Elizabeth D. Hathaway

Moderate, but not vigorous, intensity exercise training reduces C-reactive protein

Abstract Background: Sprint interval cycle training is a contemporary popular mode of training but its relative efficacy, under conditions of matched energy expenditure, to reduce risk factors for cardiometabolic disease is incompletely characterised, especially in young women. The purpose of this investigation was to determine the relative efficacy of six weeks of moderate-intensity cycling (MOD-C) and vigorous sprint-interval cycling (VIG-SIC) on lipid profile, insulin (INS) and insulin resistance using the homeostatic model assessment (HOMA-IR) and C-reactive protein (CRP) in inactive, overweight/obese (OW/OB) young women. Methods: Participants (BMI ≥25 kg/m2, waist circumference ≥88 cm) were randomly assigned to MOD-C (20–30 min at 60–70% of heart rate reserve(HRR)) or VIG-SIC (5–7 repeated bouts 30-second maximal effort sprints, followed by four minutes of active recovery) supervised training three days/week for six weeks, with each group matched on energy expenditure. Adiposity (%Fat) was measured using dual x-ray absorptiometry. Results: Forty-four participants (20.4 ± 1.6 years, 65.9% Caucasian, 29.8 ± 4.1 kg/m2) were included in the analysis. The improvement in CRP observed in the MOD-C group was larger than the VIG-C group (p = .034). Overall, high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) levels improved following training (p < .05); however, total cholesterol, triglyceride, INS and HOMA-IR did not improve (p > .05). Conclusion: These results indicate MOD-C training may be more effective in reducing CRP than VIG-SIC.

Interactive associations of physical activity, adiposity, and oral contraceptive use on C-reactive protein levels in young women

ABSTRACT Oral contraceptives (OCs) are the most frequently used type of birth control among young women. OC-users have higher C-reactive protein (CRP) values, an indicator of systemic inflammation, than do non-OC-users. In addition, adiposity (percent fat) is positively associated with CRP, and physical activity (PA) is inversely associated with CRP. The present study determined the interactive associations of PA, percent fat, and OC-use with CRP. Data were collected during 2012–2015 at the University of Georgia. Objective PA was measured via pedometers. Percent fat was measured via dual X-ray absorptiometry. The current OC-use was self-reported. High-sensitivity (hs) CRP was determined using venipuncture. Multivariate linear regression determined the interactive associations of percent fat, OC-use, and PA with hs-CRP. Participants (n = 247; mean age 18.9 ± 1.4 years, 60.7 percent white) accumulated a mean of 10,075.7 ± 3,593.4 steps/day. One-third of participants were categorized as overweight/obese by BMI (mean = 24.5 ± 4.8 kg/m2, mean percent fat = 35.2 ± 6.8). The current OC-use was reported by 26.2 percent of the sample (n = 61). A significant three-way interaction (β = 0.01, p = .03) indicated that higher PA was associated with lower hs-CRP in non-OC-users with higher percent fat, but not among OC-users with higher percent fat. These results highlight the need to measure and account for the current OC-use in studies examining the relationship between PA and CRP.

Chronic Disease Prevention in Faith-Based Organizations

According to the Centers for Disease Control and Prevention, currently one in two adults in the USA has a chronic disease and one in four has multiple chronic diseases. Many chronic diseases are largely preventable by engaging in an ongoing healthy lifestyle. This article provides (a) current rates of selected chronic diseases and their effects on individuals, (b) common modifiable risk factors for the diseases, and (c) helpful, free resources for faith-based organizations to use in health promotion programs.

Author’s reply to Paravidino et al.: Comment on: “Effect of exercise training on non-exercise physical activity: a systematic review and meta-analysis of randomized controlled trials”

We appreciate the comments and concerns expressed by Paravidino et al. [1] regarding our systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the effect of exercise training on non-exercise physical activity (NEPA) [2]. The authors’ letter raised several important points, many of which were also considered by our research team. We have used our response to expand upon our methodology, discuss the limitations of the current NEPA literature, and to highlight the research gaps that future intervention studies should address. The concept for this manuscript came after reading a number of research articles reporting changes in physical activity (PA) and diet that occur in response to an energy deficit [3–6]. In an effort to make better sense of this body of literature, our metaanalysis aimed to determine if compensatory changes in NEPA could be observed during structured exercise training interventions, and to determine potential factors (i.e. effect modifiers or moderators) that influence changes in NEPA. We would like to thank Paravidino et al. [1] for highlighting an important limitation related to the electronic database search that we acknowledged in our original publication. We used seven intentionally broad search terms, not five as suggested by Paravidino et al. [1], to ensure that our literature search was inclusive, and captured as many potentially relevant reports as possible. Additionally, we searched four electronic databases, which is recommended by others [7, 8], and is consistent with contemporary standards for conducting and reporting systematic reviews and meta-analyses, i.e. the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement [9, 10], and AMSTAR (A MeaSurement Tool to Assess Systematic Reviews) Methodological Quality Scale [11, 12]. Paravidino et al. [1] highlighted the use of two specific terms to identify RCTs as a limitation of our metaanalysis, when in fact, we view this as a strength. By using broad keywords, more records could be included in our initial search, which improved the sensitivity of our search. Although we may be sacrificing precision with this approach, we (and others) [13] are unaware of evidencebased guidelines on how to achieve greater precision without compromising sensitivity. Nonetheless, we agree that there is the potential for systematic reviews to be biased in favor of the studies that are easier to find. As such, the conclusions that can be drawn from any review, including ours, are limited to the studies that are included. We encourage future authors to include a manual reference search in systematic reviews [14], and to contact authors for missing or incomplete data, as we did in ours. Paravidino et al. [1] also commented on the potential influence that non-independent effect estimates (i.e. multiple effects nested within a single study) could have had on & Michael V. Fedewa mvfedewa@ua.edu

Crime, perceived safety, and physical activity: A meta-analysis

Perceived safety from crime and objectively-measured crime rates may be associated with physical inactivity. The purpose of this meta-analysis is to estimate the odds of accumulating high levels of physical activity (PA) when the perception of safety from crime is high and when objectively-measured crime is high. Peer-reviewed studies were identified through PubMed, Web of Science, ProQuest Criminal Justice, and ScienceDirect from earliest record through 2016. Included studies measured total PA, leisure-time PA, or walking in addition to perceived safety from crime or objective measures of crime. Mean odds ratios were aggregated with random effects models, and meta-regression was used to examine effects of potential moderators: country, age, and crime/PA measure. Sixteen cross-sectional studies yielded sixteen effects for perceived safety from crime and four effects for objective crime. Those reporting feeling safe from crime had a 27% greater odds of achieving higher levels of physical activity (OR=1.27 [1.08, 1.49]), and those living in areas with higher objectively-measured crime had a 28% reduced odds of achieving higher levels of physical activity (OR=0.72 [0.61, 0.83]). Effects of perceived safety were highly heterogeneous (I2=94.09%), but explored moderators were not statistically significant, likely because of the small sample size. Despite the limited number of effects suitable for aggregation, the mean association between perceived safety and PA was significant. As it seems likely that perceived lack of safety from crime constrains PA behaviors, future research exploring moderators of this association may help guide public health recommendations and interventions.