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Objectives: To determine the prevalence of physical activity (PA), sedentary behaviors (SB) and sleep duration and the associations between those variables among Kuwaiti Physical Education (PE) College students. Methods: A total of 418 participants (220 females) were randomly selected from the Basic Education College in the Public Authority for Applied Education and Training in Kuwait. Body weight and height were measured, and body mass index (BMI) was calculated. A validated questionnaire was used to assess lifestyle behaviors. Results: Based on BMI classification, the prevalence of overweight or obesity among males (34.9%) was significantly higher than that of females (16.7%). However, the mean (SD) of body fat percentage using bioelectrical impedance analysis was 21.3 (9.0) for males and 32.3 (7.7) for females. The proportions of highly active (>1200 METs-min/week) males (85.9%) and females (64.3%) were significantly (p, Journal of Preventive Medicine and Hygiene, Vol. 62 No. 2 (2021): 2021622

Few studies have examined referee self-efficacy in a competitive situation such as team handball. The aim of this study was to examine the relationships between handball playing and refereeing experience and referee self-efficacy as well as to investigate the differences in self-efficacy between international and national handball referees. Handball referees were conveniently selected during the 18th Asian Men’s Handball Championship 2018 and the 2017-2018 Kuwaiti Handball League. Participants completed an in person demographic information questionnaire as well as the 13-item Referee Self-Efficacy Scale (REFS) (Myers, Feltz, Guillén, & Dithurbide, 2012) which assesses Game Knowledge (GK), Decision making (DM), Pressure (PR), and Communication (CM). There were significant positive correlations for all Referee Self-Efficacy Scale dimensions with years of refereeing experience. Past playing experience was correlated with DM. Number of officiated matches in the last 12 months were significantly correlated with DM and CM. International referees were significantly more confident in their decision making; in dealing with pressure; and in their communication abilities. Expertise as an effective factor for enhancing self-efficacy was confirmed and referees should focus on developing technical, physical, and psychological skills in order to achieve superiority in refereeing. Self-efficacy can be used to differentiate expert from less-experienced handball referees

Introduction: Swimming is becoming increasing popular in Kuwait. Relationships with teachers, especially physical education (PE) teachers whether positive or negative, influences cigarette use among young people. Despite the public health concerns, comprehensive lifestyle data of Kuwaiti college age students, including physical activity and smoking habits, is lacking. Purpose: The purpose of this study was to determine the physical activity (PA) levels, swimming ability, and smoking status among Kuwaiti male and female physical education colleges students. Methods: A cross-sectional study was conducted on 418 randomly selected college students (198 males and 220 females) aged 18-25 years from the College of Basic Education during the 2017 - 2018 academic year. Physical activity levels were assessed using the Arab Teen Lifestyle Study (ATLS) questionnaire. Swimming ability and smoking status were assessed using the Godin questionnaire. Anthropometric measurements included weight (kg) and height (cm). Body fat (%) and lean muscle mass (kg) were determined with bioelectrical impedance analysis. Body mass index (BMI) was calculated using height and weight (kg/m2). Statistics: Independent t-tests were used to detect significant differences between the mean values of male and female subjects. Results: Male subjects had more muscle mass (39.1±4 kg vs. 25±4 kg) and were more physically active compared with females (645±40 vs. 443±56 min/week) (p

Swimming is a favorable and ideal modality of exercise for individuals with obesity and arthritis as it encompasses a minimal weight-bearing stress and a reduced heat load. However, the available evidence indicates that regular swimming may not be effective in reducing body weight and body fatness. A current hypothesis is that exercise in cold water stimulates appetite. We determined the effect of swimming training on appetite-related hormones. Thirty-nine adults with obesity and osteoarthritis were randomly assigned to 12 weeks of supervised swimming or cycling training. In the initial few weeks, participants exercised for 20–30 minutes/day, 3 days/week, at an exercise intensity of 40–50% of heart rate reserve (HRR). Subsequently, the intensity and duration of exercise were progressively increased to 40–45 minutes/day, 3 days/week, at an intensity of 60–70% of HRR. Fasting plasma concentrations of ghrelin, insulin, leptin, and peptide YY did not change with the swimming or cycling exercise training (p>0.05). Swimming exercise did not negatively influence appetite-related hormones in adults with obesity and osteoarthritis to impair weight loss.

