EXAMINATION OF LIFESTYLE BEHAVIORS AND

CARDIOMETABOLIC RISK FACTORS IN UNIVERSITY

STUDENTS ENROLLED IN KINESIOLOGY DEGREE
PROGRAMS
GINA M. MANY,1 ANDREA LUTSCH,2 KIMBERLY E. CONNORS,2 JANE SHEARER,2,3 HALEY C. BROWN,1
GARRETT ASH,4 LINDA S. PESCATELLO,4 HEATHER GORDISH-DRESSMAN,1 WHITNEY BARFIELD,1
GABRIEL DUBIS,5 JOSEPH A. HOUMARD,5 ERIC P. HOFFMAN,1 AND DUSTIN S. HITTEL2
1
Children’s National Medical Center, Research Center for Genetic Medicine, Washington, District of Columbia; 2Cumming
School of Medicine, University of Calgary, Calgary, Alberta, Canada; 3Faculty of Kinesiology, University of Calgary, Calgary,
Alberta, Canada; 4Human Performance Laboratory, College of Agriculture, Health and Natural Resources, University of
Connecticut, Storrs, Connecticut; and 5Human Performance Laboratory, East Carolina University, Greenville, North Carolina

ABSTRACT engaged in ,300 MET-h wk21 (p = 0.01). Our data suggest

Many, GM, Lutsch, A, Connors, KE, Shearer, J, Brown, HC, Ash,
G, Pescatello, LS, Gordish-Dressman, H, Barfield, W, Dubis, G,
Houmard, JA, Hoffman, EP, and Hittel, DS. Examination of
lifestyle behaviors and cardiometabolic risk factors in university
students enrolled in kinesiology degree programs. J Strength
Cond Res 30(4): 1137–1146, 2016—Preventing physical inac-
tivity and weight gain during college is critical in decreasing
lifelong obesity and associated disease risk. As such, we sought
to compare cardiometabolic risk factors and lifestyle behaviors
between college students enrolled in kinesiology and non-
that students enrolled in kinesiology degree programs display
improved healthy behaviors and associated outcomes (parame-
ters of glucose homeostasis). Practical outcomes of this
research indicate that implementing components of a compre-
hensive kinesiology curriculum encourages improved health be-
haviors and associated cardiometabolic risk factors.
KEY WORDS college students, kinesiology curriculum,
metabolic syndrome, HOMA-IR, Paffenbarger, REAP
INTRODUCTION

kinesiology degree programs to assess whether health and exer-
cise degree programs may influence health behaviors and asso-
ciated disease risk outcomes. Anthropometrics, fasting blood
glucose, insulin, lipid profiles and HbA1c%, blood pressure,
_ O2peak) were assessed in
and peak oxygen consumption (V
247 healthy college students. The homeostasis model assess-
ment of insulin sensitivity (HOMA) was calculated using glucose
and insulin levels. Self-reported physical activity from the Paffen-
barger questionnaire was collected to estimate the average calo-
ric expenditure due to different types of physical activities.
Despite no significant differences in body mass index or waist
circumference between groups, kinesiology majors presented
with ;20% lower fasting insulin levels and HOMA (p = 0.01;
p , 0.01, respectively) relative to nonmajors. Kinesiology majors
reported increased weekly participation in vigorous-intensity
sport and leisure activities and, on average, engaged in .300
metabolic equivalent-h$wk21, whereas non-kinesiology majors
Address correspondence to Dr. Dustin S. Hittel, dhhittel@ucalgary.ca.
30(4)/1137–1146
Journal of Strength and Conditioning Research
Ó 2016 National Strength and Conditioning Association
T
he transition from adolescence to adulthood is asso-
ciated with increased sedentary behaviors, poor eat-
ing habits, increased alcohol consumption, and
weight gain (15). Young adults entering a college/
university setting are at a critical point in their lives in terms of
developing personal lifestyle habits, such as physical activity
and dietary behaviors, which impact obesity status and asso-
ciated health outcomes (28). Obesity and physical activity are
associated with the clustering of cardiometabolic risk factors,
which include but are not limited to insulin resistance, dysli-
pidemia, hypertension, endothelial dysfunction, and systemic
inflammation (24). Metabolic syndrome (MetSyn) is classified
as a complex health condition associated with overweight/
obesity and comorbidities such as cardiovascular disease
(CVD) and type 2 diabetes (T2D) (11).
It is estimated that 12–15% of the world’s population has
MetSyn, which accounts for ;4 million deaths annually (18).
Although increasing age has historically been the strongest
predictor of increased MetSyn risk, it has been reported that
up to 17% of young Canadian adults aged 18–39 years have
MetSyn (26) and the age-adjusted prevalence of MetSyn in
the US adults older than 20 years is ;23% (3). Left

