The association between physical activity,cardiorespiratory fitness and self-rated health

Objective

To investigate the joint association between self-reported physical activity as well as cardiorespiratory fitness and self-rated health among healthy women and men.

Method

Data from 10,416 participants in The Danish Health Examination Survey 2007–2008 which took part in 13 Danish municipalities were analyzed. Leisure time physical activity level and self-rated health were based on self-reported questionnaire data. Optimal self-rated health was defined as “very good” or “good” self-rated health. Cardiorespiratory fitness (mL O₂·min^− 1·kg^− 1) was estimated from maximal power output in a maximal cycle exercise test.

Results

A strong dose–response relation between cardiorespiratory fitness and self-rated health as well as between physical activity level and self-rated health among both women and men was found. Within categories of physical activity, odds ratios for optimal self-rated health increased with increasing categories of cardiorespiratory fitness, and vice versa. Hence, participants who were moderately/vigorously physically active and had a high cardiorespiratory fitness had the highest odds ratio for optimal self-rated health compared with sedentary participants with low cardiorespiratory fitness (odds ratio = 12.2, 95% confidence interval: 9.3–16.1).

Conclusion

Although reluctant to conclude on causality, this study suggests that an active lifestyle as well as good cardiorespiratory fitness probably increase self-rated health.     

The association between physical fitness and cardiovascular disease risk factors in children in a five-year follow-up study

The relation between physical fitness and cardiovascular disease (CVD) risk factors was studied in 633 children selected from all fourth grades in 37 elementary schools in New York. They were participating in the control group of an intervention study to reduce CVD risk factors in children. Blood pressure, total and high-density lipoprotein (HDL) cholesterol and physical fitness were measured at baseline and at four subsequent examinations during five years of follow-up. Systolic blood pressure (SBP) at baseline was highest in children with poor physical fitness. The five-year change in physical fitness was inversely associated with the change in SBP, ie, children with the strongest decline in physical fitness showed the largest rise in SBP. HDL cholesterol at baseline was lowest in boys with poor physical fitness. The five-year change in physical fitness was positively related to the change in HDL cholesterol levels in boys; ie, boys with the largest decline in physical fitness had the largest decrease in HDL cholesterol level. These observations indicate that unfavourable long-term changes in physical condition in childhood may be related to unfavourable changes in blood pressure and serum lipids.     

Incidence of work-related asthma in members of a health maintenance organization

OBJECTIVE: The objective of this study was to evaluate work-related asthma among health maintenance organization (HMO) members. Recent reports suggest that the incidence of work-related asthma may be much higher than Sentinel Event Notification Systems for Occupational Risks (SENSOR) data estimate. METHODS: Using the HMO's electronic medical record, we identified 1,747 persons with evidence of new or recurrent asthma. Interviews with 352 of them elicited information about workplace exposures, symptoms, and home environment. Industrial hygienists rated the potential asthmagenicity of the respondents' work environments. RESULTS: Based on the industrial hygienist ratings and self-reported work-relatedness of asthma symptoms, we classified 33% of those interviewed as having potentially work-related asthma, suggesting an overall work-related asthma incidence/recurrence rate of 28 cases per 10,000. CONCLUSIONS: The contribution of occupation to the occurrence of adult onset asthma may be much higher than typically suggested in the literature.     

The association between occupational factors and adverse health outcomes in chronic obstructive pulmonary disease

Background and Aims: Despite recognition that occupational exposures may make a substantive contribution to the aetiology of COPD, little is known about the potential role of work related factors in COPD related health outcomes.

Methods: Prospective cohort study using structured telephone interviews among a random sample of adults aged 55–75 reporting a COPD condition (emphysema, chronic bronchitis, or COPD). Using multivariate models adjusting for smoking and demographic factors, the separate and combined associations were estimated between occupational exposure to vapours, gas, dust, or fumes (VGDF) and leaving work due to lung disease (respiratory related work disability) with health outcomes and utilisation ascertained at one year follow up.

Results: Of 234 subjects, 128 (55%) reported exposure to VGDF on their longest held jobs, 58 (25%) reported respiratory related work disability, and 38 (16%) subjects reported both. Combined exposure to VGDF and respiratory related work disability (rather than either factor alone) was associated with the greatest risk at follow up of frequent (everyday) restricted activity days attributed to a breathing or lung condition (OR 3.8; 95% CI 1.4 to 10.1), emergency department (ED) visit (OR 3.9; 95% CI 1.4 to 10.5), and hospitalisation (OR 7.6; 95% CI 1.8 to 32).

Conclusions: Among persons with COPD, past occupational exposures and work disability attributed to lung disease, particularly in combination, appear to be risk factors for adverse health related outcomes.

