Posts Tagged ‘physical activity’

Combo Diet-Exercise Programs Trim Diabetes Risk

A combination of diet and physical activity programs offered in the community reduce the risk of type 2 diabetes in patients who are at increased risk, according to new federal data.

Programs Help Patients Revert to Normal Glycemic Levels

• Strong evidence suggests that a combination of diet and physical activity programs can reduce new-onset diabetes for persons at increased risk for type 2 diabetes.

• These programs also increase the likelihood of reversion to normal glycemic levels and improve diabetes and cardiovascular disease risk factors, including weight, blood glucose levels, blood pressure, and lipid levels.

• The US Community Preventive Services Task Force recommends the use of combined diet and physical activity promotion programs to reduce progression to type 2 diabetes in those at increased risk.

Combined Program’s Critical Components

• Critical components of a combined diet and physical activity program include trained providers in clinical or community settings who work directly with program participants for at least 3 months; some combination of counseling, coaching, and extended support; and multiple sessions related to diet and physical activity, delivered in person or by other methods.

• Programs also may use 1 or more of the following: diet counselors in various specialties (eg, nutritionists, dietitians, and diabetes educators); exercise counselors in various specialties (eg, physical educators, physiotherapists, and trainers); physicians, nurses, and trained laypersons; a range of intensity of counseling, with many or few sessions, longer- or shorter-duration sessions, and individual or group sessions; and individually tailored or generic diet or physical activity programs.

• Programs should include specific weight-loss or exercise goals and a period of maintenance sessions after the primary core period of the program.

US Task Force Conducts Systematic Review

• The task force recommendation is based on evidence from a systematic review of 53 studies that described 66 programs.

• Most programs used a combination of in-person individual and group sessions.

• Almost all programs led to weight loss, reduced risk of diabetes, or both.

• More intensive programs led to more weight loss and less development of diabetes.

Group Programs More Cost-effective

• These diet-exercise programs were cost-effective; group-based programs were the most cost-effective.

• Health care providers usually are the primary resource for patients at increased risk for type 2 diabetes.

• The task force suggests that health care providers keep informed about local prevention programs offered by community centers or run by insurers or nonprofit or other private contractors.

Take-home Message:

• A federal task force’s systematic review found combined diet and physical activity programs can help prevent or delay the development of diabetes.

Physical Activity Trims Breast Cancer Risk

The risk of breast cancer tends to be lower in women who participate in physical activity.

Several studies presented at the recent American Society of Clinical Oncology annual meeting in Chicago demonstrate that even moderate levels of physical activity can help women who have breast cancer live longer lives.

However, women who have received hormone replacement therapy (HRT) may not get the same benefit from exercise.

Community-based programs at Curves or a LIVESTRONG program at YMCAs can help patients with breast cancer increase their fitness and lose weight, improving their quality of life.

High Levels of Physical Activity Reduce Breast Cancer Risk

• A lower risk of breast cancer among physically active women has been reported frequently, but the risk in women who use HRT appears to be higher.

• A systematic literature search of studies that measured physical activity in breast cancer identified 38 studies including more than 4 million women.

• The risk of breast cancer in women who engaged in the highest level of physical activity was 12% lower than in women who performed low levels of or no physical activity.

HRT Nullifies Exercise Effects

• However, there was no reduction in breast cancer risk associated with physical activity in women who used HRT.

• The capacity of physical activity to reduce the risk of breast cancer in women probably has been underestimated by studies conducted after 1989, when HRT use was more prevalent.

• Physical activity probably decreases the risk of breast cancer through lower circulating estrogen levels, but HRT use seems to nullify this action.

• Source: Pizot C, Boniol M, Mullie P, et al. Physical activity, hormone replacement therapy and breast cancer risk: a meta-analysis of prospective studies. J Clin Oncol. 33, 2015 (suppl; abstr 1561).

BMI and Physical Activity in Triple-Negative Breast Cancer

• Modifiable lifestyle factors, including body mass index (BMI) and physical activity, have been well-studied for overall breast cancer prognosis.

• No prospective study has investigated BMI and physical activity in triple-negative breast cancer, defined as ER-/PR-/HER2-.

• These researchers conducted an analysis using data from 5 breast cancer survivor cohorts in the United States, the UK, and China.

High Physical Activity Extends Lives

• The 12,240 stage I-III breast cancer cases with known ER/PR/HER2 status included 1695 triple-negative cases (13.9%).

