Vitamin B12

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The pentose phosphate pathway: contents in brief
If you're looking to cut weight, I highly recommend their "Animal Cuts" product. Typically, tissues in which a predominantly or exclusively aerobic metabolism occurs, such as the heart, synthesize H subunits to a greater extent than M subunits, whereas tissues in which anaerobic metabolism is important, such as skeletal muscle, synthesize M subunits to a greater extent than H subunits. Under this metabolic conditions therefore, what happens is an interplay between reactions of glycolysis and of the non-oxidative phase of the phosphogluconate pathway, with the latter in the direction of ribose 5-phosphate synthesis. Consider maintenance and image for veterinary clinic exteriors. The key role of the liver is due to its size; in fact, on a wet weight basis, the kidney cortex produces more glucose than the liver. And, like the reaction catalyzed by fructose 1,6-bisphosphatase , this reaction leads to the hydrolysis of a phosphate ester.

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However, with increasing numbers of people and animals, more settled cropping patterns were established, and the fallow period was gradually reduced. As a result, cultivation practices became more intensive; crop rotation, multiple cropping and intercropping were adopted as effective strategies to maximize land productivity without endangering soil fertility. Land-use patterns were complex, involving the production of a wide variety of food crops for domestic consumption; this strategy ensured a varied diet and helped to stabilize the food supply against climatic and seasonal shortages.

Gradual monetization of the economy and a shift in the socioeconomic environment increased the need for cash. For example, there was increased demand for education, better housing, health services and communications. Cash crop production was increasingly adopted by small-scale farmers as they strived to generate cash both for themselves and as foreign exchange for their countries. In most cases, governments adopted the policy of balancing the production of exportable cash crops and food crops.

The governments of several countries of eastern and southern Africa identified maize as the most appropriate food and cash crop for small-scale production, and cropping packages already adopted by commercial growers were promoted. However, in many cases there were unforeseen problems, and the maize production of the small-scale farmers failed to meet consumer demand.

The transition from subsistence farming to cash crop farming offers the opportunity to increase income, but it also harbours considerable risks. These include the food security risks of increased dependence on a limited number of crops, capital risks linked to prices and socio-economic dependence on the lender when credit is obtained. Poor farmers in particular have often failed to reap the benefits of technological change or commercialization, or have even lost from them. On the whole, cash crop production can be expected to have a positive impact on nutrition when the income it provides more than offsets not only the food production that is foregone, but also any rise in food prices that may result from an increased demand for purchased food and the freeing of prices.

Changes in cropping patterns resulting from the transition to commercial production may affect household food security.

Traditional farmers have generally adapted food production practices to meet environmental, economic and technological limitations. They minimize risk by planting a variety of staple crops that mature at different times during the year. Monocropping may encourage seasonal shortages; traditional intercropping practices provide a cushion during seasons of insufficient food see Chapter 5. In many communities, a major staple is grown as both food and cash crop.

If there is an efficient marketing organization, this crop will be sold, often by the household head male or female , as the major cash source for the household. These secondary crops are used for various purposes such as home consumption, beer brewing, sale in the informal sector, food for poultry or small livestock, food in case of drought especially cassava or informal exchange or barter during the season in return for seeds, small livestock, poultry or other goods. In the Wedza communal area of Zimbabwe, cultivation and consumption patterns are circumscribed to a large extent by the needs of households to earn money and to subsist see Box A variety of activities are undertaken, including the production of enough food for daily needs, together with a minimal store of food, usually the basic staple, to last at least until the following season.

In some cultures, the provision of food for family use is the responsibility of both husband and wife. In other cultures, it is largely the responsibility of women, who may have their own fields specifically for home food production see Box In the African context, cash crop promotion and commercialization are of particular significance for women. Commercialization has often taken place through expansion of cultivated land rather than through substitution of modern varieties or cash crops on previously cultivated land.

Frequently, the overall result of adopting cash crop production has been an increased demand for labour, especially women's labour. Some of the effects of new agricultural technology on women's workload and the shift in control over resources have been well documented Kumar, The timing of inputs, including labour, is often crucial to securing maximum yields when hybrid varieties are used; thus not only the quantity of labour but also the seasonal application of labour is important.

In many cases, this will result in diversion of labour from other activities, including domestic work, home gardening, child care and regular preparation of well-balanced meals. When adult energy requirements increase, so does food demand, which is likely to be met at the expense of children's food intake.

