Association of Energy Intake and Energy Balance with Postmenopausal Breast Cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Nonprescribed physical activity energy expenditure is maintained with structured exercise and implicates a compensatory increase in energy intake. The association between burnout and physical illness in the general population--results from the Finnish Health 2000 Study. Breaking up Sedentary Time in Overweight/Obese Adults on Work Days and Non-Work Days: Results from a Feasibility Study Total energy intake, adolescent discretionary behaviors and the energy gap A decrease in physical activity affects appetite, energy, and nutrient balance in lean men feeding ad libitum. Exercise and cognitive function: a randomized controlled trial examining acute exercise and free-living physical activity and sedentary effects. Burnout and Risk of Type 2 Diabetes: A Prospective Study of Apparently Healthy Employed Persons Evaluation of the Web-based computer-tailored FATaintPHAT intervention to promote energy balance among adolescents: results from a school cluster randomized trial. Aerobic exercise training and burnout: a pilot study with male participants suffering from burnout Relationships of physical activity with dietary behaviors among adults. A prospective study of the association between obesity and burnout among apparently healthy men and women. Physical activity, sedentary behavior, and the risk of colon and rectal cancer in the NIH-AARP Diet and Health Study Physical activity, sedentary behavior and total wellness changes among sedentary adults: a 4-week randomized controlled trial Six-month physical activity and fitness changes in Project Active, a randomized trial. Energy expenditure of nonexercise activity. Physical activity, sedentary behavior, and cause-specific mortality in black and white adults in the Southern Community Cohort Study.
Energy restriction remains one of the most effective ways known to prevent breast cancer in animal models . However , energy intake has not been consistently associated with risk of breast cancer in humans . In a prospect i ve study , we assessed whether energy intake , body size , and physical activity each independently influence  breast cancer risk in postmenopausal women and estimated the joint effect of combinations of these individual factors . As part of the Prostate , Lung , Colorectal , and Ovarian Cancer Screening Trial , 38,660 women , ages 55 to 74 years and recruited from 10 centers in the United States during 1993 to 2001 , were r and omized to the screening arm of the trial . At baseline , the women completed a self-administered question naire , including a food frequency question naire . During follow-up from 1993 to 2003 , 764 incident breast cancer cases were ascertained . Women in the highest quartile of energy intake ( ≥2,084 kcal/d ) compared with those in the lowest quartile ( < 1,316 kcal/d ) had a significantly increased risk for breast cancer [ multivariate relative risk ( RR ) , 1.25 ; 95 % confidence interval ( 95 % CI ) , 1.02 - 1.53 ; Ptrend continuous = 0.03 ] . Current body mass index ( BMI ) was also positively and significantly associated with risk ( multivariate RR comparing > 30 kg/m2 with < 22.5 kg/m2 , 1.35 ; 95 % CI , 1.06 - 1.70 ; Ptrend = 0.01 ) . Women with ≥4 hours/wk of vigorous recreational physical activity had a significantly reduced risk of breast cancer compared with those who reported no recreational physical activity ( multivariate RR , 0.78 ; 95 % CI , 0.60 - 0.99 ; Ptrend = 0.15 ) . None of these associations with individual energy balance measures was substantially confounded by the other two measures . When we estimated the joint effect of all three variables , women with the most unfavorable energy balance ( the highest energy intake , highest BMI , and least physical activity ) had twice the risk ( RR , 2.10 ; 95 % CI , 1.27 - 3.45 ) of women with the most favorable energy balance ( the lowest energy intake , lowest BMI , and most physical activity ) . Although our estimates of absolute energy intake , based on a food frequency question naire , are imperfect , these results suggest that energy intake , in addition to BMI and physical activity may be independently associated with breast cancer risk . In addition , these three aspects of energy balance may act jointly in determining  breast cancer risk . ( Cancer