Diet, physical exercise and cognitive behavioral training as a combined workplace based intervention to reduce body weight and increase physical capacity in health care workers - a randomized controlled trial The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. Reduction in cardiovascular disease risk factors: 6-month results from Project Active. Comparative effectiveness of lifestyle interventions on cardiovascular risk factors among a Dutch overweight working population: A randomized controlled trial Testing a workplace physical activity intervention: a cluster randomized controlled trial para tu Salud: Reduction of Weight and Waistlines by Integrating Exercise Breaks into Workplace Organizational Routine Worksite intervention effects on physical health: a randomized controlled trial. Effect of a Web-Based Intervention to Promote Physical Activity and Improve Health Among Physically Inactive Adults: A Population-Based Randomized Controlled Trial A randomized trial investigating the 12-month changes in physical activity and health outcomes following a physical activity consultation delivered by a person or in written form in Type 2 diabetes: Time2Act. Ability of physical activity measurements to assess health-related risks Health Promotion Through Primary Care: Enhancing Self-Management With Activity Prescription and mHealth Effectiveness of a Worksite Intervention for Male Construction Workers on Dietary and Physical Activity Behaviors, Body Mass Index, and Health Outcomes: Results of a Randomized Controlled Trial A multi-component universal intervention to improve diet and physical activity among adults with intellectual disabilities in community residences: a cluster randomised controlled trial. Should Physical Activity Recommendations Be Ethnicity-Specific? Evidence from a Cross-Sectional Study of South Asian and European Men The 'Women's Lifestyle Study', 2-year randomized controlled trial of physical activity counselling in primary health care: rationale and study design Effect of a 4-year workplace-based physical activity intervention program on the blood lipid profiles of participating employees: the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study.
Background Health care workers comprise a high-risk workgroup with respect to deterioration and early retirement . There is high prevalence of obesity and many of the workers are overweight . Together , these factors play a significant role in the health-related problems within this sector . The present study evaluates the effects of the first 3-months of a cluster r and omized controlled lifestyle intervention among health care workers . The intervention addresses body weight , general health variables , physical capacity and musculoskeletal pain . Methods 98 female , overweight health care workers were cluster-r and omized to an intervention group or a reference group . The intervention consisted of an individually dietary plan with an energy deficit of 1200 kcal/day ( 15 min/hour ) , strengthening exercises ( 15 min/hour ) and cognitive behavioral training ( 30 min/hour ) during working hours 1 hour/week . Leisure time aerobic fitness was planned for 2 hour/week . The reference group was offered monthly oral presentations . Body weight , BMI , body fat percentage ( bioimpedance ) , waist circumference , blood pressure , musculoskeletal pain , maximal oxygen uptake ( maximal bicycle test ) , and isometric maximal muscle strength of 3 body regions were measured before and after the intervention period . Results In an intention-to-treat analysis from pre to post tests , the intervention group significantly reduced body weight with 3.6 kg ( p < 0.001 ) , BMI from 30.5 to 29.2 ( p < 0.001 ) , body fat percentage from 40.9 to 39.3 ( p < 0.001 ) , waist circumference from 99.7 to 95.5 cm ( p < 0.001 ) and blood pressure from 134/85 to 127/80 mmHg ( p < 0.001 ) , with significant difference between the intervention and control group ( p < 0.001 ) on all measures . No effect of intervention was found in musculoskeletal pain , maximal oxygen uptake and muscle strength , but on aerobic fitness . Conclusion The significantly reduced body weight , body fat , waist circumference and blood pressure as well as increased aerobic fitness in the intervention group show the great potential of workplace health promotion among this high-risk workgroup . Long-term effects of the intervention remain to be investigated . Trial registration Clinical Trials.gov : BACKGROUND Physical activity has a protective effect against  cardiovascular disease ( CVD )  in high-income countries , where physical activity is mainly recreational , but it is not known if this is also observed in lower-income countries , where physical activity is mainly non-recreational . We examined whether different amounts and types of physical activity are associated with lower mortality and CVD  in countries at different economic levels . METHODS In this prospect i ve cohort study , we recruited participants from 17 countries ( Canada , Sweden , United Arab Emirates , Argentina , Brazil , Chile , Pol and , Turkey , Malaysia , South Africa , China , Colombia , Iran , Bangladesh , India , Pakistan , and Zimbabwe ) . Within each country , urban and rural areas in and around selected cities and towns were identified to reflect the geographical diversity . Within these communities , we invited individuals aged between 35 and 70 years who intended to live at their current address for at least another 4 years .  