title: The Psychobiology of Burnout: Are There Two Different Syndromes? Aerobic exercise training and burnout: a pilot study with male participants suffering from burnout Effects of Qigong in patients with burnout: a randomized controlled trial. Different interventions, same outcomes? Here are four good reasons Aerobic training for improved memory in patients with stress-related exhaustion: a randomized controlled trial Cognitive performance is associated with glucose regulation in healthy elderly persons and can be enhanced with glucose and dietary carbohydrates. Exercise to reduce work-related fatigue among employees: a randomized controlled trial. Blood profiles, body fat and mood state in healthy subjects on different diets supplemented with Omega-3 polyunsaturated fatty acids. The effect of experimentally induced sedentariness on mood and psychobiological responses to mental stress Improving the mental health, healthy lifestyle choices, and physical health of Hispanic adolescents: a randomized controlled pilot study. Exercise training increases size of hippocampus and improves memory Relation between clinical depression risk and physical activity and time spent watching television in older women: a 10-year prospective follow-up study. Cardiovascular fitness, cortical plasticity, and aging. Glucose administration, heart rate and cognitive performance: effects of increasing mental effort A prospective study of the association between obesity and burnout among apparently healthy men and women. The effect of a cognitive and a physical stress-reducing programme on psychological complaints Improved cognitive performance following supplementation with a mixed-grain diet in high school students: a randomized controlled trial. Effect of Early Adult Patterns of Physical Activity and Television Viewing on Midlife Cognitive Function. Evaluation of cognitive behavioural training and physical activity for patients with stress-related illnesses: a randomized controlled study. Is Objectively Assessed Sedentary Behavior, Physical Activity and Cardiorespiratory Fitness Linked to Brain Plasticity Outcomes in Old Age?
abstract: Background : Plasma prolactin levels are sensitive to dopamine and serotonin function , and fatigue . Low cortisol , dopamine and /or serotonin may be involved in burnout and detachment . Methods : In this double-blind within-subject study , we treated 9 female burnout subjects and 9 controls with 35 mg cortisol and placebo orally . We measured state affect and plasma prolactin , oxytocin , cortisol and adrenocorticotropic hormone levels , and administered an attachment question naire . Results : The burnout subjects displayed an extreme distribution of basal prolactin levels , displaying higher or lower levels compared to the controls . The low prolactin burnouts had profoundly low attachment scores and tended to have low oxytocin levels . The high prolactin burnout subjects tended to show cortisol-induced decreased prolactin and fatigue , and increased vigor . Conclusion : Results are consistent with the hypothesis that burnout subjects are either characterized by low serotonergic function or by low dopaminergic function , and that the latter group benefits from cortisol replacement . These preliminary results suggest that differentiating between two syndromes may resolve inconsistencies in research on burnout , and be necessary for selecting the right treatment strategy Background Occupational burnout is associated with severe negative health effects . While stress management programs proved to have a positive influence on the well-being of patients suffering from burnout , it remains unclear whether aerobic exercise alleviates burnout severity and other parameters related to occupational burnout . Therefore , the main purpose of this study was to pilot-test the potential outcomes of a 12-week exercise training to generate hypotheses for future larger scale studies . Methods The sample consisted of 12 male participants scoring high on the MBI emotional exhaustion and depersonalization subscales . The training program took place in a private fitness center with a 17.5 kcal/kg minimum requirement of weekly energy expenditure . Results The key findings are that increased exercise reduced overall perceived stress as well as symptoms of burnout and depression . The magnitude of the effects was large , revealing changes of substantial practical relevance . Additionally , profiles of mood states improved considerably after single exercise sessions with a marked shift towards an iceberg profile . Conclusion Among burnout patients , the findings provide preliminary evidence that exercise has the potential to reduce stress and prevent the development of a deeper depression . This has important health implication s given that burnout is considered an antecedent of depressive disorders . Trial registration Clinical Trials.gov Identifier : OBJECTIVE To evaluate the efficacy of Qigong in rehabilitation for patients with burnout . DESIGN Prospect i ve , r and omized controlled trial . SUBJECTS Eighty-two patients ( 68 women and 14 men , mean age 44.3 ( st and ard deviation 9.1 ) years ) diagnosed with burnout . METHODS Basic care was offered to both the intervention and the control group . Patients in the intervention group received basic care and , in addition , performed Qigong twice a week for 12 weeks .  