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      Optimism predicts sustained vigorous physical activity in postmenopausal women

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          Abstract

          Optimism and cynical hostility are associated with health behaviors and health outcomes, including morbidity and mortality. This analysis assesses their association with longitudinal vigorous physical activity (PA) in postmenopausal women of the Women's Health Initiative (WHI). Subjects include 73,485 women nationwide without history of cancer or cardiovascular disease (CVD), and no missing baseline optimism, cynical hostility, or PA data. The Life Orientation Test-Revised Scale measured optimism. A Cook Medley questionnaire subscale measured cynical hostility. Scale scores were divided into quartiles. Vigorous PA three times or more per week was assessed via self-report at study baseline (1994–1998) and through follow-up year 6. Descriptive analysis mapped lifetime trajectories of vigorous PA (recalled at ages 18, 25, 50; prospectively assessed at baseline, and 3 and 6 years later). Hierarchical generalized linear mixed models examined the prospective association between optimism, cynical hostility, and vigorous PA over 6 years. Models adjusted for baseline sociodemographic variables, psychosocial characteristics, and health conditions and behaviors. Vigorous PA rates were highest for most optimistic women, but fell for all women by approximately 60% between age 50 and study baseline. In adjusted models from baseline through year 6, most vs. least optimistic women were 15% more likely to exercise vigorously (p < 0.001). Cynical hostility was not associated with lower odds of longitudinal vigorous PA after adjustment. Results did not differ by race/ethnicity or socioeconomic status. Higher optimism is associated with maintaining vigorous PA over time in post-menopausal women, and may protect women's health over the lifespan.

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          Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test.

          Research on dispositional optimism as assessed by the Life Orientation Test (Scheier & Carver, 1985) has been challenged on the grounds that effects attributed to optimism are indistinguishable from those of unmeasured third variables, most notably, neuroticism. Data from 4,309 subjects show that associations between optimism and both depression and aspects of coping remain significant even when the effects of neuroticism, as well as the effects of trait anxiety, self-mastery, and self-esteem, are statistically controlled. Thus, the Life Orientation Test does appear to possess adequate predictive and discriminant validity. Examination of the scale on somewhat different grounds, however, does suggest that future applications can benefit from its revision. Thus, we also describe a minor modification to the Life Orientation Test, along with data bearing on the revised scale's psychometric properties.
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            Physical Activity and Public Health: Updated Recommendation for Adults From the American College of Sports Medicine and the American Heart Association

            In 1995 the American College of Sports Medicine and the Centers for Disease Control and Prevention published national guidelines on Physical Activity and Public Health. The Committee on Exercise and Cardiac Rehabilitation of the American Heart Association endorsed and supported these recommendations. The purpose of the present report is to update and clarify the 1995 recommendations on the types and amounts of physical activity needed by healthy adults to improve and maintain health. Development of this document was by an expert panel of scientists, including physicians, epidemiologists, exercise scientists, and public health specialists. This panel reviewed advances in pertinent physiologic, epidemiologic, and clinical scientific data, including primary research articles and reviews published since the original recommendation was issued in 1995. Issues considered by the panel included new scientific evidence relating physical activity to health, physical activity recommendations by various organizations in the interim, and communications issues. Key points related to updating the physical activity recommendation were outlined and writing groups were formed. A draft manuscript was prepared and circulated for review to the expert panel as well as to outside experts. Comments were integrated into the final recommendation. To promote and maintain health, all healthy adults aged 18 to 65 yr need moderate-intensity aerobic (endurance) physical activity for a minimum of 30 min on five days each week or vigorous-intensity aerobic physical activity for a minimum of 20 min on three days each week. [I (A)] Combinations of moderate- and vigorous-intensity activity can be performed to meet this recommendation. [IIa (B)] For example, a person can meet the recommendation by walking briskly for 30 min twice during the week and then jogging for 20 min on two other days. Moderate-intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates the heart rate, can be accumulated toward the 30-min minimum by performing bouts each lasting 10 or more minutes. [I (B)] Vigorous-intensity activity is exemplified by jogging, and causes rapid breathing and a substantial increase in heart rate. In addition, every adult should perform activities that maintain or increase muscular strength and endurance a minimum of two days each week. [IIa (A)] Because of the dose-response relation between physical activity and health, persons who wish to further improve their personal fitness, reduce their risk for chronic diseases and disabilities or prevent unhealthy weight gain may benefit by exceeding the minimum recommended amounts of physical activity. [I (A)]
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              Increased visceral fat and decreased energy expenditure during the menopausal transition.