Epidemiol Prev 2006;15(2):334–41 BACKGROUND Exercise interventions elicit only modest weight loss , which might reflect a compensatory reduction in nonprescribed physical activity energy expenditure ( PAEE ) . OBJECTIVE The objective was to investigate whether there is a reduction in nonprescribed PAEE as a result of participation in a 6-mo structured exercise intervention in middle-aged men . DESIGN Sedentary male participants [ age : 54 ± 5 y ; body mass index ( in kg/m² ) : 28 ± 3 ] were r and omly assigned to a 6-mo progressive exercise ( EX ) or control ( CON ) group . Energy expenditure during structured exercise ( prescribed PAEE ) and nonprescribed PAEE were determined with the use of synchronized accelerometry and heart rate before the intervention , during the intervention ( 2 , 9 , and 18 wk ) , and within a 2-wk period of detraining after the intervention . RESULTS Structured prescribed exercise increased total PAEE and had no detrimental effect on nonprescribed PAEE . Indeed , there was a trend for greater nonprescribed PAEE in the EX group ( P = 0.09 ) . Weight loss in the EX group ( -1.8 ± 2.2 kg compared with + 0.2 ± 2.2 kg in the CON group , P < 0.02 ) reflected only ≈40 % of the 300 - 373 kcal/kg body mass potential energy deficit from prescribed exercise . Serum leptin concentration decreased by 24 % in the EX group ( compared with 3 % in the CON group , P < 0.03 ) , and we estimate that this was accompanied by a compensatory increase in energy intake of ≈100 kcal/d . CONCLUSIONS The adoption of regular structured exercise in previously sedentary , middle-aged , and overweight men does not result in a negative compensatory reduction in nonprescribed physical activity . The less-than-predicted weight loss is likely to reflect a compensatory increase in energy intake in response to a perceived state of relative energy insufficiency OBJECTIVE The association between burnout and physical diseases has been studied very little . The purpose of this study was to examine the relationship between burnout and physical illness in a representative nationwide population health study . METHODS As a part of the " Health 2000 Study " in Finl and , 3368 employees aged 30 - 64 years were studied .  Burnout was assessed with the  Maslach Burnout Inventory-General Survey . Physical diseases were diagnosed in a comprehensive health examination by research physicians . RESULTS Physical illness was more common among subjects with burnout than others ( 64 % vs. 54 % , P<.0001 ) , and the prevalence of diseases increased with the severity of burnout ( P<.0001 ) . Burnout was an important correlate of cardiovascular diseases among men ( OR=1.35 ; 95 % CI , 1.13 - 1.61 ) and musculoskeletal disorders among women ( OR=1.22 , 95 % CI , 1.07 - 1.38 ) when adjusted for age , marital status , education , socioeconomic status , physical strenuousness of work , smoking , physical activity , alcohol consumption , body mass index , and depressive symptoms . The prevalence of musculoskeletal disorders and cardiovascular diseases increased with the severity of all three dimensions of burnout , that is , exhaustion ( P<.0001 and P<.001 , respectively ) , cynicism ( P=.0001 and P<.001 , respectively ) , and lack of professional efficacy ( P<.01 and P<.0001 , respectively ) . CONCLUSIONS Burnout is associated with musculoskeletal diseases among women and with cardiovascular diseases among men . These associations are not explained by sociodemographic factors , health behavior , or depression . Physical illnesses are associated with all three dimensions of burnout and not only with the exhaustion dimension . In the future , the causal relationships between burnout and physical diseases need to be investigated in prospect i ve studies Office workers are vulnerable to the adverse health effects of sedentary behavior ( i.e. , sitting time ) . Increasing physical activity and preventing time spent sitting is an occupational health priority . This r and omized crossover design study compared the short-term ( 3-days ) effects of hourly interruptions of sedentary time with 5-min micrrobouts of activity for 9 hours ( MICRO ) to a sedentary control condition ( SED ) and a duration -matched continuous single bout of physical activity ( 45-min/d , ONE ) condition on inclinometer-derived sitting-time on work and non-work days in sedentary overweight/obese adults . Differences in sitting/lying , st and ing , stepping , number of sit/st and transitions , time spent in moderate and vigorous activity ( MVPA ) , energy expenditure , self-perceived vigor and fatigue , and insulin sensitivity were also examined . Twenty-two participants ( 10M/12F ; 31.7 ± 1.3 year old BMI 30.4 ± 0.5 kg/m2 ) completed all conditions . No between-condition effects were observed in sitting-time and sit/st and transitions . Both interventions increased daily steps , MVPA and energy expenditure with increases being greater in ONE than MICRO . Feelings of vigor and fasting insulin sensitivity were also improved . Participants reported less fatigue with MICRO than SED and ONE . Both interventions increase physical activity and energy expenditure in occupational and leisure-time context s. The sustainability of these effects over the long term and on health outcomes will need to be tested in future studies Objective : To estimate total energy intake and the energy gap — the daily imbalance between energy intake and expenditure — associated with discretionary behaviors of adolescents , namely their leisure active behaviors ( playing or participating in sports and heavy chores ) , leisure sedentary behaviors ( television ( TV ) viewing and playing video and computer games ) , productive sedentary behaviors ( reading or doing homework ) . Design : Prospect i ve observational study . Participants : A total of 538 students ( mean age at baseline=11.7 years ) from public schools in the Boston area studied prospect ively from the fall of 1995 to the spring of 1997 . Measurements : Anthropometric assessment including height and weight , dietary assessment using a youth food frequency question  naire and measures of TV , video , reading/doing homework and youth physical activity .  Results : We estimate the change in total energy intake for each hour change in discretionary activity using regression methods . A 1-h increase in watching TV is associated with a 106 kcal h−1 increase in total energy intake ( 95 % confidence interval ( CI ) : 61–150 kcal day−1 ) . A similar change of 92 kcal h−1 ( 95 % CI : 37–147 kcal day−1 ) is seen with playing video and computer games . The change in energy intake associated with an hour change in physical activity is 292 kcal h−1 ( 95 % CI : 262–321 kcal day−1 ) . No significant change is associated with reading/doing homework . Assuming that typical energy expenditures are associated with these behaviors , reading/doing homework appears to be an ‘ energy neutral ’ activity , whereas watching TV and playing video and computer games is associated with an energy surplus . If we assume that physical activity levels are moderate ( 3.5 METs ) , then this is also an energy surplus activity . If physical activity is assumed to be vigorous for the entire time allotted ( > 6.0 METs ) , an energy deficit could be achieved . We vali date d these estimates by calculating regressions predicting change in weight . Results indicate that each hour increase in TV viewing is associated with a weight increase of 0.38 kg ( 95 % CI : 0.17–0.59 kg ) , with no significant associations for the other behaviors . A model with change in BMI as the dependent variable produced similar results . Conclusion : Watching TV is an activity associated with a daily energy surplus . Although physical activity is thought of as an energy deficit activity , our estimates do not support this hypothesis . Reading/doing homework is the only discretionary activity examined which appears to be clearly energy neutral . The differential impacts of these discretionary behaviors on energy intake and the energy gap are discussed in relation to food-related advertisements aim ed at children and adolescents BACKGROUND It is not clear how decreased activity quantitatively affects energy balance ( EB ) in subjects feeding ad libitum . OBJECTIVE We assessed the effect of an imposed sedentary routine on appetite , energy intake ( EI ) , EB , and nutrient balance in lean men for 7 d. DESIGN Six men with a mean ( + /-SD ) age of 23.0 + /- 2.3 y , weight of 69.2 + /- 11.4 kg , and height of 1.76 + /- 0.07 m were each studied twice during a sedentary [ 1.4 x resting metabolic rate ( RMR ) ] and a moderately active ( 1.8 x RMR ) regimen . During each treatment , they resided in the whole-body indirect calorimeter for the 7 d and had ad libitum access to a medium-fat