Paul S. Fardy

Improvements in Heart Health Behaviors and Reduction in Coronary Artery Disease Risk Factors in Urban Teenaged Girls Through a School-Based Intervention: The PATH Program

OBJECTIVES We sought to assess the effects of a school-based intervention program on cardiovascular disease risk factors in urban girls. METHODS We compared heart health knowledge, health behaviors, cardiovascular risk factors, and physical fitness among a group of 442 multiethnic teenaged girls (310 experimental participants vs 132 control participants). Testing was conducted before and after a 12-week program of vigorous exercises integrated with lectures and discussions on diet, exercise, stress, and smoking. RESULTS Significant differences in body fat, systolic and diastolic blood pressure, heart health knowledge, and whether breakfast was eaten were observed between experimental participants and control participants. CONCLUSIONS An integrated program of exercise and heart health-related lectures and discussions had a beneficial effect on health knowledge, health behaviors, and onset of risk factors for coronary artery disease among urban girls.

Comparison of two ActiGraph accelerometer generations in the assessment of physical activity in free living conditions

BackgroundThe aim of this study was to compare physical activity measured using GT1M ActiGraph and GT3X ActiGraph accelerometers in free living conditions.FindingsTwenty-five adults wore GT1M and GT3X Actigraph accelerometers simultaneously during a typical weekday of activity. Data were uploaded from the monitor to a computer at the end of test (one day). Previously established thresholds were used for defining time spent at each level of physical activity, physical activity was assessed at varying intensities comparing data from the two accelerometers by ANOVA and Bland and Altman statistical analysis. The concordance correlation coefficient between accelerometers at each intensity level was 0.99. There were no significant differences between accelerometers at any of the activity levels. Differences between data obtained in minutes with the GT1M accelerometer and the GT3X monitor were to 0.56, 0.36, 0.52 and 0.44% for sedentary, light, moderate and vigorous, respectively. The Bland and Altman method showed good agreement between data obtained for the two accelerometers.ConclusionsFindings suggest that the two accelerometers provided similar results and therefore the GT3X may be used in clinical and epidemiological studies without additional calibration or validation studies.

Coronary disease risk factor reduction and behavior modification in minority adolescents: The PATH program

PURPOSE To evaluate the impact of a unique school-based program of exercise, health education, and behavior modification on health knowledge, health behaviors, coronary risk factors, and cardiovascular fitness in minority adolescents. METHODS A total of 346 students from an inner-city public high school participated in health promotion intervention or regular physical education volleyball classes. Subjects were African-American (47%), Asian-American (9%), Hispanic (21%), white (3%), and other (19%). The health promotion curriculum consisted of 11 weeks of daily circuit training exercise and health lecture-discussions. RESULTS The groups were similar in age, height, weight, ethnicity, and socioeconomic status. Following intervention both boys (P < .001) and girls (P < .006) significantly improved health knowledge test scores. Significant benefits for girls included improved dietary habits (P < .05), reduced cholesterol (P < .004), and higher estimated V(O2)max (P < .0001). There were no other significant changes in boys. CONCLUSIONS The results suggest that a school-based health promotion program of exercise and health lecture-discussion is beneficial for multiethnic, inner-city adolescents, especially females.

Prevalence of overweight in adolescents with intellectual deficiency. Differences in socio-educative context, physical activity and dietary habits §

The study investigates the prevalence of overweight and obesity in a population of intellectually disabled (ID) adolescents. An observational study was conducted on a group of 410 ID children, living in France. Overweight and obesity, defined according to international standards, were analyzed and related to demographic and sociological parameters, educational care, physical activity and dietary habits. The study highlighted a high prevalence of overweight and obesity (19.0%) in ID adolescents and 22.5% in oldest teenagers, age 15-20 y. This observation was more likely in medico-educative institutes (25.1%) than in general schools (12.3%). Average time spent in physical activity was 4.5 h/week, compared with 3.5 h/week in obese subjects. Time spent in sedentary behavior was 26.6 h/week for the whole population, compared with 18.6 h/week in obese adolescents. Meals were ingested regularly, and adherence to eating breakfast was good. However, snacks and soft drinks were consumed between and during meals by 66.5% of subjects. Overweight in young ID appeared to be related to parental overweight. Even though ID adolescents receive a balanced diet and practice sport regularly, they exhibit a high prevalence for overweight and obesity. In subjects more than 15 years of age, enrollment in medico-educative institutes and parental overweight were contributory factors to poor weight status.