              This study assessed longitudinal changes in body composition, fat distribution and energy balance in perimenopausal women. We hypothesized that total fat and abdominal body fat would increase at menopause due to decreased energy expenditure (EE) and declining estrogen, respectively. Observational, longitudinal study with annual measurements for 4 years. Healthy women (103 Caucasian; 53 African-American), initially premenopausal. During follow-up, lack of menstruation for 1 year and follicle-stimulating hormone >30 mIU ml(-1) defined a subject as postmenopausal. Fat and lean mass (dual-energy X-ray absorptiometry), visceral (VAT) and subcutaneous abdominal fat (SAT) (computed tomography), dietary intake (4-day food record), serum sex hormones and physical activity (tri-axial accelerometry). Twenty-four hour EE was measured by whole-room calorimeter in a subset of 34 women at baseline and at year 4. Body fat and weight increased significantly over time only in those women who became postmenopausal by year 4 (n=51). All women gained SAT over time; however, only those who became postmenopausal had a significant increase in VAT. The postmenopausal group also exhibited a significant decrease in serum estradiol. Physical activity decreased significantly 2 years before menopause and remained low. Dietary energy, protein, carbohydrate and fiber intake were significantly higher 3-4 years before the onset of menopause compared with menopause onset. Twenty-four hour EE and sleeping EE decreased significantly with age; however, the decrease in sleeping EE was 1.5-fold greater in women who became postmenopausal compared with premenopausal controls (-7.9 vs -5.3%). Fat oxidation decreased by 32% in women who became postmenopausal (P<0.05), but did not change in those who remained premenopausal. Middle-aged women gained SAT with age, whereas menopause per se was associated with an increase in total body fat and VAT. Menopause onset is associated with decreased EE and fat oxidation that can predispose to obesity if lifestyle changes are not made.
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                Author and article information

                Contributors
                Journal
                Prev Med Rep
                Prev Med Rep
                Preventive Medicine Reports
                Elsevier
                2211-3355
                16 October 2017
                December 2017
                16 October 2017
                : 8
                : 286-293
                Affiliations
                [a ]Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, United States
                [b ]Department of Psychiatry, Harvard Medical School, Boston, MA, United States
                [c ]Department of Health Policy & Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States
                [d ]Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
                [e ]Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States
                [f ]Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
                [g ]Mayo Clinic Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Surgical Outcomes Program, Rochester, MN, United States
                [h ]Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States
                [i ]Department of Family and Community Medicine, College of Medicine, Qassim University, Saudi Arabia
                [j ]Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
                [k ]Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, United States
                [l ]Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
                [m ]Centers for Behavioral and Preventive Medicine, The Miriam Hospital Providence, RI, United States
                [n ]Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, United States
                [o ]Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
                Author notes
                [* ]Corresponding author at: Health Equity Research Lab, Cambridge Health Alliance, 1035 Cambridge St, Suite 26, Cambridge, MA 02141, United States.Health Equity Research LabCambridge Health Alliance1035 Cambridge StSuite 26CambridgeMA02141United States aprogovac@ 123456cha.harvard.edu
                Article
                S2211-3355(17)30152-3
                10.1016/j.pmedr.2017.10.008
                5723377
                29255664
                d8b69cd8-ef1d-4222-9c32-54b1808b6d65
                © 2017 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 18 March 2017
                : 16 October 2017
                Categories
                Regular Article

                physical activity,aging,optimism,cynical hostility,women's health

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