On the other hand, the nutritional status of overworked adult women stands to be compromised if the food available is insufficient to meet their increased body requirements for energy. Box 12 - Cash and food production strategies of households in the Wedza communal area, Zimbabwe. Most households in this area try to combine several methods of improving their living standards.

Box 13 - Gender roles in agricultural production in the Wedza communal area, Zimbabwe. Traditionally, even today, it is considered the responsibility of women to provide for the daily food needs of household members "from the field to the plate".

This has its origins in certain traditional divisions of labour between men and women, with men being the hunters and cattle owners and being responsible for heavy labour such as land clearing and ploughing. As landholders through usufruct and cattle owners, men also have controlled the households' most valuable assets. Today, the division is not as strict as it once was, with many women, by force of circumstances, taking on more responsibilities for ploughing, herding and other tasks.

Most households reported that women take the main responsibility for the production of most crops in terms of labour and decision-making. In half the survey households, the income accruing from maize sales was said to be received jointly by the husband and wife, and in two-fifths by the wife only.

Practically all other crops excepting sunflower and cotton which are cash crops are said to be "women's crops". A previous study in Wedza showed that despite this responsibility, men are still key decision-makers when it comes to allocation of land to particular crops, access to loans and control of income accruing from crop sales.

Among the survey households, there appeared to be some disagreement over those issues Women in Wedza suggested that they must have access to land in their own right or jointly with their husbands to overcome the disparity. Women have joined farmer groups in large numbers as a way of overcoming some of the constraints they face. Production of cash crops often requires a variety of additional inputs. To increase yields, farmers are encouraged to purchase hybrid or improved seeds in place of their own local varieties saved from the previous harvest.

The farmer often requires credit to purchase not only the improved seeds but also the appropriate fertilizers and pesticides. A farmer growing cash crops therefore faces the risk of going into debt, especially if payment for the previous cash crop is delayed.

These circumstances may limit the family's cash flow resources and reduce household food security. Despite the potential risks, commercial agriculture can provide opportunities for household food security and nutritional improvement, particularly if it is managed so as to benefit the rural poor.

To obtain such benefits it may be necessary to increase the productivity of small-scale farmers through targeted measures such as production incentives, development of marketing infrastructure and more research on rain-fed and other disadvantaged areas. The impact of such programmes can be strikingly enhanced if they are accompanied by effective extension services, farmer education and nutrition education programmes.

Programmes to increase production and incomes in enterprises controlled by women can also contribute to the improvement of household food security; many studies have shown that earnings by women are likely to be utilized for increasing family food consumption.

However, projects targeted towards women with the goal of income generation need to be sensitive to competing demands on their time - particularly demands generated by child care. A policy for self-sufficiency in food production or adoption of a "food first" policy that emphasizes food crops to the exclusion of cash crops is not necessarily desirable or crucial for alleviating malnutrition, when market infrastructure and transportation do not impede trade.

Where market infrastructure is not well developed, it should be strengthened in the long-term interest of achieving food security on a sustainable basis. In the short and medium term, the joint promotion of food crops and cash crops, especially home gardening and small animal rearing, is required in support of food security enhancement. Selling cash crops on the market instead of producing only food crops often increases household income and may thus also be likely to increase food consumption, provided the switch to cash crops does not lead to a change in income control at the household level and consequently to decisions for its disposal that could reduce expenditure on food.

Additional employment and income can also be derived from the development of small-scale agro-industries involving post-harvest activities, from cleaning and sorting of crops to storage, processing and marketing of foods and other agricultural crops. This is a key factor both in overall development and in providing income to poorer sectors of the population. Commercialization of agriculture, the development of labour-intensive agro-industries and an active food system, supported by an appropriate policy environment, provide the only way out of subsistence agriculture and allow communities and governments to generate the wealth required to pay for needed social and infrastructural improvements.

To ensure that agricultural growth will benefit the poor and to meet the consumption needs of present and future populations, the creation and dissemination of nutrition-enhancing agricultural technologies developed to suit different agro-ecological areas and farmer groups are of major importance. In many humid and subhumid areas, people commonly cultivate compound farms or home gardens, which are sometimes also referred to as backyard or kitchen gardens Figures 14 and The home garden is only one of several field systems operated by a farmer or farm household Figure 16 , except in urban and pert-urban areas and in areas of land scarcity, where the home garden may be the only cultivated plot.