Health Promotion in Minority Adolescents: A Healthy People 2000 Pilot Study

PURPOSE The purpose was to evaluate the effects of a health promotion curriculum on health knowledge, behavior, cardiovascular fitness, and cardiovascular risk factors. METHODS A multi-ethnic, multi-cultural sample (n = 54) of 10th grade males and females participated in a study of cardiovascular health promotion and coronary risk factor reduction. The sample was comprised of Asian-Americans (39%), blacks (33%), Hispanics (11%), whites (2%), and others (15%). Intervention consisted of a 10-week health promotion curriculum of classroom education modules in physical activity, nutrition, smoking cessation, stress management and personal problem solving, and an exercise program of walking and running. A nonintervention control group served as a basis for comparison. Classroom and exercise sessions met on alternate days. RESULTS Following intervention, a significant treatment effect (P = .007) was observed in lowered total cholesterol, and significant within group improvements (P < .01) were observed in diet habits, percent body fat, and cardiovascular health knowledge. Comparisons of knowledge and social effects revealed higher cardiovascular health knowledge (P < .05) in subjects of nonsmoking compared to smoking parents, higher self-perception of health (P < .01) in more active vs less active subjects and better dietary habits (P < .07) in children whose parents were college educated compared to parents who did not attend college. CONCLUSIONS Preliminary findings suggest that a health promotion curriculum consisting of health education, behavior modification, and regular aerobic exercise lowers cholesterol, improves health behavior and increases health knowledge.

Overweight in intellectually-disabled population: physical, behavioral and psychological characteristics.

Intellectually disabled (ID) people are at high risk of overweight and obesity. Prevalence and risk factors were assessed in a French population of ID adults attending specialized institutions, using a questionnaire focusing on demographic characteristics, physical activities, food habits and self-awareness about body and health. Data analysis included descriptive statistics, univariate and multivariate regression. Overall, 570 participants were included in the analysis (59% male), aged 19-59 years. The mean body mass index (BMI) was 24.9 kg/m(2); 45.6% of participants were overweight (BMI ≥ 25), including 17.2% who were obese (BMI ≥ 30). Participants practiced sports for 5.7h/week on average and were sedentary for 21.8h/week (time spent in front of some kind of screen). Most participants had food and self-care habits usually regarded as healthy. Eighty percent of them felt unhappy with their body and their physical capacities, but otherwise expressed a rather good opinion of themselves. Bivariate and multivariate analyses showed that some behavioral habits were associated with a reduced incidence of overweight and/or obesity, such as regular sport practice outside the institution, good personal body care or alcohol avoidance. The strongest risk factor was gender. Women were much more at risk than men of being overweight (53.9% versus 39.9%) and obese (28.2% versus 9.5%). Results suggest numerous ways to improve the health of institutionalized ID adults, related to sports education, nutrition and self-care, with particular attention paid to women.

Physical activity using wrist-worn accelerometers: comparison of dominant and non-dominant wrist.

The purpose of this study was to determine whether there is a difference in physical activity assessment between a wrist‐worn accelerometer at the dominant or non‐dominant arm. The secondary purpose was to assess the concurrent validity of measures of physical activity from the wrist‐worn accelerometer and the waist‐worn accelerometer. Forty adults wore three accelerometers simultaneously, one on the waist and one each on the non‐dominant wrist and dominant wrist, respectively, for 24 consecutive hours of free‐living conditions. Data were uploaded from the monitor to a computer following a 1‐day test period. There were no significant differences in physical activity when comparing the dominant versus the non‐dominant wrist, regardless of axis (P>0·05). Mean daily accelerometer output data from both wrists were strongly correlated with average counts per minute from the ActiGraph worn around the waist (r = 0·88, P<0·001). Findings suggest that the choice to wear the accelerometer on the non‐dominant or dominant wrist has no impact on results. Data from this study contribute to the knowledge of how to best assess physical activity habits.