diet of constant , measurable composition . Meal size , frequency , and composition were continually monitored . Motivation to eat was recorded during waking hours . Subjects were weighed in light clothing each morning , and their weight was corrected to nude . RESULTS Energy expenditure was 9.7 and 12.8 MJ/d [ P < 0.01 ; SE of the difference between means ( SED ) = 0.41 ] during the sedentary and active regimens , respectively . EI was 13.5 and 14.4 MJ/d ( P = 0.463 , SED = 1.06 ) , respectively . There was no regimen effect on hunger , appetite , or body weight . By day 7 , cumulative EB was 26.3 and 11.1 MJ , respectively . CONCLUSIONS Reducing a level of physical activity from 1.8 to 1.4 x RMR can markedly affect EB . A sedentary routine does not induce a compensatory reduction of EI and leads to a significantly positive EB , most of which is stored as fat OBJECTIVE To simultaneously examine the effects of acute exercise intensity and free-living physical activity and sedentary behavior on cognitive function in young , healthy adults . PATIENTS AND METHODS Using a counterbalanced , crossover , r and omized controlled design , 87 young adults ( mean age , 21.4 years ) completed various cognitive assessment s with and without an acute bout of exercise preceding the assessment . Participants were r and omized into 1 of 4 groups to complete a 30-minute bout of acute exercise : control ( no exercise ) , light intensity ( 40%-50 % of predicted maximum heart rate [ HR(max ) ] ) , moderate intensity ( 51%-70 % of predicted HR(max ) ) , or vigorous intensity ( 71%-85 % of predicted HR(max ) ) . Subjectively and objective ly determined ( accelerometry ) physical activity and sedentary behavior were assessed to examine the association between these free-living behaviors and cognitive function . The study duration was August 26 , 2013 , to September 11 , 2014 . RESULTS Concentration-related cognition ( mean ± SD Feature Match test score ) was significantly higher after a 30-minute acute bout of moderate-intensity exercise ( 145.1±26.9 ) compared with cognitive assessment without exercise ( 121.3±19.2 ; P=.004 ) . Furthermore , question naire-determined sedentary behavior was inversely associated with visual attention and task switching ( Trail Making Test A score ) ( β=-0.23 ; P=.04 ) . Last , estimated cardiorespiratory fitness ( volume of maximum oxygen consumption ) was positively associated with reasoning-related cognitive function ( Odd One Out test score ) ( β=0.49 ; P=.05 ) ; when adding metabolic equivalent of task minutes per week to this model , the results were not significant ( β=0.47 ; P=.07 ) . CONCLUSION These findings provide some support for acute moderate-intensity exercise , sedentary behavior , and cardiorespiratory fitness being associated with executive functioning-related cognitive function in young , healthy adults Objective : This prospect i ve study was design ed to test the extent to which the onset of type 2 diabetes in apparently healthy individuals was predicted by burnout , a unique affective response to combined exposure to chronic stressors . Methods : The study participants were 677 employed men and women who were followed up for 3 to 5 years ( mean = 3.6 years ) for the onset of diagnosed type 2 diabetes .  Burnout was assessed by the  Shirom-Melamed Burnout Measure  with its three subscales : emotional exhaustion , physical fatigue , and cognitive weariness . Results : The burnout symptoms were remarkably consistent over the follow-up period irrespective of changes in place of work and in employment status . During the follow-up period , 17 workers developed type 2 diabetes . Logistic regression results indicated that burnout was associated with a 1.84-fold increased risk of diabetes ( 95 % confidence interval [ CI ] = 1.19–2.85 ) even after adjusting for age , sex , body mass index , smoking , alcohol use , leisure time physical activity , initial job category , and follow-up duration . In a sub sample of 507 workers , the relative risk of diabetes was found to be much higher after additional control for blood pressure levels ( odds ratio = 4.32 , 95 % CI = 1.75–10.67 ) , available only for this sub sample . Conclusions : These findings suggest that chronic burnout might be a risk factor for the onset of type 2 diabetes in apparently healthy individuals . CI = confidence interval ; CVD = cardiovascular