• Patients self-reported their recreational physical activity.

• After a mean follow-up of 9.5 years, the researchers observed a trend for increasing physical activity and improved breast cancer-specific survival and overall survival.

• This was significant only for high levels of physical activity, the equivalent of 4 or more hours of moderate-intensity physical activity per week.

• Source: Nechuta SJ, Caan BJ, Chen WY, et al. Post-diagnosis BMI and physical activity in association with triple-negative breast cancer prognosis: results from 5 prospective cohorts. J Clin Oncol. 33, 2015 (suppl; abstr 1507).

Weight Loss Study in Breast Cancer

• Weight loss among overweight and obese breast cancer survivors may lead to improved disease-free survival.

• Researchers conducted a 12-month, community-situated physical activity and telephone-based dietary change weight loss intervention in female breast cancer survivors.

• The 25 evaluable patients, median age 57 years, were assigned a telephone counselor and given a 12-month membership to a local Curves fitness center, which offered a 30-minute circuit-based exercise program.

• Patients were counseled 14 times over 12 months and were instructed to exercise 150 minutes per week, walk 10,000 steps per day, and decrease caloric intake by 500 kcal per day.

Meaningful Weight Loss Over 12 Months

• At 12 months, 96% of patients met the diet goal and 28% of them met the exercise goal.

• Average weight loss was 7.6%; the median weight loss was 7.1%.

• The researchers concluded that it is feasible to recruit and retain breast cancer survivors in a multicenter weight-loss trial using dietary change plus physical activity to achieve clinically meaningful weight loss over 12 months.

• Source: Greenlee H, Lew D, Hershman DL, et al. Phase II feasibility study of a physical activity and dietary change weight loss intervention in a subset analysis of breast cancer survivors (SWOG S1008). J Clin Oncol. 33, 2015 (suppl; abstr 9572).

LIVESTRONG at the YMCA Program for Cancer Survivors

• Physical activity has been linked to cancer risk and outcomes, yet many survivors are inactive.

• Researchers evaluated the impact of a 12-week LIVESTRONG at the YMCA program, an exercise program available for cancer survivors at YMCAs across the United States.

Patients With Early-stage Cancer are Mostly Inactive

• A total of 186 participants were randomized, 95 to the LIVESTRONG Program and 91 to a control group.

• The majority of patients had stage I-II disease; half had breast cancer.

• A majority of participants were inactive at baseline; only one-third reported performing at least 150 minutes of physical activity per week.

LIVESTRONG Program Encourages Physical Activity

• Participants randomized to the LIVESTRONG Program attended an average 83% of scheduled sessions over the 3-month program.

• LIVESTRONG participants experienced significant increases in physical activity—three-fourths exercised a minimum of 150 minutes per week compared with one-fourth of controls.

• Exercisers showed improvements in fitness and quality of life compared with controls.

• Source: Irwin ML, Cartmel B, Harrigan M, et al. Impact of the LIVESTRONG at the YMCA Program on physical activity, fitness, and quality of life in cancer survivors. J Clin Oncol. 33, 2015 (suppl; abstr 9508).

Take-home Messages:

• The promotion of physical activity may help lower the risk of breast cancer, but HRT may ameliorate the effects of exercise.

• High levels of physical activity can help patients with breast cancer live longer lives.

• A combination of physical activity and caloric restriction can help patients with breast cancer achieve sustained weight loss.

• The LIVESTRONG program could provide a platform to increase physical activity, fitness, and quality of life in cancer survivors.

The Benefits of Tai Chi: Strong Body, Healthy Heart

If you have heart disease, you may want to find a physical activity that you can easily maintain.

The slow-paced “meditation in motion” of Tai Chi may be just what the doctor ordered.TaiChi older

Based on the existing evidence, Tai Chi is a promising addition to regular heart care.

Cardiac rehabilitation programs are, unfortunately, underused.

“Tai Chi may be a good option for those unable or unwilling to engage in other forms of physical activity, or as a bridge to more rigorous exercise programs in frail patients,” says Peter Wayne, Ph.D., assistant professor of medicine at Harvard Medical School and the director of research for the Osher Center for Integrative Medicine, jointly based at Harvard Medical School and Brigham and Women’s Hospital in Boston.

“If your doctor says you have borderline high blood pressure and you are not certain you want to begin drug therapy, a non-pharmacological approach such as Tai Chi may be a way to keep your blood pressure in check.

