a qualified physical education instructor for 12 weeks. The physical activity intensity has been calculated on the basis of the Borg Scale (RPE scale=13 "somewhat hard"). Results:At 3 months of follow-up, a reduction in waist circumference, total and percentage fat mass, an improvement of peak torque and power of lower limbs and in all the performance test administered was observed.In addition, dividing the population into two sub-groups based on the frequency to walking groups, it was observed that the group with higher attendance presented a significantly greater increase of muscle peak torque, power and specific power values. Moreover subjects with greater attendance showed significantly higher reduction of the time to perform the 400 meters test. Conclusions:Moderate aerobic exercise can improve muscle strength, physical performance and body composition. Dividing the study population into two groups on the basis of greater or lesser participation in the walk groups, the group with frequency percentage higher than 70% showed a significantly greater improvement in peak torque, power and the specific power, suggesting a dose-dependent effect.
Unhealthy lifestyles contribute, with other risk factors, to the high prevalence of mortality and physical comorbidity among mental patients compared to the general population. We collected data on the lifestyles of 193 subjects with psychosis in contact with a Community Mental Health Service in north-eastern Italy and compared them with a representative sample (total: 3219 subjects) of the general population of the same region. Diet, exercise, smoking and alcohol consumption were worse in mental patients. A higher percentage of patients was overweight or obese. The associations between socio-demographic and lifestyles variables showed that older patients exercise less, female patients tend to smoke and use alcohol less, while more educated patients tend to have higher alcohol consumption levels. Mental patients have unhealthier lifestyles and they appear to be more refractory to recommendations than the general population, indicating the necessity of specific health promotion programmes in this population.
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