disease ; SMBM = Shirom-Melamed Burnout Measure ; HbA1c = glycosylated hemoglobin A1c ; VE = vital exhaustion ; MI = myocardial infa rct ion ; MBI = Maslach Burnout Inventory ; BMI = body mass index ; SBP = systolic blood pressure ; DBP = diastolic blood pressure ; OR = odds ratio ; APR = acute phase response ; CRP = C-reactive protein ; HDL = high-density lipoprotein ; HPA = hypothalamic – pituitary – adrenal OBJECTIVE To evaluate the short- and long-term results of FATaintPHAT , a Web-based computer-tailored intervention aim ing to increase physical activity , decrease sedentary behavior , and promote healthy eating to contribute to the prevention of excessive weight gain  among adolescents . DESIGN Cluster r and omized trial with an intervention group and a no-intervention control group . SETTING Twenty schools in the Netherl and s. PARTICIPANTS A total of 883 students ( aged 12 - 13 years ) . INTERVENTION The FATaintPHAT ( VETisnietVET in Dutch ) Web-based computer-tailored intervention . OUTCOME MEASURES Self-reported behaviors ( diet , physical activity , sedentary behavior ) and pedometer counts were measured at baseline and at 4-month and 2-year follow-up ; body mass index ( BMI ) , waist circumference , and fitness were measured at baseline and at 2-year follow-up . Descriptive and multilevel regression analyses were conducted among the total study population and among students not meeting behavioral recommendations at baseline ( students at risk ) . RESULTS The complete case analyses showed that FATaintPHAT had no effect on BMI and waist circumference . However , the intervention was associated with lower odds ( 0.54 ) of drinking more than 400 mL of sugar-sweetened beverages per day and with lower snack intake ( β = -0.81 snacks/d ) and higher vegetable intake ( β = 19.3 g/d ) but also with a lower step count ( β = -10 856 steps/wk ) at 4-month follow-up . In addition , among students at risk , FATaintPHAT had a positive effect on fruit consumption ( β = 0.39 g/d ) at 4-month follow-up and on step count ( β = 14 228 steps/wk ) at 2-year follow-up but an inverse effect on the odds of sports participation ( odds ratio , 0.45 ) at 4-month follow-up . No effects were found for sedentary behavior . CONCLUSION The FATaintPHAT intervention was associated with positive short-term effects on diet but with no effects or unfavorable effects on physical activity and sedentary behavior Background Occupational burnout is associated with severe negative health effects . While stress management programs proved to have a positive influence on the well-being of patients suffering from burnout , it remains unclear whether aerobic exercise alleviates burnout severity and other parameters related to occupational burnout . Therefore , the main purpose of this study was to pilot-test the potential outcomes of a 12-week exercise training to generate hypotheses for future larger scale studies . Methods The sample consisted of 12 male participants scoring high on the MBI emotional exhaustion and depersonalization subscales . The training program took place in a private fitness center with a 17.5 kcal/kg minimum requirement of weekly energy expenditure . Results The key findings are that increased exercise reduced overall perceived stress as well as symptoms of burnout and depression . The magnitude of the effects was large , revealing changes of substantial practical relevance . Additionally , profiles of mood states improved considerably after single exercise sessions with a marked shift towards an iceberg profile . Conclusion Among burnout patients , the findings provide preliminary evidence that exercise has the potential to reduce stress and prevent the development of a deeper depression . This has important health implication s given that burnout is considered an antecedent of depressive disorders . Trial registration Clinical Trials.gov Identifier : BACKGROUND Physical activity and diet are important influences on health , but few data are available about the relationship between these two factors . The purpose of this study was to examine relationships between physical activity and  dietary quality  and to identify determinants of the combination of sedentary behavior and suboptimal diet . METHODS The design of this study was cross-sectional . The setting was a large managed-care organization and the participants were 1,322 racially