Total physical activity  was assessed using the  International Physical Activity Question naire ( IPQA ) . Participants with pre-existing CVD were excluded from the analyses . Mortality and CVD were recorded during a mean of 6·9 years of follow-up . Primary clinical outcomes during follow-up were mortality plus major CVD ( CVD mortality , incident myocardial infa rct ion , stroke , or heart failure ) , either as a composite or separately . The effects of physical activity on mortality and CVD were adjusted for sociodemographic factors and other risk factors taking into account household , community , and country clustering . FINDINGS Between Jan 1 , 2003 , and Dec 31 , 2010 , 168 916 participants were enrolled , of whom 141 945 completed the IPAQ . Analyses were limited to the 130 843 participants without pre-existing CVD . Compared with low physical activity ( < 600 metabolic equivalents [ MET ] × minutes per week or < 150 minutes per week of moderate intensity physical activity ) , moderate ( 600 - 3000 MET × minutes or 150 - 750 minutes per week ) and high physical activity ( > 3000 MET × minutes or > 750 minutes per week ) were associated with grade d reduction in mortality ( hazard ratio 0·80 , 95 % CI 0·74 - 0·87 and 0·65 , 0·60 - 0·71 ; p<0·0001 for trend ) , and major CVD ( 0·86 , 0·78 - 0·93 ; p<0·001 for trend  ) . Higher physical activity was associated with lower risk of CVD and mortality  in high-income , middle-income , and low-income countries . The adjusted population attributable fraction for not meeting the physical activity guidelines was 8·0 % for mortality and 4·6 % for major CVD , and for not meeting high physical activity was 13·0 % for mortality and 9·5 % for major CVD . Both recreational and non-recreational physical activity were associated with benefits . INTERPRETATION Higher recreational and non-recreational physical activity was associated with a lower risk of mortality and CVD events in individuals from low-income , middle-income , and high-income countries . Increasing physical activity is a simple , widely applicable , low cost global strategy that could reduce deaths and CVD in middle age . FUNDING Population Health Research Institute , the Canadian Institutes of Health Research , Heart and Stroke Foundation of Ontario , Ontario SPOR Support Unit , Ontario Ministry of Health and Long-Term Care , AstraZeneca , Sanofi-Aventis , Boehringer Ingelheim , Servier , GSK , Novartis , King Pharma , and national and local organisations in participating countries that are listed at the end of the Article CONTEXT Even though the strong association between physical inactivity and ill health is well documented , 60 % of the population is inadequately active or completely inactive . Traditional methods of prescribing exercise have not proven effective for increasing and maintaining a program of regular physical activity . OBJECTIVE To compare the 24-month intervention effects of a lifestyle physical activity program with traditional structured exercise on improving physical activity , cardiorespiratory fitness , and cardiovascular disease risk factors . DESIGN R and omized clinical trial conducted from August 1 , 1993 , through July 31 , 1997 . PARTICIPANTS Sedentary men ( n = 116 ) and women ( n = 119 ) with self-reported physical activity of less than 36 and 34 kcal/kg per day , respectively . INTERVENTIONS Six months of intensive and 18 months of maintenance intervention on either a lifestyle physical activity or a traditional structured exercise program . MAIN OUTCOME MEASURES Primary outcomes were physical activity assessed by the 7-Day Physical Activity Recall and peak oxygen consumption ( VO2peak ) by a maximal exercise treadmill test . Secondary outcomes were plasma lipid and lipoprotein cholesterol concentrations , blood pressure , and body composition . All measures were obtained at baseline and at 6 and 24 months . RESULTS Both the lifestyle and structured activity groups had significant and comparable improvements in physical activity and cardiorespiratory fitness from baseline to 24 months . Adjusted mean changes ( 95 % confidence intervals [ CIs ] ) were 0.84 ( 95 % CI , 0.42 - 1.25 kcal/kg per day ; P<.001 ) and 0.69 ( 95 % CI , 0.25 - 1.12 kcal/kg day ; P = .002 ) for activity , and 0.77 ( 95 % CI , 0.18 - 1.36 mL/kg per minute ; P = .01 ) and 1.34 ( 95 % CI , 0.72 - 1.96 mL/kg per minute ; P<.001 ) for VO2peak for the lifestyle and structured activity groups , respectively . There were significant and comparable reductions in systolic blood pressure ( -3.63 [ 95 % CI , -5.54 to -1.72 