The purpose of this investigation was to determine if Bikram yoga, a style of heated hatha yoga, would improve endothelial function in young and middle-aged and older, healthy adults. This trial was performed in 36 young (n = 17) and middle-aged and older adults (n = 19) who completed 3 weekly Bikram yoga classes for 8 weeks. Height, body weight and body composition were determined and endothelial function was measured noninvasively using brachial artery flow-mediated dilation (FMD) before and after the intervention. No changes in body weight, BMI or body fat percentage occurred as a result of the intervention in either group. Brachial artery FMD was significantly increased in middle-aged and older (P

Background:Obesity is associated with arterial stiffening and diminished quality of life. Bikram yoga may be a feasible alternative to traditional exercise among obese individuals. Accordingly, the purpose of this study was to investigate the impact of Bikram yoga, a heated style of hatha yoga, on arterial stiffness in normal and overweight/obese adults.Methods:Forty-three (23 normal body mass index or BMI; 20 overweight/obese) apparently healthy participants completed an 8-week Bikram yoga intervention. Body composition was estimated via dual energy x-ray absorptiometry, arterial stiffness was measured via brachialankle pulse wave velocity, and health-related quality of life was assessed via RAND 36-Item Short Form survey at baseline and at the end of the 8-week intervention.Results:After the intervention, brachial-ankle pulse wave velocity decreased (P < .05) in overweight/obese participants while no such changes were observed in normal BMI participants. In the quality of life measures, emotional well-being improved (P < .05) in both groups, and general health improved (P < .05) only in the normal weight BMI group.Conclusion:Bikram yoga ameliorates arterial stiffness in overweight/obese adults and can positively impact quality of life regardless of BMI.

Objectives: Excessive adipose tissue, especially in the abdominal area, is associated with increased risk of dementia in older adults. However, the mechanisms underlying this relationship are poorly understood. As increased adiposity is also associated with lower circulating levels of brain-derived neurotrophic factor (BDNF), a key molecule modulating brain plasticity and neuronal regeneration, we hypothesized that the changes in cognition that occur as a result of excessive abdominal adiposity would be driven by lower levels of circulating BDNF. Methods: Fasting blood samples were obtained from 60 participants aged 40–60 years (mean±SD=52.3±5.6) and BDNF levels were assessed with an enzyme linked immunosorbent assay. Abdominal adiposity was measured using a ratio of waist circumference to hip circumference (WHR). Participants also completed a neuropsychological assessment battery to assess executive function. Statistical mediation was assessed using traditional causal steps and nonparametric bootstrapping. Results: Higher WHR was significantly associated with poorer performance on the Controlled Oral Word Association (COWA) letter fluency test (β=−0.489; p=.003) and lower levels of circulating BDNF (β=−0.345; p=.006). Linear regression and bootstrapping methods indicated that BDNF fully mediated the relationship between WHR and performance on the COWA (β=0.60; 95% confidence interval [−3.79, −0.26]). Conclusions: The relationship between higher WHR and verbal fluency was fully statistically mediated by circulating BDNF levels. The BDNF pathway is thus a useful probable mechanism through which executive function decline occurs in individuals with high abdominal adiposity. BDNF enhancing interventions (physical exercise and dietary restriction) could thus be used to improve executive function in these individuals. (JINS, 2016, 22, 1–8)