If you have established high blood pressure and find it difficult to engage in a regular exercise regimen, again, think about using Tai Chi to aid the treatment program your doctor has designed for you.”

Regular physical activity, including Tai Chi, has beneficial effects on many risk factors for heart disease, such as high blood pressure, high cholesterol levels and pre-diabetes, says Ruth E. Taylor-Piliae, Ph.D., R.N., associate professor and Robert Wood Johnson Foundation nurse faculty scholar alumna at the University of Arizona’s College of Nursing in Phoenix, where she conducts Tai Chi research.

“Regular physical activity promotes weight reduction, which can help reduce high blood pressure.

Exercise can lower total LDL, or “bad”, cholesterol levels, as well as raise HDL, or “good”, cholesterol levels,” she says.

“Among those with pre-diabetes, regular exercise can aid the body’s ability to use insulin to control blood glucose levels.”

Importantly, all studies to date suggest that Tai Chi may be safe for heart patients.

It may offer you additional options, whether in addition to a formal cardiac rehab program, as a part of maintenance therapy or as an exercise alternative.

Irregular Heart Rhythm in Men Associated With Exercise Intensity Over Time

Young men who undertake endurance exercise for more than 5 hours a week may increase their risk of developing an irregular heart rhythm later in life, according to the results of a new study.

“Physical activity contributes to prevention of several diseases, and in general is good for the well-being of your body and mind.

However, frequent high-intensity exercise during many years could increase the risk for atrial fibrillation (AF),” lead author Dr Nikola Drca, Department of Cardiology, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden, said in an interview.

The increase in risk is real, but quite small, he added.

The researchers presented their results online in the May 14, 2014, issue of the journal Heart.

RISK FACTOR FOR STROKE

In the Swedish study, the researchers quizzed more than 44,000 men aged 45 to 79 years about their leisure-time physical activity patterns at the ages of 15, 30, 50, and during the past year, when their average age was 60.

They tracked the participants’ heart health for an average of 12 years from 1997 onward to gauge how many developed AF, which is a known risk factor for stroke.

The men who had exercised intensively for more than 5 hours a week were 19% more likely to have developed AF later in their lives than those exercising for less than 1 hour a week.

The level of risk rose to 49% among those who did more than 5 hours of exercise a week at the age of 30, but who subsequently did less than an hour by the time they were age 60.

But those who cycled or walked briskly for an hour a day or more at age 60 were about 13% less likely to develop AF than those who did virtually no exercise at all.

MODERATION, MODERATION, MODERATION

“It seems that moderate doses of physical activity are enough to get the positive effects without acquiring the negative effects, while these benefits are lost with very high intensity and prolonged efforts,” Dr. Drca noted.

There are several possible mechanisms by which frequent endurance exercise could increase the risk for AF, he said.

These include enlargement of the left atrium, enlargement of and left ventricular hypertrophy, inflammatory changes in the left atrium, and an increase in the activity of the parasympathetic nervous system.

“In our study, the men who had the highest risk of developing atrial fibrillation were those who were very physically active when they were young, but stopped being physical active.

I think that moderate intensity regular physical activity that you continue throughout your life is the best way to maximize the benefits obtained by regular exercise while preventing undesirable effects.”

He added: “Physical inactivity and a sedentary lifestyle is a far bigger problem in the general population than excessive physical activity.

However, frequent high-intensity exercise during many years is associated with an increased risk of AF.”

Exercise More, Sit Less to Prevent Heart Failure

Be more active and sit less and you’ll improve your chances of preventing heart failure.

That’s the message of the first study to provide evidence that high levels of sedentary time, even among physically active men, places them at risk for heart failure.

“The evidence of the effects of physical activity on heart failure is developing.

Our study adds to this by examining the associations in a large racially and ethnically diverse population.

We provide even more evidence that moving more and sitting less can lead to better health,” says lead author Deborah Rohm Young, PhD, research scientist at the Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA.

Dr. Young and colleagues examined the electronic health records of nearly 83,000 men aged 45 years and older who were part of the California Men’s Health Study and had enrolled in Kaiser Permanente health plans in the Northern and Southern California regions.

The researchers published their results in the January 21, 2014 issue of the journal Circulation: Heart.

After monitoring these men for more than 10 years, they found that the risk of heart failure in those who reported high levels of sedentary time and low levels of physical activity was twice that in men who reported high physical activity and low sedentary time.

Although the researchers were not able to identify the types of exercise that the men did in the study, Dr. Young suggested that “brisk walking is a great form of physical activity.

