Nutrition of the elderly: Interactions with physical activity

Elderly subjects have a lower energy requirement compared to young adults as a result of lower physical activity and a lower basal metabolic rate. A lower energy intake in the elderly could lead to undesirable low intakes of essential nutrients. The reduction of the energy turnover is caused by, or a consequence of, a decrease in active cell mass. Thus, the effect of exercise training on habitual activity across age ranges, and age-related changes in body composition in relation to habitual activity level, are investigated here. The focus is on data on physical activity and body composition obtained with doubly labelled water. The results suggest that exercise training does not affect energy requirement in the elderly and the age-related decrease in fat-free mass is not delayed in subjects with a relatively high habitual activity level. Beneficial effects of exercise training in the elderly are endurance, flexibility, range of motion and balance control, all contributing to a delay in the age-induced impairment of personal mobility. Energy intake will inevitably go down as a result of a reduction of the energy requirement. Thus, the nutrition of elderly subjects needs more attention with regard to the essential nutrients than the nutrition of younger adults.     

Effects of multicomponent training on functional fitness in older adults

The purpose of this study was to evaluate the effects of a 9-week supervised multicomponent exercise program on functional fitness and body composition in independent older adults. Forty-two adults age 60-86 years were randomly assigned to an exercise or a control group and were evaluated before and after training. The training program consisted of 3 sessions of walking, strengthening, and flexibility exercises per week. The multicomponent training program resulted in significant (p < .005) improvements on the chair stand, arm curl, 6-min walk, and up-and-go tests. The findings of this study indicate that a 9-week training program increased upper and lower body strength, aerobic endurance, and agility/dynamic balance in older adults. The most affected components of functional fitness were lower body strength and aerobic endurance. There was no effect of the 9-week training on body composition.     

Best practices for physical activity programs and behavior counseling in older adult populations

Physical activity offers one of the greatest opportunities for people to extend years of active independent life and reduce functional limitations. The article identifies key practices for promoting physical activity in older adults, with a focus on those with chronic disease or low fitness and those with low levels of physical activity. Key practices identified: (a) A multidimensional activity program that includes endurance, strength, balance, and flexibility training is optimal for health and functional benefits; (b) principles of behavior change including social support, self-efficacy, active choices, health contracts, assurances of safety, and positive reinforcement enhance adherence; (c) manage risk by beginning at low intensity but gradually increasing to moderate physical activity, which has a better risk:benefit ratio and should be the goal for older adults; (d) an emergency procedure plan is prudent for community-based programs; and (e) monitoring aerobic intensity is important for progression and motivation. Selected content review of physical activity programming from major organizations and institutions is provided.     

Best practices for physical activity programs and behavior counseling in older adult populations

Physical activity offers one of the greatest opportunities for people to extend years of active independent life and reduce functional limitations. The purpose of this paper is to identify key practices for promoting physical activity in older adults, with a focus on older adults with chronic disease or low fitness and those with low levels of physical activity. Key practices identified in promotion activity in older adults include: (1) a multidimensional activity program that includes endurance, strength, balance, and flexibility training is optimal for health and functional benefits; (2) principles of behavior change, including social support, self-efficacy, active choices, health contracts, assurances of safety, and positive reinforcement, enhance adherence; (3) management of risk by beginning at low intensity but gradually increasing to moderate physical activity which has a better risk/benefit ratio should be the goal for older adults; (4) an emergency procedure plan is prudent for community-based programs; and (5) monitoring aerobic intensity is important for progression and for motivation. Selected content reviews of physical activity programming from major organizations and institutions are provided. Regular participation in physical activity is one of the most effective ways for older adults, including those with disabilities, to help prevent chronic disease, promote independence, and increase quality of life in old age.Publication Note All National Blueprint Publications are in the public domain and can be freely reproduced without copyright. This article has been previously published in Medicine Science and Sports and Exercise and the Journal of Aging and Physical Activity. Individuals or organizations who wish to publish National Blueprint articles should contact the National Blueprint Office for permission.     

