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  • Effectiveness of a Timing and Coordination Group Exercise Program to Improve Mobility in Community-Dwelling Older Adults: A Randomized Clinical Trial

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    JAMA Intern Med. 2017; 177(10):1437-1444. doi: 10.1001/jamainternmed.2017.3609

    This cluster-randomized trial compares the effectiveness of a group exercise program that focuses on the timing and coordination of movement with a seated strength, endurance, and flexibility program (usual care) on function, disability, and walking ability of older adults.

  • JAMA Internal Medicine August 1, 2017

    Figure: Subgroup Analyses of Effect of Cardiac Testing Per 1000 Patients at 1 Year

    Results are presented as the change in outcome associated with performing testing in 1000 patients (standard error) in each subgroup, estimated using the average marginal effect for each subgroup. Presented P values are the difference between the average marginal effects in paired subgroups (ie, women and men) in 1000 bootstrapped samples. Cardiac testing includes either noninvasive test (exercise electrocardiography, stress echocardiography, myocardial perfusion scan, and cardiac computed tomographic angiography) or coronary angiography. Analyses were adjusted for age; sex; comorbid conditions (diabetes, hypertension, hyperlipidemia, chronic kidney disease, cerebrovascular disease, peripheral vascular disease, tobacco use); and history of ischemic heart disease, noninvasive test in the previous year, coronary angiography in the previous year, antiplatelet medication use, and antihyperlipidemic medication use. Revascularization is either coronary artery bypass graft surgery or percutaneous coronary intervention. AMI indicates acute myocardial infarction; ED, emergency department. Error bars indicate standard error.
  • Effects of Moderate and Vigorous Exercise on Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial

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    JAMA Intern Med. 2016; 176(8):1074-1082. doi: 10.1001/jamainternmed.2016.3202

    This randomized clinical trial compares the effects of moderate and vigorous exercise on intrahepatic triglyceride content and metabolic risk factors among patients with nonalcoholic fatty liver disease.

  • JAMA Internal Medicine August 1, 2016

    Figure: Benefits of Exercise and Weight Loss on Adipose Tissue Compartments and Insulin Resistance

    Exercise alone can reduce hepatic steatosis and have a modest effect on visceral adipose tissue, but additional weight loss can provide a greater effect on visceral adipose tissue and subcutaneous adipose tissue. Weight loss first improves visceral adipose tissue followed by subcutaneous adipose tissue. Improvement in insulin resistance occurs with improvement in visceral adipose tissue.
  • JAMA Internal Medicine August 1, 2016

    Figure 2: Effects of Moderate and Vigorous Exercise on Intrahepatic Triglyceride Content (IHTG)

    Numbers in parentheses are 95% CIs. aP < .005. bP < .001.
  • Moderate Exercise for Nonalcoholic Fatty Liver Disease

    Abstract Full Text
    JAMA Intern Med. 2016; 176(8):1083-1084. doi: 10.1001/jamainternmed.2016.3221
  • Innovative Self-Regulation Strategies to Reduce Weight Gain in Young Adults: The Study of Novel Approaches to Weight Gain Prevention (SNAP) Randomized Clinical Trial

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    JAMA Intern Med. 2016; 176(6):755-762. doi: 10.1001/jamainternmed.2016.1236

    This randomized clinical trial compared 2 self-regulation interventions vs control in reducing weight gain in young adults over a mean follow-up of 3 years.

  • Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults

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    JAMA Intern Med. 2016; 176(6):816-825. doi: 10.1001/jamainternmed.2016.1548

    This study of pooled data from 12 US and European cohorts examines the association of leisure-time physical activity with incidence of 26 common types of cancer and whether the associations vary by body size and/or smoking.

  • Exercise and the Prevention of Low Back Pain: Ready for Implementation

    Abstract Full Text
    JAMA Intern Med. 2016; 176(2):208-209. doi: 10.1001/jamainternmed.2015.7636
  • Prevention of Low Back Pain: A Systematic Review and Meta-analysis

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    JAMA Intern Med. 2016; 176(2):199-208. doi: 10.1001/jamainternmed.2015.7431

    This systematic review and meta-analysis assesses randomized clinical trials that have evaluated interventions to prevent episodes of low back pain.

