***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Aboriginal and Torres Strait Isl and er women experience higher rates of heart disease and type 2 diabetes than non-Indigenous Australian women . Increasing physical activity , improving diets and losing weight have been shown to reduce cardio metabolic risk . The primary aim was to evaluate the effectiveness of a 12-week structured exercise and nutrition program in a cohort of urban Indigenous Australian women on waist circumference , weight and biomedical markers of metabolic functioning from baseline ( T1 ) to program completion ( T2 ) . The secondary aim assessed whether these outcomes were maintained at 3-month follow-up . Methods One hundred Aboriginal and /or Torres Strait Isl and er women aged 18–64 years living in the Adelaide metropolitan area were recruited . The program included two 60-minute group cardiovascular and resistance training classes per week , and four nutrition education workshops . Participants were r and omly assigned to an ‘ active ’ group or ‘ waitlisted ’ control group .  Body weight , height , waist and hip circumference , blood pressure , fasting glucose , fasting insulin , glycated haemoglobin ( HbA1C ) , lipid profile and C-reactive protein ( CRP ) were assessed at baseline ( T1 ) , immediately after the program ( T2 ) and three months post program ( T3 ) . Results The active group showed modest reductions in weight and body mass index ( BMI ) . Compared to the waitlisted group , the active group had a statistically significantly change in weight and BMI from baseline assessment s ; at T2 , -1.65 kg and -0.66 kg/m2 and at T3 , -2.50 kg and -1.03 kg/m2 , respectively . Systolic and diastolic blood pressure also had a statistically significant difference from baseline in the active group compared to the waitlisted group at T2 , -1.24 mmHg and -2.46 mmHg and at T3 , -4.09 mmHg and -2.17 mmHg , respectively . The findings were independent of the baseline measure of the outcome variable , age , households with children and employment status . Changes in waist circumference and other clinical measures were not significant at T2 or T3 . The primary outcome measure , waist circumference , proved problematic to assess reliably . Missing data and participants lost to follow-up were significant . Conclusions This 12-week exercise program demonstrated modest reductions in weight , BMI and blood pressure at T2 , which improved further at 3-month follow-up ( T3 ) . Positive intervention effects were observed despite low attendance at exercise classes . Structured exercise programs implemented in community setting s require attention to underst and ing the barriers to participation for this high risk group . Trial registration Australian New Zeal and Clinical Trials Registry AIMS Despite the known benefits , 60 % of individuals with diabetes do not engage in regular physical activity ( PA ) . This pilot study tested the effects of a counseling intervention using continuous glucose monitoring system ( CGMS ) feedback on PA self-efficacy , PA levels , and physiological variables . METHODS Adults ( N=52 ) with type 2 diabetes ( non-insulin requiring , inactive ) were r and omized to intervention ( n=27 ) or control ( n=25 ) groups . Both groups received 90min of diabetes education with a follow-up phone call 4 weeks later . The intervention group also received counseling derived from self-efficacy theory . This intervention included feedback on each participant 's CGMS graph and used role model CGMS graphs to clearly depict glucose reductions in response to PA . Outcomes were assessed at baseline and 8 weeks . RESULTS Participants receiving the intervention had higher self-efficacy scores than the control group for sticking to activity/resisting relapse at 8 weeks ( p<0.05 ) , indicating more confidence in maintaining a PA program . Intervention group participants light/sedentary activity minutes decreased significantly ( p<0.05 ) , moderate activity minutes increased significantly ( p<0.05 ) , and , HbA1c and BMI decreased significantly ( p<0.05 ) . CONCLUSIONS These data suggest that PA counseling interventions using CGMS feedback for individuals with type 2 diabetes may improve PA levels and reduce risk factors for diabetes-related complications Background Recent systematic review