mm Hg ; P<.001 ] and -3.26 [ 95 % CI , -5.26 to -1.25 mm Hg ; P = .002 ] ) and diastolic blood pressure ( -5.38 [ 95 % CI , -6.90 to -3.86 mm Hg ; P<.001 ] and -5.14 [ 95 % CI , -6.73 to -3.54 mm Hg ; P<.001 ) for the lifestyle and structured activity groups , respectively . Neither group significantly changed their weight ( -0.05 [ 95 % CI , -1.05 to 0.96 kg ; P = .93 ] and 0.69 [ 95 % CI , -0.37 to 1.74 kg ; P = .20 ] ) , but each group significantly reduced their percentage of body fat ( -2.39 % [ 95 % CI , -2.92 % to -1.85 % ; P<.001 ] and -1.85 % [ 95 % CI , -2.41 % to -1.28 % ; P<.001 ] ) in the lifestyle and structured activity groups , respectively . CONCLUSIONS In previously sedentary healthy adults , a lifestyle physical activity intervention is as effective as a structured exercise program in improving physical activity , cardiorespiratory fitness , and blood pressure BACKGROUND Project Active is a r and omized clinical trial that compares a lifestyle physical activity intervention with a traditional structured exercise intervention . The purpose of this paper is to report 6-month results of these interventions on cardiovascular disease ( CVD ) risk factors among healthy , sedentary , middle-aged men and women , and to examine the psychological strategies used in each group ( Lifestyle and Structured ) to reach the level of physical activity recommended by the Centers for Disease Control and Prevention ( CDC ) and American College of Sports Medicine ( ACSM ) and to achieve changes in these CVD risk factors . METHODS A total of 116 initially sedentary men ( mean + /- SD self-reported physical activity , 33.2 + /- 1.4 kcal.kg-1.day-1 ) and 119 women ( 32.9 + /- 1.0 kcal.kg-1.day-1 ) , ages 35 - 60 years ( 46.0 + /- 6.7 years ) were r and omly assigned to a 6-month lifestyle physical activity counseling intervention or a 6-month gymnasium-based structured program . At baseline and 6 months , changes in lipid and lipoprotein-cholesterol concentrations , blood pressure , and body composition and cognitive and behavioral measures of change were assessed . One-way analyses of variance with covariate adjustment were used to test for between-group differences in CVD risk factors . Associations between achieving the CDC/ACSM criterion and changes in cognitive and behavioral measures were assessed with multiple logistic regression models . RESULTS After 6 months of intervention , 78 % of Lifestyle participants and 85 % of Structured participants were meeting or exceeding the CDC/ACSM recommendation of accumulating 30 min or more of moderate-intensity physical activity on most , preferably all , days of the week . This was verified by a significant increase in cardiorespiratory fitness in both groups . The adjusted mean increase in maximal METs ( VO2peak divided by 3.5 ml.kg-1.min-1 ) between treadmill tests was 0.4 kcal.kg-1.hr-1 ( P < 0.001 ) for Lifestyle and 1.1 kcal.kg-1.hr-1 ( P < 0.001 ) for Structured . There was a significant difference between intervention groups for this outcome . Both groups had significant reductions in total cholesterol , total cholesterol/HDL-C ratio , diastolic blood pressure , and percentage of body fat . There were no significant between-group differences in changes in these outcomes . Adjusted mean changes in total cholesterol , systolic blood pressure , and percentage of body fat in Lifestyle [ in Structured ] participants were -0.2 [ -0.3 ] mmol . L-1 , -3.2[-1.8 ] mm Hg , and -1.4 [ -1.7 ] % , respectively . There were significant associations between achieving the CDC/ACSM physical activity criterion and greater use of the cognitive and behavioral strategies of change . Both groups changed self-efficacy and many of the behavioral measures , but there were no significant differences between intervention groups . CONCLUSIONS These results demonstrate that lifestyle physical activity counseling is as effective as structured exercise programs in increasing physical activity and improving CVD risk factors after 6 months among initially sedentary men and women . Furthermore , specific cognitive and behavioral counseling strategies were increased significantly as a result of the intervention . These strategies are effective and could be used in a wide variety of setting Background Overweight ( Body Mass Index [ BMI ] ≥ 25 kg/m2 ) and obesity ( BMI ≥ 30 kg/m2 ) are associated with increased cardiovascular risk , posing a considerable burden to public health . The main aim of this study was to investigate lifestyle intervention effects on cardiovascular risk factors in healthy overweight employees . Methods Participants were 276 healthy overweight employees ( 69.2 % male ; mean age 44.0 years [ SD 9.2 ] ; mean BMI 29.7 kg/m2 [ SD 3.1 ] ) . They were r and omized to one of two intervention groups receiving a six month lifestyle intervention with behavior counseling by phone ( phone group ) or e-mail ( Internet group ) , or to a control group receiving usual care .  