Psychological variables , health-related quality of life , perceived relaxation and physical measurements were assessed at baseline and after the intervention period . RESULTS No significant difference in treatment efficacy between the groups was found by either intention-to-treat or per- protocol analyses . Both groups improved significantly over time , with reduced levels of burnout , fatigue , anxiety and depression , and increased dynamic balance and physical capacity . CONCLUSION In this study , a Qigong intervention twice a week for 12 weeks had no additional effect beyond basic care for patients with burnout Conundrums in musculoskeletal research are common . Halliday and colleagues1 demonstrated similar outcomes for patients with chronic low back pain who received two seemingly different interventions : ( 1 ) a McKenzie approach and ( 2 ) motor control exercises .  Chmielewski and associates2 reported similar knee function and psychosocial status scores in those who received either low intensity or high intensity plyometric exercise programmes . Finally , van Beijsterveildt et al found no differences in the prevention of injuries among amateur footballers when usual care was compared against an exercise strategy that consisted of core stability , eccentric training of thigh muscles , proprioceptive training , dynamic stabilisation and plyometrics exercises.3 These findings beg the question : Why do we see similar outcomes in r and omised trials , which compare treatment strategies that are ostensibly different ? Our goal is to provide explanations beyond the obvious answers —such as treatments that have similarly effective or ineffective causal mechanisms or failing to account for patient heterogeneity in trial design and consequent insufficient statistical power to detect differences . In this editorial , we present the reader with four additional yet plausible explanations for why trials report similar outcomes . # # # Reason 1 : the type of outcome assessment may bias findings Our first explanation is the most obvious one . Outcome measures that capture direct measurements of strength and /or flexibility , or other indices of physical performance , may yield findings that are notably different from outcome measures that capture self-reports of pain , function , overall health status or quality of life . Therefore , null findings ( no difference among groups ) may be related to the fact that different sets of outcome measures are being used to compare the groups being studied . Examples of variant findings among outcomes are present in the literature . One month after total hip arthroplasty , Dayton and colleagues4 report that performance-based function ( eg , timed up and go , 6 min walk test and stair climbing test ) declined compared with baseline , whereas self-reported Background Patients with stress-related exhaustion suffer from cognitive impairments , which often remain after psychological treatment or work place interventions . It is important to find effective treatments that can address this problem . Therefore , the aim of this study was to investigate the effects on cognitive performance and psychological variables of a 12-week aerobic training program performed at a moderate-vigorous intensity for patients with exhaustion disorder who participated in a multimodal rehabilitation program . Methods In this open-label , parallel , r and omized and controlled trial , 88 patients diagnosed with exhaustion disorder participated in a 24-week multimodal rehabilitation program . After 12 weeks in the program the patients were r and omized to either a 12-week aerobic training intervention or to a control group with no additional training . Primary outcome measure was cognitive function , and secondary outcome measures were psychological health variables and aerobic capacity . Results In total , 51 % patients in the aerobic training group and 78 % patients in the control group completed the intervention period . The aerobic training group significantly improved in maximal oxygen uptake and episodic memory performance . No additional improvement in burnout , depression or anxiety was observed in the aerobic group compared with controls . Conclusion Aerobic training at a moderate-vigorous intensity within a multimodal rehabilitation program for patients with exhaustion disorder facilitated episodic memory . A future challenge would be the clinical implementation of aerobic training and methods to increase feasibility in this patient group . Trial registration Clinical Trials.gov : NCT03073772 . Retrospectively registered 21 February 2017 BACKGROUND A glucose drink has been shown to improve memory in persons with poor glucose regulation and poor cognition . OBJECTIVE The objective of this study was to determine 1 ) whether an association between cognition and glucose regulation is apparent in healthy seniors and 2 ) the effects of dietary carbohydrates on cognition . DESIGN After an overnight fast , 10 men and 10 women ( aged 60 - 82 y ) consumed 50 g carbohydrate as glucose , potatoes , or barley or a placebo on 4 separate mornings . Cognitive tests were administered 15 , 60 , and 105 min after ingestion of the carbohydrate .  