human
***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 Age‐related endothelial dysfunction and vascular stiffening are associated with increased cardiovascular ( CV ) risk . Many groups have encouraged goals of ≥10 000 steps/day or ≥30 min/day of moderate intensity physical activity ( MPA ) to reduce age‐related CV risk . The impact of MPA on the vasculature of older adults remains unclear . Methods and Results We r and omized 114 sedentary older adults ages ≥50 to 12 weeks of either no intervention ( group 1 ) , a pedometer‐only intervention ( group 2 ) , or a pedometer with an interactive website employing strategies to increase the adoption of habitual physical activity ( PA , group 3 ) . Endothelial function by brachial flow‐mediated dilation ( FMD% ) , vascular stiffness by tonometry , step‐count by pedometer , and PA intensity/distribution by accelerometer were measured . Step‐count increased in groups 2 ( 5136±1554 to 9596±3907 , P<0.001 ) and 3 ( 5474±1512 to 8167±3111 , P<0.001 ) but not in group 1 ( 4931±1667 to 5410±2410 ) . Both groups 2 and 3 increased MPA ≥30 min/day . Only group 3 increased MPA in continuous bouts of ≥10 minutes ( P<0.001 ) and improved FMD% ( P=0.001 ) . Neither achievement of ≥10 000 steps/day nor ≥30 min/day of MPA result ed in improved FMD% . However , achieving ≥20 min/day in MPA bouts result ed in improved FMD% . No changes in vascular stiffness were observed . Conclusions MPA reverses age‐related endothelial dysfunction , but may require MPA to be performed in bouts of ≥10 minutes duration for ≥20 min/day to be effective . Commonly encouraged PA goals do not guarantee improved endothelial function and may not be as effective in reducing CV risk . Clinical Trial Registration URL : Clinical trials.gov . Unique identifier : NCT‐01212978 CONTEXT High vitamin D and physical activity ( PA ) levels are independently associated with improved body composition and muscle function in older adults . OBJECTIVE The objective of this study was to investigate the interaction of 25-hydroxyvitamin D ( 25OHD ) and PA status in maintenance of body composition and muscle function in older adults . DESIGN AND SETTING This was a 5-year prospect i ve population -based study of Australian community-dwelling older adults . PARTICIPANTS Participants in the study included 615 community-dwelling volunteers aged 50 years old or older [ 61.4 ± 6.9 ( mean ± SD ) y ; 48 % female ] r and omly selected from electoral rolls and categorized according to baseline serum 25OHD ( ≥ or < 50 nmol/L ) and PA ( ≥ or < 10,000 pedometer determined steps/d ) levels as follows : high 25OHD and high PA ( VitD+PA+ ) ; high 25OHD and low PA ( VitD+PA- ) ; low 25OHD and high PA ( VitD-PA+ ) ; and low 25OHD and low PA ( VitD-PA- ) . A subset of 518 participants completed accelerometer assessment s during follow-up . MAIN OUTCOME MEASURES Changes in dual-energy X-ray absorptiometry-assessed body composition and lower-limb muscle function were measured . RESULTS VitD+PA+ had significantly smaller increases in body fat over 5 years compared with other groups ( all P < .05 ) . Higher baseline pedometer-determined PA result ed in declines in total body fat ( β = -.23 kg per 100 steps/d , P = .001 ) over 5 years for participants with high 25OHD but not those with low 25OHD ( P > .05 ) . Among participants with accelerometer data , these associations were generally mediated by higher levels of moderate/vigorous PA . CONCLUSIONS High vitamin D status appears to enhance PA-related declines in body fat during aging , but the mechanism may be greater amounts of outdoor moderate/vigorous PA rather than a direct effect of 25OHD 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 Objective : To examine whether engagement in physical activity might favorably alter the age-dependent evolution of Alzheimer disease (AD)-related brain and cognitive changes in a cohort of at-risk , late-middle-aged adults . Methods : Three hundred seventeen enrollees in the Wisconsin Registry for Alzheimer 's Prevention underwent  T1 MRI ; a subset also underwent 11C-Pittsburgh compound B – PET ( n = 186 ) and 18F-fluorodeoxyglucose – PET ( n = 152 ) imaging . Participants ' responses on a self-report measure of current physical activity were used to classify them as either physically active or physically inactive based on American Heart Association guidelines . They also completed a comprehensive neuropsychological battery . Covariate-adjusted regression analyses were used to test whether the adverse effect of age on imaging and cognitive biomarkers was modified by physical activity . Results : There were significant age × physical activity interactions for β-amyloid burden ( p = 0.014 ) , glucose metabolism ( p = 0.015 ) , and hippocampal volume ( p = 0.025 ) such that , with advancing age , physically active individuals exhibited a lesser degree of biomarker alterations compared with the physically inactive . Similar age × physical activity interactions were also observed on cognitive domains of Immediate Memory ( p = 0.042 ) and Visuospatial Ability ( p = 0.016 ) . In addition , the physically active group had higher scores on Speed and Flexibility ( p = 0.002 ) compared with the inactive group . Conclusions : In a middle-aged , at-risk cohort , a physically active lifestyle is associated with an attenuation of the deleterious influence of age on key biomarkers of AD pathophysiology . However , because our observational , cross-sectional design can not establish causality , r and omized controlled trials/longitudinal studies will be necessary for determining whether midlife participation in structured physical exercise forestalls the development of AD and related disorders in later life Objective : To compare the effects of behavioral interventions targeting decreased sedentary behavior versus increased moderate-to-vigorous intensity physical activity ( MVPA ) in older adults . Method : Inactive older adults ( N = 38 , 68 ± 7 years old , 71 % female ) were r and omized to 12-week interventions targeting decreased sedentary behavior ( Sit Less ) or increased MVPA ( Get Active ) . The SenseWear armb and was used to objective ly assess activity in real time . Assessment s included a blinded armb and , the Community Health Activites Model Program for Senior ( CHAMPS ) question naire , 400-meter walk , and the Short Physical Performance Battery ( SPPB ) . Results : Objective ly measured MVPA increased in Get Active ( 75 ± 22 min/week , p < .001 ) ; self-reported MVPA increased in both groups ( p < .05 ) . Sedentary behavior did not change in either group ( all p > .05 ) . Only the Sit Less group improved the SPPB score ( 0.5 ± 0.3 , p = .046 ) . Discussion : Targeting reduced sedentary behavior had a greater effect on physical function among inactive but high functioning older adults over 12 weeks . Future studies of longer duration and combining increased MVPA with reduced sedentary behavior are needed Abstract Background : Physical activity guidelines recommend engaging in moderate- and vigorous-intensity physical activity to elicit health benefits . Similarly , these higher intensity ranges for activity are typically targeted in healthy living interventions ( ie , exercise prescription ) . Comparatively less attention has been focused on changing lower intensity physical activity ( ie , sedentary activity ) behaviors . The purpose of this study was to explore the effects of prescribing changes to physical activity of various intensities ( ie , sedentary through exercise ) through the primary care setting . Methods : Sixty older adults ( aged 55–75 years ; mean age 63 ± 5 years ) volunteered to participate , and were r and omly assigned to 4 groups : 3 receiving an activity prescription intervention targeting a specific intensity of physical activity ( exercise , sedentary , or both ) , and 1 control group . During the 12-week intervention period participants followed personalized activity programs at home . Basic clinical measures ( anthropometrics , blood pressure , aerobic fitness ) and blood panel for assessing cardiometabolic risk ( glucose , lipid profile ) were conducted at baseline ( week 0 ) and follow-up ( week 12 ) in a primary care office . Results : There were no differences between groups at baseline ( P > 0.05 ) . The intervention changed clinical ( F(5 , 50 ) = 20.458 , P = 0.000 , ηP2 = 0.672 ) and blood panel measures ( F(5 , 50 ) = 4.576 , P = 0.002 , ηP2 = 0.314 ) of cardiometabolic health . Post hoc analyses indicted no differences between groups ( P > 0.05 ) . Conclusion : Physical activity prescription of various intensities through the primary care setting improved cardiometabolic health status . To our knowledge , this is the first report of sedentary behavior prescription ( alone , or combined with exercise ) in primary care . The findings support the ongoing practice of fitness assessment and physical activity prescription for chronic disease management and prevention BACKGROUND Sedentary behavior is regarded as a distinct risk factor for cardiometabolic morbidity and mortality , but knowledge of the efficacy of interventions targeting reductions in sedentary behavior is limited . PURPOSE To investigate the effect of an individualized face-to-face motivational counseling intervention aim ed at reducing sitting time . DESIGN A r and omized , controlled , observer-blinded , community-based trial with two parallel groups using open-end r and omization with 1:1 allocation . SETTING / PARTICIPANTS A total of 166 sedentary adults were consecutively recruited from the population -based Health2010 Study . INTERVENTION Participants were r and omized to a control ( usual lifestyle ) or intervention group with four individual theory-based counseling sessions . MAIN OUTCOME MEASURES Objective ly measured overall sitting time ( ActivPAL 3TM , 7 days ) ; secondary measures were breaks in sitting time , anthropometric measures , and cardiometabolic biomarkers , assessed at baseline and after 6 months . Data were collected in 2010 - 2012 and analyzed in 2013 - 2014 using repeated measures multiple regression analyses . RESULTS Ninety-three participants were 
    Output:
    
agent
R and omized controlled trials found a positive correlation for SB with BMI , neck circumference , fat mass , HbA1C , cholesterol and insulin levels , cohort studies additionally for WC , leptin , C-peptide , ApoA1 and Low density lipoprotein and a negative correlation for HDL .
