OBJECTIVE: To investigate whether walking or resistance training improves weight maintenance after weight loss when added to dietary counselling. DESIGN: Two months' weight reduction with very-low-energy-diet (VLED) followed by randomization into three groups (control, walking, resistance training) for 6 months' weight maintenance (WM) program and 23 months' unsupervised followup. During VLED and WM all groups received similar dietary counselling. SUBJECTS: The main inclusion criteria were BMI > 30 kg=m 2 , waist > 100 cm and physical inactivity (exercise once a week). Ninety healthy, obese (mean BMI 32.9 kg=m 2 and waist 112.5 cm), 35 -50 y-old men started the study and 68 were measured at the end of the study. MEASUREMENTS: Weight and body composition assessed by underwater weighing. Exercise diaries and dietary records to assess energy balance. RESULTS: During VLED the mean body weight decreased from 106.0 (s.d. 9.9) kg to 91.7 (9.4) kg. Weight was regained mostly during follow-up and in the end of the study the mean weight in groups was 99.9 -102.0 kg. Exercise training did not improve short or long-term weight maintenance when compared to the control group. However, resistance training attenuated the regain of body fat mass during WM (P ¼ 0.0l), but not during follow-up. In the combined groups the estimated total energy expenditure (EE) of reported physical activity was associated with less weight regain during WM. EE of 10.1 MJ=week was associated with maintaining weight after weight loss. EE of physical activity tended to decrease after WM in exercise groups due to poor long-term adherence to prescribed exercise. Energy intake seemed to increase during follow-up. CONCLUSION: Exercise training of moderate dose did not seem to improve long-term weight maintenance because of poor adherence to prescribed exercise.

Objectives. To study physiological, therapeutic and adverse effects of sauna bathing with special reference to chronic diseases, medication and special situations (pregnancy, children). Study design. A literature review. Methods. Experiments of sauna bathing were accepted if they were conducted in a heated room with sufficient heat (80 to 90ºC), comfortable air humidity and adequate ventilation. The sauna exposure for five to 20 minutes was usually repeated one to three times. The experiments were either acute (one day), or conducted over a longer period (several months). Results. The research data retrieved were most often based on uncontrolled research designs with subjects accustomed to bathing since childhood. Sauna was well tolerated and posed no health risks to healthy people from childhood to old age. Baths did not appear to be particularly risky to patients with hypertension, coronary heart disease and congestive heart failure, when they were medicated and in a stable condition. Excepting toxemia cases, no adverse effects of bathing during pregnancy were found, and baths were not teratogenic. In musculoskeletal disorders, baths may relieve pain. Medication in general was of no concern during a bath, apart from antihypertensive medication, which may predispose to orthostatic hypotension after bathing. Conclusions. Further research is needed with sound experimental design, and with subjects not accustomed to sauna, before sauna bathing can routinely be used as a non-pharmacological treatment regimen in certain medical disorders to relieve symptoms and improve wellness. (Int J Circumpolar

Objective: To study relationships between obesity, physical inactivity and sleep-related disturbances (obstructive sleep apnea (OSA), sleep duration, sleep disturbances concomitant with daytime tiredness) in adults (X30 years). Design: Cross-sectional study with a random population sample. Participants: A total of 3377 men (mean age 52.3, s.d. 14.8, years) and 4264 women (56.4, s.d. 17.2, years). Main outcome measures: Dependent variables, measured: Waist circumference (WC) and body mass index (BMI). Independent variables, from a detailed interview/questionnaire: probable OSA, other sleep-related disturbances, sleep duration, type and frequency of leisure physical activity. Age, mental health, smoking and education were included in analyses as potential confounders. Results: In men, OSA and physical inactivity increased likelihood for abdominal obesity (WC X102 cm). Physical inactivity also increased, but long (X9 h/day) sleep decreased likelihood for abdominal overweight (WC: 94-101 cm) in men. In women, abdominal obesity (WC X88 cm) was associated positively with OSA, moderate sleep-related disturbances, and physical inactivity. Education modulated the influence of age on abdominal obesity in both genders. Using BMI as the dependent variable did not change the general information obtained by the model. In addition, abdominal obesity was found to be an independent risk factor also in multivariable models predicting categories of a combined sleep duration and sleep disturbances. Conclusions: Sleep duration and sleep-related disturbances are associated with obesity, even after controlling for OSA and physical inactivity. The results support the hypothesis of vicious circle between sleep and obesity.

