1,993 publications from this institution
Background Substantial policy changes to control obesity, limit chronic disease, and reduce air pollution emissions, including greenhouse gasses, have been recommended. Transportation and planning policies that promote active travel by walking and cycling can contribute to these goals, potentially yielding further co-benefits. Little is known, however, about the interconnections among effects of policies considered, including potential unintended consequences. Objectives and methods We review available literature regarding health impacts from policies that encourage active travel in the context of developing health impact assessment (HIA) models to help decision-makers propose better solutions for healthy environments. We identify important components of HIA models of modal shifts in active travel in response to transport policies and interventions. Results and discussion Policies that increase active travel are likely to generate large individual health benefits through increases in physical activity for active travelers. Smaller, but population-wide benefits could accrue through reductions in air and noise pollution. Depending on conditions of policy implementations, risk tradeoffs are possible for some individuals who shift to active travel and consequently increase inhalation of air pollutants and exposure to traffic injuries. Well-designed policies may enhance health benefits through indirect outcomes such as improved social capital and diet, but these synergies are not sufficiently well understood to allow quantification at this time. Conclusion Evaluating impacts of active travel policies is highly complex; however, many associations can be quantified. Identifying health-maximizing policies and conditions requires integrated HIAs.
Objectives. This study evaluated a neighborhood environment survey and compared the physical activity and weight status of the residents in 2 neighborhoods. Methods. On 2 occasions, 107 adults from neighborhoods with differing “walkability” were selected to complete a survey on their neighborhood environment. Physical activity was assessed by self-report and by accelerometer; height and weight were assessed by self-report. Results. Neighborhood environment characteristics had moderate to high test–retest reliabilities. Residents of high-walkability neighborhoods reported higher residential density, land use mix, street connectivity, aesthetics, and safety. They had more than 70 more minutes of physical activity and had lower obesity prevalence (adjusted for individual demographics) than did residents of low-walkability neighborhoods. Conclusions. The reliability and validity of self-reported neighborhood environment subscales were supported. Neighborhood environment was associated with physical activity and overweight prevalence.
The purposes of the study were to assess differences in physical activity levels and correlates of physical activity among overweight (‡ 85 th percentile of body mass index for their sex and age) and non-overweight (< 85th percentile) youth. The sample included 509 seventh through twelfth graders. Activity was measured by a 7-day, 46-item activity checklist. Overweight girls were more sedentary than non-overweight girls ( p < .03), and non-overweight girls engaged in more vigorous physical activity than overweight girls ( p < .03). For boys, there were no significant differences in activity. The regression analyses for vigorous activity yielded the largest total R 2 ’s (R 2 = .49 for overweight and R 2 = .27 for non-overweight.) The significant factor for overweight youth was greater athletic coordination ( p < .01). For non-overweight youth, the significant factors were greater family support ( p < .05), greater peer support ( p < .001), fewer barriers ( p < .03), and greater athletic coordination ( p < .01). Correlates of physical activity vary by weight status of young people.