diverse men and women ages 25 - 91 years . We categorized subjects ' physical activity into vigorous , moderate , and sedentary based on answers to two vali date d interviewer-administered questions about intensity and duration of specified activities . Dietary assessment was by means of a vali date d short food frequency question naire . We defined suboptimal diet as consuming unhealthful quantities of at least two of the following five food groups : fruits , vegetables , whole grain foods , whole-fat dairy foods , and red and processed meats . RESULTS Seven hundred fifty-four ( 57 % ) subjects were sedentary and 617 ( 47 % ) consumed a suboptimal diet . Using multiple linear regression , we found that sedentary individuals consumed smaller amounts of foods and nutrients considered to be healthful , such as fruits and vegetables , fiber , calcium , folate , and vitamins A , C , and E , than more active participants . For nutrients considered to be harmful , such as saturated fat , trans fat , and dietary cholesterol , the association with physical activity was inverse . In multiple logistic regression analyses , the strongest sociodemographic correlates of the joint presence of inactivity and poor diet were less education [ odds ratio for 1-year decrease 1.14 ( 95 % confidence interval 1.06 , 1.22 ) ] , nonwhite race [ 1.48 ( 1.05 , 2.07 ) ] , and nonmarried status [ 1.49 ( 1.06 , 2.10 ) ] . CONCLUSIONS  Physical activity and diet quality  are correlated behaviors . Suboptimal diet and sedentary behavior tend to cluster in individuals who are less educated , not married , and of nonwhite race . Programs that target diet and activity together , informed by their joint determinants , may attain enhanced outcomes The authors prospect ively tested the hypothesis that obesity predicts burnout and the reverse-causation hypothesis that burnout predicts obesity . Respondents were 724 men and 340 women , apparently healthy employees , who underwent routine periodic health examinations at 2 points of time about 18 months apart . Obesity was assessed by body mass index , waist-hip ratio , and waist circumference . In regression analyses , done separately for men and women , the authors controlled for depressive symptomatology , sport activity , and Time 1 levels of the criterion . The hypothesis that burnout predicts obesity was not supported . The authors found that  Time 1 measures of obesity  predicted reductions rather than the hypothesized elevations of Time 2 burnout levels . The authors also found that for male respondents with relatively higher levels of Time 1 burnout , the higher their level of Time 1 obesity measure , the lower their level of T2 burnout Objective In order to prospect ively investigate physical activity at varying intensities and sedentary behavior in relation to colorectal cancer . Methods We considered 488,720 participants of the NIH-AARP Diet and Health Study who were aged 50–71 years at baseline in 1995–1996 . Through 31 December , 2003 , we identified 3,240 and 1,482 colorectal cancers among men and women , respectively . We estimated multivariable relative risks ( RR ) and 95 % confidence intervals ( CI ) of colorectal cancer using Cox regression . Results Engaging in exercise/sports five or more times per week compared to never or rarely exercising was associated with a reduced risk of colon cancer among men ( p = 0.001 ; RR = 0.79 , 95 % CI = 0.68–0.91 ) and a suggestive decrease in risk among women ( p = 0.376 ; RR = 0.85 , 95 % CI = 0.70–1.04 ) . Engaging in exercise/sports was also associated with a decreased risk of rectal cancer in men ( P = 0.074 ; RR comparing extreme categories = 0.76 , 95 % CI = 0.61–0.94 ) . In men , we observed inverse relations of both low intensity ( p = 0.017 ; RR = 0.81 , 95 % CI = 0.65–1.00 for ≥7 h/week ) and moderate to vigorous intensity activity ( p = 0.037 ; RR = 0.82 , 95 % CI = 0.67–0.99 for ≥7 h/week ) to colon cancer risk . In contrast , sedentary behavior ( time spent watching television/videos ) was positively associated with colon cancer ( p < 0.001 ; RR = 1.61 , 95 % CI = 1.14–2.27 for ≥9 h/day ) among men . Similar , but less pronounced relations were observed in women . Conclusion Engaging in physical activity of any intensity is associated with reductions in colon and rectal cancer risk . Conversely , time spent sedentary is associated with increased colon