Swimming exercise is an ideal and excellent form of exercise for patients with osteoarthritis (OA). However, there is no scientific evidence that regular swimming reduces vascular dysfunction and inflammation and elicits similar benefits compared with land-based exercises such as cycling in terms of reducing vascular dysfunction and inflammation in patients with OA. Forty-eight middle-aged and older patients with OA were randomly assigned to swimming or cycling training groups. Cycling training was included as a non-weight-bearing land-based comparison group. After 12 weeks of supervised exercise training, central arterial stiffness, as determined by carotid-femoral pulse wave velocity, and carotid artery stiffness, through simultaneous ultrasound and applanation tonometry, decreased significantly after both swimming and cycling training. Vascular endothelial function, as determined by brachial flow-mediated dilation, increased significantly after swimming but not after cycling training. Both swimming and cycling interventions reduced interleukin-6 levels, whereas no changes were observed in other inflammatory markers. In conclusion, these results indicate that regular swimming exercise can exert similar or even superior effects on vascular function and inflammatory markers compared with land-based cycling exercise in patients with OA who often has an increased risk of developing cardiovascular disease.

Although the associations between chronic levels of arterial stiffness and blood pressure (BP) have been fairly well studied, it is not clear whether and how much arterial stiffness is influenced by acute perturbations in BP. The primary aim of this study was to determine magnitudes of BP dependence of various measures of arterial stiffness during acute BP perturbation maneuvers. Fifty apparently healthy subjects, including 25 young (20–40 yr) and 25 older adults (60–80 yr), were studied. A variety of BP perturbations, including head-up tilt, head-down tilt, mental stress, isometric handgrip exercise, and cold pressor test, were used to encompass BP changes induced by physical, mental, and/or mechanical stimuli. When each index of arterial stiffness was plotted with mean BP, all arterial stiffness indices, including cardio-ankle vascular index or CAVI ( r = 0.50), carotid-femoral pulse wave velocity or cfPWV ( r = 0.51), brachial-ankle pulse wave velocity or baPWV ( r = 0.61), arterial compliance ( r = −0.42), elastic modulus ( r = 0.52), arterial distensibility ( r = −0.32), β-stiffness index ( r = 0.19), and Young's modulus ( r = 0.35) were related to mean BP (all P < 0.01). Changes in CAVI, cfPWV, baPWV, and elastic modulus were significantly associated with changes in mean BP in the pooled conditions, while changes in arterial compliance, arterial distensibility, β-stiffness index, and Young's modulus were not. In conclusion, this study demonstrated that BP changes in response to various forms of pressor stimuli were associated with the corresponding changes in arterial stiffness indices and that the strengths of associations with BP varied widely depending on what arterial stiffness indices were examined.

OBJECTIVE: To investigate the effect of Apolipoprotein E (APOE) genotype on the association between dietary polyunsaturated fat (PUFA), cognitive function, and cerebral glutamate. METHODS: A participant sample of 122 middle-aged adults were grouped according to APOE genotype (ε4 carrier or ε4 non-carrier) and asked to record dietary intake for three consecutive days. All participants also underwent neuropsychological testing and a proton magnetic resonance spectroscopy ((1)H MRS) scan to assess glutamate in the posterior cingulate cortex. RESULTS: Multiple regression analyses revealed a significant interaction between APOE genotype and PUFA intake on memory performance, F(1,113) = 6.749, p = .016. Greater PUFA intake was associated with better memory performance in healthy middle-aged adults who were APOE ε4 non-carriers, but not for ε4 carriers. Furthermore, there was a significant interaction between APOE genotype and PUFA intake on cerebral glutamate, in that dietary PUFA was associated with greater cerebral glutamate in APOE ε4 carriers, but not for ε4 non-carriers, F(1,114) = 5.173, p = .025. CONCLUSIONS: The findings suggest that PUFA action on the brain differs according to APOE polymorphism and points towards cerebral glutamate as a potential marker of genetic risk for Alzheimer’s disease (AD). Early treatment consisting of PUFA supplementation that is tailored to APOE genotype may be an important intervention for the prevention of cognitive decline.