It can be done almost anywhere, it does not require equipment, and most people of all ages can do it.”

She says that a brisk walk is “as if you’re in a hurry, and is defined as a 3- to 4-mile per hour pace or a 15- to 20-minute mile.”

To prevent heart disease, Dr. Young encourages men to meet the National Physical Activity Guideline—150 minutes per week of moderate intensity physical activity.

“We are still learning about the detrimental effects of high daily sedentary time,” she says.

“At this point, there is no consensus on how much sedentary time is too much.

Plus, our study only asked about sitting time outside of work.

But given the number of health benefits from being physically active, people should find ways to put physical activity into their lives and spend less time sitting.”

At Kaiser Permanente, clinicians have initiated an “Exercise Vital Sign” program in which all members are asked about their physical activity at every outpatient visit.

“The information is recorded in their electronic health record and is available for the health care providers when they see the patient.

It provides an opportunity for the provider to counsel the patient on physical activity levels,” Dr. Young says.

She suggests that primary care physicians ask their patients about their regular physical activity.

“When it’s insufficient, patients need to hear that regular physical activity is important for their health.

Physicians can be powerful advocates in helping to promote this message.”

Exercise More, Sit Less to Prevent Heart Failure

Be more active and sit less and you’ll improve your chances of preventing heart failure.

That’s the message of the first study to provide evidence that high levels of sedentary time, even among physically active men, places them at risk for heart failure.

“The evidence of the effects of physical activity on heart failure is developing.

Our study adds to this by examining the associations in a large racially and ethnically diverse population.

We provide even more evidence that moving more and sitting less can lead to better health,” says lead author Deborah Rohm Young, PhD, research scientist at the Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA.

Dr. Young and colleagues examined the electronic health records of nearly 83,000 men aged 45 years and older who were part of the California Men’s Health Study and had enrolled in Kaiser Permanente health plans in the Northern and Southern California regions.

The researchers published their results in the January 21, 2014 issue of the journal Circulation: Heart.

After monitoring these men for more than 10 years, they found that the risk of heart failure in those who reported high levels of sedentary time and low levels of physical activity was twice that in men who reported high physical activity and low sedentary time.

Although the researchers were not able to identify the types of exercise that the men did in the study, Dr. Young suggested that “brisk walking is a great form of physical activity.

It can be done almost anywhere, it does not require equipment, and most people of all ages can do it.”

She says that a brisk walk is “as if you’re in a hurry, and is defined as a 3- to 4-mile per hour pace or a 15- to 20-minute mile.”

To prevent heart disease, Dr. Young encourages men to meet the National Physical Activity Guideline—150 minutes per week of moderate intensity physical activity.

“We are still learning about the detrimental effects of high daily sedentary time,” she says.

“At this point, there is no consensus on how much sedentary time is too much.

Plus, our study only asked about sitting time outside of work.

But given the number of health benefits from being physically active, people should find ways to put physical activity into their lives and spend less time sitting.”

At Kaiser Permanente, clinicians have initiated an “Exercise Vital Sign” program in which all members are asked about their physical activity at every outpatient visit.

“The information is recorded in their electronic health record and is available for the health care providers when they see the patient.

It provides an opportunity for the provider to counsel the patient on physical activity levels,” Dr. Young says.

She suggests that primary care physicians ask their patients about their regular physical activity.

“When it’s insufficient, patients need to hear that regular physical activity is important for their health.

Physicians can be powerful advocates in helping to promote this message.”

Varsity Athletes Stay Active into Their 70s

Men who played a varsity sport in high school tend to be physically active into their 70s, and therefore healthier, according to the results of a new study.

Organized sports foster better health and fitness in old age,” says lead author Dr Simone Dohle of ETH Zurich, Department of Health Science and Technology.

The researchers analyzed a unique data set of 712 healthy US men, average age 78 years, who had passed a rigorous physical exam in the 1940s and who were surveyed 50 years later (in 2000).

Their physical activity level after 50 years was correlated and regressed across a wide number of demographic, behavioral, and personality variables from when they were 50 years younger.

The single strongest predictor of later-life physical activity was whether a man played a varsity sport in high school, in particular, football, basketball, baseball, or track and field; this also was related to fewer self-reported visits to the doctor.

The researchers published their results in the December 1, 2013 issue of BMC Public Health.