  • Interactive Effects of Physical Fitness and Body Mass Index on the Risk of Hypertension

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    JAMA Intern Med. 2016; 176(2):210-216. doi: 10.1001/jamainternmed.2015.7444

    This Swedish national cohort study evaluates the interactive effects of body mass index and physical fitness on the risk of hypertension.

  • Obesity, Fitness, Hypertension, and Prognosis: Is Physical Activity the Common Denominator?

    Abstract Full Text
    JAMA Intern Med. 2016; 176(2):217-218. doi: 10.1001/jamainternmed.2015.7571
  • Association of Fitness in Young Adulthood With Survival and Cardiovascular Risk: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

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    JAMA Intern Med. 2016; 176(1):87-95. doi: 10.1001/jamainternmed.2015.6309

    This review examines whether cardiorespiratory fitness in US young adults is associated with clinical outcomes and subclinical cardiovascular disease at a 25-year follow-up reassessment.

  • JAMA Internal Medicine January 1, 2016

    Figure: Kaplan-Meier Unadjusted Survival Curves

    The main study outcomes—all-cause mortality and cardiovascular disease—were stratified by 1-minute reduction in exercise duration. P values were calculated using the unadjusted log-rank test.
  • JAMA Internal Medicine January 1, 2016

    Figure: Frequency of Exclusion of Patients With Kidney Disease From Trials of Cardiovascular Interventions

    Percentage of trials excluding patients with kidney disease based on specific intervention categories (A) and specific diagnostic categories (B). The bar graphs represent the percentage of trials out of the total that evaluate a particular intervention or a particular diagnostic category. HFpEF indicates heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; NSTEMI, non–ST-segment elevation myocardial infarction; PCI, percutaneous coronary intervention; RAAS, renin-angiotensin-aldosterone system; STEMI, ST-segment elevation myocardial infarction; UA, unstable angina.aIncludes management, exercise, oxygen therapy, and systems-wide quality improvement initiatives.
  • Longitudinal Associations Between Neighborhood Physical and Social Environments and Incident Type 2 Diabetes Mellitus: The Multi-Ethnic Study of Atherosclerosis (MESA)

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    JAMA Intern Med. 2015; 175(8):1311-1320. doi: 10.1001/jamainternmed.2015.2691

    This population-based cohort study of the longitudinal incidence of type 2 diabetes mellitus finds varying associations of incident diagnoses with neighborhood resources for healthy food and physical activity and with social environment in a population of multiethnic noninstitutionalized adults.

  • JAMA Internal Medicine June 1, 2015

    Figure: Hazard Ratios (HRs) and 95% CIs for Leisure Time Moderate- to Vigorous-Intensity Physical Activity and Mortality

    The dose-response curve and category-specific HR estimates of exercise levels compared with the federally recommended minimum of 7.5 metabolic equivalent (MET) hours per week. Models were stratified by cohort and use age as the underlying time scale. The model was adjusted for sex, smoking (never, former, current, or missing), alcohol (none, <15 g/day, 15 to <30 g/day, or ≥30 g/day), educational level (dropout, high school, post–high school training, some college, college graduate, postcollege, or missing), marital status (married, divorced, widowed, single, or missing), history of cancer, history of heart disease, and body mass index (calculated as weight in kilograms divided by height in meters squared) (<18.5, 18.5 to <25.0, 25.0 to <30.0, 30.0 to <35.0, or ≥35.0).The dotted line between categories illustrates an assumed dose-response curve rather than individual data points. Crude and adjusted risk estimates are presented in eTable 3 in the Supplement.
  • Using Physical Activity to Gain the Most Public Health Bang for the Buck

    Abstract Full Text
    JAMA Intern Med. 2015; 175(6):968-969. doi: 10.1001/jamainternmed.2015.0544
  • Leisure Time Physical Activity and Mortality: A Detailed Pooled Analysis of the Dose-Response Relationship

    Abstract Full Text
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    JAMA Intern Med. 2015; 175(6):959-967. doi: 10.1001/jamainternmed.2015.0533

    This pooled analysis reports a benefit threshold at approximately 3 to 5 times the recommended leisure time physical activity minimum and no excess risk at 10 or more times the minimum. See the Invited Commentary by Manini.

  • Effect of Moderate to Vigorous Physical Activity on All-Cause Mortality in Middle-aged and Older Australians

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    JAMA Intern Med. 2015; 175(6):970-977. doi: 10.1001/jamainternmed.2015.0541

    This prospective cohort study found a dose-response relationship between vigorous activity and mortality.