cancer risk Background The construct of total wellness includes a holistic approach to the body , mind and spirit components of life . While the health benefits of reducing sedentary behavior and increasing physical activity are well documented , little is known about the influence on total wellness of an internet-based physical activity monitor design ed to help people to achieve higher physical activity levels . Purpose The purpose of this four-week , personal activity monitor-based intervention program was to reduce sedentary behavior and increase physical activity levels in daily living for sedentary adults and to determine if these changes would also be associated with improvement in total wellness . Methods Twenty-two men and 11 women ( 27 years ± 4.0 ) were r and omly assigned to either an intervention ( n = 18 ) or control group ( n = 15 ) . The intervention group interacted with an online personal activity monitor ( Gruve Solution ™ ) design ed to reduce sedentary time  and increase physical activity during activities of daily living . The control group did not interact with the monitor , as they were asked to follow their normal daily physical activities and sedentary behavior routines . The Wellness Evaluation of Lifestyle ( WEL ) inventory was used to assess total wellness . Sedentary time , light , walking , moderate and vigorous intensity physical activities were assessed for both intervention and control groups at baseline and at week-4 by the 7-day Sedentary and Light Intensity Physical Activity Log ( 7-day SLIPA Log ) and the International Physical Activity Question naire ( IPAQ ) . Results Significant increases in pre-post total wellness scores ( from 64 % ± 5.7 to 75 % ± 8.5 ) ( t ( 17 ) = -6.5 , p < 0.001 ) were observed in the intervention group by the end of week four . Intervention participants decreased their sedentary time ( 21 % , 2.3 hours/day ) and increased their light ( 36.7 % , 2.5 hours/day ) , walking ( 65 % , 1057 MET-min/week ) , moderate ( 67 % , 455 MET-min/week ) and vigorous intensity ( 60 % , 442 MET-min/week ) physical activity ( all p < 0.001 ) . No significant differences for total wellness were observed between the groups at baseline and no pre-post significant differences were observed for any outcome variable in the control group . Conclusion Total wellness is improved when sedentary , but sufficiently physically active adults , reduce sedentary time and increase physical activity levels ( i.e. light , waking , moderate and vigorous ) PURPOSE Project Active is a r and omized clinical trial ( N = 235 ) comparing a lifestyle physical activity program with a structured exercise program in changing physical activity ( total energy expenditure [ kcal.kg-1.d-1 ] ) and cardiorespiratory fitness ( VO2peak in mL.kg-1.min-1 ) . METHODS Sedentary but healthy adults ( N = 235 ) aged 35 - 60 years received 6 months of intensive intervention . RESULTS Analysis of covariance ( ANCOVA ) , adjusting for baseline measure , age , gender , body mass index ( BMI ) , cohort , and ethnicity , showed that at 6 months both lifestyle and structured groups significantly increased energy expenditure over baseline ( P < 0.001 ) . The mean increases + /- SE , 1.53 + /- 0.19 kcal.kg-1.d-1 for the lifestyle group and 1.34 + /- 0.20 kcal.kg-1 d-1 for the structured group , were not significantly different between groups ( P = 0.49 ) . For cardiorespiratory fitness , both groups had significant increases from baseline ( P < 0.001 ) . Mean increases + /- SE were 1.58 + /- 0.33 mL.kg-1.min-1 and 3.64 + /- 0.33 mL.kg-1.min-1 for the lifestyle and structured groups , respectively . This was significantly greater in the structured group ( P < 0.001 ) . We also studied changes in intensity of physical activity . Both groups significantly increased moderate intensity activity from baseline , but the increase was significantly greater in the lifestyle group than the structured group ( P = 0.02 ) . In contrast , the structured group increased its hard activity more than the lifestyle group , but the difference was not significantly different ( P = 0.02 ) . In contrast , the structured group increased its hard increased ( P < 0.01 ) for both groups by 0.25 kcal.kg-1.d-1 . CONCLUSION Both intervention approaches are effective for increasing physical activity and fitness over a 6-month period in initially sedentary men and women