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 Cardiometabolic Risk Factors in the Young
untreated, the MetSyn in young adults places affected indi-
viduals at ;2–3 times greater risk of developing CVD and 5
times greater risk of developing T2D (11,18). Through edu-
cation and screening of MetSyn criteria, interventions may
be individually tailored or “personalized” to attenuate the
progression of MetSyn risk factors into the full-blown dis-
ease state (e.g., CVD or T2D) later in life. Lifestyle habits
learned in college are thus critical factors in the future health
and disease risk of many young adults.
Previous studies of community-based (12,22,23,30) and ele-
mentary school education programs (25) have indicated that
health education can decrease cardiometabolic risk factors.
Despite these findings, many college-age population studies
do not consider enrollment in a kinesiology degree program,
which emphasizes many aspects of health education (i.e., phys-
ical activity, nutrition, and exercise), as a confounding variable
in statistical analyses. We therefore sought to examine whether
the prevalence of MetSyn, lifestyle behaviors, and cardiometa-
bolic risk factors differed based on enrollment in kinesiology
degree programs. Findings of this study are of relevance to the
strength and conditioning field because this study examines
the potential impact of health and fitness education on lifestyle
behaviors and cardiometabolic risk factors in college students.
METHODS
Experimental Approach to the Problem
The AIMMY study is a National Institutes of Health–spon-
sored multicenter study with the aim of identifying genetic
variants associated with risk factors for the development of
MetSyn, T2D, and CVD in a young adult population. Par-
ticipants were recruited through classroom announcements,
campus-wide poster advertisements, and word of mouth.
Individuals who expressed interest were contacted via email
or telephone. During the initial telephone screening, subjects
were asked to self-report medical history, pregnancy status,
excessive alcohol consumption, and medication use. Inclu-
sion criteria consisted of age between 18 and 35 years, post-
pubertal, free of chronic medical conditions, not pregnant (as
assessed initially by self-report [telephone screening] and
then by urine pregnancy testing [visit #2]), and not taking
any medications known to affect metabolism.
Subjects
All participants were 18 years or older and consented to
participate in the Assessing Inherited Metabolic Syndrome
Markers in the Young (AIMMY) Study at the University of
Calgary (UC), Canada and East Carolina University (ECU),
United States. Contents of informed consent were approved
by the governing Ethical Review Boards (UC or ECU).
Consent was obtained from all eligible subjects before study
participation. Students were not given extra credit for
study participation and told they could drop out of the
study at any time without this affecting them in any way.
The University of Calgary participants (n = 183; 92
women and 91 men) and the ECU participants (n = 64; 39
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1138 Journal of Strength and Conditioning Research
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women and 25 men) consisted of healthy young individuals
with an average age of 22 6 4.0 years who consented for
study participation (17). In the UC cohort, participants were
primarily white (75%), and Asian (16%), with the remaining
9% being of African American, Hispanic, or mixed ethnic-
ities. In the ECU cohort, participants were primarily white
(77%) and African American (17%), with the remaining 6%
being Hispanic or mixed ethnicities. The study conforms to
the Code of Ethics of the World Medical Association
(approved by the Ethics Advisory Board of Swansea Univer-
sity) and required players to provide informed consent
before participation.
Risk Factor Screening
Visit 1. During visit 1, body composition was analyzed by
dual-energy x-ray absorptiometry (Hologic Discovery Wi,
Bedford, MA, USA) at the UC or via Bod Pod (COSMED,
Concord, CA, USA) at the ECU. Anthropometric measures
taken included height, weight, and waist (suprailiac, narrow
waist, and midwaist) and neck circumferences. Self-reported
physical activity within the last year was assessed via the
Paffenbarger Physical Activity Questionnaire. Derived phys-
ical activity variables included weekly energy expenditure
that was estimated based on reported weekday and weekend
duration and intensity of physical activity. In this question-
naire, subjects were asked to divide the time spent engaging
in light-, moderate-, and vigorous-intensity physical activity,
sitting, and sleeping over a typical 24-hour weekday and
weekend (1). Dietary habits were assessed by the Rapid
Eating and Activity Assessment for Patients (REAP) (13).
Validity and reliability of the REAP survey has been assessed
previously using a cohort similar in age (29), and via a meta-
analysis of dietary surveys (16). In addition, demographic,
self and family medical history, and ancestry questionnaires
were completed. Students were asked to report their major
on survey administration.
Visit 2. A blood draw was obtained from each participant the
morning after 8–12 hours of overnight fast by a nurse or cer-
tified phlebotomist. Peripheral blood (;35 ml) was obtained by
venipuncture and collected into preservative-free, EDTA or
sodium heparin tubes; all samples were processed for serum
or plasma isolation at 48 C within 30 minutes of venipuncture.
After blood sample processing, samples were shipped for quan-
tification of fasting glucose, insulin, triglycerides, high-density
lipoprotein (HDL) and low-density lipoprotein cholesterol,
hemoglobin-A1c (HbA1c), and serum human chorionic
gonadotropin (for pregnancy eligibility screening in female par-
ticipants) at Quest Diagnostics. The homeostatic model assess-
ment for insulin resistance (HOMA-IR) was calculated from
fasting glucose and insulin levels, where HOMA-IR = (fasting
glucose 3 fasting insulin)/22.5 (20). The following cut-points
were used to define elevated MetSyn components according to
the National Cholesterol Education Program (NCEP):ATP III
criteria: (a) waist circumference .102 cm (men) or .88 cm

