Scott B Going

Abstract:

This study compared CETP and LCAT activities in post-menopausal women not undergoing HRT nor doing exercise (CNT group), those undergoing HRT and those doing aerobic endurance exercise 3 days/wk, one h/day during a 6 month period (EXE group). Participants were 55-70 years old (10 CNT, 12 HRT and 10 EXE). Values for plasma total and HDL cholesterol and CETP and LCAT activities were calculated from the mean of two samples taken at different times to adjust for variability within subjects. There was a strong correlation between plasma total and HDL cholesterol of samples measured day 1 versus day 2 which was taken 7-14 days later (r = 0.86 and 0.91, respectively, P 0.001) Plasma total and HDL cholesterol were not different among groups. Values were 209 ± 24, 211 ± 38 and 209 ± 22 for total and 53 ± 14, 50 ± 9 and 57 ± 16 for HDL in the CNT, HRT and EXE groups respectively. Plasma LCAT activity expressed as μg/ml-h was higher in the EXE group (26.9 ± 7.4) compared to CNT group (21.2 ± 4.6) (P 0.05) and the HRT group had an intermediate value (25.3 ± 7.0) not different from either group. CETP activities did not differ among groups (14.6 ± 4.5, 15.5 ± 3.1 and 13.8 ± 5.2 μg/ml-h). These studies suggest that although differences were not observed on plasma HDL cholesterol values among groups, exercise favors cholesterol esterification in HDL through LCAT activity improving reverse cholesterol transport in postmenopausal women.

Abstract:

In a multi-site study focusing on a complex intervention, impact and outcome data must be linked to program activities to explain any changes that occur in measurements during the program. Process evaluation systematically documents activities within both intervention and control environments. In Pathways, instruments were developed to document exposure to and implementation of the intervention components and the alternative intervention at control schools, as well as community-level conditions. A combination of quantitative and qualitative methods were used to collect data for the process evaluation. These methods include indepth (structured and open-ended) interviews, observations, structured check lists, and questionnaires. These instruments were pilot tested during the fall of 1995. The instruments provided rich data which, triangulated from qualitative and quantitative methods, were instructive and revealing as to the strengths and weaknesses of the implementation of each of the components.

PMID: 12634293;Abstract:

Background. Menopause is associated with decreases in lean mass and increases in fat mass. Serum hormone levels and hormone replacement therapy (HRT) may modify the effects of exercise training on body composition in postmenopausal women. Methods. We assessed the changes in total body and regional lean soft tissue and fat mass (using dual-energy x-ray absorptiometry) in 94 sedentary postmenopausal women, aged 40-65 years, after 12 months of resistance and weight-bearing aerobic exercise training. Women currently on oral HRT (n = 39) and not on HRT (n = 55) were randomized within groups to exercise and no exercise, resulting in four groups: exercise + HRT (n = 20), HRT (n = 22), exercise (n = 24), and control (n = 28). Fasting blood samples were measured for resting serum total levels of estrone, estradiol, cortisol, androstenedione, growth hormone, and insulin-like growth factor 1 at baseline and 12 months. Results. We found significant effects of exercise on increases in total body, arm, and leg lean soft tissue mass, and decreases in leg fat mass and percentage of body fat. There were no interaction effects of exercise and HRT on the changes in muscle strength and body composition. No significant changes in total hormone levels were found after 12 months. Conclusions. Exercise training resulted in significant beneficial changes in lean soft tissue and fat mass in early postmenopausal women. These changes in body composition were neither influenced by prolonged HRT use nor accompanied by changes in total levels of the hormones determined in this study.

PMID: 23471926;Abstract:

Background: Childhood obesity is a growing epidemic in family medicine with few clinical treatment options. We implemented and evaluated a group office-visit intervention by family physicians for overweight children and their parents, emphasizing nutrition and physical activity within a resiliency psychosocial model. Methods: The intervention lasted for 3 months, with half of the children crossing over to intervention after 6 months in the study. Participants included 35 children who met eligibility criteria of being in third through fifth grades and having a body mass index (BMI) above the 85th percentile. The 3-month, 12-session intervention, "Choices," included topics on nutrition, physical activity, and resiliency. The sessions were developed for delivery by a family physician and a nutritionist who received training in positive psychology and resilience skills. Main outcome measures were BMI z scores for age and sex and z scores for weight by age and sex, as well as qualitative interviews to understand individual and family processes. Results: The intervention resulted in a significant effect on one primary outcome, BMI z score (- 0.138 per 9 months [P = .017]) and a trend toward significance on the weight for age z score (- 0.87 per 9 months [P = .09]). The net shift of activity from the low metabolic equivalents (METs) to the high METs had an intervention effect of 2.84 METs (P = .037). Families reported lasting changes in behaviors and attitudes. Discussion: The innovative approach used in this study demonstrated modest efficacy in reducing BMI z score, changing physical activity levels, and possibly shifting family dynamics.