Most studied biomarkers associated with SB were of cardiovascular or metabolic origin .
***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 Age‐related endothelial dysfunction and vascular stiffening are associated with increased cardiovascular ( CV ) risk . Many groups have encouraged goals of ≥10 000 steps/day or ≥30 min/day of moderate intensity physical activity ( MPA ) to reduce age‐related CV risk . The impact of MPA on the vasculature of older adults remains unclear . Methods and Results We r and omized 114 sedentary older adults ages ≥50 to 12 weeks of either no intervention ( group 1 ) , a pedometer‐only intervention ( group 2 ) , or a pedometer with an interactive website employing strategies to increase the adoption of habitual physical activity ( PA , group 3 ) . Endothelial function by brachial flow‐mediated dilation ( FMD% ) , vascular stiffness by tonometry , step‐count by pedometer , and PA intensity/distribution by accelerometer were measured . Step‐count increased in groups 2 ( 5136±1554 to 9596±3907 , P<0.001 ) and 3 ( 5474±1512 to 8167±3111 , P<0.001 ) but not in group 1 ( 4931±1667 to 5410±2410 ) . Both groups 2 and 3 increased MPA ≥30 min/day . Only group 3 increased MPA in continuous bouts of ≥10 minutes ( P<0.001 ) and improved FMD% ( P=0.001 ) . Neither achievement of ≥10 000 steps/day nor ≥30 min/day of MPA result ed in improved FMD% . However , achieving ≥20 min/day in MPA bouts result ed in improved FMD% . No changes in vascular stiffness were observed . Conclusions MPA reverses age‐related endothelial dysfunction , but may require MPA to be performed in bouts of ≥10 minutes duration for ≥20 min/day to be effective . Commonly encouraged PA goals do not guarantee improved endothelial function and may not be as effective in reducing CV risk . Clinical Trial Registration URL : Clinical trials.gov . Unique identifier : NCT‐01212978 CONTEXT High vitamin D and physical activity ( PA ) levels are independently associated with improved body composition and muscle function in older adults . OBJECTIVE The objective of this study was to investigate the interaction of 25-hydroxyvitamin D ( 25OHD ) and PA status in maintenance of body composition and muscle function in older adults . DESIGN AND SETTING This was a 5-year prospect i ve population -based study of Australian community-dwelling older adults . PARTICIPANTS Participants in the study included 615 community-dwelling volunteers aged 50 years old or older [ 61.4 ± 6.9 ( mean ± SD ) y ; 48 % female ] r and omly selected from electoral rolls and categorized according to baseline serum 25OHD ( ≥ or < 50 nmol/L ) and PA ( ≥ or < 10,000 pedometer determined steps/d ) levels as follows : high 25OHD and high PA ( VitD+PA+ ) ; high 25OHD and low PA ( VitD+PA- ) ; low 25OHD and high PA ( VitD-PA+ ) ; and low 25OHD and low PA ( VitD-PA- ) . A subset of 518 participants completed accelerometer assessment s during follow-up . MAIN OUTCOME MEASURES Changes in dual-energy X-ray absorptiometry-assessed body composition and lower-limb muscle function were measured . RESULTS VitD+PA+ had significantly smaller increases in body fat over 5 years compared with other groups ( all P < .05 ) . Higher baseline pedometer-determined PA result ed in declines in total body fat ( β = -.23 kg per 100 steps/d , P = .001 ) over 5 years for participants with high 25OHD but not those with low 25OHD ( P > .05 ) . Among participants with accelerometer data , these associations were generally mediated by higher levels of moderate/vigorous PA . CONCLUSIONS High vitamin D status appears to enhance PA-related declines in body fat during aging , but the mechanism may be greater amounts of outdoor moderate/vigorous PA rather than a direct effect of 25OHD 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 Objective : To examine whether engagement in physical activity might favorably alter the age-dependent evolution of Alzheimer disease (AD)-related brain and cognitive changes in a cohort of at-risk , late-middle-aged adults . Methods : Three hundred seventeen enrollees in the Wisconsin Registry for Alzheimer 's Prevention underwent  T1 MRI ; a subset also underwent 11C-Pittsburgh compound B – PET ( n = 186 ) and 18F-fluorodeoxyglucose – PET ( n = 152 ) imaging . Participants ' responses on a self-report measure of current physical activity were used to classify them as either physically active or physically inactive based on American Heart Association guidelines . They also completed a comprehensive neuropsychological battery . Covariate-adjusted regression analyses were used to test whether the adverse effect of age on imaging and cognitive biomarkers was modified by physical activity . Results : There were significant age × physical activity interactions for β-amyloid burden ( p = 0.014 ) , glucose metabolism ( p = 0.015 ) , and hippocampal volume ( p = 0.025 ) such that , with advancing age , physically active individuals exhibited a lesser degree of biomarker alterations compared with the physically inactive . Similar age × physical activity interactions were also observed on cognitive domains of Immediate Memory ( p = 0.042 ) and Visuospatial Ability ( p = 0.016 ) . In addition , the physically active group had higher scores on Speed and Flexibility ( p = 0.002 ) compared with the inactive group . Conclusions : In a middle-aged , at-risk cohort , a physically active lifestyle is associated with an attenuation of the deleterious influence of age on key biomarkers of AD pathophysiology . However , because our observational , cross-sectional design can not establish causality , r and omized controlled trials/longitudinal studies will be necessary for determining whether midlife participation in structured physical exercise forestalls the development of AD and related disorders in later life Objective : To compare the effects of behavioral interventions targeting decreased sedentary behavior versus increased moderate-to-vigorous intensity physical activity ( MVPA ) in older adults . Method : Inactive older adults ( N = 38 , 68 ± 7 years old , 71 % female ) were r and omized to 12-week interventions targeting decreased sedentary behavior ( Sit Less ) or increased MVPA ( Get Active ) . The SenseWear armb and was used to objective ly assess activity in real time . Assessment s included a blinded armb and , the Community Health Activites Model Program for Senior ( CHAMPS ) question naire , 400-meter walk , and the Short Physical Performance Battery ( SPPB ) . Results : Objective ly measured MVPA increased in Get Active ( 75 ± 22 min/week , p < .001 ) ; self-reported MVPA increased in both groups ( p < .05 ) . Sedentary behavior did not change in either group ( all p > .05 ) . Only the Sit Less group improved the SPPB score ( 0.5 ± 0.3 , p = .046 ) . Discussion : Targeting reduced sedentary behavior had a greater effect on physical function among inactive but high functioning older adults over 12 weeks . Future studies of longer duration and combining increased MVPA with reduced sedentary behavior are needed Abstract Background : Physical activity guidelines recommend engaging in moderate- and vigorous-intensity physical activity to elicit health benefits . Similarly , these higher intensity ranges for activity are typically targeted in healthy living interventions ( ie , exercise prescription ) . Comparatively less attention has been focused on changing lower intensity physical activity ( ie , sedentary activity ) behaviors . The purpose of this study was to explore the effects of prescribing changes to physical activity of various intensities ( ie , sedentary through exercise ) through the primary care setting . Methods : Sixty older adults ( aged 55–75 years ; mean age 63 ± 5 years ) volunteered to participate , and were r and omly assigned to 4 groups : 3 receiving an activity prescription intervention targeting a specific intensity of physical activity ( exercise , sedentary , or both ) , and 1 control group . During the 12-week intervention period participants followed personalized activity programs at home . Basic clinical measures ( anthropometrics , blood pressure , aerobic fitness ) and blood panel for assessing cardiometabolic risk ( glucose , lipid profile ) were conducted at baseline ( week 0 ) and follow-up ( week 12 ) in a primary care office . Results : There were no differences between groups at baseline ( P > 0.05 ) . The intervention changed clinical ( F(5 , 50 ) = 20.458 , P = 0.000 , ηP2 = 0.672 ) and blood panel measures ( F(5 , 50 ) = 4.576 , P = 0.002 , ηP2 = 0.314 ) of cardiometabolic health . Post hoc analyses indicted no differences between groups ( P > 0.05 ) . Conclusion : Physical activity prescription of various intensities through the primary care setting improved cardiometabolic health status . To our knowledge , this is the first report of sedentary behavior prescription ( alone , or combined with exercise ) in primary care . The findings support the ongoing practice of fitness assessment and physical activity prescription for chronic disease management and prevention BACKGROUND Sedentary behavior is regarded as a distinct risk factor for cardiometabolic morbidity and mortality , but knowledge of the efficacy of interventions targeting reductions in sedentary behavior is limited . PURPOSE To investigate the effect of an individualized face-to-face motivational counseling intervention aim ed at reducing sitting time . DESIGN A r and omized , controlled , observer-blinded , community-based trial with two parallel groups using open-end r and omization with 1:1 allocation . SETTING / PARTICIPANTS A total of 166 sedentary adults were consecutively recruited from the population -based Health2010 Study . INTERVENTION Participants were r and omized to a control ( usual lifestyle ) or intervention group with four individual theory-based counseling sessions . MAIN OUTCOME MEASURES Objective ly measured overall sitting time ( ActivPAL 3TM , 7 days ) ; secondary measures were breaks in sitting time , anthropometric measures , and cardiometabolic biomarkers , assessed at baseline and after 6 months . Data were collected in 2010 - 2012 and analyzed in 2013 - 2014 using repeated measures multiple regression analyses . RESULTS Ninety-three participants were 
    Output:
    