Body weight , height , waist circumference , sum of skinfolds , blood pressure , total cholesterol level and predicted aerobic fitness were measured at baseline , at 6 and at 24 months . Regression analyses included the 141 participants with complete data . Results At 6 months a significant favorable effect on total cholesterol level ( -0.2 mmol/l , 95%CI -0.5 to -0.0 ) was observed in the phone group and a trend for improved aerobic fitness ( 1.9 ml/kg/min , 95%CI -0.2 to 3.9 ) in the Internet group . At two years , favorable trends for body weight ( -2.1 kg , 95%CI -4.4 to 0.2 ) and aerobic fitness ( 2.3 ml/kg/min , 95%CI -0.2 to 4.8 ) were observed in the Internet group . Conclusions The intervention effects were independent of the used communication mode . However short-term results were in favor of the phone group and long-term results in favor of the internet group . Thus , we found limited evidence for our lifestyle intervention to be effective in reducing cardiovascular risk in a group of apparently healthy overweight workers . Trial registration IS RCT Background Increased physical activity levels benefit both an individuals ' health and productivity at work . The purpose of the current study was to explore the impact and cost-effectiveness of a workplace physical activity intervention design ed to increase physical activity levels . Methods A total of 1260 participants from 44 UK worksites ( based within 5 organizations ) were recruited to a cluster r and omized controlled trial with worksites r and omly allocated to an intervention or control condition . Measurement of physical activity and other variables occurred at baseline , and at 0 months , 3 months and 9 months post-intervention . Health outcomes were measured during a 30 minute health check conducted in worksites at baseline and 9 months post intervention . The intervention consisted of a 3 month tool-kit of activities targeting components of the Theory of Planned Behavior , delivered in-house by nominated facilitators . Self-reported physical activity ( measured using the IPAQ short-form ) and health outcomes were assessed . Results and discussion Multilevel modelling found no significant effect of the intervention on MET minutes of activity ( from the IPAQ ) at any of the follow-up time points controlling for baseline activity . However , the intervention did significantly reduce systolic blood pressure ( B = -1.79 mm/Hg ) and resting heart rate ( B = -2.08 beats ) and significantly increased body mass index ( B = .18 units ) compared to control . The intervention was found not to be cost-effective , however the substantial variability round this estimate suggested that further research is warranted . Conclusions The current study found mixed support for this worksite physical activity intervention . The paper discusses some of the tensions involved in conducting rigorous evaluations of large-scale r and omized controlled trials in real-world setting s . Trial registration Current controlled trials IS RCT Introduction Proactive worksite strategies that change the physical or sociocultural environment(s ) to incorporate obligatory physical activity may be necessary to engage sedentary people . This study describes implementation and evaluation of an intervention , Pausa para tu Salud ( Pause for Your Health ) , that integrated a brief period of group exercise into the workday . Methods An uncontrolled pretest – post-test study design tested the effects of integrating daily 10-minute exercise breaks during paid work time during January 2003 through January 2004 . A total of 335 Mexican Ministry of Health office workers provided baseline data as a part of routine annual clinical screening examinations . Results Baseline mean body mass index and waist circumferences were 27.8 kg/m2 and 87.6 cm for women and 26.6 kg/m2 and 89.7 cm for men . Complete data were available for 271 ( 80.9 % ) employees at 1-year follow-up . Two-tailed , paired t-test comparisons were used . Body mass index decreased by 0.32 kg/m2 ( P = .05 ) , and waist circumference by 1.6 cm ( P = .0009 ) overall . The body mass index decrease , however , was significant only for men ( −0.43 kg/m2 , P = .03 ) . Multivariate analyses revealed a significant decrease in diastolic blood pressure among women ( z = −2.04 , P = .042 ) . Conclusion The intervention was associated with significant improvements in both measures of body composition . Substantive health and organizational benefits may result from integrating brief periods of physical activity into the workday if these findings are replicated in r and omized controlled trials in other worksites Overweight and physical inactivity are risk factors for increased disease burden and health care expenditure . Well- design ed studies are still needed to determine the treatment efficacy of worksite interventions targeting such risk factors . This r and omized controlled trial was conducted at one of Australia 's casinos in 2002 - 2003 , to investigate the effects of a comprehensive exercise and lifestyle intervention on physical fitness . Only 6.4 % of the workforce