(women); (b) triglycerides $150 mg$dl21; (c) HDL cholesterol
,40 mg$dl21 (men) or ,50 mg$dl21 (women); (d) blood
pressure $130 mm Hg (systolic) or $85 mm Hg (diastolic);
and (e) fasting glucose $100 mg$dl21. Participants were clas-
sified as having MetSyn if they displayed $3 of 5 elevated
MetSyn components.
Visit 3. Grip strength measurements were performed using
an Almedic 100 kg handgrip dynamometer in the UC cohort
(Almedic, Montreal, QC, Canada) or a Takei Grip-A
dynamometer in the ECU group (Miller Medical Supplies,
Newport, South Wales). Seated resting blood pressure and
heart rate measures were taken 3 times over 2 separate visits
using an automated monitor cuff. V_ O2peak was assessed using
the Bruce treadmill protocol (5). Oxygen consumption in
both groups was assessed via utilization of a Hans Rudolph
nonbreathing 2-way valve mouthpiece (Hans Rudolph Inc.,
Shawnee, KS, USA) and a ParvoMedics TrueOne 2400 met-
abolic cart (ParvoMedics, Sandy, UT, USA).
Statistical Analyses
All data was de-identified for storage and analysis. Data were
analyzed using SPSS Statistics version 21 (IBM Corporation,
Armonk, NY, USA). Differences between kinesiology
(KNES) and non-kinesiology (non-KNES) majors were
analyzed via 1-way analysis of variance using university
(site) as a covariate; independent t-tests were used to com-
pare differences between majors within each university.
Nonnormally distributed data were log transformed before
data analysis. Chi-squared tests were used to compare the
presentation of MetSyn components between majors. Pear-
son’s correlation coefficient was calculated to assess correla-
tions between lifestyle and cardiometabolic variables.
Statistical significance was set at p # 0.05 for all analyses.
Data are presented as mean 6 SEM values.
RESULTS
Sample Description
Of a total of 247 participants from both cohorts, 81 were self-
reported as KNES majors and the remaining 166 were non-
KNES majors. Nondegree seeking students, students who
did not report a concentration of study, and students in
health-related fields other than KNES were excluded from
analyses. Non-KNES participants were included but were
not limited to students from science, arts, engineering, and
business programs.
Fasting Cardiometabolic Profile
When KNES majors were compared with non-KNES
majors in both cohorts, KNES majors displayed a ;20%
lower average fasting insulin (p = 0.012) and ;20% lower
HOMA-IR (p = 0.009), despite no significant differences in
body mass index (BMI), waist circumference, or waist-to-hip
ratio between majors (Table 1). Fasting blood glucose levels
seemed to be lower in the KNES group but only trended
toward statistical significance (p = 0.06). On average, KNES
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major weighed slightly less, but no statistically significant
differences in BMI were observed between groups. No other
differences in other cardiometabolic risk factors were
observed between KNES and non-KNES majors (Table 1).
A summary of the combined and between-site subject
characteristics is provided in Table 2. Mean values for all sub-
ject characteristics were within normal ranges as defined by
the NCEP:ATP III Guidelines (2). According to these subject
characteristics, 1 subject was considered to have MetSyn
(0.4% of study population). Overall, 67.8% of subjects
did not present with any elevated MetSyn components,
32.2% of subjects presented with 1 elevated MetSyn compo-
nent, and 6.2% presented with 2 elevated MetSyn compo-
nents. Overall, the distribution of elevated MetSyn
components was less frequent in the KNES group, but this
did not reach statistical significance, likely because of the low
prevalence of elevated MetSyn components in this cohort
(Table 3). Cardiometabolic risk factors significantly correlated
with HOMA-IR as follows: suprailiac waist circumference
(r = 0.44, p , 0.001); V_ O2peak (r = 0.37; p , 0.001); waist-
to-hip ratio (r = 0.29, p , 0.001); midwaist circumference (r =
0.38, ,0.001); and fasting triglycerides (r = 0.32, p , 0.001)
(data not shown), suggesting a clustering of cardiometabolic
risk factors.
Habitual Physical Activity and Cardiorespiratory Fitness
Overall, the total MET h$wk21 spent engaging in all activ-
ities was ;5% greater in KNES relative to non-KNES majors
(p = 0.010). The weekly caloric expenditure spent engaging
in moderate- and vigorous-intensity sport and leisure activ-
ities was ;32 and ;67%, respectively, greater in the KNES
group (p , 0.001). The average weekly caloric expenditure
spent engaging in all sport and leisure activities was ;44%
greater in KNES vs. non-KNES majors. Kinesiology majors
reported a ;17% increased engagement (hour per week) in
vigorous sport and leisure activities (p = 0.022). No statisti-
cally significant differences in the time spent engaging in
light- or moderate-intensity leisure-time physical activity
were observed between majors (p . 0.05). No statistically
significant differences in walking or stair climbing activities
were observed between majors (p . 0.05) (Table 4).
Of all of the calculated Paffenbarger scores, the estimated
total weekly caloric expenditure in vigorous and all intensi-
ties of sport and leisure activities displayed the strongest
correlation with V_ O2peak (r = 0.30, p , 0.001; r = 0.31, p ,
0.001, respectively) (not shown). On average, KNES majors
displayed a trend toward a ;5% higher V_ O2peak (p = 0.08)
relative to non-KNES majors. In the total population,
V_ O2peak displayed a negative correlation to parameters of
glucose homeostasis: fasting insulin (r = 20.393, p , 0.001)
and HOMA-IR (r = 20.374, p , 0.001).
Dietary Habits
Other lifestyle differences observed between majors included
differences in dietary choices as indicated by responses to
the REAP survey (Table 5). Major differences in eating
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TABLE 1. Comparison of subject characteristics between kinesiology and non-kinesiology majors.*†

UC ECU Combined

KINES majors, Non-KNES major, KNES major, Non-KNES major, KNES major, Non-KNES major,
Characteristic n = 63 n = 120 n = 18 n = 46 n = 81 n = 166

Age at collectionz 22.60 6 0.46 23.23 6 0.41 20.10 6 0.42 19.48 6 0.32 22.04 6 0.39 22.15 6 0.34
Height (cm) 171.93 6 1.21 173.19 6 1.04 169.93 6 1.67 170.10 6 1.29 171.44 6 1.00 172.21 6 0.83
Weight (kg) 68.72 6 1.55 70.18 6 1.34 69.78 6 2.67 77.64 6 2.76§ 68.98 6 1.33 72.67 6 1.30§
BMI 23.15 6 0.33 23.09 6 0.27 23.88 6 0.67 25.25 6 0.85 23.31 6 0.29 23.71 6 0.31
% Total BF (DXA) 19.55 6 0.84 20.25 6 0.69
% Total BF (Bod Pod) 19.06 6 2.55 26.74 6 1.81§
Neck circumference (cm) 34.57 6 0.38 35.37 6 0.34 34.69 6 0.91 34.38 6 0.55 34.60 6 0.36 35.11 6 0.29
Narrow waist circumference (cm) 76.13 6 0.99 77.08 6 0.82 75.34 6 1.54 78.66 6 1.72 75.95 6 7.38 77.54 6 0.76
Midwaist circumference (cm) 78.24 6 0.98 79.45 6 0.79 76.60 6 1.49 80.21 6 1.86 77.87 6 0.84 79.68 6 0.77
TM