Endurance training for cancer patients during and shortly after completion of the anti-cancer treatment

Cardiorespiratory fitness is one of the most important indicators of health and improves length of life. The attention and acceptance for endurance training in patients with several cancer diagnoses increased during the last decade. This review highlight’s the effect of endurance training in cancer patients by summarizing exemplary randomized clinical trials and systematic reviews both within the acute hospital treatment context, as in a rehabilitation setting. To date, most studies focus on endurance training in patient groups with moderate to good prognosis. The studies within these patient groups evaluate the endurance training in cancer patients using a moderate training intensity between 50 and 75 % of the VO₂ peak with an exercise time varying from 20 min (five times per week) in hospital up to 45 min (two to three times per week) in an ambulatory setting. Recently, the American College of Sports Medicine indicated that cancer survivors should follow the Physical Activity Guidelines for Americans, which represents ≥150 min per week of moderate intensity, ≥75 min per week of vigorous intensity aerobic exercise, or an equivalent combination of moderate and vigorous intensity aerobic exercises. To date, fewer studies evaluate the effects of endurance training in a palliative setting to maintain physical function of the patient. Future studies should investigate the effect of endurance training by evaluating different types of intensity training (moderate vs. high intensity training), the use of high-tech devices to improve physical activity, and to evaluate the effect of endurance training in patients with a palliative intention.     

Type of activity and fitness benefits as moderators of the effect of physical activity on affect in advanced age: a review

This study aimed to review studies exploring the effect of physical activity on affect in advanced age with a special focus on the moderating role of fitness improvement and mode of exercise and to examine those studies in relation to the potential mechanisms for explaining the physical activity–affect relationship. Studies were assembled through a computer search of online psychological, medical, and exercise science databases. Randomized controlled studies having as their purpose the examination of physical activity effects on affect, with a mean sample population age of at least 50 years, were included. Thirty-nine studies were collated and divided into three groups: those applying aerobic activity, those applying strength training, and those applying non-specific physical activity. The main finding was that aerobic exercise and aerobic fitness do not moderate the effect of physical activity on affect. While fewer than 50% of the aerobic studies reporting fitness improvement also reported improvement in affect, over 50% of the strength training studies and of the non-specific exercise studies reported improvement in affect. Theories with a physiological orientation claiming that aerobic fitness is the mediator between physical activity and affect are not supported, whereas theories with a psychological orientation maintaining that alterations in affect are not dependent on physiological alterations do receive support. It is argued that the differentiation between physiologically and psychologically oriented theories is arbitrary. It is recommended that the relationship between physical activity and affect be explored further, embracing a psychophysiological perspective in which the psychological and physiological perspectives are complementary.     

Level of physical activity and anthropometric characteristics in old age—results from a national health survey

Advanced age is associated with degenerative changes in body composition. There is evidence suggesting that changes may vary upon differences in lifestyle, environment, or gender. Physical activity engagement is considered an important component of lifestyle definition. There are suggestions that engaging in physical activity might alleviate degenerative body compositional changes. The objective is to assess the relationship between adherence to recommended guidelines of physical activity and anthropometric parameters in Israeli older adults. Anthropometric measures, including height, weight, and waist circumference, were taken, and BMI was calculated, from a random sample of 1,663 elderly adults (799 men and 864 women), aged 74.31 (±6.05) years old. Participants reported their physical activity habits and, based on official guidelines recommendations, they were divided into sufficiently active, insufficiently active, and inactive groups. One-way ANOVA (level of physical activity) for both genders was conducted for each anthropometric variable. In both genders, an association between level of physical activity and weight, waist circumference, and BMI was found, with lower values among the sufficiently active. In addition, a relationship between level of physical activity and height was indicated among women, implying that the more active women were taller than the less active. In addition to the already known health benefits of physical activity in old age, it is possible that adherence to recommended guidelines of physical activity is associated with favorable anthropometric characteristics.     

The effect of three different exercise training modalities on cognitive and physical function in a healthy older population

Background

Older adults are encouraged to participate in regular physical activity to counter the age-related declines in physical and cognitive health. Literature on the effect of different exercise training modalities (aerobic vs resistance) on these health-related outcomes is not only sparse, but results are inconsistent. In general, it is believed that exercise has a positive effect on executive cognitive function, possibly because of the physiological adaptations through increases in fitness. Indications are that high-intensity interval training is a potent stimulus to improve cardiovascular fitness, even in older adults; however, its effect on cognitive function has not been studied before.Therefore, the purpose of this study was to compare the effects of resistance training, high-intensity aerobic interval training and moderate continuous aerobic training on the cognitive and physical functioning of healthy older adults.