expressed interest in being study participants . Seventy-three employees ( aged 32 + /- 8 years , 51 % overweight/obese , 73 % shift workers and 52 % women ) were recruited and r and omized to treatment or wait-list control groups for 24 weeks , 44 of whom completed the intervention . Components of the intervention include supervised moderate-to-high intensity exercise including combined aerobic ( at least 20 min duration 3 days/week ) and weight-training ( for an estimated 30 min completed 2 - 3 days/week ) , and dietary/health education ( delivered via group seminars , one-on-one counselling and literature through the provision of a worksite manual ) . ANCOVA , by intention-to-treat and of study completers , found significant between-group differences in the mean waist circumference and predicted maximal oxygen uptake ( VO2max ) , favouring the intervention , but effects were concentrated in one subject . For study completers , between-group differences in the mean waist circumference ( 82.3 + /- 9.2 versus 90.5 + /- 17.8 cm , p = 0.01 ) and predicted VO2max ( 47 versus 41 ml/kg/min , p < 0.001 ) remained significant without the outlier , favouring the intervention . Higher intervention compliance predicted greater improvements in physical fitness . No significant effects on body mass or body mass index were found . This worksite intervention significantly improved waist circumference and aerobic fitness in healthy but sedentary employees , most of whom were shift workers .  Worksite interventions have the potential to counter the increasing burden of overweight and obesity , particularly visceral adiposity , as well as physical inactivity ; however , substantial barriers to adoption/adherence need to be overcome for greater feasibility and impact on employee physical health Background Many people in Western countries do not follow public health physical activity ( PA ) recommendations . Web-based interventions provide cost- and time-efficient means of delivering individually targeted lifestyle modification at a population level . Objective To examine whether access to a website with individually tailored feedback and suggestions on how to increase PA led to improved PA , anthropometrics , and health measurements . Methods Physically inactive adults ( n = 12,287 ) participating in a nationwide eHealth survey and health examination in Denmark were r and omly assigned to either an intervention ( website ) ( n = 6055 ) or a no-intervention control group ( n = 6232 ) in 2008 . The intervention website was founded on the theories of stages of change and of planned behavior and , apart from a forum page where a physiotherapist answered questions about PA and training , was fully automated . After 3 and again after 6 months we emailed participants invitations to answer a Web-based follow-up question naire , which included the long version of the International Physical Activity Question naire . A subgroup of participants ( n = 1190 ) were invited to a follow-up health examination at 3 months . Results Less than 22.0 % ( 694/3156 ) of the participants logged on to the website once and only 7.0 % ( 222/3159 ) logged on frequently . We found no difference in PA level between the website and control groups at 3- and 6-month follow-ups . By dividing participants into three groups according to use of the intervention website , we found a significant difference in total and leisure-time PA in the website group . The follow-up health examination showed no significant reductions in body mass index , waist circumference , body fat percentage , and blood pressure , or improvements in arm strength and aerobic fitness in the website group . Conclusions Based on our findings , we suggest that active users of a Web-based PA intervention can improve their level of PA . However , for unmotivated users , single-tailored feedback may be too brief . Future research should focus on developing more sophisticated interventions with the potential to reach both motivated and unmotivated sedentary individuals . Trial Registration Clinical trials.gov NCT01295203 ; http:// clinical trials.gov/ct2/show/NCT01295203 ( Archived by WebCite at http://www.webcitation.org/6B7HDMqiQ BACKGROUND AND AIMS Physical activity is a cornerstone of Type 2 diabetes management but is underutilized . Physical activity consultations increase physical activity in people with Type 2 diabetes but re sources are often limited . Time2Act is a r and omized control trial to study the 12-month effectiveness of a physical activity consultation delivered by a person or in written form , in contrast to st and ard care , for people with Type 2 diabetes . METHODS A total of 134 inactive people with Type 2 diabetes in a contemplation or preparation stage were r and omized to either intervention or st and ard care .  