Relative effects of reduced weight and increased physical activity on hemoglobin A1c: Suggestions for behavioral treatments

Behavioral treatments for diabetes have often been unsuccessful and may benefit from a better understanding of the relative effects of two common treatment foci – decreased weight and increased volume of physical activity – on blood glucose. Overweight and obese adults (N = 59; M_age = 60 years) with hemoglobin A1c (HbA1c) values consistent with diabetes participated in a 6-month community-based behavioral treatment based on tenets of self-efficacy theory and social cognitive theory. The treatment was associated with significantly increased physical activity, reduced body mass index (BMI), and reduced HbA1c levels (ps < .001). Changes in BMI and physical activity accounted for a significant portion of the variance in change in HbA1c, R² = .13, p = .023. Change in volume of physical activity, β = ?.36, p = .007, but not change in BMI, β = ?.03, p = .792, significantly contributed to the variance in HbA1c change that was accounted for. There was no effect based on the sex of participants. Discussion focused on how findings might impact the efficacy, efficiency, and application of behavioral treatments for diabetes management.     

身体活动对情绪的影响及其脑机制

身体活动不仅有助于提高人的生理机能, 还具有改善心境、调节情绪的功能。有规律的身体活动不仅能够增强个体的积极情绪, 提升幸福感和自尊感, 也可以缓解消极情绪、矫治情绪障碍。关于身体活动对情绪影响的脑神经机制, 研究者先后提出神经递质假说、大脑可塑性假说、前额叶偏侧化假说和双模型假说。进一步的研究需要控制运动强度对身体活动情绪效益的影响, 比较不同类型身体活动的情绪调节效果, 同时考察基因、神经生长及社会互动等因素对情绪的交互作用。     

A brief intervention to increase physical activity behavior among adolescents using mental simulations and action planning

This study evaluated the effectiveness of a brief integrated theory-based intervention to increase physical activity (PA) among adolescents over a three-month follow-up period. A 2 (mental simulation: present vs. absent) × 2 (action planning: present vs. absent) × 4 (time: baseline vs. one-month vs. two-month vs. three-month follow-up) mixed-model randomized controlled design was adopted. Adolescents aged 14–15 years (N = 267) completed baseline psychological measures and self-reported PA followed by the relevant intervention manipulation, if appropriate, with follow-up measures collected one, two, and three months later. Results revealed no significant effects for the mental simulation and action planning strategies nor the interaction of the two strategies. However, among participants with low levels of baseline PA, participants in both mental simulation alone and action planning alone groups reported significantly higher levels of PA at one-month follow up than other groups, suggesting that individual intervention components may be effective in low-active adolescents.     

Challenging body weight: evidence from a community-based intervention on weight,behaviour and motivation

The objective of this study was to examine the effectiveness of a 12 week weight loss intervention within a commercial fitness centre on body weight, moderate to vigorous physical activity (MVPA), dietary intake, and behavioural regulations for exercise and healthy eating. Using a quasi-experimental design, the intervention group received weekly coaching sessions and bi-weekly seminars designed to increase MVPA and improve dietary intake. Outcome variables were assessed at three time points over a six month period. Results showed a significant interaction for body weight (p = .04) and dietary changes (p < .05) following the weight loss challenge but were not maintained across the six month period. Changes in behavioural regulations favoured the intervention condition. Results imply that a 12 week weight loss challenge within a commercial fitness centre may be effective at prompting short-term weight loss and support the internalization of behavioural regulations specific to healthy eating and exercise.     

Determinants of physical activity among patients with type 2 diabetes: the role of perceived autonomy support,autonomous motivation and self-care competence

Based on self-determination theory (SDT), this study investigated, whether the three central SDT variables (perceived autonomy support, autonomous motivation and self-care competence), were associated with engagement in physical activity (PA) among patients with type 2 diabetes when the effect of a wide variety of other important life-context factors (perceived health, medication, duration of diabetes, mental health, stress and social support) was controlled for. Patients from five municipalities in Finland with registry-based entitlement to a special reimbursement for medicines used in the treatment of type 2 diabetes (n = 2866, mean age 63 years, 56% men) participated in this mail survey in 2011. Of all measured explanatory factors, autonomous motivation was most strongly associated with engagement in PA. Autonomous motivation mediated the effect of perceived autonomy support on patients’ PA. Thus, perceived autonomy support (from one’s physician) was associated with the patient’s PA through autonomous motivation. This result is in line with SDT. Interventions for improved diabetes care should concentrate on supporting patients’ autonomous motivation for PA. Internalizing the importance of good self-care seems to give sufficient energy to maintain a physically active lifestyle.     