Purpose: Ischemic preconditioning (IPC) has been used to protect myocardial cells against ischemia- reperfusion injury and is recently utilized for improving exercise performance. It is unknown whether remote IPC (RIPC) to tissues not involved in exercise can induce similar exercise improvements and what "dose" of IPC is necessary to induce exercise performance benefits. This study determined if unilateral and bilateral upper limb RIPC improves lower body anaerobic power output. Methods: Using two randomized, sham-controlled, crossover study designs, we studied 43 recreationally-active adults. For study 1, unilateral RIPC was used, while for study 2, the ischemic stimuli was increased to bilateral occlusion. After either the RIPC or sham control treatment, subjects completed four 30 s Wingate anaerobic tests on a Monark cycle ergometer with 2 min passive rest between trials. Results: In the unilateral occlusion trial, peak power, mean power, and fatigue index were not different between the two conditions at every Wingate test. In the bilateral occlusion trial, mean power was greater in the RIPC condition during the first Wingate test compared with the sham control (both p

Objective: Arterial stiffness is associated with cognitive decline and may serve as an early marker of brain vulnerability. In search of potential early intervention targets, the present study examined the neural correlates of working memory in relation to arterial stiffness in middle-aged, cognitively healthy adults. Methods: Twenty-eight adults, ages 40- 60 years, completed a 2-Back verbal working memory task during fMRI. Arterial stiffness was measured using the 􀀁- stiffness index via simultaneous ultrasound and applanation tonometry on the carotid artery. Mean task-related activation intensity was determined for 12 a priori regions of interest (ROI). Statistical analyses included partial correlations, controlling for hypertension status and antihypertensive medication. Results: Arterial stiffness was correlated negatively with task-related activation in 3 ROIs: left precentral gyrus/BA 6 (r=-0.64, p Conclusions: Greater arterial stiffness was significantly associated with decreased task-related brain activation during a verbal working memory task, possibly reflecting increased vulnerability for cognitive impairment. Arterial stiffness should be investigated further as an early marker of cognitive risk and a potential target for early intervention.

Bikram yoga is the most popular form of hot yoga, despite the limited information available on its cardiovascular benefits. This study sought to determine the effect of Bikram yoga on arterial stiffness and insulin resistance in young and older adults.Twenty-four young (mean age±standard deviation, 30±1 years) and 18 middle-aged and older (mean age, 53±2 years) adults completed an 8-week Bikram yoga intervention. Bikram yoga classes were performed for 90 minutes per session, three times per week, in a room heated to 40.5°C with 40%--60% relative humidity.Body mass, body fat percentage, blood pressure, and fasting blood glucose and triglyceride concentrations did not significantly change as a result of the intervention in either the young or the older group. Trunk flexibility, as measured by the sit-and-reach test, increased in both groups (p0.01). Total (p0.05) and low-density lipoprotein cholesterol (p0.05) levels, plasma insulin concentrations (p0.01), and scores on the homeostatic model of the assessment of insulin resistance (p0.01) decreased in older adults, whereas total and high-density lipoprotein cholesterol concentrations were reduced in young adults (all p0.05). Carotid artery compliance (p0.05) was increased and β-stiffness index decreased in young (p0.05) but not in older adults. Carotid pulse pressure did not significantly change in either group.A relatively short-term Bikram yoga intervention improved arterial stiffness in young but not older adults and significantly reduced insulin resistance index in older but not young adults.

Bikram yoga is an exotic form of physical activity combining hatha yoga and thermal therapy that could positively impact metabolic health. Although this increasingly popular alternative exercise may be ideal for obese adults due to its low impact nature, few studies have elucidated the health benefits associated with it. As an initial step, we determined the effect of Bikram yoga on glucose tolerance. Fourteen young lean and 15 older obese subjects completed an 8-week Bikram yoga intervention in which classes were completed 3 times per week. Glucose tolerance was assessed using a 75 g oral glucose tolerance test. The area under the glucose curve following the oral glucose tolerance test was significantly reduced as a result of the Bikram Yoga intervention in older obese (P < 0.05) but not in young lean subjects. We concluded that a short-term Bikram yoga intervention improved glucose tolerance in older obese, but not in young lean adults.