Suprailiac waist circumference (cm)z 82.03 6 0.92 82.93 6 0.76 80.02 6 1.42 85.75 6 1.94§ 81.58 6 0.78 83.68 6 0.77
Hip circumference (cm) 97.41 6 0.67 97.46 6 0.58 96.91 6 1.56 101.08 6 1.66 97.30 6 0.62 98.45 6 0.63
Waist:hip ratio 0.84 6 0.01 0.85 6 0.00 0.78 6 0.01 0.78 6 0.01 0.83 6 0.01 0.83 6 0.00
Fasting glucose (mg$dl21) 81.88 6 0.75 83.25 6 0.61 80.94 6 2.01 83.49 6 0.85 81.69 6 0.72 83.29 6 0.50
Fasting triglycerides (mg$dl21)z 81.09 6 4.65 82.77 6 3.35 77.44 6 10.90 90.22 6 7.28 80.35 6 4.29 85.51 6 3.15
Fasting total cholesterol (mg$dl21) 162.46 6 4.00 163.95 6 2.81 143.88 6 7.73 158.95 6 5.94 158.69 6 3.15 162.92 6 3.62
Fasting HDL-C (mg$dl21) 62.91 6 2.71 62.08 6 1.56 60.38 6 3.11 56.76 6 2.21 62.40 6 2.24 60.70 6 1.29
Fasting LDL-C (mg$dl21) 85.28 6 3.70 85.43 6 2.12 76.25 6 4.37 82.58 6 3.64 83.45 6 3.10 84.79 6 1.83
Fasting insulin (uIU$ml21)z 5.46 6 0.31 6.58 6 0.30§ 4.37 6 0.94 6.02 6 0.72 5.25 6 0.31 6.40 6 0.29§
HbA1c %z 5.56 6 0.03 5.51 6 0.02 5.21 6 0.07 5.41 6 0.05§ 5.49 6 0.03 5.48 6 0.02
HOMAz 1.12 6 0.07 1.37 6 0.07§ 0.93 6 0.23 1.23 6 0.14 1.08 6 0.07 1.32 6 0.06§
Right peak grip strength (kg)z 46.25 6 1.40 46.63 6 1.34 38.56 6 3.26 34.79 6 1.51 44.26 6 1.38 42.45 6 1.15
Left peak grip strength (kg)z 44.72 6 1.43 43.93 6 1.31 35.90 6 3.74 31.83 6 1.43 42.45 6 1.49 40.09 6 1.12
Max grip strength score (kg)z 46.84 6 1.37 47.47 6 1.26 39.56 6 3.52 35.11 6 1.51 44.96 6 11.78 43.76 6 14.28
Systolic blood pressure 113.45 6 1.26 112.51 6 1.06 114.20 6 2.50 112.09 6 1.37 113.65 6 1.13 112.40 6 0.84
Diastolic blood pressure 66.47 6 1.11 68.50 6 0.77 68.69 6 1.35 68.90 6 1.09 67.05 6 0.90 68.61 6 0.63
V_ O2peak (ml$kg21$min21) 48.75 6 1.11 47.55 6 0.85 45.83 6 2.57 41.52 6 1.59 48.12 6 1.03 45.77 6 0.80

*UC = University of Calgary; ECU = East Carolina University; KNES = kinesiology; BF = body fat; BMI = body mass index; DXA = dual-energy x-ray absorptiometry; HDL-C = high-
density lipoprotein cholesterol; LDL-C = low-density lipoprotein cholesterol; HOMA = homeostatic model assessment for insulin resistance; ANCOVA = analysis of covariance.
†Baseline subjects’ characteristics between kinesiology and non-kinesiology students enrolled between 2009 and 2011 in ECU, UC, and combined cohorts. In the combined
group, a 1-way ANCOVA using site (university) as a covariate was performed; all other analyses were performed by independent t-tests.
zData were nonnormally distributed and thus log transformed before ANCOVA testing.
§Statistically significant differences between KNES majors and non-KNES majors (P # 0.05).

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TABLE 2. Characteristics of AIMMY participants between sites.*†

Characteristic UC (n = 183) ECU (n = 64) Combined (n = 247)

Age at collectionz 23.05 6 0.31 19.6 6 0.26 22.14 6 0.26§

Gender
Male (%) 49.73 39.06 46.99
Female (%) 50.27 60.94 53.01
Height (cm) 172.82 6 0.79 170.05 6 1.01 171.93 6 0.63§
Weight (kg) 69.78 6 1.01 75.43 6 2.09 71.46 6 0.96§
BMI 23.13 6 0.21 24.86 6 0.62 23.58 6 0.23§
% Total BF (DXA) 20.06 6 0.54
% Total BF (Bod Pod) 24.67 6 1.96
Neck circumference (cm) 35.09 6 0.26 34.47 6 0.47 34.93 6 0.23
Narrow waist circumference (cm) 76.75 6 0.63 77.34 6 1.27 77.01 6 0.57
Midwaist circumference (cm) 79.04 6 0.62 79.19 6 1.36 79.08 6 0.57
Suprailiac waist circumference (cm)z 82.62 6 0.60 84.14 6 1.43 83.01 6 0.58
Hip circumference (cm) 97.44 6 0.44 99.91 6 1.25 98.08 6 0.47
Waist:hip ratio 0.847 6 0.01 0.784 6 0.01 0.834 6 0.01§
Fasting glucose (mg$dl21) 82.77 6 0.48 82.82 6 0.81 82.78 6 0.41
Fasting triglycerides (mg$dl21)z 82.18 6 2.73 86.87 6 5.95 83.37 6 2.53
Fasting total cholesterol (mg$dl21) 163.43 6 2.29 154.48 6 4.73 161.36 6 2.08
Fasting HDL-C (mg$dl21) 62.38 6 1.39 57.70 6 1.76 61.19 6 1.14
Fasting LDL-C (mg$dl21) 85.38 6 1.90 80.92 6 2.81 84.25 6 1.59
Fasting insulin (uIU$ml21)z 6.19 6 0.24 5.59 6 0.57 6.04 6 0.23§
HbA1c % 5.53 6 0.02 5.35 6 0.04 5.49 6 0.02§
HOMA 1.28 6 0.05 1.15 6 0.12 1.25 6 0.05§
Right peak grip strength (kg)z 46.50 6 1.01 35.84 6 1.48 43.43 6 0.89§
Left peak grip strength (kg)z 44.19 6 0.99 32.97 6 1.51 40.12 6 0.90§
Max grip strength score (kg)z 47.26 6 1.02 36.36 6 1.53 44.12 6 0.91§
Systolic blood pressure (mm Hg) 112.82 6 0.81 112.68 6 1.24 112.78 6 0.68
Diastolic blood pressure (mm Hg) 67.84 6 0.63 68.84 6 0.89 68.13 6 0.52
V_ O2peak (ml$kg21$min21) 47.95 6 0.68 42.56 6 1.36 46.45 6 0.64

*AIMMY = Assessing Inherited Metabolic Syndrome Markers in the Young; UC = University of Calgary; ECU = East Carolina
University; BMI = body mass index; BF = body fat; DXA = dual-energy x-ray absorptiometry; HDL-C = high-density lipoprotein
cholesterol; LDL-C = low-density lipoprotein cholesterol; HOMA = homeostatic model assessment for insulin resistance.
†Baseline subjects’ characteristics in subjects at ECU and UC AIMMY sites. Data were analyzed between UC and ECU subjects by
independent t-tests.
zNonparametric tests were used to determine statistical significance.
§Statistically significant differences between UC and ECU sites, p # 0.05.

behaviors between KNES majors and nonmajors observed (p = 0.004), vegetables (p = 0.007), and dairy (p = 0.006).
in both cohorts included skipping breakfast less often Furthermore, KNES majors self-reported consuming less
(p = 0.009), consuming the recommended servings of fruits dark meat (p = 0.010), fried foods (p = 0.003), and alcohol

TABLE 3. Distribution of elevated MetSyn components based on KNES major.*†

Distribution of MetS components between majors

No. MetS Percentage of
components Subjects (n) total population KNES (%) Non-KNES (%)

0 164 67.8 72.5 65.4

$1 78 32.2 23.8 27.2
$2 15 6.2 3.8 6.8
$3 1 0.4 0.0 0.6

*MetSyn = metabolic syndrome; KNES = kinesiology.