“I believe that it is important that physicians specifically target physical activity in preventive counseling, combined with suggestions for exercise or physical activity, and information on how to start an exercise routine or where to find a sports or fitness club,” says Dr. Dohle.

“When a physician takes down a patient’s medical history, it would be crucial to assess physical activity levels too,” she continues.

“In addition, a physician could encourage a patient by highlighting that physical activity is one of the most effective ways to prevent chronic diseases.”

Physicians need to keep in mind, however, that every patient has his own needs, abilities, and constraints, Dr. Dohle says.

“Find an activity that ensures long-time involvement and that the patient enjoys.”

The findings also offer some compelling reasons to maintain or enhance high school athletic programs, even in an era of shrinking school budgets.

Dr. Dohle says, “It has been noted that physical education classes may be the only opportunity for many to engage in weekly physical activity. School-based organized sports should be preserved because they contribute to later physical activity levels and decrease the risk factors for early morbidity.”

She suggests that perhaps there are more cost-effective ways to maintain sports programs without eliminating them.

For younger patients, physicians need to ask about physical activity, including time spent playing outside or participation in organized sports, Dr. Dohle states.

“Parents and other caregivers play a role in encouraging them to be active and should be involved in this discussion.

It might be that other forms of relatively vigorous exercise and physical education classes could be promoted across grade levels,” she notes.

“They need not concentrate on competition but rather on enjoyment, and on the benefits of and ways to stay physically active over the lifespan.”

Less competitive students can be steered toward noncompetitive activities, such as dance, weight lifting, and martial arts, Dr. Dohle suggests.

Making Fitness Fun for Kids

Get moving with your kids to keep them active.

That’s one of the messages from a sidebar, “Making Fitness Fun for Kids,” to my cover story in the August 2012 issue of Heart Insight magazine, just released online.

The main subject of the cover story is Tamika Catchings, a star professional basketball player and member of the NBA/WNBA FIT team, a program that encourages physical activity and healthy living for children and families.

Basketball players participate in games with kids around the country and get them excited about health and fitness.

Taking my own advice, I’m heading to my local Y this afternoon to workout with my 15-year-old daughter.

Here’s the full sidebar. Enjoy.

“Making Fitness Fun for Kids”

To maintain a healthy lifestyle, kids need to get regular physical activity.

Guidelines from the American Heart Association and other organizations suggest that kids should participate in at least 60 minutes of moderate to vigorous physical activity every day.

Being physically active doesn’t necessarily mean playing on a school team or working out at the gym.

Kids can ride bikes, jump rope, play hopscotch and run around the park with their friends.

Any game where kids are up and moving is a great way to help them stay physically active and make their heart, bones and muscles stronger, too, says Denver Nuggets head strength coach Steve Hess.

“The fun part of physical activity comes from kids working hard at something exciting that they like to do.

If you make the activity about them, they will find out that hard work can be fun, too.”

Parents need to find out what stimulates their kids and put a plan into place for optimum buy in, says Hess.

He and his sons Jordan, 13, and Korey, 10, will, on a snowy day, build 10 sledding ramps of different heights and then take turns zooming down them.

If the weather is bad, he creates an obstacle course or treasure hunt inside the house.

“Once they get into doing the activity, they lose track of time. They don’t even know that they’re working out and getting fit,” he says.

Here are some other tips on how to make physical activity more fun for kids:

Find activities your kids will love.

Some kids just don’t like competing in sports.

There are lots of other ways to be physically active, including swimming, horseback riding, dancing, cycling, skateboarding, yoga, hopscotch or brisk walking.

Encourage your child to explore multiple activities to find one he or she really enjoys and one that is appropriate for his or her age.

Get the whole family moving.

Plan times for everyone to be physically active.

Take walks, ride bikes, go swimming, garden or just play hide-and-seek outside.

Everyone will benefit from the exercise and the time spent together.

Participate in a local walkathon.

Find a local fundraising walk or “fun run” and bring the whole family.

If it’s animal-friendly, bring your dog along, too.

Make household chores into a dance party.

Put on a favorite CD and allot a certain number of songs to complete a household chore.

For example, allow two songs to vacuum the living room, three songs to wash the dishes and one song to pick up toys in the playroom.

Your kids will be moving faster and working harder to beat the clock, causing their hearts to pump harder and get stronger.

Don’t make exercise a punishment.

Forcing your child to go outside and play may increase resentment and resistance.

Use physical activity to encourage your child to do something she wants to do.