Objective ( accelerometer ) and subjective ( 7-day recall ) physical activity levels were measured over 1 week , along with physiological [ blood pressure , body mass index ( BMI ) , waist circumference ] and biochemical [ glycated haemoglobin ( HbA(1c ) ) , total and high-density lipoprotein ( HDL ) cholesterol ] measures at baseline , 6 and 12 months . RESULTS Neither a physical activity consultation delivered by a person nor in written form was better than st and ard care at increasing physical activity levels or improving health outcomes in the full study cohort . Total and HDL cholesterol , waist circumference and both systolic and diastolic blood pressure improved over 12 months in all groups , whilst HbA(1c ) improved over 6 months . In a subgroup ( baseline pedometer steps < 5000/day ) , the physical activity consultation delivered by a person significantly increased physical activity over 12 months and the st and ard care group significantly decreased . CONCLUSIONS More research is needed which not only investigates the most economical and effective methods to promote physical activity , but also the best setting to conduct physical activity consultations and the participant factors affecting uptake of physical activity in Type 2 diabetes The aim of this study is to evaluate if two different physical activity ( PA ) question naires have similar ability to rank individuals , and to examine associations with cardiovascular-metabolic risk factors , compared to an objective measure . In a r and om sample ( n=369 , age : 65±6 years ) from the population -based ‘ Malmö Diet and Cancer ’ ( MDC ) cohort , PA was measured by a leisure-time comprehensive question naire ( MDC-score ) , a simple leisure-time question naire and by accelerometer-monitoring ( CSA ) . Moderate correlations were observed between MDC-score and CSA in men and women ( r=0.35 and 0.24 , respectively ) . In men , both question naires and CSA were inversely associated with waist circumference , insulin resistance and metabolic syndrome . In women , the MDC-score was positively associated with high-density lipoprotein-cholesterol , and the simple question naire inversely associated with anthropometric indexes , but no association was seen between PA estimates and cardiovascular components . We conclude that both PA question naires distinguish health risks associated with anthropometric-metabolic risk factors , particularly in men Abstract Background : It is well established in the literature that regular participation in physical activity is effective for chronic disease management and prevention . Remote monitoring technologies ( ie , mHealth ) hold promise for engaging patients in self-management of many chronic diseases . The purpose of this study was to test the effectiveness of an mHealth study with tailored physical activity prescription targeting changes in various intensities of physical activity ( eg , exercise , sedentary behavior , or both ) for improving physiological and behavioral markers of lifestyle-related disease risk . Methods : Forty-five older adults ( aged 55–75 years ; mean age 63 ± 5 years ) were r and omly assigned to receive a personal activity program targeting changes to either daily exercise , sedentary behavior , or both . All participants received an mHealth technology kit including smartphone , blood pressure monitor , glucometer , and pedometer . Participants engaged in physical activity programming at home during the 12-week intervention period and su bmi tted physical activity ( steps/day ) , blood pressure ( mm Hg ) , body weight ( kg ) , and blood glucose ( mmol/L ) measures remotely using study -provided devices . Results : There were no differences between groups at baseline ( P > 0.05 ) . The intervention had a significant effect ( F(10 488 ) = 2.947 , P = 0.001 , ηP2 = 0.057 ) , with similar changes across all groups for physical activity , body weight , and blood pressure ( P > 0.05 ) . Changes in blood glucose were significantly different between groups , with groups prescribed high-intensity activity ( ie , exercise ) demonstrating greater reductions in blood glucose than the group prescribed changes to sedentary behavior alone ( P < 0.05 ) . Conclusions : Findings demonstrate the utility of pairing mHealth technologies with activity prescription for prevention of lifestyle-related chronic diseases among an at-risk group of older men and women . Results support the novel approach of prescribing changes to sedentary behaviors ( alone , and in conjunction with exercise ) to reduce risk of developing lifestyle-related chronic conditions Purpose : To evaluate the effectiveness of an individually tailored intervention for improvement in lifestyle behavior , health indicators , and prevention and reduction of overweight among construction workers . Design : R and omized controlled trial . Setting : Various blue-collar departments of a large construction company in the Netherl and s. Participants : Blue-collar workers r and omized to an intervention ( n = 162 ) or a control group ( n = 152 ) . Intervention : The intervention group received individual coaching sessions , tailored information , and material s to improve lifestyle behavior during a 6-month period , and the control group