†The number of elevated MetSyn components in the total population and is grouped for KNES major.

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Cardiometabolic Risk Factors in the Young

TABLE 4. Comparison of paffenbarger survey scores between kinesiology and non-kinesiology majors.*†

University of Calgary East Carolina university Combined

Journal of Strength and Conditioning Research
the

Paffenbarger Non-KNES major, Non-KNES major, Non-KNES major,

survey scores KNES major, n = 62 n = 113 KNES major, n = 18 n = 46 KNES major, n = 80 n = 159

Total walking 11.36 6 1.38 8.85 6 0.71 10.19 6 2.71 9.31 6 1.02 11.11 6 1.22 8.98 6 0.58
(miles$wk21)z
Total walking 1,090.19 6 132.49 849.91 6 68.10 978.35 6 260.38 893.40 6 97.71 1,066.13 6 117.45 861.90 6 56.06
(kcal$wk21)z
Total stair climbing 432.65 6 78.58 290.65 6 28.66 306.35 6 81.86 350.98 6 57.62 405.47 6 64.19 307.28 6 26.13
(kcal$wk21)z
Combined walking 1,522.84 6 165.65 1,140.57 6 76.65 1,284.71 6 331.09 1,244.37 6 126.82 1,471.59 6 147.66 1,169.18 6 65.50
and stair
climbing
(kcal$wk21)z
Total sports and 9,206.51 6 1,267.06 6,532.57 6 577.09§ 11,372.27 6 3,226.72 4,625.27 6 693.98§ 9,693.81 6 1,214.57 5,980.77 6 460.64§
leisure
(kcal$wk21)z
TM

Light sports and 383.61 6 68.05 444.74 6 110.15 439.90 6 142.15 206.05 6 96.79 396.28 6 61.29 375.69 6 83.42
leisure
(kcal$wk21)z
Moderate sports 4,175.07 6 567.58 3,188.77 6 352.48§ 3,910.66 6 1,011.40 2,504.42 6 584.21 4,115.58 6 492.41 2,990.78 6 302.2§
and leisure
(kcal$wk21)z
Vigorous sports 4,647.83 6 903.20 2,859.13 6 311.98§ 7,021.71 6 2,403.82 1,906.81 6 294.49§ 5,181.95 6 883.39 2,583.62 6 239.50§
and leisure
(kcal$wk21)z
Total Physical 10,729.35 6 1,367.55 7,673.14 6 581.21§ 12,601.16 6 3,286.68 5,742.15 6 745.29 11,150.51 6 1,284.49 7,114.49 6 469.89§
Activity Index
(kcal$wk21)z
Sitting time 41.55 6 2.23 45.91 6 1.64 40.86 6 4.55 44.22 6 2.66 41.39 6 1.99 45.42 6 1.39
(h$wk21)z
Light activity 36.87 6 2.04 35.48 6 1.42 35.03 6 3.85 34.91 6 1.63 36.46 6 1.79 35.31 6 1.11
(h$wk21)z
Moderate activity 21.79 6 1.61 19.40 6 1.02 20.61 6 2.59 19.09 6 1.73 21.53 6 1.37 19.31 6 0.88
(h$wk21)z
Vigorous activity 11.69 6 1.03 10.52 6 0.66 16.61 6 1.84 11.59 6 1.44 12.80 6 0.92 10.83 6 0.62§
(h$wk21)z
Total MET 306.92 6 5.93 294.88 6 4.14 327.31 6 9.45 299.02 6 9.15§ 311.51 6 5.13 296.08 6 3.94§
(h$wk21)z

*KNES = kinesiology; ANCOVA = analysis of covariance.

†Self-reported yearly physical activity scores between KNES and non-KNES majors. In the combined group, a 1-way ANCOVA using site (university) as a covariate was performed;
all other analyses were performed by independent t-tests.
zData were nonnormally distributed and thus log transformed before ANCOVA testing.
§Statistically significant differences between KNES majors and non-KNES majors (p # 0.05).

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 the TM

Journal of Strength and Conditioning Research | www.nsca.com

TABLE 5. REAP survey scores between kinesiology and non-kinesiology majors.*†

UC ECU Combined

KNES major, Non-KNES KNES major, Non-KNES KNES major, Non-KNES

REAP Survey Scorez n = 63 major, n = 120 n = 18 major, n = 46 n = 81 major, n = 166

