Physical Activity and Risk of Stroke in Women

Hu, Frank B.; Stampfer, Meir J.; Colditz, Graham A.; Ascherio, Alberto; Rexrode, Kathryn M; Willett, Walter C.; Manson, JoAnn E.

doi:10.1001/jama.283.22.2961

Cited by 444 publications

(273 citation statements)

References 40 publications

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“…These data on physical activity have been assessed using an instrument that was validated in the current population and shown to classify women reasonably well. Using the same activity assessment in parallel studies among slightly older women we have shown that greater activity predicts reduced risk of diabetes , heart disease , stroke (Hu et al, 2000), colon cancer (Martinez et al, 1999), osteoporotic fractures (Feskanich et al, 2002), and reduced weight gain after smoking cessation (Kawachi et al, 1996). In the NHS II, higher physical activity predicts reduced ovulatory infertility (RichEdwards et al, 2002), and is strongly related to lower BMI.…”

Section: Discussionmentioning

confidence: 99%

Physical activity and risk of breast cancer in premenopausal women

et al. 2003

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Physical activity appears to be inversely related to risk of breast cancer, yet the results remain inconsistent. To evaluate this relation among premenopausal women and examine variation in risk according to level of obesity and use of oral contraceptives (OCs), the authors examined data from the Nurses' Health Study II. During 10 years of follow-up, 849 cases of invasive premenopausal breast cancer were confirmed. Physical activity was assessed by self-report at baseline and during follow-up using a validated questionnaire. Total physical activity was unrelated to risk of breast cancer. Women engaging in X27 metabolic equivalent (MET)-h week À1 had a multivariate-adjusted relative risk (RR) of 1.04 (95% confidence interval (CI) 0.82 -1.33) compared to those in the o3 METh week À1 category. Among women with a BMI X30 kg m À2 , we observed a significant positive dose -response relation (P ¼ 0.04). Activity was unrelated to breast cancer risk at lower levels of BMI. A test for interaction between activity and BMI (o30, X30 kg m À2 ) was statistically significant (P ¼ 0.02). Among current OC users, higher activity was associated with a non-significantly lower risk of breast cancer (RR ¼ 0.59, 95% CI 0.30 -1.16 for X27 vs o9 MET-h week À1 , P for linear trend ¼ 0.14). These results show no overall association between physical activity and risk of breast cancer among premenopausal women, but suggest that the effect of physical activity could be substantially modified by the underlying degree of adiposity. The potential interactions between physical activity, adiposity, and current use of OCs require further study. The relation of physical activity to risk of breast cancer has been assessed by the International Agency for Research on Cancer, which concluded that, although studies have not been entirely consistent, the overall results support a reduction in risk with higher levels of activity (International Agency for Research on Cancer, 2002). The majority of studies, however, have been focused on postmenopausal breast cancer. Also, upon review of more than 30 studies, it was noted that the most important time periods in life for activity is not currently known. Furthermore, which activities may offer the greatest protection have not been systematically examined.In a previous analysis of the Nurses' Health Study II (NHSII) cohort with 372 cases among predominantly premenopausal women, Rockhill et al (1998) observed no association between nonoccupational activity levels in late adolescence or the recent past and risk of breast cancer. We now extend that analysis, adding 477 additional premenopausal cases in an effort to understand better the relation between physical activity and risk of premenopausal breast cancer.In addition to evaluating the type of physical activity, we examined the relation between activity and breast cancer within subgroups of adiposity and oral contraceptive (OC) use, which we hypothesised, might modify the relationship. Potential health effects of (OCs) were the original focus of the NHS II coh...