Plasma glucose and serum insulin were measured . RESULTS In a multiple regression analysis , poor baseline ( placebo )  verbal declarative memory ( immediate and 20-min delayed paragraph recall and word list recall ) and visuomotor task performance were predicted by poor beta cell function , high incremental area under the glucose curve , low insulin resistance , and low body mass index . The difference in plasma glucose after food consumption [ glucose > potatoes > barley > placebo ( P : < 0.03 ) ] did not predict performance . Although overall performance did not differ with consumption of the different test foods , baseline score and beta cell function correlated with improvements in immediate and delayed paragraph recall for all 3 carbohydrates ( compared with placebo ) ; the poorer the baseline memory or beta cell function , the greater the improvement ( correlation between beta cell function and improvement in delayed paragraph recall : r > -0.50 , P : < 0.03 ) . Poor beta cell function correlated with improvement for all carbohydrates in visuomotor task performance but not on an attention task . CONCLUSIONS Glucose regulation was associated with cognitive performance in elderly subjects with normal glucose tolerance . Dietary carbohydrates ( potatoes and barley ) enhanced cognition in subjects with poor memories or beta cell function independently of plasma glucose Objectives The present study evaluated the efficacy of an exercise intervention to reduce work-related fatigue ( emotional exhaustion , overall fatigue , and need for recovery ) . The effects of exercise on self-efficacy , sleep , work ability , cognitive functioning and aerobic fitness ( secondary outcomes ) were also investigated . Methods Employees with high levels of work-related fatigue were r and omly assigned to either a 6-week exercise intervention  ( EI ; N=49 ) or a wait-list control group ( WLC  ; N=47 ) . All participants were measured pre- ( T0 ) and post-intervention ( T1 ) . EI participants were also measured 6 ( T2 ) and 12 weeks ( T3 ) after the end of the intervention . Analyses were based on intention-to-treat ( ITT ) and per- protocol ( PP ) . PP analyses only included EI participants ( N=31 ) who completed the intervention and WLC participants ( N= 35 ) who did not increase their exercise level during the wait period . Results Analyses of covariance ( ANCOVA ) revealed that , at T1 , the EI group reported lower emotional exhaustion and overall fatigue than the WLC group , however , only according to PP analyses . Both according to ITT and PP analyses , EI participants showed higher sleep quality , work ability , and self-reported cognitive functioning at T1 compared to WLC participants . Intervention effects were maintained at T2 and T3 . Conclusions The exercise intervention had enduring effects on work-related fatigue and broader indicators of employee well-being . This study demonstrates that , in case of work-related fatigue , exercise does constitute a powerful medicine for those who comply with the treatment BACKGROUND Diets and Omega-3 polyunsaturated fatty acids have been considered as important factors to reduce the risk of cardiovascular and inflammatory diseases , but there are few details on the effects on healthy subjects . The aim of the present study was to examine the variation of several physiological parameters in healthy subjects on different diets supplemented with Omega-3 fatty acids .  MATERIAL S AND METHODS The experiment was carried out on 33 subjects divided into four groups according to a double-blind cross-over design with a 1 : 1 ratio for Omega-3 ( vs. placebo ) and open-label parallel-groups with a 1 : 1 ratio for the Zone diet ( vs. the diet suggested by the Italian National Research Institute for Nutrition and Foods ) . Blood sample s were collected at the beginning of the experiment and after 35 ( cross-over ) and 70 days . The Profile of Mood States test ( POMS ) was also performed . RESULTS The arachidonic acid/eicosapentaenoic acid ratio ( AA/EPA ) was strongly reduced by Omega-3 with a supplementary effect of the diet and in particular the Zone diet . The AA/EPA reduction was correlated with a concomitant decrease of insulin and homocysteine levels . The Zone diet reduced skinfold thickness and body fat percentage and also showed antioxidant effects . The mood state changed after Omega-3 supplementation , with an increased POMS index . This was related to a concomitant reduction of AA/EPA and was particularly evident in the Zone diet . CONCLUSION AA/EPA and mood state are differently influenced by diet and Omega-3 , body fat is particularly reduced by Zone diet , while blood parameters such as triglycerides/HDL ratio , insulin and homocysteine are related to AA/EPA variations . These findings are discussed in terms of differences in the composition of the diets and the influences of Omega-3 on physiological functions Background Evidence suggests a link between sedentary behaviours and depressive symptoms . Mechanisms underlying this relationship are not understood , but inflammatory processes may be involved . Autonomic and inflammatory responses to stress may be heightened in sedentary