Obesity is associated with arterial stiffening and diminished quality of life. Bikram yoga may be a feasible alternative to traditional exercise among obese individuals. Accordingly, the purpose of this study was to investigate the impact of Bikram yoga, a heated style of hatha yoga, on arterial stiffness in normal and overweight/obese adults.Forty-three (23 normal body mass index or BMI; 20 overweight/obese) apparently healthy participants completed an 8-week Bikram yoga intervention. Body composition was estimated via dual energy x-ray absorptiometry, arterial stiffness was measured via brachialankle pulse wave velocity, and health-related quality of life was assessed via RAND 36-Item Short Form survey at baseline and at the end of the 8-week intervention.After the intervention, brachial-ankle pulse wave velocity decreased (P.05) in overweight/obese participants while no such changes were observed in normal BMI participants. In the quality of life measures, emotional well-being improved (P.05) in both groups, and general health improved (P.05) only in the normal weight BMI group.Bikram yoga ameliorates arterial stiffness in overweight/obese adults and can positively impact quality of life regardless of BMI.

Background A number of different techniques and methodologies have been applied to quantify stiffness of arteries. Because measures of arterial stiffness differ in regards to measurement locations as well as properties, it is not clear how well these measures that are supposed to reflect the same arterial wall properties are related. Methods Interrelationships between different measures of arterial stiffness were evaluated in 50 apparently healthy subjects varying in age. Results Significant relations ranging from mild to strong were observed among measures of arterial stiffness while some measures were not significantly associated. Cardio-ankle vascular index (CAVI) was significantly associated with carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV). Ultrasound-derived measures of arterial stiffness (e.g., compliance, distensibility) were weakly or not significantly related to pulse wave velocity (PWV) measures. The limits of agreement between each of arterial stiffness measures based on the Bland-Altman analyses indicate that there were close agreements (CI = 1.12-1.52) between CAVI, cfPWV, and baPWV. However, agreements between PWV measures and ultrasound-derived measures were mild to moderate. β-stiffness index demonstrated large 95% CIs with other measures. When associations between relative changes in various measures of arterial stiffness in response to isometric handgrip exercise were evaluated, the general trend of associations was similar to the relations observed at rest. β-stiffness index was not related to most measures of arterial stiffness. Conclusion These results suggest that the techniques used to assess arterial stiffness may not be interchangeable in clinical and research settings and that comparisons of findings obtained with different arterial stiffness measures should be conducted with caution.

Objective.Arthritis and its associated joint pain act as significant barriers for adults attempting to perform land-based physical activity. Swimming can be an ideal form of exercise for patients with arthritis. Yet there is no information on the efficacy of regular swimming exercise involving patients with arthritis. The effect of a swimming exercise intervention on joint pain, stiffness, and physical function was evaluated in patients with osteoarthritis (OA).Methods.Using a randomized study design, 48 sedentary middle-aged and older adults with OA underwent 3 months of either swimming or cycling exercise training. Supervised exercise training was performed for 45 min/day, 3 days/week at 60–70% heart rate reserve for 12 weeks. The Western Ontario and McMaster Universities Arthritis Index was used to measure joint pain, stiffness, and physical limitation.Results.After the exercise interventions, there were significant reductions in joint pain, stiffness, and physical limitation accompanied by increases in quality of life in both groups (all p < 0.05). Functional capacity as assessed by maximal handgrip strength, isokinetic knee extension and flexion power (15–30% increases), and the distance covered in the 6-min walk test increased (all p < 0.05) in both exercise groups. No differences were observed in the magnitude of improvements between swimming and cycling training.Conclusion.Regular swimming exercise reduced joint pain and stiffness associated with OA and improved muscle strength and functional capacity in middle-aged and older adults with OA. Additionally, the benefits of swimming exercise were similar to the more frequently prescribed land-based cycling training. Trial registration: clinicaltrials.govNCT01836380.

