Physical exercises in patients with eating disorders

CONTEXTO: Diferentes estudos discutem a relação da prática excessiva de exercícios físicos com transtornos alimentares como estratégia para perda de peso. OBJETIVO: Revisar a literatura sobre a prática de exercícios físicos em pacientes com transtornos alimentares, discutindo definições, critérios diagnósticos e propostas terapêuticas. MÉTODOS: Levantamento bibliográfico foi realizado por meio de MedLine, LiLacs e Cochrane Library, com os termos "transtornos alimentares", "anorexia", "bulimia", "exercício físico excessivo", "atividade física", "exercício obrigatório", "exercício compulsivo" e "exercício excessivo". RESULTADOS: Dos 80 artigos encontrados, foram selecionados 12 que incluíam a investigação de um padrão de atividade física considerado excessivo em indivíduos acima dos 18 anos e uso de algum instrumento de avaliação para essa finalidade. A prática de exercícios físicos em pacientes com transtornos do comportamento alimentar é revisada. CONCLUSÃO: Não há consenso sobre critérios diagnósticos e instrumentos para considerar o exercício físico como inadequado ou excessivo e seu uso como recurso para perder peso. Por outro lado, a prática de exercícios físicos durante o tratamento de pacientes com transtornos alimentares pode ser benéfica desde que orientada e supervisionada.BACKGROUND: Several studies discuss the relationship between excessive physical exercises and eating disorder patient as a strategy to lose weight. OBJECTIVE: Review the literature concerning physical exercises in eating disorder patients including definitions, diagnostic criteria and therapeutic proposals. METHODS: A literature review was done through MedLine, LILACS and Cochrane databases using the terms "eating disorders", "anorexia nervosa", "bulimia nervosa", "physical activity", "obligatory exercise", "compulsive exercise" and "excessive exercise". RESULTS: 12 articles in a sampling of 80 were selected. These articles include the investigation of a physical pattern that was considered excessive in adults over 18 and the use of evaluation instruments. The practice of physical exercises in patients with disturbed eating behaviors is revised. DISCUSSION: There is no consensus in literature about diagnostic criteria and instruments to consider the physical exercise as inadequate or excessive and its use as a way to lose weight. On the other hand the practice of physical exercises along the treatment of eating disorder patients could be beneficial if oriented and supervised

Is a population-level physical activity legacy of the London 2012 Olympics likely?

Organizing committees for Olympic Games often promise a diverse range of long-term health and other legacies emanating directly from having hosted the Games. Some of these legacies appear supported by evidence, whereas others may be part of the rhetoric surrounding the initial bids for the Games

Physical activity mass media campaigns and their evaluation: a systematic review of the literature 2003–2010

Internationally, mass media campaigns to promote regular moderate-intensity physical activity have increased recently. Evidence of mass media campaign effectiveness exists in other health areas, however the evidence for physical activity is limited. The purpose was to systematically review the literature on physical activity mass media campaigns, 2003–2010. A focus was on reviewing evaluation designs, theory used, formative evaluation, campaign effects and outcomes. Literature was searched resulting in 18 individual adult mass media campaigns, mostly in high-income regions and two in middle-income regions. Designs included: quasi experimental (n = 5); non experimental (n = 12); a mixed methods design (n = 1). One half used formative research. Awareness levels ranged from 17 to 95%. Seven campaigns reported significant increases in physical activity levels. The review found that beyond awareness raising, changes in other outcomes were measured, assessed but reported in varying ways. It highlighted improvements in evaluation, although limited evidence of campaign effects remain. It provides an update on the evaluation methodologies used in the adult literature. We recommend optimal evaluation design should include: (1) formative research to inform theories/frameworks, campaign content and evaluation design; (2) cohort study design with multiple data collection points; (3) sufficient duration; (4) use of validated measures; (5) sufficient evaluation resources

A prática de exercícios físicos em pacientes com transtornos alimentares

BACKGROUND: Several studies discuss the relationship between excessive physical exercises and eating disorder patient as a strategy to lose weight. OBJECTIVE: Review the literature concerning physical exercises in eating disorder patients including definitions, diagnostic criteria and therapeutic proposals. METHODS: A literature review was done through MedLine, LILACS and Cochrane databases using the terms "eating disorders", "anorexia nervosa", "bulimia nervosa", "physical activity", "obligatory exercise", "compulsive exercise" and "excessive exercise". RESULTS: 12 articles in a sampling of 80 were selected. These articles include the investigation of a physical pattern that was considered excessive in adults over 18 and the use of evaluation instruments. The practice of physical exercises in patients with disturbed eating behaviors is revised. DISCUSSION: There is no consensus in literature about diagnostic criteria and instruments to consider the physical exercise as inadequate or excessive and its use as a way to lose weight. On the other hand the practice of physical exercises along the treatment of eating disorder patients could be beneficial if oriented and supervised.CONTEXTO: Diferentes estudos discutem a relação da prática excessiva de exercícios físicos com transtornos alimentares como estratégia para perda de peso. OBJETIVO: Revisar a literatura sobre a prática de exercícios físicos em pacientes com transtornos alimentares, discutindo definições, critérios diagnósticos e propostas terapêuticas. MÉTODOS: Levantamento bibliográfico foi realizado por meio de MedLine, LiLacs e Cochrane Library, com os termos "transtornos alimentares", "anorexia", "bulimia", "exercício físico excessivo", "atividade física", "exercício obrigatório", "exercício compulsivo" e "exercício excessivo". RESULTADOS: Dos 80 artigos encontrados, foram selecionados 12 que incluíam a investigação de um padrão de atividade física considerado excessivo em indivíduos acima dos 18 anos e uso de algum instrumento de avaliação para essa finalidade. A prática de exercícios físicos em pacientes com transtornos do comportamento alimentar é revisada. CONCLUSÃO: Não há consenso sobre critérios diagnósticos e instrumentos para considerar o exercício físico como inadequado ou excessivo e seu uso como recurso para perder peso. Por outro lado, a prática de exercícios físicos durante o tratamento de pacientes com transtornos alimentares pode ser benéfica desde que orientada e supervisionada