individuals contributing to risk , but no study has experimentally investigated this . Aims To examine the effect of sedentary time on mood and stress responses using an experimental design . Method Forty-three individuals were assigned to a free-living sedentary condition  and to  a control condition ( usual activity ) in a cross-over , r and omised fashion and were tested in a psychophysiology laboratory after spending 2 weeks in each condition . Participants completed mood question naires ( General Health Question naire and Profile of Mood States ) and wore a motion sensor for 4 weeks . Results Sedentary time increased by an average of 32 min/day ( P = 0.01 ) during the experimental condition compared with control . Being sedentary result ed in increases in negative mood independent of changes in moderate to vigorous physical activity ( ΔGHQ = 6.23 , ΔPOMS = 2.80 ) . Mood disturbances were associated with greater stress-induced inflammatory interleukin-6 ( IL-6 ) responses ( β = 0.37 ) . Conclusions Two weeks of exposure to greater free-living sedentary time result ed in mood disturbances independent of reduction in physical activity . Stress-induced IL-6 responses were associated with changes in mood BACKGROUND Obesity and mental health disorders are 2 major public health problems in American adolescents , with prevalence even higher in Hispanic teens . Despite the rapidly increasing incidence and adverse health outcomes associated with overweight and mental health problems , very few intervention studies have been conducted with adolescents to improve both their healthy lifestyles and mental health outcomes . Even fewer studies have been conducted with Hispanic youth . The purpose of this study was to evaluate the preliminary efficacy of the COPE ( Creating Opportunities for Personal Empowerment ) Healthy Lifestyles TEEN ( Thinking , Emotions , Exercise , and Nutrition ) program , a manualized educational and cognitive behavioral skills-building program , on Hispanic adolescents ' healthy lifestyle choices as well as mental and physical health outcomes . METHODS A cluster r and omized controlled pilot study was conducted with 19 Hispanic adolescents enrolled in 2 health classes in a southwestern high school . One class received COPE and the other received an attention control program . RESULTS Adolescents in the COPE program increased their healthy lifestyle choices and reported a decrease in depressive and anxiety symptoms from baseline to postintervention follow-up . A subset of 7 overweight adolescents in the COPE program had a decrease in triglycerides and an increase in high-density lipoproteins . In addition , these overweight adolescents reported increases in healthy lifestyle beliefs and nutrition knowledge along with a decrease in depressive symptoms . CONCLUSION The COPE TEEN program is a promising school-based strategy for improving both physical and mental health outcomes in adolescents The hippocampus shrinks in late adulthood , leading to impaired memory and increased risk for dementia . Hippocampal and medial temporal lobe volumes are larger in higher-fit adults , and physical activity training increases hippocampal perfusion , but the extent to which aerobic exercise training can modify hippocampal volume in late adulthood remains unknown . Here we show , in a r and omized controlled trial with 120 older adults , that aerobic exercise training increases the size of the anterior hippocampus , leading to improvements in spatial memory .  Exercise training increased hippocampal volume by 2 % , effectively reversing age-related loss in volume by 1 to 2 y. We also demonstrate that increased hippocampal volume is associated with greater serum levels of BDNF , a mediator of neurogenesis in the dentate gyrus . Hippocampal volume declined in the control group , but higher preintervention fitness partially attenuated the decline , suggesting that fitness protects against volume loss . Cau date nucleus and thalamus volumes were unaffected by the intervention . These theoretically important findings indicate that aerobic exercise training is effective at reversing hippocampal volume loss in late adulthood , which is accompanied by improved memory function Although  physical activity ( PA ) has been inversely associated with depressive symptoms , it is not clear whether regular PA and television watching are associated with clinical depression risk . The authors conducted a prospect i ve analysis involving 49,821 US women from the Nurses ' Health Study who were free from depressive symptoms at baseline ( 1996 ) . Information on PA was obtained from vali date d question naires completed in 1992 , 1994 , 1996 , 1998 , and 2000 ; analyses were conducted using the cumulative average of PA ( minutes/day ) with a 2-year latency period applied . Participants were asked about television-watching habits in 1992 . Cox proportional hazards regression models adjusted for multiple risk factors were used to estimate relative risks of clinical depression ( self-reported physician-diagnosed depression or use of antidepressants ) . During 10 years of follow-up ( 1996 - 2006 ) , 6,505 incident cases of depression were documented . Higher  levels of PA  were associated with lower depression risk . The