Methods

Sixty-seven inactive individuals (55 to 75 years) were randomly assigned to a resistance training (RT) group (n = 22), high-intensity aerobic interval training (HIIT) group (n = 13), moderate continuous aerobic training (MCT) group (n = 13) and a control (CON) group (n = 19) for a period of 16 weeks. Cognitive function was assessed with a Stroop task and physical function with the Timed-Up-and-Go (TUG) and submaximal Bruce treadmill tests.

Results

No significant GROUP x TIME interaction was found for Stroop reaction time (P > .05). The HIIT group showed the greatest practical significant improvement in reaction time on the information processing task, i.e. Stroop Neutral (ES = 1.11). MCT group participants had very large practical significant improvements in reaction time on the executive cognitive tasks, i.e. Stroop Incongruent and Interference (ES = 1.28 and 1.31, respectively). The HIIT group showed the largest practically significant increase in measures of physical function, i.e. walking endurance (ES = 0.91) and functional mobility (ES = 0.36).

Conclusions

MCT and RT proved to be superior to HIIT for the enhancement of older individuals’ executive cognitive function; whereas HIIT were most beneficial for improvement in information processing speed. HIIT also induced the largest gains in physical function.

     

Physical activity, genes, and lifetime predisposition to chronic disease

This mini-review summarizes the main associations between physical activity and chronic diseases and discusses the basic concepts related to the role of genetic factors in studies evaluating the effects of physical activity/exercise therapy on chronic disease prevention/treatment during the life course. Many observational cohort studies have shown that high physical activity during young adulthood or middle age is associated with reduced later life morbidity, mobility limitations and mortality. Physical activity or exercise therapy has a positive effect on health via many disease-specific mechanisms. The most consistent finding of the various randomized controlled studies conducted to date is that aerobic/functional capacity and/or muscle strength can be improved by exercise training among patients with different chronic diseases. Genes are known to play a role in chronic disease predisposition and to contribute to physical fitness levels, physical activity participation and ageing. Physical fitness, physical activity and health outcomes may be partly due to underlying genetic factors that have a favourable effect on all these traits (genetic pleiotropy). This means that in observational studies, the relationship between baseline activity and the later occurrence of diseases may not be interpreted entirely as causal. Increased knowledge on the role of nuclear genome, mitochondrial genome, epigenetics, telomeres and regulation of gene expression will increase our understanding of their relationships with physical activity and morbidity.     

Exercise intervention designed to improve strength and dynamic balance among community-dwelling older adults

Loss of balance and falling are critical concerns for older adults. Physical activity can improve balance and decrease the risk of falling. The purpose of this study was to evaluate a simple, low-cost exercise program for community-dwelling older adults. Sixteen senior adults were evaluated using the Senior Fitness Test for measures of functional strength, aerobic endurance, dynamic balance and agility, and flexibility. In addition, measures of height, weight, resting blood pressure, blood lipids, and cognitive function were obtained. Participants then attended a 10-week exercise class including stretching, strengthening, and balance-training exercises. At the completion of the program, significant improvements were observed in tests measuring dynamic balance and agility, lower and upper extremity strength, and upper extremity flexibility. The results indicate that exercise programs such as this are an effective, low-cost solution to improving health and factors that affect falling risk among older adults.     

Oxidative stress and antioxidant defense system in healthy,elderly men: relationship to physical activity

The aim of the present study was to compare selected markers of oxidative stress and the antioxidant system between groups of men aged 65 or more, differentiated by their level of physical activity. Thirty-one community-dwelling healthy, elderly men (mean age 73.4 ± 6.1 years) with a good nutritional status participated in the study. The Caltrac accelerometer was used to estimate energy expenditure related to physical activity. Subjects were divided into two groups according to the criteria proposed by Bauman: less active (< 1600 kcal/week) and more active (> 1600 kcal/week). In all the men, plasma total antioxidant status (TAS), thiobarbituric acid reactive substances (TBARS) concentrations and hydrogen peroxide (H₂O₂) levels were determined. The reduced glutathione (GSH) content and glutathione peroxidase (GPx) activity in hemolyzed red blood cells were also measured. There were no significant differences in TAS, H₂O₂ concentrations and the activity of GPx between less and more active men. In the group of more active subjects, plasma levels of GSH were higher, while TBARS concentrations were lower compared with the group of less active men (p < 0.05). Negative correlation between GSH and TBARS levels was observed (r = -0.71; p < 0.01), and GSH concentrations positively correlated with level of physical activity (r = 0.63; p < 0.05). The results indicate that habitual physical activity can favorably affect antioxidant potential and prevent lipid peroxidation in healthy, elderly men.     