received usual care . Measures : Body weight , body mass index ( BMI ) , waist circumference , physical activity ( PA ) levels , dietary behavior , blood pressure , and blood cholesterol were assessed . Analysis : Effectiveness of the intervention on outcome measures at 6- and 12-month follow-up was assessed by using linear and logistic regression models adjusting for baseline levels . Results : After 6 months , a statistically significant intervention effect was found on body weight ( B = −1.06 , P = .010 ) , BMI ( B = −0.32 , P = .010 ) , and waist circumference ( B = −1.38 , P = .032 ) . At 6 months , the percentage of those meeting public health guidelines for PA increased significantly in the intervention group compared to the control group ( B = 2.06 , P = .032 ) , and for sugar-sweetened beverages , an intervention effect was found at 6 months as well ( B = −2.82 , P = .003 ) . At 12 months , for weight-related outcomes , these differences were slightly smaller and no longer statistically significant . The intervention was not effective on the total amount of moderate to vigorous PA and other dietary and health outcomes . Conclusion : Intervention participants showed positive changes in vigorous PA and intake of sugar-sweetened beverages compared to controls , as well as effects on weight-related outcomes at 6 months . Long-term effects were still promising but not statistically significant People with ID have an increased risk for unhealthy diets , physical inactivity and weight disturbances . The aim of the current study was to investigate the effectiveness of a novel and complex intervention to improve diet and physical activity , targeting both caregivers and residents , in community residences for people with ID . A three component intervention based on Social Cognitive Theory was developed , including : ( 1 ) appointment of a health ambassador in each community residence attending network meetings , ( 2 ) a study circle for caregivers , and ( 3 ) a health course for the residents . The intervention lasted for 12 - 16 months and allowed for some local tailoring . A cluster r and omised controlled trial , r and omised at residence level , was conducted to evaluate the effects of the intervention . Thirty community residences for people with mild or moderate ID in Stockholm County , Sweden , were included . A total of 130 participants , 74 women and 56 men aged 20 - 66 years , entered , and 129 participants completed the study . The primary outcome was physical activity , measured by pedometry . Secondary outcomes were BMI , waist circumference , dietary quality measured by digital photography , satisfaction with life assessed with a scale , and work routines assessed with a question naire . Outcomes were related to intervention fidelity . A positive intervention effect was found on physical activity , with an average increase of 1608 steps/day among participants in the intervention group ( P=0.045 ) . The effect size was 0.29 ( Cohen 's d ) . The type of residence was found to be an effect moderator . A positive intervention effect was found as well on work routines , with an average increase of 7.1 percentage points on a self- assessment scale among residences in the intervention group ( P=0.016 ) . No significant effects were found on BMI , waist circumference , dietary quality , or satisfaction with life . In conclusion , this innovative intervention was effective in improving physical activity and work routines . It is likely that even greater effects could be achieved by improvements in implementation strategies , leading to higher fidelity Background Expert bodies and health organisations recommend that adults undertake at least 150 min.week−1 of moderate-intensity physical activity ( MPA ) . However , the underpinning data largely emanate from studies of population s of European descent . It is unclear whether this level of activity is appropriate for other ethnic groups , particularly South Asians , who have increased cardio-metabolic disease risk compared to Europeans . The aim of this study was to explore the level of MPA required in South Asians to confer a similar cardio-metabolic risk profile to that observed in Europeans undertaking the currently recommended MPA level of 150 min.week−1 . Methods Seventy-five South Asian and 83 European men , aged 40–70 , without cardiovascular disease or diabetes had fasted blood taken , blood pressure measured , physical activity assessed objective ly ( using accelerometry ) , and anthropometric measures made .  