multivariate relative risk comparing the highest level of PA  ( ≥ 90 minutes/day ) with the lowest ( < 10 minutes/day ) was 0.80 ( 95 % confidence interval : 0.70 , 0.92 ; P(trend ) < 0.001 ) . In contrast , the risk of depression increased with increasing television-watching time . The multivariate relative risk comparing women who spent 21 hours/week or more watching television with those who spent 0 - 1 hour/week was 1.13 ( 95 % confidence interval : 1.00 , 1.27 ; P(trend ) = 0.01 ) . Analyses simultaneously  considering PA and television watching suggested that both contributed independently to depression risk Cardiovascular fitness is thought to offset declines in cognitive performance , but little is known about the cortical mechanisms that underlie these changes in humans . Research using animal models shows that aerobic training increases cortical capillary supplies , the number of synaptic connections , and the development of new neurons . The end result is a brain that is more efficient , plastic , and adaptive , which translates into better performance in aging animals . Here , in two separate experiments , we demonstrate for the first time to our knowledge , in humans that increases in cardiovascular fitness results in increased functioning of key aspects of the attentional network of the brain during a cognitively challenging task . Specifically , highly fit ( Study 1 ) or aerobically trained ( Study 2 ) persons show greater task-related activity in regions of the prefrontal and parietal cortices that are involved in spatial selection and inhibitory functioning , when compared with low-fit ( Study 1 ) or nonaerobic control ( Study 2 ) participants . Additionally , in both studies there exist groupwise differences in activation of the anterior cingulate cortex , which is thought to monitor for conflict in the attentional system , and signal the need for adaptation in the attentional network . These data suggest that increased cardiovascular fitness can affect improvements in the plasticity of the aging human brain , and may serve to reduce both biological and cognitive senescence in humans Abstract Rationale : It is known that glucose administration is capable of improving performance on tests of declarative verbal memory and non-mnemonic tasks requiring high ” mental effort ” . At the same time , cognitively dem and ing tasks are associated with elevated heart rate , a response that could feasibly be part of a physiological mechanism serving to increase the delivery of glucose to active brain substrates . Objective : The present placebo-controlled , double-blind , balanced , crossover study examined the interaction between glucose administration , cognitive performance and heart rate during three tasks of differing mental dem and and somatically-matched control tasks . Methods : The effects of a glucose drinkon  participants ’ performance on two  serial subtraction tasks ( Serial Threes and Serial Sevens ) and a Word Retrieval ( Verbal Fluency ) task were assessed . Heart rates were monitored throughout the experiment , and participants rated each task in terms of its perceived mental dem and . Results : Serial Sevens was rated as the most mentally dem and ing task , followed by Word Retrieval , then Serial Threes . Glucose consumption significantly improved performance on Serial Sevens , with a trend for improved performance on Word Retrieval . Both Serial Sevens and Serial Threes were associated with significant heart rate elevation above that seen in somatically matched control tasks ( ruling out the possibility that accelerated heart rate was due to peripheral mechanisms alone ) . Unexpectedly , participants in the glucose condition had higher heart rates during cognitive processing . Additionally , individuals whose baseline heart rates were below the median performed better on Serial Threes and Serial Sevens . Conclusion : We suggest that supplemental glucose preferentially targets tasks with a relatively high cognitive load , which itself ( through unknown mechanisms ) mobilises physiological reserves as part of a natural response to such tasks . Furthermore , baseline heart rate and responses to cognitive dem and and glucose administration may represent important physiological individual differences The authors prospect ively tested the hypothesis that obesity predicts burnout and the reverse-causation hypothesis that burnout predicts obesity . Respondents were 724 men and 340 women , apparently healthy employees , who underwent routine periodic health examinations at 2 points of time about 18 months apart . Obesity was assessed by body mass index , waist-hip ratio , and waist circumference . In regression analyses , done separately for men and women , the authors controlled for depressive symptomatology , sport activity , and Time 1 levels of the criterion . The hypothesis that burnout predicts obesity was not supported . The authors found that  Time 1 measures of obesity  predicted reductions rather than the hypothesized elevations of Time 2 burnout levels . The authors also found that for male respondents with relatively higher levels of Time 1 burnout , the higher their level of Time 1 obesity measure , the lower their level of T2 burnout Objectives : To