The home garden is thus one of the components of the whole farming system and is under the same household management or subject to related multiple decision-making processes Okigbo, The home garden often includes a permanent agricultural plot or forest garden which contains an ecologically balanced mixture of perennial and annual crops. The garden forms a hub' with the homestead at its centre, from which paths lead to other field systems and other production units devoted to annual crops for the market and for home consumption.

Home gardens are often highly diversified. Crop mixtures found in home gardens are mainly the result of deliberate selection and cultivation of a wide variety of herbs and trees occupying complementary levels and playing supportive roles.

The gardens provide farmers with a mixture of food and cash crops Table Livestock, including sheep, goats, poultry and to some extent cattle and pigs, are also kept, although on a small scale, providing food, income and manure. Mixed tree and herb cropping systems have greatly extended harvesting periods and thus ensure continuous availability of some food. Tree species, once established, require only minimal labour and inputs for maintenance.

They provide a continual food supply for years without the need for annual replanting. The biological diversity and complexity of home gardens decline with the transition from the humid to the semi-arid and arid areas of the Sahelian countries.

Precipitation exceeds potential evapotranspiration for two to seven months of the year. Rainfall tends to be erratic, both in timing and areas covered, and this problem is worse in the low-rainfall areas.

The dry season is a period of drought, with hot days and warm nights. In some areas, rainfall is less than 30 mm per month for five to seven months of the year. Thus plant growth is limited for a considerable part of the year. FIGURE 16 - Schematic diagram of compound farms in relation to associated field systems in traditional farming systems of the humid tropics of Africa. An increase in land productivity in these areas is essential to reduce the pressure to extend into even more marginal areas, which could provoke further land degradation.

As the drylands are characterized by marked seasons, the availability of resources changes through the yearly cycle. Insufficient water is one of the major constraints to successful gardening in dryland areas; however, through effective soil management and cheap and effective solutions for harvesting and storing water, crops can be kept growing through some of the dry periods. Gardens in dryland areas can contribute greatly to the nutritional and economic well-being of households by reducing the level and duration of seasonal food shortages and introducing an increased variety of nutrient-rich foods into the household diet.

Boxes 14 and 15 describe some of the gardening principles and suitable plants for home gardens in the semi-arid tropics. As Africa's marginal lands are much greater in area than its fertile rain-fed or irrigable lands, even modest increases in local food supplies in the semi-arid areas could contribute considerably to the food security of the continent. Ecologically the compound farm or home or forest garden, together with animals, forms one of the most sustainable traditional farming systems; it maximizes biological production, protects the soil against erosion and can provide a varied and nutritious diet on a continuous basis, thus ensuring food security at the household level.

However, with increasing population density farmers have sometimes adopted farming practices that have led to tree removal, thus enhancing soil erosion and decreasing crop yields and returns to labour. Tree removal has often culminated in serious environmental degradation. Continuing replacement of home gardens and traditional farming systems with row crop production systems has also resulted in increased soil erosion, soil degradation and deterioration of the environment.

Box 14 - Gardening for food in the semi-arid tropics. A garden may surround a house or be located in a family field or in a community gardening area on the edge of, or some distance from, the village. It may be a home garden for one family, an income-generating project for a group of village women or a youth group, a school project or a health centre garden. The following suggestions advocate the use of indigenous design and systems rather than a fixed model.

The structure of the garden is adapted to the semi-arid tropical environment. It provides a diversity of foods over a long harvest period. Unlike the neat rows of annual crops characteristic of the industrialized countries in the temperate zone, the mature mixed garden consists of a dense mixture of annual crops and perennial trees.

The mixed garden makes maximum use of limited space and maximizes the total yield, even though some of the individual plants would yield more it given more space and sun.

It is multi-storied, making full use of the air space with a maximum of trees, bushes, climbing plants on poles or branches, erect and spreading plants and ground-trailing plants. The roots also exploit different levels underground, with some close to the surface and others, including the trees, reaching to the moisture further down.

A good design for a mixed garden takes account of the way different plants can share light, air and root space and leave little room for weeds. The multi-storied garden provides "canopy mulch" and protects the soil and the plants from the wind, excessive sun and rain. Soil fertility is increased by composting, mulching and the incorporation of dead plant material, which in turn increases crop production and conserves soil moisture.