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Clinical studies have shown that obstructive sleep apnea (OSA) increases atherosclerosis risk. The inflammation, especially mediated by the macrophages via nuclear factor-κB (NF-κB), has been speculated to contribute to atherogenicity in OSA patients. Inhibitor of NF-κB kinase-β (IKKβ) is an essential element of the NF-κB pathway and is linked to atherosclerosis. We previously reported that atherosclerosis was accelerated in pulmonary artery (PA) but not in aorta when low-density lipoprotein receptor knockout (<i>Ldlr<sup>-/-</sup></i>) mice were exposed to intermittent hypoxia/hypercapnia (IHH), a surrogate for recurrent upper-airway obstruction. Therefore, we hypothesized that IKKβ-dependent NF-κB activation in monocytes and macrophages plays a role in IHH-induced PA atherosclerosis. To test this hypothesis, myeloid restricted IKKβ deletion (<i>Ikkβ<sup>ΔMye</sup></i>) or control (<i>Ikkβ<sup>F/F</sup></i>) mice were crossed with <i>Ldlr<sup>-/-</sup></i> mice to generate double-knockout mice. Then, the mice were exposed to IHH or room air (Air) on high-fat diet for 8 or 16 wk. Lesions of PA and aorta were examined in <i>Ikkβ<sup>ΔMye</sup></i>;<i>Ldlr<sup>-/-</sup></i> and <i>Ikkβ<sup>F/F</sup></i>;<i>Ldlr<sup>-/-</sup></i> male mice under IHH vs. Air. The results revealed that IKKβ deletion abolished IHH-induced PA atherosclerosis after 8-wk exposure but not after 16-wk exposure (8 wk: <i>Ikkβ<sup>F/F</sup></i>;<i>Ldlr<sup>-/-</sup></i>, IHH 13.5 ± 1.4 vs. Air 5.7 ± 0.7%, <i>P</i> < 0.01; <i>Ikkβ<sup>ΔMye</sup></i>;<i>Ldlr<sup>-/-</sup></i>, IHH 7.4 ± 1.9% vs. Air 4.6 ± 1.3%, <i>P</i> = 0.24). Both IKKβ deletion and IHH had no effects on atherosclerosis in the aorta. Our findings demonstrate that IKKβ-dependent NF-κB activity in myeloid-lineage cells plays a critical role in IHH-induced PA atherosclerosis at the early stage.
MCKENZIE, T. L., J. F. SALLIS, J. J. PROCHASKA, T. L. CONWAY, S. J. MARSHALL, and P. ROSENGARD. Evaluation of a Two-Year Middle-School Physical Education Intervention: M-SPAN. Med. Sci. Sports Exerc., Vol. 36, No. 8, pp. 1382–1388, 2004. Purpose: School physical education (PE) is highly recommended as a means of promoting physical activity, and randomized studies of health-related PE interventions in middle schools have not been reported. We developed, implemented, and assessed an intervention to increase physical activity during middle-school PE classes. Methods: Twenty-four middle schools (approximately 25,000 students, 45% nonwhite) in Southern California participated in a randomized trial. Schools were assigned to intervention (N = 12) or control (N = 12) conditions, and school was the unit of analysis. A major component of the intervention was a 2-yr PE program, which consisted of curricular materials, staff development, and on-site follow-up. Control schools continued usual programs. Student activity and lesson context were observed in 1849 PE lessons using a validated instrument during baseline and intervention years 1 and 2. Results: The intervention significantly (P = 0.02) improved student moderate to vigorous physical activity (MVPA) in PE, by approximately 3 min per lesson. Effects were cumulative; by year 2 intervention schools increased MVPA by 18%. Effect sizes were greater for boys (d = 0.98; large) than girls (d = 0.68; medium). Conclusions: A standardized program increased MVPA in middle schools without requiring an increase in frequency or duration of PE lessons. Program components were well received by teachers and have the potential for generalization to other schools. Additional strategies may be needed for girls.
Inflammation is thought to underlie the pathogenesis of many chronic diseases. It is now established that obesity results in a state of chronic low-grade inflammation thought to contribute to several metabolic disorders, including insulin resistance and pancreatic islet dysfunction. The protein kinases JNK1 and IKKbeta have been found to serve as critical molecular links between obesity, metabolic inflammation, and disorders of glucose homeostasis. The precise mechanisms of these linkages are still being investigated. However, as we discuss here, JNK1 and IKKbeta are activated by almost all forms of metabolic stress that have been implicated in insulin resistance or islet dysfunction. Furthermore, both JNK1 and IKKbeta are critically involved in the promotion of diet-induced obesity, metabolic inflammation, insulin resistance, and beta-cell dysfunction. Understanding the molecular mechanisms by which JNK1 and IKKbeta mediate obesity-induced metabolic stress is likely to be of importance for the development of new treatments for a variety of obesity-associated diseases.