Computerized tabletop games as a form of a video game training for old-old

This research aimed at investigating the utility of a computerized version of a cognitively stimulating activity as a video game intervention for elderly. The study focused on the effect of a 6-week extensive practice intervention on aspects of cognitive functioning (vigilance, working memory (WM), inhibition, reasoning) of old-old participants (N = 29), randomly assigned to trained or active control group. The difference between groups was in the content of the extended video game practice – cognitively complex card game for trained and computerized version of a simple dice-game of chance for control participants. A pretest, posttest and a 4-month follow-up measurement was conducted. Results revealed improvements in both groups, except for improved reasoning found only in trained participants. These results suggest that: (1) improvements are dependent on the complexity of the program, (2) cognitively stimulating activity are a valid training procedure for old-old, (3) novelty of computer use is an important factor in determining training efficacy.     

Different perspectives on measuring lifestyle engagement: a comparison of activity measures and their relation with cognitive performance in older adults

Given the limitations associated with assessing activity engagement via the frequency of specific activities, it may be valuable to consider the characteristics of an activity. The method of asking individuals to report the amount of time spent engaging in activities that have certain characteristics was compared to a specific activity questionnaire, and a daily diary regarding their relation to cognitive functioning. Participants 60–90 years old (n = 187) completed the activity measurement methods and a series of cognitive tasks. Structural equation models showed that all three activity methods were predictive of adults’ cognitive performance, but no measure predicted all outcomes. Each activity measure provided unique information. Notably, the combination of the measurement types predicted more variance than any of the measures alone. There is additional power to predict cognition when multiple activity measurement methods are used, and daily assessment can be a valuable tool to augment traditional specific activity questionnaires.     

Socioeconomic status as a moderator between social cognitions and physical activity: Systematic review and meta-analysis based on the Theory of Planned Behavior

BackgroundHealth inequalities are to a substantial degree due to socioeconomic status (SES) related differences in health behaviors such as physical activity. However, little is known about the role SES plays in the self-regulation of physical activity.PurposeThis systematic review with meta-analysis examines whether a comprehensive set of indicators of SES (income, education, occupational status) impacts on the behavioral self-regulation by moderating the relationships between social cognitions in the Theory of Planned Behavior (TPB) and physical activity.MethodsA systematic literature search identified 99 studies from 88 articles that provided information on sample SES and correlations between TPB variables and physical activity. Random-effects meta-analyses were used to pool correlations corrected for sampling and measurement error. Random-effects meta-regression was used to examine moderating effects of study-level SES on these correlations.ResultsEducation moderated the relationship between intentions and physical activity, such that studies with better educated samples reported stronger intention-physical activity relationships.ConclusionsThese results suggest that education might play a major role in the self-regulation of physical activity, with better educated samples more likely to translate intentions into behavior. This can both help to explain heterogeneity in the relation between intentions and physical activity as well as support the development of more effective interventions targeting intentions and physical activity.     

Efficacy of guided self-help behavioural activation and physical activity for depression: a randomized controlled trial

Behavioural activation and physical activity have received empirical support that highlight their efficacy in reducing depression. Even though both behavioural activation and physical activity share the common goal of reactivating the individual, limited research has directly compared these interventions, and more research is required to evaluate their efficacy when offered in low-intensity formats. The present study involves a randomized controlled clinical trial comparing the efficacy of two guided self-help interventions for the treatment of depression: behavioural activation and physical activity. Fifty-nine participants presenting mild-to-moderate symptoms of depression were randomized either to a behavioural activation intervention (n = 20), a physical activity intervention (n = 19) or a wait-list control group (n = 20). All participants completed symptom measure pre-, mid- and post-intervention, as well as at a two-month follow-up. Mixed-model analyses of variance revealed that both interventions were significantly more efficacious in reducing depressive symptoms in comparison with the control group. Physical activity involved significantly less time-investment compared to the behavioural activation condition (less than half the amount of time). These results indicate that physical activity and behavioural activation both effectively reduce depressive symptoms and are favourably applicable in low-intensity formats. Implications of these results and avenues for future research are discussed.     

The two sides of goal intentions: Intention self-concordance and intention strength as predictors of physical activity

Objective: The present research introduces an extended conceptualisation of self-concordance, which is considered an attribute not only of goals, but also of goal intentions. Based on a corresponding operationalisation, we investigate the interplay of both intention strength and intention self-concordance in the prediction of physical activity.

Design: Data were taken from a longitudinal study of 134 obese people who were asked to fill out a questionnaire three times every six months.

Main measures: Physical activity and intention self-concordance were measured by validated scales. Intentions strength was assessed by an item typically employed in the extant literature.

Results: Logistic regression analyses and path analyses showed both intention strength and self-concordance to be significant predictors of changes in physical activity over time. Additional analyses found self-efficacy to be a significant predictor of intention strength and self-concordance; for outcome expectations this was not the case.

Conclusions: Findings support the idea that intention strength and self-concordance are two critical facets of a goal intention that need to be considered in the prediction of physical activity participation. Whereas intention strength refers to the degree of determination with which a goal intention is adopted, self-concordance rather captures the quality of this intention.