s have suggested that pedometers may be effective motivational tools to promote walking . However , studies tend to be of a relatively short duration , with small clinical based sample s. Further research is required to demonstrate their effectiveness in adequately powered , community based studies . Objective Using a r and omized controlled trial design , this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts , self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations . MethodS ixty-three women and 16 men ( 49.2 years ± 8.8 ) were r and omly assigned to either an intervention ( physical activity consultation and 12-week pedometer-based walking program ) or control ( no action ) group . Measures for step-counts , 7-day physical activity recall , affect , quality of life ( n = 79 ) , body mass , BMI , % body fat , waist and hip circumference ( n = 76 ) , systolic/diastolic blood pressure , total cholesterol and HDL cholesterol ( n = 66 ) were taken at baseline and week 12 . Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data . Results Significant increases were found in the intervention group for step-counts ( p < .001 ) , time spent in leisure walking ( p = .02 ) and positive affect ( p = .027 ) . Significant decreases were found in this group for time spent in weekday ( p = .003 ) , weekend ( p = .001 ) and total sitting ( p = .001 ) with no corresponding changes in the control group . No significant changes in any other health outcomes were found in either group . In comparison with the control group at week 12 , the intervention group reported a significantly greater number of minutes spent in leisure time ( p = .008 ) , occupational ( p = .045 ) and total walking ( p = .03 ) , and significantly fewer minutes in time spent in weekend ( p = .003 ) and total sitting ( p = .022 ) . Conclusion A pedometer-based walking program , incorporating a physical activity consultation , is effective in promoting walking and improving positive affect over 12 weeks in community based individuals . The discussion examines possible explanations for the lack of significant changes in health outcomes . Continued follow-up of this study will examine adherence to the intervention and possible result ing effects on health outcomes BACKGROUND Sedentary behavior is a risk factor for cardiometabolic disease . Regularly interrupting sedentary behavior with activity breaks may lower this risk . OBJECTIVE We compared the effects of prolonged sitting , continuous physical activity combined with prolonged sitting , and regular activity breaks on  postpr and ial metabolism . DESIGN Seventy adults participated in a r and omized crossover study . The prolonged sitting intervention involved sitting for 9 h , the physical activity intervention involved walking for 30 min and then sitting , and the regular-activity-break intervention involved walking for 1 min 40 s every 30 min . Participants consumed a meal-replacement beverage at 60 , 240 , and 420 min . RESULTS The plasma incremental area under the curve ( iAUC ) for insulin differed between interventions ( overall P < 0.001 ) . Regular activity breaks lowered values by 866.7 IU · L(-1 ) · 9 h(-1 ) ( 95 % CI : 506.0 , 1227.5 IU · L(-1 ) · 9 h(-1 ) ; P < 0.001 ) when compared with prolonged sitting and by 542.0 IU · L(-1 ) · 9 h(-1 ) ( 95 % CI : 179.9 , 904.2 IU · L(-1 ) · 9 h(-1 ) ; P = 0.003 ) when compared with physical activity . Plasma glucose iAUC also differed between interventions ( overall P < 0.001 ) . Regular activity breaks  lowered values by 18.9 mmol · L(-1 ) · 9 h(-1 ) ( 95 % CI : 10.0 , 28.0 mmol · L(-1 ) · 9 h(-1 ) ; P < 0.001 ) when compared with prolonged sitting and by 17.4 mmol · L(-1 ) · 9 h(-1 ) ( 95 % CI : 8.4 , 26.3 mmol · L(-1 ) · 9 h(-1 ) ; P < 0.001 ) when compared with physical activity . Plasma triglyceride iAUC differed between interventions ( overall P = 0.023 ) . Physical activity  lowered values by 6.3 mmol · L(-1 ) · 9 h(-1 ) ( 95 % CI : 1.8 , 10.7 mmol · L(-1 ) · 9 h(-1 ) ; P = 0.006 ) when compared with regular activity breaks . CONCLUSION Regular activity breaks were more effective than continuous physical activity at decreasing postpr and ial glycemia and insulinemia in healthy , normal-weight adults . This trial was registered with the Australian New Zeal and Clinical Trials