Skip breakfast 2.78 6 0.07 2.48 6 0.07§ 2.11 6 0.20 2.00 6 0.13 2.63 6 0.07 2.35 6 0.06§
Prepared meal 2.62 6 0.08 2.36 6 0.07§ 2.83 6 0.12 2.41 6 0.12§ 2.67 6 0.07 2.37 6 0.06§
consumption
Reduced whole grain 2.60 6 0.09 2.48 6 0.06 2.72 6 0.14 2.41 6 0.10 2.63 6 0.08 2.46 6 0.05§
consumption
Reduced fruit 2.68 6 0.06 2.35 6 0.07§ 2.06 6 0.20 2.07 6 0.10 2.54 6 0.07 2.27 6 0.06§
consumption
Reduced vegetable 2.56 6 0.07 2.32 6 0.06§ 2.28 6 0.18 2.09 6 0.11 2.49 6 0.07 2.25 6 0.05§
consumption
Reduced dairy 2.46 6 0.09 2.25 6 0.07 2.72 6 0.11 2.22 6 0.11§ 2.52 6 0.07 2.24 6 0.06§
consumption
Reduced fat dairy 1.46 6 0.16 1.77 6 0.11 2.28 6 0.23 1.74 6 0.12 1.64 6 0.14 1.76 6 0.09
consumption
Full fat cheese 1.41 6 0.14 1.30 6 0.08 1.44 6 0.22 1.41 6 0.12 1.42 6 0.12 1.33 6 0.07
consumption
Dark meat consumption 1.75 6 0.10 1.48 6 0.07§ 1.83 6 0.20 1.61 6 0.12 1.77 6 0.09 1.51 6 0.06§
White meat consumption 2.06 6 0.11 2.04 6 0.08 1.78 6 0.21 2.00 6 0.11 2.00 6 0.10 2.03 6 0.06
High fat red meat 2.08 6 0.12 2.03 6 0.08 2.17 6 0.23 1.87 6 0.13 2.10 6 0.11 1.98 6 0.07
consumption
Meat skin/fat 2.30 6 0.13 2.21 6 0.09 2.11 6 0.21 2.24 6 0.14 2.26 6 0.11 2.22 6 0.08
consumption
Processed meat 2.08 6 0.15 1.71 6 0.11§ 2.11 6 0.21 1.93 6 0.17 2.09 6 0.12 1.77 6 0.09
consumption
Fried food consumption 2.76 6 0.06 2.52 6 0.06§ 2.22 6 0.17 1.98 6 0.12 2.64 6 0.07 2.37 6 0.06§
High fat snack 1.78 6 0.14 1.67 6 0.10 2.28 6 0.25 1.76 6 0.14§ 1.89 6 0.12 1.69 6 0.08
consumption
Full-fat dressing 1.76 6 0.15 1.61 6 0.10 2.17 6 0.23 1.50 6 0.16§ 1.85 6 0.13 1.58 6 0.09
consumption
Added fat preference 1.79 6 0.12 1.58 6 0.08 1.83 6 0.28 1.57 6 0.18 1.80 6 0.11 1.58 6 0.07
Added fat consumption 2.21 6 0.10 2.00 6 0.08 2.22 6 0.19 2.24 6 0.12 2.21 6 0.09 2.07 6 0.06
(butter/margarine/oil)
Sweetened dessert/ 1.51 6 0.13 1.53 6 0.09 2.06 6 0.23 1.57 6 0.15 1.63 6 0.12 1.54 6 0.07
snack preference
Ice cream consumption 1.48 6 0.15 1.41 6 0.12 1.72 6 0.31 1.54 6 0.17 1.53 6 0.14 1.45 6 0.09
Sweetened dessert/ 2.76 6 0.07 2.49 6 0.06§ 2.78 6 0.10 2.41 6 0.10§ 2.77 6 0.06 2.47 6 0.05§
snack consumption
Sweetened beverage 2.89 6 0.05 2.73 6 0.05§ 2.61 6 0.14 2.54 6 0.09 2.83 6 0.05 2.67 6 0.05
consumption
High-sodium processed 2.54 6 0.08 2.39 6 0.06 2.39 6 0.16 2.24 6 0.12 2.51 6 0.07 2.35 6 0.06
food consumption
Added table salt 2.40 6 0.09 2.22 6 0.07 2.50 6 0.19 2.20 6 0.12 2.42 6 0.08 2.21 6 0.06§
consumption
Alcohol consumption 2.70 6 0.06 2.48 6 0.06§ 2.72 6 0.11 2.76 6 0.07 2.70 6 0.05 2.56 6 0.05§
Physical inactivity 2.81 6 0.05 2.60 6 0.06§ 2.78 6 0.10 2.48 6 0.11 2.80 6 0.05 2.57 6 0.05§
Television watching 2.21 6 0.09 2.09 6 0.07 2.17 6 0.19 2.20 6 0.12 2.20 6 0.08 2.12 6 0.06
frequency

*REAP = Rapid Eating and Activity Assessment for Patients; UC = University of Calgary; ECU = East Carolina University; KNES =
kinesiology; ANCOVA = analysis of covariance.
†REAP survey data collected from ECU and UC participants. A total of 230 subjects at both sites completed the REAP survey.
Data from these subjects were used in analysis. Data were analyzed by independent t-tests when comparing differences between
KNES and non-KNES students within the same university. ANCOVA testing was performed using university as a covariate when
comparing differences in the combined cohort.
zScores: 1 = usually; 2 = sometimes; 3 = rarely/never.
§Statistically significant differences between KNES majors and non-KNES majors (p # 0.05).