Effects of Pilates method in physical fitness on older adults. A systematic review

Pilates method is employed for physical and mental conditioning. Elderly people could be benefited from a patterned and regulated conditioning work based on Pilates method. We performed a systematic review to assess the evidence on the effects of Pilates method in physical fitness on older adults. Our search included the following databases: MEDLINE-PubMed, Scopus and CINAHL Plus with Full Text via EBSCO and SPORTDiscus databases (up to April 2014). A summary of the results was performed using a best evidence synthesis and was reported according to the systematic review method proposed by Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodology quality of selected studies. Seventeen experimental studies were included in this review. Fourteen were randomized controlled trials (RCT) and three clinical controlled trials (CCT). Quality scores according to PEDro indicate low quality of the included studies (range 1–6, mean 3.8?±?1.2). The most studied components related to physical fitness were neuromotor fitness (n?=?11), muscle strength (n?=?8), cardiorespiratory endurance (n?=?4), body composition (n?=?4) and flexibility (n?=?4). Results indicate that Pilates method seems to present positive effects in neuromotor fitness, especially in static and dynamic balance. Related to the other components of physical fitness (cardiorespiratory endurance, muscle strength, body composition and flexibility), contradictory results were observed. The Pilates method indicates to be an appropriate exercise modality in order to improve balance on older adults. Nevertheless, more intervention research is needed to build a solid knowledge base about the health benefits of Pilates method on older people, especially regarding the other components of physical fitness.     

Physical and psychological outcomes of a supported physical activity program for older carers

This study evaluated health benefits of a supported physical activity program for 116 older carers (mean age 64.4 [SD = 7.9], 85% women). Participants undertook a 6-month center-based physical activity program (strength training, yoga, or Tai Chi). Eighty-eight participants (76%) completed the program. Multivariate repeated-measures ANOVA identified overall significant improvement postintervention (p = .004). Univariate analyses revealed significant improvements for balance, strength, gait endurance, depression, and SF-36 (physical component; p < .05). There was no change in the Zarit Carer Burden Scale (p > .05). Change in performance scores did not differ significantly between those with higher and lower attendance at classes, although there was significantly greater improvement in gait endurance and balance (p < .05) in those attending classes run twice weekly than in those attending once-weekly classes. In conclusion, a carer physical activity program, providing additional carer support to facilitate participation, can achieve high levels of involvement by carers and significant health benefits.     

Rapid repetitive passive movement promotes knee proprioception in the elderly

Joint proprioception plays an important role in the generation of coordinated movements, maintenance of normal body posture, body conditioning, motor learning, and relearning. Previous studies have demonstrated that proprioceptive function of the elderly can be enhanced via specific exercises; however, not all of the elderly can actively and safely participate in physical activities. The purpose of this study was to evaluate the effects of rapid repetitive passive movement in an average velocity of 90°/s on knee proprioception in the elderly. A repeated-measure design was employed. Two age groups (12 young/12 elderly) were intervened with repetitive passive movements of 60 repetitions to the knee joint via two machines (isokinetic dynamometer/self-designed machine) in separate days. Changes in proprioception were evaluated via joint active repositioning and kinesthesia, both before and after the intervention. The results revealed that all subjects demonstrated good test–retest reliabilities on proprioceptive measurements. For the active repositioning and kinesthesia, significant statistical main effects were found for group and time, but not for machine. No statistical interactions were revealed. Despite of age-related proprioceptive declines, elderly subjects could benefit from rapid repetitive passive movements. This indicates that repetitive passive movement may be an alternative to physical activity for those who are home-bound, in a sedentary lifestyle, or with other health conditions that may limit their abilities to actively maintain or strengthen joint proprioception.     

Impact of recreational physical activity on bone mineral density in middle-aged men

Physical activity is known to exert beneficial effects on general health status of young, adult and elderly populations. Exercise (aside from genetic, hormonal, nutritional and pathological factors) also influences bone mineral density (BMD). Unfortunately, the association between physical exercise and BMD in adult population is controversial. Our aim was to assess relations between recreational physical activity and BMD in middle-aged men. We performed densitometry and hormonal measurements (total testosterone, free testosterone, dehydroepiandrosterone sulfate, estradiol) in a homogenous group of 38 subjects. Among them, we distinguished 22 who had not engaged in any physical activity, and 16 who had recreationally exercised for about 10 years. Both groups did not differ in regard to hormonal status. Similarly, densitometry did not reveal any statistically significant differences in BMD between both groups of men. Upon our observation, we can hypothesize that recreational physical activity does not affect bone mineral density in middle-aged men.     