Factor analysis was used to summarise measured risk biomarkers into underlying latent ‘ factors ’ for glycaemia , insulin resistance , lipid metabolism , blood pressure , and overall cardio-metabolic risk . Age-adjusted regression models were used to determine the equivalent level of MPA ( in bouts of ≥10 minutes ) in South Asians needed to elicit the same value in each factor as Europeans undertaking 150 min.week−1 MPA . Findings For all factors , except blood pressure , equivalent MPA values in South Asians were significantly higher than 150 min.week−1 ; the equivalent MPA value for the overall cardio-metabolic risk factor was 266 ( 95 % CI 185 - 347 ) min.week−1 . Conclusions South Asian men may need to undertake greater levels of MPA than Europeans to exhibit a similar cardio-metabolic risk profile , suggesting that a conceptual case can be made for ethnicity-specific physical activity guidance . Further study is needed to extend these findings to women and to replicate them prospect ively in a larger cohort Background Physical inactivity is an independent risk factor for diabetes and heart disease . There is evidence that increasing physical activity can reduce the risk of developing these chronic diseases , but less evidence about effective ways to increase adherence to physical activity . Interventions are therefore needed that produce sustained increases in adherence to physical activity , are cost-effective and improve clinical endpoints . Methods The Women 's Lifestyle Study is a two year r and omized controlled trial involving a nurse-led intervention to increase physical activity in 40–74 year old physically inactive women recruited from primary care . Baseline measures were assessed in a face-to-face interview with a primary care nurse . The intervention involved delivery of a ' Lifestyle script ' by a primary care nurse followed by telephone counselling for nine months and a face-to-face nurse visit at six months . Outcome measurements are assessed at 12 and 24 months . The primary outcome is physical activity measured using a vali date d physical activity question naire . Secondary outcomes include blood pressure , weight , waist circumference , physical fitness ( step test ) , serum HbA1c , fasting glucose , lipids , insulin , and quality of life ( SF36 ) . Costs were measured prospect ively to allow a subsequent cost-effectiveness evaluation if the trial is positive . Discussion Due to report in 2008 , the Women 's Lifestyle Study tests the effectiveness of an enhanced low-cost , evidence -based intervention in increasing physical activity , and improving cardiovascular and diabetes risk indicators over two years . If successful in demonstrating improvements in health outcomes , this r and omized controlled trial will be the first to demonstrate long-term cardiovascular and diabetes risk health benefit , in addition to improvements in physical activity , from a sustainable physical activity intervention based in primary care . Trial Registration Australian Clinical Trials Registry ( ACTR ) , ACTRN012605000490673 Individuals who are physically fit or engage in regular physical activity have a lower incidence of cardiovascular disease and risk of mortality . We conducted a large-scale controlled trial of interventions to decrease cardiovascular risk factors , during which we assessed the effect of a workplace-based intervention program , which was part of a population strategy for promoting long-term increases in physical activity , on the blood lipid profiles  of participating employees . Data were collected from 2929 participants and this report presents the results of a survey conducted in five factories for the intervention group and five factories for the control group at baseline and year 5 . The absolute/proportional changes in HDL-cholesterol were 2.7 mg/dL ( 4.8 % ) in the intervention group and -0.6 mg/dL ( -1.0 % ) in the control group . The differences between the two groups in the change in serum levels of HDL-cholesterol were highly significant ( p<0.001 ) in each analysis of covariance , in which the number of cigarettes smoked was included or excluded . In the intervention group , the  daily walking time  increased significantly ( p<0.001 ) when compared between baseline and year 5 , whereas no significant difference was observed in daily walking time in the control group over the identical period . Our results show that an intervention program promoting physical activity raises serum HDL-cholesterol levels of middle-aged employees . Increased awareness of the benefits of physical activity , using environmental rearrangement and health promotion campaigns , which especially target walking , may have contributed to a beneficial change in serum HDL-cholesterol levels in the participants
Reduction in blood pressure , lipids and blood glucose was not statistically significant .
Conclusions Workplace interventions  significantly reduced body weight , BMI and waist circumference .
Non-significant results for biochemical markers could be due to them being secondary outcomes in most studies .
Background Adults in urban areas spend almost 77 % of their waking time being inactive at workplaces , which leaves little time for physical activity .
The aim of this systematic review and meta- analysis was to synthesize evidence for the effect of workplace physical activity interventions on the cardio-metabolic health markers ( body weight , waist circumference , body mass index ( BMI ) , blood pressure , lipids and blood glucose ) among working adults .