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 Cardiometabolic Risk Factors in the Young
(p = 0.001) than did non-KNES majors. Kinesiology majors
also reported a reduced frequency of sedentary behaviors in
this separate survey of physical activity (p = 0.006), whereas
no significant differences in television watching frequency
were reported between groups (Table 5).
DISCUSSION
To the best of our knowledge this is the first study
comparing MetSyn, cardiometabolic risk factors, and life-
style behaviors between students enrolled in kinesiology
degree programs versus other courses of study in a popula-
tion of healthy college students. We observed that students
enrolled in kinesiology curricula degree programs from 2
international and demographically diverse institutions dis-
played reduced fasting insulin and HOMA-IR values relative
to students in degree programs outside of the kinesiology
field. Major lifestyle differences between majors and non-
majors included a greater weekly caloric expenditure attrib-
uted to engagement in moderate- and vigorous-intensity
sport and leisure activities. Overall, the most pronounced
difference between majors was the increased engagement in
vigorous physical activity; KNES majors expended ;67%
more kcal$wk21 engaging in vigorous physical activity rela-
tive to non-KNES majors. Additionally, KNES students re-
ported less frequent unhealthy eating behaviors, such as
reduced fruit, vegetable, dairy, whole grain, and prepared
food consumption, and reported reduced fried food, dessert,
alcohol, and dark meat consumption relative to non-KNES
students. Together, our data suggests that in a young,
healthy college-aged population, KNES majors display
improved health behaviors and improved parameters of glu-
cose homeostasis relative to non-KNES students. Interest-
ingly, these findings are in contrast to findings in nursing
students around the same age (;21 years) (6), where nursing
students reported increased sedentary behaviors relative
to students enrolled in other degree programs. Together,
these data suggest that KNES curriculum requiring fitness
education and participation in physical activity classes may
influence health behaviors and associated disease outcomes.
Differences in parameters of glucose homeostasis between
majors may be attributed to increased healthy behaviors,
such as increased weekly engagement in physical activity
and improved dietary behaviors, between groups. Regular
physical activity is critical in the maintenance of glucose
tolerance, T2D prevention, blood pressure regulation, and
CVD risk prevention (8). One of the major differences in self-
reported physical activity between KNES majors and non-
KNES majors was increased engagement in vigorous sport
and leisure activity. Leisure-time vigorous physical activity is
associated with improved parameters of glucose homeostasis
(fasting glucose) in adults aged 20–70 years (9) and
a decreased risk of developing MetSyn in middle-aged
men (19). Acute bouts of vigorous exercise have also been
shown to induce greater improvements in insulin sensitivity
relative to isocaloric bouts of moderate-intensity exercise in
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1144 Journal of Strength and Conditioning Research
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prediabetic adults (27). High bouts of vigorous exercise train-
ing have been observed to induce greater reductions in
measures of central adiposity (31). On average, KNES ma-
jors reported partaking in greater than 300 MET-h$wk21 of
physical activity, whereas non-KNES majors reported
engaging in less than 300 MET-h$wk21 of physical activity.
In longitudinal studies, engagement in greater than 300
MET-h$wk21, as reported through the Paffenbarger survey,
is associated with reduced waist circumference in middle-
aged women (7). Additionally, decreased fruit and vegetable
intake and the increased consumption of snack foods are
positively associated with changes in waist circumference,
as assessed by food frequency questionnaires (14), a major
risk factor being glucose intolerance.
Our findings are particularly important as the benefits of
these more frequent healthy behaviors observed in KNES
majors are associated with improved health outcomes at
an early age in a group of “pre-symptomatic” college-aged
students. Furthermore, insulin resistance during young adult-
hood is among the strongest predictors for the development
of T2D later in life (4). Our findings thus contribute to a body
of literature supporting the preventative efficacy of increased
participation in physical activity, particularly of vigorous
intensity, given that a 1.0 unit increase in HOMA-IR is asso-
ciated with a ;5.4% increase in cardiovascular risk (21).
The prevalence of MetSyn, 0.4%, was lower in this
population than previously reported; other studies in similar
college-aged populations have documented the prevalence
of MetSyn to vary between 0.6 and 13% (10). The prevalence
of MetSyn in non-KNES students was similar to the lower
end of previous reports (0.6%), and no KNES students pre-
sented with MetSyn. Therefore, the lower prevalence of
MetSyn in our study population, relative to previous reports,
may be due to the large number of KNES students enrolled.
Based on our initial study design, we were not able to
quantify the contribution of structured physical activity
provided by KNES curriculum to the total time spent
engaging in physical activity. Future analyses of the total
caloric expenditure associated with KNES physical activity
classes may thus be of interest. All subjects were given the
same instructions for completing the questionnaires. How-
ever, we cannot predict whether KNES majors were likely to
report improved health behaviors. We do believe these
reports were valid because V_ O2peak was correlated with
self-reported physical scores and cardiometabolic risk
factors.
PRACTICAL APPLICATIONS
This study suggests that individuals enrolled in accredited
kinesiology degree programs display improved parameters
of glucose homeostasis relative to non-kinesiology majors
and that these differences may be modulated by increased
participation in physical activity and improved dietary
choices. Our data support previous literature indicating that
frequent engagement in physical activity helps to regulate