investigate the short-term and long-term effectiveness of two , brief , preventive , work stress management programmes . One programme was a cognition-focused programme , the other was a newly developed intervention in which physical exercise and relaxation were combined . It was hypothesised that the newly developed intervention would be more effective in reducing psychological complaints than the cognitive intervention . Both programmes consisted of four sessions in a period of 10 weeks . Methods : From a working population engaged in a periodic health check-up , employees above a minimum stress level ( n=396 ) were invited to participate in a r and omised comparative outcome study with pre-trial , post-trial and 6-month follow-up measures . After giving informed consent 130 participants entered the study ( response rate 33 % ) . Outcome measures consisted of three self-reported question naires on psychological complaints . Results : It was found that both interventions revealed a positive impact on psychological complaints , burnout and fatigue , both at short-term and at 6-month follow-up . No statistical interaction effects between the two interventions were found . Calculation of the clinical significance of the effects indicated that 50 % of the employees with psychological complaints who participated in the physical intervention and 60 % of the employees who participated in the cognitive intervention improved and returned to functioning within normal range both in the short term and in the long term at 6 months . Conclusion : The data indicate that interventions were equally effective on psychological complaints , burnout and fatigue OBJECTIVE Adolescence is a stage of rapid growth , when rich nutritional supplementation is important . Maintaining optimal cognitive functioning is critical in high school students , who are under considerable academic pressure . The objectives of this study were to identify the effects of a 9-wk r and omly assigned diet of mixed grains versus a regular diet on cognitive performance and on levels of plasma brain-derived neurotrophic factor ( BDNF ) and S100B , a calcium-binding protein produced by astroglial cells , in healthy high school students ( grade s 10 and 11 ) . METHODS In this 9-wk , single-blind , controlled study , subjects were r and omly allocated to either a mixed-grain or a regular diet .  Cognitive assessment s and measurements of plasma BDNF and S100B levels were performed at baseline and after the 9-wk intake of a mixed-grain or regular diet .  Computerized neuropsychological tests and self-rating scales were used for the cognitive assessment s. RESULTS Significant improvements in some neuropsychological tests were found after 9 wk in both the mixed-grain and the regular-diet groups , but the changes from baseline between the two groups were not significantly different . Significant impairments on the AX-continuous performance test were observed at the endpoint in the regular-diet group , and the changes from baseline between the two groups were also significantly different for this test . A significant difference in changes in BDNF levels was observed between the two groups . CONCLUSIONS These results suggest that intake of mixed grains for 9 wk is beneficial for cognitive performance and plasma BDNF levels in high school students . These beneficial effects seem to be related to the prevention of cognitive deterioration in a mental-fatigue test with the mixed-grain diet , rather than cognitive enhancement per se IMPORTANCE Sedentary behaviors and physical inactivity are not only increasing worldwide but also are critical risk factors for adverse health outcomes . Yet , few studies have examined the effects of sedentary behavior on cognition or the long-term role of either behavior in early to middle adulthood . OBJECTIVE To investigate the association between 25-year patterns of television viewing and physical activity and midlife cognition . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve study of 3247 adults ( black and white races ; aged 18 - 30 years ) enrolled in the Coronary Artery Risk Development in Young Adults ( CARDIA ) Study ( March 25 , 1985 , to August 31 , 2011 ) . Data analysis was performed June 1 , 2014 , through April 15 , 2015 . MAIN OUTCOMES AND MEASURES We assessed television viewing and physical activity at repeated visits ( ≥3 assessment s ) over 25 years using a vali date d question naire . A 25-year pattern of high television viewing was defined as watching TV above the upper baseline quartile ( > 3 hours/d ) for more than two-thirds of the visits , and a 25-year pattern of low physical activity was defined as activity levels below the lower , sex-specific baseline quartile for more than two-thirds of the of the visits . We evaluated cognitive function at year 25 using the Digit Symbol Substitution Test ( DSST ) , Stroop test , and Rey Auditory Verbal Learning Test . RESULTS At baseline , the mean ( SD ) age of the 3247 study participants was 25.1 ( 3.6 ) years , 1836 ( 56.5 % ) were female , 1771 ( 54.5 % ) were white , and 3015 ( 92.9 % ) had completed at least high school . Compared with participants with low television viewing , those with high television viewing during 25 years ( 353 of 3247 [ 