For instance, tell your child she can ride a bike for 30 minutes before starting homework after school.

It’s likely she’ll beg for 20 more minutes outside just to put off the homework if she enjoys bike-riding.

Mix it up to keep it interesting.

Don’t get stuck in a workout rut.

Incorporate a new type of physical activity every few weeks to keep your child motivated.

Varying activities also prevents your child’s body from getting used to the same workout, helping improve your child’s strength and fitness.

Break it up.

Kids don’t have to have to get in 60 minutes of physical activity all at once.

As long as daily physical activity adds up to at least 60 minutes of aerobic physical activity, your child meets the guidelines.

That might mean 20 minutes of play during recess, 20 minutes of bike riding after school and 20 minutes of briskly walking the dog after dinner.

For the best effects, parents need to put their own energy and enthusiasm into an activity to set an example, says Hess.

“Parents have to get up and going, too,” he says.

“When I take my sons to the park, I’m not just sitting on a bench watching.

I’ll shoot hoops with Korey and ask Jordan to show me some moves on the skateboard ramps.

I am truly excited about the things they are doing, and they can see that.”

More Screen Time Means Less Fit Kids

As the father of two electronically stimulated teens, I’m keening aware of the countless hours they spend in front of their laptops listening to music, chatting with friends, watching TV shows, or surfing the Web.

Now there’s more evidence that kids who spend more time in front of electronic devices are less likely to be fit.

The study was published in the June edition of Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine.

Researchers followed more than 5,000 children from age 12 to 16 to determine changes in their sedentary behavior.

Each child recorded his or her screen time and completed a shuttle run test to provide a measure of fitness.

Importantly, the researchers adjusted for time spent in high-intensity physical activity.

“In this technology age, children spend more time in sedentary behavior,” said lead author Jonathan Mitchell, Ph.D., then at the Arnold School of Public Health at the University of South Carolina.

“We wanted to see if high screen-based sedentary behavior affected cardiorespiratory fitness levels in childhood, and if this effect was independent of physical activity levels.”

As you might expect, the kids who had more screen time completed fewer shuttle run laps.

The association was strongest for the children who had mid-to-high fitness, and was independent of physical activity levels.

The researchers suggest that if the kids spent less time being sedentary, that is, had less screen time, their fitness levels would increase.

“The results are interesting and add to the evidence that spending too much time sitting is hazardous to children’s health,” said Mitchell. “If children limit the amount of time spent sitting in front of a screen, then this could help to combat declining levels of cardiorespiratory fitness in youth.”

I encourage my kids to get outside and be active whenever possible.

Luckily, they are both athletic and love to skateboard, shoot hoops, kick around a soccer ball, or play catch.

I try to keep up with what they are doing on their laptops so I’m in touch with what they like, however, there’s only so much dub step music one can take.

I suggest they practice the guitar or drums instead of mindlessly listening to tunes, and I am moderately successful.

And now I have even more motivation to get them to limit their screen time.

Wellness Revolution Now Taught at School

When the administrators of the Milton Hershey School recently reviewed the school’s BMI data they realized they had a problem.

The school administration knew they could make a difference in the students’ lives by making health and fitness a priority this school year by highlighting physical activity and nutrition.

Most students at the private school in Derry Township, PA, live at the school, which is funded by the Milton Hershey School Trust.

The new approach, called the “Wellness Revolution”, includes the school’s 5-hour rule.

Students must account for 5 hours of physical activity beyond normal school hours between Monday and Sunday, according to an article in local daily newspaper, The Patriot-News.

There’s no mandated activity; no sit-up requirement or 10,000 steps to count.

Instead, the school’s staff put together a list of activities — from ice hockey, to bicycle riding to weight lifting and swimming — and let the students follow their own desires, writes reporter Nick Malawskey.

As expected, there was some grumbling at first.

But the students have gotten into the groove.

Some of their physical activities include Zumba, turbo kickboxing, and yoga.

Menus at the school have changed as well.

Chicken nuggets, ramen noodles, and spaghetti are out.

Vegetables and buffalo chicken salad are in.

The students said they’re more conscious about what goes into their food — keeping an eye out for high fructose corn syrup and saturated fat content — than they were before, reports Malawskey.

It will take a few years to compile data to see how well the Wellness Revolution is working.

But some students have already lost more than 30 pounds and say they feel better.

If they learn how to maintain a healthy lifestyle, the real gain will be in the prevention of obesity and other chronic diseases when they go off on their own into the real world.