Blood pressure (BP) reactivity has been assessed by a variety of stimuli, including physical, psychological, and physiological perturbations, that can be further classified into cardiac or vascular...

High consumption of low- and non-fat dairy products is associated with reduced risk of high blood pressure (BP) and central arterial stiffness. However, interventional studies to determine if the addition of non-fat dairy products to the diet is capable of reducing central BP and improving vascular function are lacking. The aim of this study was to determine if the solitary addition of non-fat dairy products to the normal routine diet would reduce central BP and improve vascular function in middle-aged and older adults with elevated BP.Using a randomized, crossover intervention study design, forty-nine adults (44% men, 53 ± 2 years, 170 ± 2 cm, 88 ± 3 kg; mean ± SEM) with elevated BP (134 ± 1/81 ± 1 mm Hg) underwent a High Dairy condition (+4 servings/day of conventional non-fat dairy products) and No Dairy condition (+4 servings/day fruit products) in which all dairy products were removed. Both dietary conditions lasted 4 weeks with a 2-week washout before crossing over into the alternate condition. The High Dairy condition produced reductions in central systolic BP (-3 ± 1 mm Hg) and carotid-femoral pulse wave velocity (-0.5 ± 0.1 m/sec), with a concomitant increase in brachial flow-mediated dilation (+1.1 ± 0.4%) and cardiovagal baroreflex sensitivity (+5 ± 1 ms/mm Hg) (P0.05 for all vs. baseline). In the No Dairy condition, brachial flow-mediated dilation was reduced (-1.0 ± 0.1%, P0.05 vs. baseline).The solitary manipulation of conventional dairy products in the normal routine diet modulates levels of central BP and vascular function in middle-aged and older adults with elevated BP.clinicaltrials.gov Identifier: NCT01577030.

Background: The high consumption of low-fat and nonfat dairy products is associated with reduced risk of high blood pressure. Objective: We aimed to investigate whether the solitary addition of nonfat dairy products to the normal routine diet was capable of lowering blood pressure in middle-aged and older adults with elevated blood pressure. Design: With the use of a randomized, crossover intervention-study design, 49 adults (56% women) with elevated blood pressure (mean 6 SEM age: 53 6 2 y; systolic blood pressure: 135 6 1; diastolic blood pressure: 80 6 1 mm Hg) underwent a high-dairy condition (+4 servings conventional nonfat dairy products/d) and isocaloric no-dairy condition (+4 servings fruit products/d) in which all dairy products were removed. Both dietary conditions lasted 4 wk with a 2-wk washout before crossing over into the alternate condition. Results: The high-dairy condition produced reductions in systolic blood pressure (135 6 1 to 127 6 1 mm Hg) and pulse pressure (54 6 1t o 486 1 mm Hg) (both P , 0.05). The hypotensive effects were observed within 3 wk after the initiation of the dietary intervention and in both casual seated and ambulatory (24-h) measurements (P , 0.05). Pulse pressure was increased after the removal of all dairy products in the no-dairy condition (54 6 1t o 566 1 mm Hg; P , 0.05). There were no changes in diastolic blood pressure after either dietary condition. Conclusion: We concluded that the solitary manipulation of conventional dairy products in the normal routine diet would modulate blood pressure in middle-aged and older adults with prehypertension and hypertension. This trial was registered at clinicaltrials.gov as NCT01577030. Am J Clin Nutr 2014;100:80–7.

Elevated central systolic blood pressure and vascular dysfunction increase the risk of cardiovascular disease. Using a randomized, crossover study design, we tested the hypothesis that the addition...