Leguminous trees and plants build fertility, and companion planting decreases pest buildup. Economically, the mixed garden is a low-capital, high-return cropping system. Local planting materials, if they cannot be stored by the family, are usually available at low cost through trade or purchase. Most crops that are native or have become adapted to the environment over time are relatively resistant to many pests and diseases.

These crops are generally less dependent on fertilizer and water than temperate species. The appearance of the garden changes dramatically according to the season. During the rainy season there is an impressive mass of greenery. In the dry season the absence of greenery is noticeable, except for a dark-green mass of trees usually surrounding the home compound, and a small watered area. A larger mixed garden provides an ongoing supply of vegetables and fruits that contribute significant quantities of energy, protein, vitamin A, iron and vitamin C to the family diet.

Also the garden, and especially the trees, is an amenity for the household and the surrounding area. Additionally, the complete garden can produce some fuelwood. Box 15 - Some plants suitable for basic garden categories in the semi-arid tropics.

Amaranth, Ceylon spinach Basella rubra, Basella alba , chaya Cnidoscolus chayamansa , mustard Brassica juncea and leaves from baobab, cassava, drumstick tree, cowpea, sweet potato, pumpkin. Avocado, baobab fruit, cashew fruit, citrus fruits, guava, mango, papaya, passion fruit, banana, jackfruit. Eggplant, gourd, green pepper, okra, squash, pumpkin, tomato, chili. Bambara nut, cowpea, guar or cluster bean, hyacinth bean, mung bean, lima bean, groundnut, pigeon pea, soybean.

Increased urbanization and deforestation threaten some edible and useful plants that feature in the home garden but that have remained largely semi-wild and underutilized. An increasing focus on a few major staples such as maize and rice and changes in food habits towards the increased use of convenience foods have narrowed the food base of urban and to some extent also of rural populations.

All these factors call for measures to ensure that the full potential of plants found in home and forest gardens be realized through genetic improvement, improved home garden management and better processing and utilization. African food supply systems and types of agricultural production have traditionally inclined largely towards rain-fed cultivation.

Additional needed food has come mainly from increasing the area cultivated. If food production is to keep up with population growth and dependency on commercial or concessionary imports is to be avoided, production increases of up to 4 percent per year are needed. Attempts are being made to increase crop production in dry areas through more irrigation development schemes.

Irrigated agriculture is particularly appropriate for the production of high-value horticultural crops in pert-urban areas, and it can also extend production of other crops such as wheat, rice and barley, which are not easily grown in most of Africa.

The physical potential for irrigated crop production in Africa is large. Areas of irrigable land are considerable, and there are large amounts of surplus water that could be used for irrigation. On average, 27 percent of the potential has been realized in continental Africa, but large disparities exist among the regions.

North Africa has already realized 79 percent of its potential, but a large amount of potential remains untapped in central African countries, where water resources are relatively abundant. Sub-Saharan Africa, where only 4 percent of arable land is under irrigation, is far from reaching the world average of Institutional, economic and social considerations are among the main constraints to an expanded programme of irrigated production, especially for production units under central control such as State farms.

Large irrigation schemes tend to be fairly expensive both to initiate and to maintain and should therefore be discussed fully in terms of viability and cost-effectiveness before they are recommended as a strategy to improve food production. Smaller-scale community-supported irrigation systems using locally appropriate technologies, including water harvesting, small pump schemes and inland valley swamp development locally known as fadema Nigeria and vleis, dambos or mapani in southern Africa , have a large potential for achieving and sustaining needed increases in food production.

There are, however, environmental risks associated with irrigation schemes. Waterlogging and soil salinization are major causes of declining yields on irrigated land. Waterlogging may occur if provision of drainage is inadequate. Soil salinity increases because plants extract pure water and most of the salt contained in irrigated water is left behind.

Degradation of water resources through the excessive exploitation of groundwater using tubewells is already recognized as a cause of desertification in some countries, especially India see Box Diagram of the molecular signaling cascades that are involved in myofibrillar muscle protein synthesis and mitochondrial biogenesis in response to physical exercise and specific amino acids or their derivatives primarily L -leucine and HMB.

Health and fitness portal Medicine portal Society portal Sports portal. Active living Behavioural change theories Bodybuilding Exercise hypertension Exercise-induced nausea Exercise intensity Exercise intolerance Exercise-induced anaphylaxis Exercise-induced asthma Kinesiology Metabolic equivalent Physical fitness Supercompensation Warming up.