Oja P, Manttari A, HeinonenA, Kukkonen-Harjula K, Laukkanen R, Pasanen M, Vuori I. Physiological effects of walking and cycling to work. Scand J Med Sci Sports 1991: 1: 151-157.Sixty-eight previously sedentary volunteers (38 men and 30 women) were randomly divided into active and control groups and subjected to a 10-week programme of walking or cycling while commuting to and from work. The active commuters and the controls complied with the programme on 75-78% and 92% of the workdays, respectively. The mean walking distance was 3.5 km and that of cycling 10 km. Cardiorespiratory strain of approximately 50% of maximal oxygen uptake Vo2,,, in walking and 60% of Vo,,,, in cycling was observed. Statistically consistent improvements caused by active commuting were seen in cardiorespiratory responses to both maximal and submaximal work and in metabolic response to submaximal work. Cycling was more effective than walking. These findings indicate that low-intensity walking and cycling to and from work improved cardiorespiratory and metabolic I fitness.Walking and cycling are well documented as having conditioning effects. Significant aerobic training effects have been reported for walking regimens with a sufficient frequency, number of sessions and programme duration: for example, level walking for elderly people (1) and sedentary middle-aged men and women (2), uphill walking on a treadmill for sedentary men (3) and women (4) and worksite stair walking for men (5). In principle, the training stimulus in cycling can be aerobically maximal, and the training effect is at least as great as that of jogging or running, as shown by Pollock et al. (3) with cycle ergometer training and by Wilmore et al. (6) with free cycling. As regards the training effects conducive to cardiovascular health, evidence shows that an exercise intensity corresponding to that of brisk walking may be sufficient to lower blood pressure (7), decrease serum triglycerides and increase the high-density lipoprotein (HDL) fraction of cholesterol (8-10).Work-commuting exercise in Finland is characterized by relatively short duration, high frequency and low intensity (11). In a pilot study, we showed that the cardiovascular strain of such exercise was approximately 40% of the maximal oxygen uptake (VozmaX) for walking and 55% of the Vo2ma for cycling (12). Thus, this type of exercise represents the low end of the intensity zone recommended for aerobic conditioning (13). We examined the effects of walking and cycling to and from work on the cardiovascular fitness and blood lipids of healthy men and women. Material and methods SubjectsThe subjects were selected from 860 20-to &year-old men and women who had participated in a postal survey on commuting to work (11) and who worked outside the home, resided 2-20 km from their workplace, and had previously reported that they were in good health. Of 160 volunteers, the 88 who commuted by bus or car did not exercise regularly and vigorously during leisure time and accepted the outcome of random assignment into experim...

The purpose of this study was to compare physical fitness and health-related quality-of-life between twenty-three postmenopausal women with fibromyalgia (age 58 +/- 3 years) and eleven healthy women (58 +/- 5 years). Aerobic fitness and isometric force of different muscle groups were measured. Functional performance was assessed by walking and stair-climbing times. Symptoms were assessed by visual analog scale and quality-of-life by RAND-36 questionnaire. Women with fibromyalgia had significantly lower isometric force in bilateral leg extensors (1285 vs. 1898 N), unilateral knee extensors (414 vs. 502 N) and flexors (197 vs. 235 N) than healthy women, but no differences were observed in forces of the trunk and upper extremities. Maximal workload in the aerobic test (130 vs. 151 W), functional performance and quality-of-life were lower in women with fibromyalgia and they reported more symptoms than healthy subjects, while maximal oxygen uptake did not differ between the groups. A lower maximal load in the aerobic test suggests the patients' unsatisfactory ability to stand physical loading and resist overall fatigue. Moreover, fatigue rather than pain was the main factor to decrease the quality-of-life in women with fibromyalgia. Additional efforts should be addressed to strength training, when planning health promotion and rehabilitation programs in fibromyalgia.