Desertification: measuring population decline in rural Ireland

"This paper addresses the issue of rural population decline in the Republic of Ireland during the past two decades having regard to size of place and estimated net migration for key age groups. The analysis is pursued at the level of some 160 Rural Districts. The results of the analysis confirm expected relationships between peripheral locations, small population size and a depletion of the young working age groups. The method used, however, permits the links between size of place, population change and the composition of that change to be identified with some precision."     

Study of the association between gait variability and physical activity

Background

Gait variability can be considered an indirect measure of gait stability, in particular regarding temporal or spatial variability assessment. Physical activity, such as walking, is advised for the elderly and can be improved by gait stability. The aim of this study was to investigate the associations between gait stability and physical activity in women of different age ranges.

Methods

Forty-two healthy women of different age ranges (18-40 yrs. and 65-75 yrs.) were recruited in the study. To assess physical activity, the subjects wore a multi-sensor activity monitor for a whole week, inferring the time spent in moderate to vigorous physical activity (MVPA). MVPA were analysed in bouts of at least 10 subsequent minutes (MVPA_bouts) and in overall minutes (MVPA_tot). A kinematic analysis was performed with an optoelectronic system to calculate gait variability - expressed as standard deviation (SD) and coefficient of variability (CV) of step width, stride length, stance and swing time (during treadmill walking at different speeds).

Results

Elderly women, with high walking speed (5 km/h), and moderate step width variability (CV = 8–27%), met the recommended levels of physical activity (MVPA_tot and MVPA_bouts). Furthermore, gait variability, adjusted for age and number of falls, was significantly and negatively associated with MVPA_tot only at 3.5 km/h, and with MVPA_bouts only at 4 km/h.

Conclusions

In a population of healthy elderly women, gait variability was significantly and negatively associated with the level of physical activity. Healthy elderly women, with moderate gait variability (step width variability), and high preferred walking speed, seem to be able to meet the recommended levels of physical activity.

     

Body Image Development and Sexual Satisfaction: A Prospective Study From Adolescence to Adulthood

The aim of the current study was to explore whether developmental trajectories of body satisfaction from adolescence to young adulthood predicted measures of sexual satisfaction in young adulthood, even when controlling for important covariates such as gender, weight development, relationship status, mental health, and frequency of sexual intercourse and masturbation. Data were collected from a population-based prospective cohort of Norwegian adolescents (n = 2,587) over a period of 13 years in four waves (1992, 1994, 1999, and 2005; mean age = 14.9 in 1992, 57.3% women). Latent growth curves were estimated for body satisfaction and body mass index (BMI). Men reported higher sexual satisfaction, sexual activity, baseline body satisfaction, and BMI than women. The developmental trajectories revealed a slight increase in body satisfaction and BMI from adolescence to young adulthood in both genders. Moreover, structural equation models showed that baseline body satisfaction in both genders predicted sexual satisfaction as a young adult, independent of relationship status and frequency of sexual activity. Neither the development of BMI nor of body satisfaction predicted sexual satisfaction. The results elucidate the vital role of body satisfaction in sexual satisfaction in adults and the importance of addressing body dissatisfaction in childhood.     

Affective and self-efficacy responses to acute aerobic exercise in sedentary older and younger adults

This study examined the psychological responses to an acute bout of aerobic exercise in sedentary older and younger adults. Eighteen young (mean age 24 years) and 15 older adults (mean age 64 years) completed a 20-min bout of stationary cycling at 65% of VO2peak. Affective responses were assessed before, during, and immediately after exercise. Participants'exercise self-efficacy beliefs were assessed before and immediately after exercise. Both groups reported reduced pleasant feeling states and self-efficacy and increased physical exhaustion in response to acute exercise. Older adults also demonstrated a significant decrease in revitalization during and after cycling. Correlation analyses revealed that self-efficacy was related to feelings of fatigue during exercise and postexercise feelings of energy and fatigue. Both groups reported negative shifts in affect and self-efficacy during and 5 min after cycling.Acute affective and self-efficacy responses might influence one's motivation to adopt and maintain regular physical activity. The relationship between these acute responses and physical activity behavior across the life span warrants future inquiry.