Encyclopedia of Life Support Systems. Retrieved 5 December Department of Health and Human Services. The Physician and Sportsmedicine. The Journals of Gerontology. Retrieved 12 September United States Department of Health.

Cochrane Database of Systematic Reviews. Medicine and Science in Sports and Exercise. Explaining variation in human athletic performance". Retrieved 5 May The Journal of Pediatrics. F; Balady, G; Blair, S. Executive summary of a Cochrane Collaboration systematic review". Journal of Cachexia, Sarcopenia and Muscle. Diagnosis, assessment, and treatment". Current Opinion in Behavioral Sciences.

Aerobic physical exercise PE activates the release of neurotrophic factors and promotes angiogenesis, thereby facilitating neurogenesis and synaptogenesis, which in turn improve memory and cognitive functions.

Exercise limits the alteration in dopaminergic neurons in the substantia nigra and contributes to optimal functioning of the basal ganglia involved in motor commands and control by adaptive mechanisms involving dopamine and glutamate neurotransmission.

The benefits of regular exercise, physical fitness and sports participation on cardiovascular and brain health are undeniable Exercise also enhances psychological health, reduces age-related loss of brain volume, improves cognition, reduces the risk of developing dementia, and impedes neurodegeneration.

Aerobic physical exercise produces numerous health benefits in the brain. Regular engagement in physical exercise enhances cognitive functioning, increases brain neurotrophic proteins, such as brain-derived neurotrophic factor BDNF , and prevents cognitive diseases [76—78]. Recent findings highlight a role for aerobic exercise in modulating chromatin remodelers [21, 79—82]. These results were the first to demonstrate that acute and relatively short aerobic exercise modulates epigenetic modifications.

The transient epigenetic modifications observed due to chronic running training have also been associated with improved learning and stress-coping strategies, epigenetic changes and increased c-Fos-positive neurons Nonetheless, these studies demonstrate the existence of epigenetic changes after acute and chronic exercise and show they are associated with improved cognitive function and elevated markers of neurotrophic factors and neuronal activity BDNF and c-Fos.

The aerobic exercise training-induced changes to miRNA profile in the brain seem to be intensity-dependent []. These few studies provide a basis for further exploration into potential miRNAs involved in brain and neuronal development and recovery via aerobic exercise. Retrieved 9 December A range of validated platforms assessed CF across three domains: In studies of executive function, five found a significant ES in favour of higher PA, ranging from small to large.

Although three of four studies in the memory domain reported a significant benefit of higher PA, there was only one significant ES, which favoured low PA.

Only one study examining processing speed had a significant ES, favouring higher PA. A limited body of evidence supports a positive effect of PA on CF in young to middle-aged adults. Further research into this relationship at this age stage is warranted. Significant positive effects of PA on cognitive function were found in 12 of the 14 included manuscripts, the relationship being most consistent for executive function, intermediate for memory and weak for processing speed.

A meta-analysis including the evaluation of control group response". Exercise has established efficacy as an antidepressant in people with depression. Exercise significantly improved physical and psychological domains and overall QoL. The lack of improvement among control groups reinforces the role of exercise as a treatment for depression with benefits to QoL. Research investigating the effects of exercise on older adults has primarily focused on brain structural and functional changes with relation to cognitive improvement.

In particular, several cross-sectional and intervention studies have shown a positive association between physical activity and cognition in older persons [86] and an inverse correlation with cognitive decline and dementia [87].

Older adults enrolled in a 6-month aerobic fitness intervention increased brain volume in both gray matter anterior cingulate cortex, supplementary motor area, posterior middle frontal gyrus, and left superior temporal lobe and white matter anterior third of corpus callosum [88]. In addition, Colcombe and colleagues showed that older adults with higher cardiovascular fitness levels are better at activating attentional resources, including decreased activation of the anterior cingulated cortex.

One of the possible mechanisms by which physical activity may benefit cognition is that physical activity maintains brain plasticity, increases brain volume, stimulates neurogenesis and synaptogenesis, and increases neurotrophic factors in different areas of the brain, possibly providing reserve against later cognitive decline and dementia [89, 90]. A large collection of research in humans has shown that a single bout of exercise alters behavior at the level of affective state and cognitive functioning in several key ways.