registry as ACTRN12610000953033 Background Pedometers provide a simple , cost effective means of motivating individuals to increase walking yet few studies have considered if short term changes in walking behaviour can be maintained in the long-term . The role of physical activity consultations in such interventions is unclear . The purpose of this study was to assess the sustainability of pedometer-based interventions and empirically examine the role of physical activity consultations using long-term results of a community-based walking study . Methods 79 low active Scottish men and women ( 63 women and 16 men ) from the Walking for Wellbeing in the West intervention study were r and omly assigned to receive either : Group 1 ; pedometer-based walking programme plus physical activity consultations or Group 2 ; pedometer-based walking programme and minimal advice .  Step counts ( Omron HJ-109E Step-O-Meter pedometer ) , 7 day recall of physical activity ( IPAQ long ) , mood ( PANAS ) and quality of life ( EuroQol EQ-5D ) were assessed pre-intervention and 12 , 24 and 48 weeks after receiving the intervention . Body mass , body mass index and waist and hip circumference were assessed pre-intervention and 12 and 24 weeks after receiving the intervention . Analyses were performed on an intention to treat basis ( baseline value carried forward for missing data ) using mixed-factorial ANOVAs and follow-up t-tests . Results A significant main effect of time ( p < 0.001 ) was found for step-counts attributable to significant increases in steps/day between : pre-intervention ( M = 6941 , SD = 3047 ) and 12 weeks ( M = 9327 , SD = 4136 ) , t(78 ) = - 6.52 , p < 0.001 , d = 0.66 ; pre-intervention and 24 weeks ( M = 8804 , SD = 4145 ) , t(78 ) = - 4.82 , p < 0.001 , d = 0.52 ; and pre-intervention and 48 weeks ( M = 8450 , SD = 3855 ) , t(78 ) = - 4.15 , p < 0.001 , d = 0.44 . Significant effects were found for several variables of self-reported physical activity , mood and quality of life and are discussed . No other significant effects in health related outcomes were found . Conclusion Both interventions successfully increased and maintained step counts over 12 months . Physical activity consultations may encourage individuals to be active in other ways beyond walking and to reduce sitting time . Trial Registration NumberCurrent Controlled Trials Ltd IS RCT BACKGROUND Although epidemiologic studies have shown associations between sedentary behavior and mortality , few have focused on older women with adequate minority representation and few have controlled for both physical activity and functional status . PURPOSE The objective of this study was to determine the relationship between sedentary time and total ; cardiovascular disease ( CVD ) ; coronary heart disease ( CHD ) ; and cancer mortality in a prospect i ve , multiethnic cohort of postmenopausal women . METHODS The study population included 92,234 women aged 50 - 79 years at baseline ( 1993 - 1998 ) who participated in the Women 's Health Initiative Observational Study through September 2010 .  Self-reported sedentary time  was assessed by question naire and examined in 4 categories ( ≤4 , > 4 - 8 , ≥8 - 11 , > 11 hours ) . Mortality risks were examined using Cox proportional hazard models adjusting for confounders . Models were also stratified by age , race/ethnicity , body mass index , physical activity , physical function , and chronic disease to examine possible effect modification . Analyses were conducted in 2012 - 2013 . RESULTS The mean follow-up period was 12 years . Compared with women who reported the least sedentary time , women reporting the highest sedentary time had increased risk of all-cause mortality in the multivariate model ( HR=1.12 , 95 % CI=1.05 , 1.21 ) . Results comparing the highest versus lowest categories for CVD , CHD , and cancer mortality were as follows : HR=1.13 , 95 % CI=0.99 , 1.29 ; HR=1.27 , 95 % CI=1.04 ,  
    Output:
    
There was no evidence of an effect of PA and combined PA/SB interventions on reducing sedentary time .
CONCLUSIONS There was evidence that it is possible to intervene to reduce  SB in adults .
More high quality research is needed to determine if SB interventions are sufficient to produce clinical ly meaningful and sustainable reductions in sedentary time