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Section: Discussionmentioning

confidence: 99%

Physical activity and risk of breast cancer in premenopausal women

et al. 2003

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“…Moderate-intensity activities such as brisk walking generate 40-60% of maximum oxygen uptake [9,10] and have been associated with reduced risk of coronary heart disease [11], stroke [12,13], and insulin resistance [14]. These beneficial effects are associated with decreases in body weight, blood pressure (BP), serum cholesterol, and improved glucose tolerance [15].…”

Section: Introductionmentioning

confidence: 99%

Continuous glucose monitoring counseling improves physical activity behaviors of individuals with type 2 diabetes: A randomized clinical trial

Allen¹,

Fain²,

Braun³

et al. 2008

Diabetes Research and Clinical Practice

139

152

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Aims-Despite the known benefits, 60% of individuals with diabetes do not engage in regular physical activity (PA). This pilot study tested the effects of a counseling intervention using continuous glucose monitoring system (CGMS) feedback on PA self-efficacy, PA levels, and physiological variables.Methods-Adults (N = 52) with type 2 diabetes (non-insulin requiring, inactive) were randomized to intervention (n = 27) or control (n = 25) groups. Both groups received 90 min of diabetes education with a follow-up phone call 4 weeks later. The intervention group also received counseling derived from self-efficacy theory. This intervention included feedback on each participant's CGMS graph and used role model CGMS graphs to clearly depict glucose reductions in response to PA. Outcomes were assessed at baseline and 8 weeks.Results-Participants receiving the intervention had higher self-efficacy scores than the control group for sticking to activity/resisting relapse at 8 weeks (p < 0.05), indicating more confidence in maintaining a PA program. Intervention group participants light/sedentary activity minutes decreased significantly (p < 0.05), moderate activity minutes increased significantly (p < 0.05), and, HbA1c and BMI decreased significantly (p < 0.05).Conclusions-These data suggest that PA counseling interventions using CGMS feedback for individuals with type 2 diabetes may improve PA levels and reduce risk factors for diabetes-related complications.

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“…Only 25% of Americans meet the recommended levels of physical activity participation [2] despite the health benefits of a physically active lifestyle (e.g., reduced risk of cardiovascular disease and non-insulin-dependent diabetes) [3,4].…”

Section: Introductionmentioning

confidence: 99%

Examination of print and telephone channels for physical activity promotion: Rationale, design, and baseline data from Project STRIDE

Marcus

Napolitano

King

et al. 2007

Contemporary Clinical Trials

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Background-Project STRIDE is a 4-year randomized controlled trial comparing two computerbased expert system guided intervention delivery channels (phone vs. print) for physical activity adoption and short-term maintenance among previously sedentary adults.Methods-Sedentary adults (n=239) were randomized to one of the following (1) telephonebased, individualized motivationally-tailored feedback; (2) print-based, individualized motivationally-tailored feedback; (3) contact-control delayed treatment group (received intervention after 12 months as control). This paper: (1) outlines the study design, rationale, and participant sample; and (2) describes relationships between baseline variables to better understand their influence on the efficacy of the intervention.Results-Participants averaged 19.8±25.0 min of physical activity/week that was at least of moderate intensity, with no group differences. The average estimated VO 2 at 85% of maximum heart rate was 25.6 ml/kg/min. Body fat was 34.1% for women and 23.2% for men and the BMI of the sample averaged 28.5 kg/m 2 .Conclusions-Project STRIDE examines non face-to-face approaches for promoting physical activity behavior. It has unique features including a direct comparison of an expert system guided intervention delivered via phone or print. Future analyses will examine the cost-effectiveness of the interventions and this will likely yield important information for policy-makers.

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Physical Activity and Risk of Stroke in Women

Abstract: These data indicate that physical activity, including moderate-intensity exercise such as walking, is associated with substantial reduction in risk of total and ischemic stroke in a dose-response manner. JAMA. 2000.

Cited by 444 publications

References 40 publications

Physical activity and risk of breast cancer in premenopausal women

Physical activity and risk of breast cancer in premenopausal women

Continuous glucose monitoring counseling improves physical activity behaviors of individuals with type 2 diabetes: A randomized clinical trial

Examination of print and telephone channels for physical activity promotion: Rationale, design, and baseline data from Project STRIDE

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