In terms of affective state, acute exercise decreases negative affect, increases positive affect, and decreases the psychological and physiological response to acute stress [28]. These effects have been reported to persist for up to 24 hours after exercise cessation [28, 29, 53]. In terms of cognitive functioning, acute exercise primarily enhances executive functions dependent on the prefrontal cortex including attention, working memory, problem solving, cognitive flexibility, verbal fluency, decision making, and inhibitory control [9].

These positive changes have been demonstrated to occur with very low to very high exercise intensities [9], with effects lasting for up to two hours after the end of the exercise bout Fig.

Moreover, many of these neuropsychological assessments measure several aspects of behavior including both accuracy of performance and speed of processing. McMorris and Hale performed a meta-analysis examining the effects of acute exercise on both accuracy and speed of processing, revealing that speed significantly improved post-exercise, with minimal or no effect on accuracy [17]. These authors concluded that increasing task difficulty or complexity may help to augment the effect of acute exercise on accuracy.

Arq Bras Endocrinol Metabol in Portuguese. Interestingly, some symptoms of OT are related to beta-endorphin beta-end effects. Some of its effects, such as analgesia, increasing lactate tolerance, and exercise-induced euphoria, are important for training. The runner's high describes a euphoric state resulting from long-distance running. Scand J Med Sci Sports. This systematic review and meta-analysis found that physical activity reduced depressive symptoms among people with a psychiatric illness.

The current meta-analysis differs from previous studies, as it included participants with depressive symptoms with a variety of psychiatric diagnoses except dysthymia and eating disorders. This review provides strong evidence for the antidepressant effect of physical activity; however, the optimal exercise modality, volume, and intensity remain to be determined.

Conclusion Few interventions exist whereby patients can hope to achieve improvements in both psychiatric symptoms and physical health simultaneously without significant risks of adverse effects. Physical activity offers substantial promise for improving outcomes for people living with mental illness, and the inclusion of physical activity and exercise programs within treatment facilities is warranted given the results of this review.

Consistent evidence indicates that exercise improves cognition and mood, with preliminary evidence suggesting that brain-derived neurotrophic factor BDNF may mediate these effects. The aim of the current meta-analysis was to provide an estimate of the strength of the association between exercise and increased BDNF levels in humans across multiple exercise paradigms. Moderators of this effect were also examined. Effect size analysis supports the role of exercise as a strategy for enhancing BDNF activity in humans.

This omission is relevant, given the evidence that aerobic-based physical activity generates structural changes in the brain, such as neurogenesis, angiogenesis, increased hippocampal volume, and connectivity 12, In children, a positive relationship between aerobic fitness, hippocampal volume, and memory has been found 12, Mental health outcomes included reduced depression and increased self-esteem, although no change was found in anxiety levels This systematic review of the literature found that [aerobic physical activity APA ] is positively associated with cognition, academic achievement, behavior, and psychosocial functioning outcomes.

Importantly, Shephard also showed that curriculum time reassigned to APA still results in a measurable, albeit small, improvement in academic performance The actual aerobic-based activity does not appear to be a major factor; interventions used many different types of APA and found similar associations.

In positive association studies, intensity of the aerobic activity was moderate to vigorous. The amount of time spent in APA varied significantly between studies; however, even as little as 45 minutes per week appeared to have a benefit. Considered overall, the studies included in the present review showed a strong effectiveness of exercise combined with antidepressants. Conclusions This is the first review to have focused on exercise as an add-on strategy in the treatment of MDD.

Our findings corroborate some previous observations that were based on few studies and which were difficult to generalize. Moreover, we hypothesize that the main role of exercise on treatment-resistant depression is in inducing neurogenesis by increasing BDNF expression, as was demonstrated by several recent studies.

A Clinical Review and Management Guideline". Keeping in mind that exercise shows no medication side effects such as withdrawal symptoms 20 , weight gain, dry mouth or insomnia 21 , but shows potential health benefits such as weight reduction, it is highly recommended to use exercise as an adjunctive treatment for depression New findings confirm that exercise can be recommended as a first-line treatment for mild to moderate depression; as an adjunct to medications 23 ; as an alternative to cognitive behavioral therapy 11 ; and in preventing depression in clinical as well as healthy populations 24— Although recent findings have shown that exercise can decrease depressive symptoms, there are still many questions and limitations to wider application of exercise in depression.