10.9 % ] ) were more likely to have poor cognitive performance ( < 1 SD below the race-specific mean ) on the DSST and Stroop test , with findings reported as adjusted odds ratio ( 95 % CI ) : DSST , 1.64 ( 1.21 - 2.23 ) and Stroop test , 1.56 ( 1.13 - 2.14 ) , but not the Rey Auditory Verbal Learning Test , adjusted for age , race , sex , educational level , smoking , alcohol use , body mass index , and hypertension . Low physical activity during 25 years in 528 of 3247 participants ( 16.3 % ) was significantly associated with poor performance on the DSST , 1.47 ( 1.14 - 1.90 ) . Compared with participants with low television viewing and high physical activity , the odds of poor performance were almost 2 times higher for adults with both high television viewing and low physical activity in 107 of 3247 ( 3.3 % ) ( DSST , 1.95 [ 1.19 - 3.22 ] , and Stroop test , 2.20 [ 1.36 - 3.56 ] ) . CONCLUSIONS AND RELEVANCE High television viewing and low physical activity in early adulthood were associated with worse midlife executive function and processing speed . This is one of the first studies to demonstrate that these risk behaviors may be critical targets for prevention of cognitive aging even before middle age OBJECTIVE To evaluate the effects of a cognitive behavioural training programme and a physical activity programme for patients with stress-related illnesses . DESIGN In a r and omized controlled study , patients were allocated r and omly to 1 of 3 groups , where group 1 participated in a cognitive behavioural training programme , group 2 participated in a physical activity programme , and group 3 , the control group  , was offered usual care for the course of the study . SUBJECTS A total of 75 patients participated in the study . They had been on sick leave for at least 50 % of the time for between 1 month and 2 years due to stress-related illnesses . METHODS Measurements of autonomic activity , pressure-pain thresholds and subjective ratings of health and behaviour were made before and after a 10-week intervention period , and at 6 and 12 months after the intervention . RESULTS Minor differences in autonomic activity and pressure-pain thresholds were found between the groups immediately after the intervention . At the 6- and 12-month follow-up assessment s , the differences were no longer present . Patients in the cognitive behavioural training group improved their ratings of general health compared with the physical activity group throughout the study . CONCLUSION The study showed little difference in the effect of cognitive behavioural training and physical activity , compared with usual care , for patients with stress-related illnesses The aim of this cross-sectional study was to determine the associations of objective ly assessed habitual physical activity and physical performance with brain plasticity outcomes and brain-derived neurotrophic factor ( BDNF ) levels in cognitively healthy older adults . Physical performance was analyzed based on cardiopulmonary exercise-testing data and accelerometer-based physical activity was analyzed as total activity counts , sedentary time , light physical activity and moderate to vigorous physical activity . Brain plasticity outcomes included magnetic resonance spectroscopy (MRS)-based markers , quantitative imaging-based hippocampal volume and BDNF serum levels . The association between physical performance and hippocampal volume was strongly influenced by participants ' education , sex , age and BMI . Confounder-controlled correlation revealed significant associations of brain plasticity outcomes with physical activity but not with performance . MRS-based adenosine triphosphate to phosphocreatine and glycerophosphocholine to phosphocreatine ratios were significantly associated with accelerometer total activity counts . BDNF was detrimentally associated with sedentary time but beneficially related to  accelerometer total activity  counts and moderate to vigorous physical activity . Exceeding the current moderate to vigorous physical activity recommendations led to significantly higher BDNF levels . Our results indicate that regular physical activity might be beneficial for preserving brain plasticity in higher age . In this study these associations were not mediated significantly by physical performance . Overall physical activity and exceeding current moderate to vigorous physical activity recommendations were positively associated with BDNF . Sedentary behavior , however , seems to be negatively related to neurotrophic factor bioavailability in the elderly
target: It can be concluded that physical activity may be effective in reducing burn-out risk .
  The few observational studies linking sedentary and dietary behavior with burn-out risk suggest that being more sedentary and eating less healthy are each associated with higher burn-out risk .
background: Although it is believed that physical activity , sedentary , and dietary behavior ( i.e. , energy balance-related behavior ) may decrease the risk of burn-out  , the association between both is currently not well understood .
  Therefore , the aim of this systematic review was to synthesize studies investigating the relationship between energy balance-related behavior  and  burn-out risk .