parameters of glucose homeostasis,25 which may later
decrease the risk of cardiometabolic risk factors such as
insulin resistance. Both the UC and ECU have an extensive
set of courses required by kinesiology majors, which includes
courses in nutrition, exercise physiology, motor learning,
exercise and sports psychology, anatomy and physiology,
and biomechanics. These data suggest that the improved
knowledge of physical activity and nutrition that is provided
by kinesiology degree programs and/or encapsulated by stu-
dents interested in enrolling kinesiology degree programs
may affect participation in sport and leisure activities and
other healthy lifestyle behaviors (e.g., improved dietary be-
haviors) and thereby attenuate cardiometabolic risks factors
in early adulthood.
It is thus of interest to examine the components of
kinesiology curricula and traits of students attracted to
kinesiology degree programs to understand factors contrib-
uting to increased participation in sport and leisure activities
and other healthy lifestyle behaviors. Additionally, our data
highlight the importance of stratifying for health and fitness
interest and knowledge when analyzing larger data sets
because the recruitment of KNES students may add hidden
stratification to population-based research studies as it
suggests that KNES students are a very healthy group of
preallied health professionals.
ACKNOWLEDGMENTS
The AIMMY Study was funded by a grant from the DC-
Baltimore Research Center on Child Health Disparities
(2P20MD000198-06) and the Clark Charitable Foundation,
Inc. D. S. Hittel was funded by philanthropic donations from
the Eresman Family, BURNCO Foundations, as well as Jay
and Karen Westman. A. Lutsch was funded by the Markin
Undergraduate Student Research Program in Health and
Wellness. This study was registered at ClinicalTrials.gov
(#NCT00966407). The authors have no conflicts of interest
to declare.
REFERENCES
1. Ainsworth, BE, Haskell, WL, Herrmann, SD, Meckes, N,
Bassett, DR Jr, Tudor-Locke, C, Greer, JL, Vezina, J, Whitt-
Glover, MC, and Leon, AS. 2011 Compendium of physical
activities: A second update of codes and MET values. Med Sci Sports
Exerc 43: 1575–1581, 2011.
2. Antonopoulos, S. Third report of the National Cholesterol
Education Program (NCEP) expert panel on detection, evaluation,
and treatment of high blood cholesterol in adults (Adult Treatment
Panel III) final report. Circulation 106: 3421, 2002.
3. Beltran-Sanchez, H, Harhay, MO, Harhay, MM, and McElligott, S.
Prevalence and trends of metabolic syndrome in the adult US
population, 1999–2010. J Am Coll Cardiol 62: 697–703, 2013.
4. Blanco, MER, Ballesteros, MRA, Martins, MS, Basalo, AR,
Domnquez, AO, and Lacalle, CG. Prevalence of insulin resistnace in
a young adults population. Relationship with weight status.
Endocrinol Nutr 59: 98–104, 2011.
5. Bruce, RA, Kusumi, F, and Hosmer, D. Maximal oxygen intake and
nomographic assessment of functional aerobic impairment in
cardiovascular disease. Am Heart J 85: 545–562, 1973.
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
the TM
Journal of Strength and Conditioning Research | www.nsca.com
6. Cancela Carral, JM and Ayan Perez, C. Prevalence and relationship
between physical activity and abnormal eating attitudes in Spanish
women university students in Health and Education Sciences [in
Spanish]. Rev Esp Salud Publica 85: 499–505, 2011.
7. Choi, J, Guiterrez, Y, Gilliss, C, and Lee, KA. Physical activity,
weight, and waist circumference in midlife women. Health Care
Women Int 33: 1086–1095, 2012.
8. Colberg, SR, Sigal, RJ, Fernhall, B, Regensteiner, JG, Blissmer, BJ,
Rubin, RR, Chasan-Taber, L, Albright, AL, and Braun, B. Exercise
and type 2 diabetes: The American college of sports medicine and
the American diabetes association: Joint position statement
executive summary. Diabetes Care 33: 2692–2696, 2010.
9. Faam, B, Hosseinpanah, F, Amouzegar, A, Ghanbarian, A,
Asghari, G, and Azizi, F. Leisure-time physical activity and its
association with metabolic risk factors in Iranian adults: Tehran
Lipid and Glucose Study, 2005–2008. Prev Chronic Dis 10: E36,
2013.
10. Fernandes, J and Lofgren, IE. Prevalence of metabolic syndrome and
individual criteria in college students. J Am Coll Health 59: 313–321,
2011.
11. Fernandes, J and Lofgren, IE. Prevalence of metabolic syndrome and
individual criteria in college students. J Am Coll Health 59: 313–321,
2011.
12. Fortmann, SP, Williams, PT, Hulley, S, Haskell, WL, and
Farguhar, JW. Effect of health education on dietary behaviour: The
Stanford three community study. Am J Clin Nutr 34: 2030–2038,
1981.
13. Gans, KM, Risica, PM, Wylie-Rosett, J, Ross, EM, Strolla, LO,
McMurray, J, and Eaton, CB. Development and evaluation of the
nutrition component of the rapid eating and activity assessment for
patients (REAP): A new tool for primary care providers. J Nutr Educ
Behav 38: 286–292, 2006.
14. Halkjaer, J, Tjonneland, A, Overvad, K, and Sorensen, TI. Dietary
predictors of 5-year changes in waist circumference. J Am Diet Assoc
109: 1356–1366, 2009.
15. Huang, TT, Kempf, AM, Strother, ML, Li, C, Lee, RE, Harris, KJ,
and Kaur, H. Overweight and components of the metabolic
syndrome in college students. Diabetes Care 27: 3000–3001, 2004.
16. Hunter, J and Leeder, S. Patient questionnaires for use in the
integrative medicine primary care setting‚ Äı̂A systematic literature
review. Eur J Integr Med 5: 194–216, 2013.
17. Karlos, AESJ, Gnatiuk, E, Onyewu, C, Many, G, Hoffman, EP, and
Hittel, DS. The effect of the SORT1 LDL-cholesterol locus is sex
specific in a fit, Canadian young adult population. Appl Physiol Nutr
Metab 38: 188–193, 2012.
18. Koziarska-Rosciszeska, M, Panasiuk, M, and Cypryk, K. Prevalence
of metabolic syndrome and its’ components in the young adult-
students of universities in Lodz, Poland. Pediatr Endocrinol Diabetes
Metab 16: 277–283, 2010.
19. Laaksonen, DE, Lakka, HM, Salonen, JT, Niskanen, LK,
Rauramaa, R, and Lakka, TA. Low levels of leisure-time physical
activity and cardiorespiratory fitness predict development of the
metabolic syndrome. Diabetes Care 25: 1612–1618, 2002.
20. Matthews, DR, Hosker, JP, Rudenski, AS, Naylor, BA,
Treacher, DF, and Turner, RC. Homeostasis model assessment:
Inuslin resistance and beta-cell function from fasting plasma
glucose and insulin concentrations in man. Diabetologia 28: 412–419,
1985.
21. Mercurio, V, Carlomagno, G, Fazio, V, and Fazio, S. Insulin
resistance: Is it time for primary prevention? World J Cardiol 4: 1–7,
2012.
22. Mittelmark, MB, Luepker, RV, Jacobs, DR, Bracht, NF, Carlaw, RW,
Crow, RS, Finnegan, J, Grimm, RH, Jeffery, RW, and Kline, FG.
Community-wide prevention of cardiovascular disease: Education
strategies of the Minnesota Heart Health program. Prev Med 15:
1–17, 1986.
VOLUME 30 | NUMBER 4 | APRIL 2016 | 1145
 Cardiometabolic Risk Factors in the Young
23. Puska, P, Tuomilehto, J, Salonen, J, Neittaankamki, L, Maki, J,
Virtamo, J, Nissinen, A, Koskela, K, and Takalo, T. Changes in
coronary risk factors during comprehensive five-year community
programme to control cardiovascular diseases (North Karelia
project). Br Med J 2: 1173–1178, 1979.
24. Reaven, GM. Relationships among insulin resistance, type 2
diabetes, essential hypertension, and cardiovascular disease:
Similarities and differences. J Clin Hypertens (Greenwich) 13: 238–
243, 2011.
25. Resnicow, K and Robinson, TN. School-based cardiovascular
disease prevention studies: Review and synthesis. Ann Epidemiol 7:
814–831, 1997.
26. Riediger, ND and Clara, I. Prevalence of metabolic syndrome in the
Canadian adult population. Can Med Assoc J 183: E1127–E1134,
2011.
27. Rynders, CA, Weltman, JY, Jiang, B, Breton, M, Patrie, J, Barrett, EJ,
and Weltman, A. Effects of exercise intensity on postprandial
the TM
1146 Journal of Strength and Conditioning Research
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
improvement in glucose disposal and insulin sensitivity in
prediabetic adults. J Clin Endocrinol Metab 99: 220–228, 2014.
28. Sacheck, JM, Kuder, JF, and Economos, CD. Physical fitness,
adiposity, and metabolic risk factors in young college students. Med
Sci Sports Exerc 42: 1039–1044, 2010.
29. Segal-Isaacson, CJ, Wylie-Rosett, J, and Gans, KM. Validation of
a short dietary assessment questionnaire: The rapid eating and
activity assessment for participants short version (REAP-S). Diabetes
Educ 30: 774, 776, 778 passim, 2004.
30. Shea, S and Basch, CE. A review of five major community-based
cardiovascular disease prevention programs. Part I: Rational, desigin
and theoretcial framework. Am J Health Promot 4: 203–213, 1990.
31. Slentz, CA, Duscha, BD, Johnson, JL, Ketchum, K, Aiken, LB,
Samsa, GP, Houmard, JA, Bales, CW, and Kraus, WE. Effects of the
amount of exercise on body weight, body composition, and
measures of central obesity: STRRIDE—A randomized controlled
study. Arch Intern Med 164: 31–39, 2004.