For instance, there are deficiencies in methodological planning such as uncontrolled nonrandomized trials, small sample sizes, inadequate allocation concealment, lack of intention-to-treat analyses, non-blinded outcome assessments, and inclusion of subjects without clinical diagnosis that limit the interpretability of research outcomes The effects of physical exercise on cognition and behavior in children and adults with ADHD: The present review summarises the impact of exercise interventions 1—10 weeks in duration with at least two sessions each week on parameters related to ADHD in 7-to year-old children.

We may conclude that all different types of exercise here yoga, active games with and without the involvement of balls, walking and athletic training attenuate the characteristic symptoms of ADHD and improve social behaviour, motor skills, strength and neuropsychological parameters without any undesirable side effects. Available reports do not reveal which type, intensity, duration and frequency of exercise is most effective in this respect and future research focusing on this question with randomised and controlled long-term interventions is warranted.

Lay summary — Exercise may improve thinking ability and memory 27 December In patients with MCI, exercise training 6 months is likely to improve cognitive measures and cognitive training may improve cognitive measures. Clinicians should recommend regular exercise Level B. Exercise generally had a positive effect on rate of cognitive decline in AD. A meta-analysis found that exercise interventions have a positive effect on global cognitive function, 0.

Cognitive decline in AD is attributable at least in part to the buildup of amyloid and tau proteins, which promote neuronal dysfunction and death Hardy and Selkoe, ; Karran et al. Evidence in transgenic mouse models of AD, in which the mice have artificially elevated amyloid load, suggests that exercise programs are able to improve cognitive function Adlard et al. Adlard and colleagues also determined that the improvement in cognitive performance occurred in conjunction with a reduced amyloid load.

Research that includes direct indices of change in such biomarkers will help to determine the mechanisms by which exercise may act on cognition in AD. Am J Occup Ther. All studies included people with AD who completed an exercise program consisting of aerobic, strength, or balance training or any combination of the three. The length of the exercise programs varied from 12 weeks to 12 months. Six studies involving participants tested the effect of exercise on ADL performance These positive effects were apparent with programs ranging in length from 12 wk Santana-Sosa et al.

Furthermore, the positive effects of a 3-mo intervention lasted 24 mo Teri et al. No adverse effects of exercise on ADL performance were noted. The "stimulation" mode no longer works and I've only used the pump four times! The suction was weak from the beginning but I swear it's gotten worse since the first use. It takes an hour to get an ounce using this pump.

I can manually pump two ounces in 15 minutes or less using my hand pump! I wanted an electric pump for convenience but honestly this pump is nothing but a pain. The only good thing I can possibly think of in regards to this pump is the fact that it's easy to assemble, but that does NOT make up for the fact that it is incapable of performing its task efficiently.

Be smart- either set your money on fire or buy a Medela! I was looking for something affordable which, really, I should've just looked at double electrics since this one is half the price of good doubles and I read the single review that said it was a great pump for a stay-at-home mom. I only work part time, so I don't pump every single day, so I thought maybe it would be fine.

No, it's completely useless. It takes about 3 seconds for one cycle. Secondly, the suction on the highest setting is barely noticeable. I pumped with it for minutes and only ended up with about a teaspoon of milk and never had a let down. I am not new to pumping, this is my second breastfed baby.

My first pump was a lansinoh double electric which has seen better days and I need something efficient. This is not it!! Of course it can't be returned to WM. I have emailed Nuk twice with no reply, so I guess I will have to call to try and get a refund. Do not buy this pump unless you don't need an efficient and useful pump. I love this pump. The motor isn't very loud. I like the overall design. Functionally, it does it's job. It's a nice little portable pump without any fuss.

It has no individual speed control or suction strength setting. It just increases both gradually the higher you turn it up. The woman that says she can't feel it on it's highest setting must have some pretty tough nipples because this is also my second breastfed child and I have to keep it on about half or my nipples start bleeding.

So far I've used this pump to help in the stimulation of milk production because it took my son 4 days to effectively latch. It worked very well for that purpose.

And now I'm using it after feedings to finish emptying my supply to bother further production and store extra milk for that first growth spurt!

The pump is designed to fit NUK bottles and there are no adapters for it. So if you want to use bottles other than NUK you will have to pump and pour. It also uses 3 AAA batteries aside from the wall adapter. I would suggest rechargeable batteries.

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