Inbrief: Sep/Oct 2000

Intervention Focus
	Fitness; Older Adults
Steven N. Blair Ming Wei	Sedentary Habits, Health, and Function in Older Women and Men The literature was reviewed to determine the relationship of physical activity and cardiorespiratory fitness to morbidity, mortality, and functional limitations in older persons. Prospective epidemiological studies and clinical trials that included data from age groups 60 years and older, used valid measures of exposures, clearly specified outcomes, and controlled for confounders were included. These studies showed that active and fit individuals were at much lower risk for morbidity, mortality, and loss of function when compared with sedentary and unfit persons. A steep inverse dose-response gradient was found across activity or fitness categories. Results were consistent, temporally appropriate, strong, and graded, and therefore support a casual hypothesis that a fit and active way of life improves health and function in older individuals.
	Fitness; Nutrition
Catherine M. Angotti Wing T. Chan C. James Sample Marshal S. Levine	Combined Dietary and Exercise Intervention for Control of Serum Cholesterol in the Workplace Medical charts were reviewed among 858 NASA employees with elevated cholesterol levels who participated in exercise and nutrition interventions designed to reduce cholesterol between 1988 and 1996. On the average, mean HDL cholesterol levels remained the same while total cholesterol levels declined slightly.
Applied Research Briefs
	Fitness; Culture
Sharon Lee Hammond Bruce Leonard Fred Fridinger	The Centers for Disease Control and Prevention Director's Physical Activity Challenge: An Evaluation of a Worksite Health Promotion Intervention In 1996, the Centers for Disease Control and Prevention launched a 50-day exercise campaign called the "Director's Physical Activity Challenge" to stimulate its employees to exercise. Of the 5822 eligible employees, 3740 (64%) joined, but pre- and post-data was available on only 1192 (20.5%) people. Of this group, 86% of those in contemplation and 64% of those in preparation, and 34% of those in action advanced to a higher stage.
	Alternative Medicine
Michael A. Veronin Gilbert Ramirez	The Validity of Health Claims on the World Wide Web: A Systematic Survey of the Herbal Remedy Opuntia In an effort to compare the accuracy of health claims made on the World Wide Web, the results of a search on the Web were compared with the results of a search of the published literature on the herbal remedy called "opuntia". A total of 184 web pages were found which reported health claims for the opuntia herb, and these reported 98 different health claims; 51 research studies were found in the published literature. Only 33 (34%) of the 98 health claims on the web were discussed in the published literature and only 16 of these were based on human versus animal studies. For three of the claims, the published literature was conflicting or contradictory. Of the 16 studies on human subjects, none met high quality standards on the Jaded or JAMA scales.
	Stress Management
Carla A. Green Clyde R. Pope	Depressive Symptoms, Health Promotion and Health Risk Behaviors A 200+ item questionnaire measuring general health status, history of depressive symptoms, alcohol consumption and history, attempts to change health behaviors and medical office visits was sent to 13,372 randomly selected members of the Kaiser Permanente members residing in Northwest Oregon and Southwest Washington. Only 5841 responded, for a 43.6% response rate. Those with depressive symptoms were more likely to smoke cigarettes, drink more alcohol, and utilize medical services. They were also more likely to attempt to lose weight, increase exercise , reduce fat intake, increase fiber intake, and for women, to have a mammogram.
	Financial Analysis; Methods, Issues, and Results in Evaluation and Research
Joseph A. Leutzinger Ronald J. Ozminkowski Rodney L. Dunn Ron Z. Goetzel Dennis E. Richling Maureen Stewart R. William Whitmer	Projecting Future Medical Care Costs Using Four Scenarios of Lifestyle Risk Rates Data on employee risk factors, demographics and medical care cost at Union Pacific Railroad were combined with algorithms linking these three factors to predict future medical care costs in 10 years under for different scenarios based on levels of risk factors. If nothing were done to control health risk factors, and normal changes in risk factors related to employee aging occurred, costs were projected to increase 26.1% over 10 years. If risks were held constant, costs would increase 23.2%; if costs decreased .1% per year, costs would increase 20.7%; of risks decreased 1% per year, costs would increase only 5.8%. The current health promotion program at Union Pacific Railroad costs $1.9 million per year. To pay for this program, health risks need to decrease only .09% per year.
	Methods, Issues, and Results in Evaluation and Research
David R. Anderson R. William Whitmer Ron Z. Goetzel Ronald J. Ozminkowski Jeffery Wasserman Seth Serxner	The Relationship Between Modifiable Health Risks and Group-level Health Care Expenditures The relationship between 11 modifiable risk factors (stress, current or former smoking, sedentary lifestyle, obesity, nutrition, depression, high blood pressure, high cholesterol, alcohol use, and blood glucose) and group level medical care costs were examined for 46,026 employees working in six companies. Overall, these risk factors accounted for approximately 25% of total medical care costs for these companies. Almost 8% of costs were attributed to high stress, and just over 8% to current plus former smoking.
Thomas Golaszewski	Commentary - Health Risks and Group-level Health Care Expenditures

Abstracts	16 abstracts are featured from a variety of publications.
DataBase: Research and Evaluation Results	Four new studies are critiqued and are added to the DataBase chart.