Health-related factors correlate with behavior trends in physical activity level in old age: longitudinal results from a population in São Paulo, Brazil

<p>Abstract</p> <p>Background</p> <p>Physical inactivity in leisure time is common among elderly in Brazil and this finding is particularly alarming considering that this population is greatly affected by chronic diseases. The identification of health factors that influence physical activity level (PAL) will help in the development of strategies for increasing PAL older adults. The current research aimed to identify variables that independently affect behavior trends in PAL over the course of two years among elderly.</p> <p>Methods</p> <p>A survey entitled the Epidoso Project ("Epidemiology of aging") studied 1,667 community-based older individuals in São Paulo city, Brazil over the course of two years. Physical activity level was determined through questions about frequency and duration of physical activities. Body Mass Index was calculated; functional capacity was assessed through the ADL (activities of daily living) scale; cognition was assessed by Mini-Mental State Examination; and mental health was assessed through the Dysthymia Screening. Experiences of falls and fractures were also assessed. Subjects were divided into three groups according to their self-report of Physical Activity Level: a - Regularly Active; b - Insufficiently Active and c - Physically Inactive. Behavior trends in PAL were also measured after two years. Multivariate regression model methodology was used to test associations longitudinally.</p> <p>Results</p> <p>Results from the final model demonstrated that the risk of a not favorable behavior trend in PAL, which included the group who remained physically inactive and the group that displayed decreased PAL, in this cohort of older adults was significantly increased if the individual was female (OR = 2.50; 95% CI = 1.60-3.89; <it>P < 0.01</it>), older (80 y vs. 65 y, OR = 6.29, 95% CI = 2.69-14.67; <it>P < 0.01</it>), dependent on help from others for activities in the ADL scale (moderate-severe = 4-7+ vs. 0 ADLs) (OR = 2.25, 95% CI = 1.20-4.21; <it>P < 0.011</it>) or had experienced a history of falls with consequences (OR = 6.88, 95% CI = 0.91-52.01; <it>P < 0.062</it>).</p> <p>Conclusions</p> <p>Age, gender, ADL scores and falls were associated with a not favorable behavior trend in PAL. Promotion programs should target these factors, reducing barriers to achieve desired changes in PAL.</p

How many steps/day are enough? for adults

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions or translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognize that "some physical activity is better than none" while maintaining a focus on time spent in moderate-to-vigorous physical activity (MVPA). Thus, the purpose of this review was to update our existing knowledge of "How many steps/day are enough?", and to inform step-based recommendations consistent with current physical activity guidelines. Normative data indicate that healthy adults typically take between 4,000 and 18,000 steps/day, and that 10,000 steps/day is reasonable for this population, although there are notable "low active populations." Interventions demonstrate incremental increases on the order of 2,000-2,500 steps/day. The results of seven different controlled studies demonstrate that there is a strong relationship between cadence and intensity. Further, despite some inter-individual variation, 100 steps/minute represents a reasonable floor value indicative of moderate intensity walking. Multiplying this cadence by 30 minutes (i.e., typical of a daily recommendation) produces a minimum of 3,000 steps that is best used as a heuristic (i.e., guiding) value, but these steps must be taken over and above habitual activity levels to be a true expression of free-living steps/day that also includes recommendations for minimal amounts of time in MVPA. Computed steps/day translations of time in MVPA that also include estimates of habitual activity levels equate to 7,100 to 11,000 steps/day. A direct estimate of minimal amounts of MVPA accumulated in the course of objectively monitored free-living behaviour is 7,000-8,000 steps/day. A scale that spans a wide range of incremental increases in steps/day and is congruent with public health recognition that "some physical activity is better than none," yet still incorporates step-based translations of recommended amounts of time in MVPA may be useful in research and practice. The full range of users (researchers to practitioners to the general public) of objective monitoring instruments that provide step-based outputs require good reference data and evidence-based recommendations to be able to design effective health messages congruent with public health physical activity guidelines, guide behaviour change, and ultimately measure, track, and interpret steps/day