BACKGROUND We found recently that changes in nonexercise activity thermogenesis ( NEAT ) mediate resistance to weight gain with overfeeding in sedentary adults . A potentially important , yet seldom investigated , component of NEAT is the energy expenditure of fidgeting-like activities . OBJECTIVE Our goal was to measure changes in energy expenditure with fidgeting-like activities . DESIGN Energy expenditure was measured in 24 subjects ( 17 women and 7 men x+/- SD body weight : 76 + /- 21 kg ) while recumbent at rest , sitting motionless , st and ing motionless , partaking of self-selected fidgeting-like movements while seated and while st and ing , and walking on a treadmill at 1.6 , 3.2 , and 4.8 km/h ( 1 , 2 , and 3 mph ) . Measurements were performed by using a high-precision , indirect calorimeter connected to the subject via a transparent , lightweight facemask that enabled almost unrestricted movement . RESULTS Compared with metabolic rate in the supine position ( 5.4 + /- 1.5 kJ/min ) , energy expenditure increased while sitting motionless by 4 + /- 6 % , while fidgeting while seated by 54 + /- 29 % ( P : < 0.0001 ) , while st and ing motionless by 13 + /- 8 % ( P : < 0.0001 ) , while fidgeting while st and ing by 94 + /- 38 % ( P : < 0.0001 ) , while walking at 1.6 km/h by 154 + /- 38 % ( P : < 0.0001 ) , while walking at 3.2 km/h by 202 + /- 45 % ( P : < 0.0001 ) , and while walking at 4.8 km/h by 292 + /- 81 % ( P : < 0.0001 ) . There was a significant , positive correlation between changes in energy expenditure and body weight for fidgeting-like activities while st and ing ( r = 0.43 , P : = 0.02 ) but not while seated . CONCLUSIONS There is marked variance between subjects in the energy expenditure associated with self-selected fidgeting-like activities . The thermogenic potential of fidgeting-like and low- grade activities is sufficiently great to substantively contribute to energy balance There is limited evidence demonstrating the benefits of physical activity with regard to mortality risk or the harms associated with sedentary behavior in black adults , so we examined the relationships between these health behaviors and cause-specific mortality in a prospect i ve study that had a large proportion of black adults . Participants ( 40 - 79 years of age ) enrolled in the Southern Community Cohort Study between 2002 and 2009 ( n = 63,308 ) were prospect ively followed over 6.4 years , and 3,613 and 1,394 deaths occurred in blacks and whites , respectively . Black adults who reported the highest overall physical activity level ( ≥32.3 metabolic equivalent-hours/day vs. < 9.7 metabolic equivalent-hours/day ) had lower risks of death from all causes ( hazard ratio ( HR ) = 0.76 . 95 % confidence interval ( CI ) : 0.69 , 0.85 ) , cardiovascular disease ( HR = 0.81 , 95 % CI : 0.67 , 0.98 ) , and cancer ( HR = 0.76 , 95 % CI : 0.62 , 0.94 ) . In whites , a higher physical activity level was associated with a lower risk of death from all causes ( HR = 0.76 , 95 % CI : 0.64 , 0.90 ) and cardiovascular disease ( HR = 0.69 , 95 % CI : 0.49 , 0.99 ) but not cancer ( HR = 0.95 , 95 % CI : 0.67 , 1.34 ) . Spending more time being sedentary ( > 12 hours/day vs. < 5.76 hours/day ) was associated with a 20%-25 % increased risk of all-cause mortality in blacks and whites . Blacks who reported the most time spent being sedentary ( ≥10.5 hours/day ) and lowest level of physical activity ( < 12.6 metabolic equivalent-hours/day ) had a greater risk of death ( HR = 1.47 , 95 % CI : 1.25 , 1.71 ) . Our study provides evidence that suggests that health promotion efforts to increase physical activity level and decrease  sedentary time could help reduce mortality risk in black adults
It can be concluded that physical activity may be effective in reducing burn-out risk .
The few observational studies linking sedentary and dietary behavior with burn-out risk suggest that being more sedentary and eating less healthy are each associated with higher burn-out risk .
Although it is believed that physical activity , sedentary , and dietary behavior ( i.e. , energy balance-related behavior ) may decrease the risk of burn-out  , the association between both is currently not well understood .
Therefore , the aim of this systematic review was to synthesize studies investigating the relationship between energy balance-related behavior  and  burn-out risk .