The six-minute walk test in obese youth: reproducibility, validity, and prediction equation to assess aerobic power

Purpose: The aim of this study was to assess reproducibility and validity of the 6 minute walk test (6MWT) in obese youth and to develop an equation to predict aerobic power (VO2max). Methods: Fifty-two girls and 45 boys, ages 7–17.8 participated in the study. Three walk tests were administered 1 week apart. Each visit corresponded to a specific test, either an incremental treadmill test, or the 6MWT. The 6MWT was performed on two occasions 1 week apart to assess reproducibility. Treadmill and walk tests were randomly assigned to avoid order effect. Results: Subjects walked 689.4 ± 98.6 m on the initial 6MWT and 690.4 ± 98.2 m on the second test. Intraclass correlation coefficient was r = 0.99. The Bland and Altman method also showed good agreement between the two 6MWTs. Stepwise multiple regression determined that distance walked in 6 MWT and BMI are the most significant factors in predicting VO2max. The prediction equation is VO2 max (ml.kg.min-1) = 26.9 + 0.014 × 6 MWT (meters) – 0.38 × BMI (kg/m2). Conclusions: In obese youth, the 6 MWT is a reproducible and valid test for assessing aerobic power. A prediction equation was developed to estimate VO2max, using distance walked in 6MWT and BMI. Implications for Rehabilitation The six-minute walk test can be used to predict the maximal oxygen uptake without a calorimetry indirect test very cumbersoming, expensive and time consuming. The six-minute walk test can also to estimate the maximal fat oxidation point (FATmax). It is therefore to prescript exercises using the target of FATmax for the rehabilitation of obese young individuals.

Validation of the Vivago Wrist-Worn accelerometer in the assessment of physical activity.

BackgroundMost accelerometers are worn around the waist (hip or lower back) to assess habitual physical activity. Wrist-worn accelerometers may be an alternative to the waist-worn monitors and may improve compliance in studies with prolonged wear. The aim of this study was to validate the Vivago® Wrist-Worn Accelerometer at various intensities of physical activity (PA) in adults.MethodsTwenty-one healthy adults aged 20–34 years were recruited for the study. Accelerometer data and oxygen uptake (VO2) were measured at sedentary, light, moderate and vigorous levels of PA.ResultsActivity categories and accelerometer counts were: sedentary, 0–15 counts·min−1; light, 16–40 counts·min−1; moderate, 41–85 counts·min−1; and vigorous activity, >; 85 counts·min−1. ANOVA repeated measures was used to determine the relationship between accelerometry data output and oxygen consumption (r = .89; p <; .001). The Bland and Altman method showed good agreement in the assessment of energy expenditure between the indirect calorimetry and the data obtained by the accelerometer.ConclusionsResults of the study suggest that the Vivago® wrist-worn accelerometer is a valid measure of PA at varying levels of intensity. The study has also defined threshold values at 4 intensities and hence te Vivago® accelerometer may be used to quantify PA in free living conditions among adults. This device has possible application in treating a variety of important health concerns.

A conative educational model for an intervention program in obese youth

BackgroundObesity in children has increased in recent years throughout the world and is associated with adverse health consequences. Early interventions, including appropriate pedagogy strategies, are important for a successful intervention program. The aim of this study was to assess changes in body mass index, the ability to perform sport activities, behavior in the classroom and academic performance following one year of a health-wellness intervention program in obese youth.MethodsThe CEMHaVi program included 37 obese children (19 girls and 18 boys). Participants received an intervention program consisting of physical activity and health education. Assessment included body mass index, academic performance, classroom performance and ability to perform sport activities. Paired t tests were used to assess the effects of intervention, and chi square was used to assess inter-action between measures.ResultsFindings of the study suggest significant decrease in Z scores of Body Mass Index and an improvement of academic performance, classroom behavior and the ability to perform sport activities (p < 0.05). Chi square testing showed significant positive inter-actions between body mass index, classroom behavior and academic performance.ConclusionsResults following year one of CEMHaVi showed that a program of physical activity and health education had positive effects on obesity, behavior in the classroom and the ability to perform sport activities in obese adolescents. Significant inter-action in changes between variables was observed. Findings are important for designing intervention models to improve health in obese youth.