A patologização do sedentarismo

A identifica????o do sedentarismo como fator de risco para doen??as cr??nico-degenerativas influenciou significativamente nas recomenda????es de sa??de p??blica em defesa de estilos de vida fisicamente ativos. O artigo estuda o processo de patologiza????o do sedentarismo e seus desdobramentos para o campo da sa??de p??blica. Num primeiro momento, discutimos de que maneira o modelo biom??dico serve de base para a transposi????o de aspectos da conduta humana como ???fator de risco??? e, a seguir, como patologia, tal qual no caso espec??fico da ???S??ndrome da Morte Sedent??ria???, assim classificada por alguns autores. Em seguida, analisamos como essa vis??o vem sendo difundida no campo da sa??de, tomando por base um programa institucional que, ao mesmo tempo em que transforma o sedentarismo em doen??a, apresenta a atividade f??sica como um rem??dio cujos resultados podem se estender a todas as esferas da vida. Nessa linha de racioc??nio, em que os mal-estares de nossa civiliza????o s??o medicalizados e tornados mercadoria ao serem transformados em riscos e patologias, a atividade f??sica torna-se vacina para o corpo social.The identification of physical inactivity as a risk factor for chronic degenerative diseases has significantly influenced public health recommendations in support of physically active lifestyles. This study analyzes the pathologization of sedentariness and its implications in the public health field. First we discuss how the biomedical model serves as a basis to transform aspects of human behavior into ???risk factors??? and subsequently into pathologies such as the ???Sedentary Death Syndrome???, as some authors classify it. Second, we analyze how this view is being spread in the health field; our analysis is based on an institutional program which transforms sedentariness into illness while presents physical activity as a medicine whose results can reach all aspects of life. According to this rationale, in which the discomforts of our civilization are medicalized and made into commodities as they are transformed into risks and pathologies, physical activity becomes a vaccine to be applied to the social body

Relationship between soft drink consumption and obesity in 9-11 years old children in a multi-national study

The purpose of this study was to determine the association between regular (sugar containing) and diet (artificially sweetened) soft drink consumption and obesity in children from 12 countries ranging in levels of economic and human development. The sample included 6162 children aged 9-11 years. Information on soft drink consumption was obtained using a food frequency questionnaire. Percentage body fat (%BF) was estimated by bio-electrical impedance analysis, body mass index (BMI) z-scores were computed using World Health Organization reference data, and obesity was defined as a BMI &gt; +2 standard deviations (SD). Multi-level models were used to investigate trends in BMI z-scores, %BF and obesity across categories of soft drink consumption. Age, sex, study site, parental education and physical activity were included as covariates. There was a significant linear trend in BMI z-scores across categories of consumption of regular soft drinks in boys (p = 0.049), but not in girls; there were no significant trends in %BF or obesity observed in either boys or girls. There was no significant linear trend across categories of diet soft drink consumption in boys, but there was a graded, positive association in girls for BMI z-score (p = 0.0002) and %BF (p = 0.0001). Further research is required to explore these associations using longitudinal research designs.</p

How many steps/day are enough? For older adults and special populations

Older adults and special populations (living with disability and/or chronic illness that may limit mobility and/or physical endurance) can benefit from practicing a more physically active lifestyle, typically by increasing ambulatory activity. Step counting devices (accelerometers and pedometers) offer an opportunity to monitor daily ambulatory activity; however, an appropriate translation of public health guidelines in terms of steps/day is unknown. Therefore this review was conducted to translate public health recommendations in terms of steps/day. Normative data indicates that 1) healthy older adults average 2,000-9,000 steps/day, and 2) special populations average 1,200-8,800 steps/day. Pedometer-based interventions in older adults and special populations elicit a weighted increase of approximately 775 steps/day (or an effect size of 0.26) and 2,215 steps/day (or an effect size of 0.67), respectively. There is no evidence to inform a moderate intensity cadence (i.e., steps/minute) in older adults at this time. However, using the adult cadence of 100 steps/minute to demark the lower end of an absolutely-defined moderate intensity (i.e., 3 METs), and multiplying this by 30 minutes produces a reasonable heuristic (i.e., guiding) value of 3,000 steps. However, this cadence may be unattainable in some frail/diseased populations. Regardless, to truly translate public health guidelines, these steps should be taken over and above activities performed in the course of daily living, be of at least moderate intensity accumulated in minimally 10 minute bouts, and add up to at least 150 minutes over the week. Considering a daily background of 5,000 steps/day (which may actually be too high for some older adults and/or special populations), a computed translation approximates 8,000 steps on days that include a target of achieving 30 minutes of moderate-to-vigorous physical activity (MVPA), and approximately 7,100 steps/day if averaged over a week. Measured directly and including these background activities, the evidence suggests that 30 minutes of daily MVPA accumulated in addition to habitual daily activities in healthy older adults is equivalent to taking approximately 7,000-10,000 steps/day. Those living with disability and/or chronic illness (that limits mobility and or/physical endurance) display lower levels of background daily activity, and this will affect whole-day estimates of recommended physical activity