     

The association between midlife cardiorespiratory fitness and later life chronic kidney disease: The Cooper Center Longitudinal Study

BackgroundChronic kidney disease (CKD) is a major public health problem, particularly in older age and in those with diabetes mellitus (DM), with high comorbidity and treatment costs.Study designProspective observational cohort study.Setting & participants17,979 participants, 22% women with a mean age of 50.0 (SD 8.8), in the Cooper Center Longitudinal Study (CCLS) seen initially between 1971 to 2009 who also received Medicare coverage from 1999 to 2009.PredictorsAge, body mass index, blood pressure, cholesterol, glucose levels, current tobacco use, and cardiorespiratory fitness.OutcomesIncident CKD and DM were determined from Medicare administrative claims data.ResultsDuring 116,973 person-years of observation, 2022 cases of incident CKD occurred. Multivariable-adjusted proportional hazards models revealed a 24% lower risk of CKD among moderate fit (hazards ratio[HR] 0.76, 95% CI 0.67–0.85 compared to low fit) and a 34% lower risk of CKD among high fit (HR 0.66, 95% CI 0.58–0.76 compared to low fit). Even following the development of DM, fitness was associated with lower risk of CKD (HR 0.94, 95% CI 0.89–0.99) per 1-MET increment.LimitationsRelatively homogeneous population of well-educated Caucasians.ConclusionResults of the present study suggest that higher fitness is associated with lower risk of CKD decades later even in at-risk populations such as diabetics. The findings support a role for enhancing fitness through regular physical activity in preventive strategies for CKD including those who may develop DM in later life.     

The association between work performance and physical activity, cardiorespiratory fitness, and obesity

The purpose of this study was to test the association between lifestyle-related modifiable health risks (physical activity, cardiorespiratory fitness, and obesity) and work performance. Data were obtained from 683 workers. Dependent variables included number of work loss days, quantity and quality of work performed, overall job performance, extra effort exerted, and interpersonal relationships. Results indicated that higher levels of physical activity related to reduced decrements in quality of work performed and overall job performance; higher cardiorespiratory fitness related to reduced decrements in quantity of work performed, and a reduction in extra effort exerted to perform the work; obesity related to more difficulty in getting along with coworkers; severe obesity related to a higher number of work loss days. It is concluded that lifestyle-related modifiable health risk factors significantly impact employee work performance.     

Trends in dementia-free life expectancy among elderly members of a large health maintenance organization

BACKGROUND: This study examined the secular trends of life expectancy without dementia among elderly American members of a health maintenance organization, and observed if an increased life expectancy is accompanied by an increase in the duration of life with dementia. METHODS: The data derived from two chronological 9-year prospective cohort studies of members of the Kaiser Permanente Medical Care Program of Northern California. The first and second cohorts included 2,702 and 2,926 people aged > or =65 years free from dementia at baseline. Life expectancy without dementia or dementia-free life expectancy (DemFLE) is defined as the average number of years a person is expected to live without dementia. Total life expectancy is equal to the sum of DemFLE and life expectancy with dementia. Estimations of DemFLE were based on mortality data and incidence of dementia, using double-decrement life tables. RESULTS: Between the first and second cohorts, all-cause mortality rates declined, while the incidence of dementia remained constant in both men and women. Among the males, total life expectancy increased at a higher rate than DemFLE. Consequently, the duration of life with dementia was extended in the second cohort. Conversely, among the females DemFLE increased at a higher rate than total life expectancy, thus the duration of life with dementia decreased in the second cohort. The median age of dementia onset was postponed by 2-3 years in the second cohort for females, and did not show any specific difference between the two cohorts in males. CONCLUSION: The trends of health expectancies suggest an extension of the duration of life with dementia for males and a compression of dementia for females. A decreased incidence of risk factors for dementia among females in the second cohort such as stroke may explain these trends.     

The association between high blood pressure,physical fitness,and body mass index in adolescents

BACKGROUND: The aim of this study was to analyze the association of fitness and fatness with blood pressure (BP) and hypertension.This was a cross-sectional study of 13,557 boys and girls 15-20 years of age. Fitness was estimated from a shuttle run test, fatness from body mass index (BMI), and BP was measured sitting after 5 min of rest. Other lifestyle variables were self-reported. RESULTS: Boys had a higher systolic BP (SBP) than girls. A low physical fitness level and high BMI were independently associated with a high BP and risk of having hypertension in both girls and boys. Interaction was found between BMI and fitness. In a stratified analysis an odds ratio (OR) of 3.99 was found for hypertension in girls with a BMI > 25 kg m(-2) compared to lean girls if all had a low fitness level, and an OR of 2.14 for a high BMI in girls with a high fitness level. In boys, OR for high versus low BMI were 3.23 in the low fit and 2.34 and 2.50 in the middle and upper tertile of fitness, respectively. CONCLUSIONS: Fitness and BMI were independently associated to BP. BMI was a stronger predictor of hypertension in those with a low fitness level, especially in girls.     

纳西族中小学生体质健康状况及其与体育锻炼行为的关系

了解纳西族中小学生体质健康现状及其与体育锻炼行为的关系,为更好地开展青少年体质健康提供参考.方法 对云南丽江市2 636名纳西族中小学生进行体质测查,参照《国家学生体质健康标准》评价学生的体质水平,并分析纳西族中小学生体质与体育锻炼行为的关系.结果 7~18岁纳西族学生体质优秀率为3.1%,良好率为17.5%,及格率为65.6%,不及格率为13.9%.男、女生体质得分随学段升高均呈下降趋势(F值分别为28.133,11.727,P值均<0.01).男生(71.44±11.22)体质得分高于女生(70.48±10.29),差异有统计学意义(t=2.268,P<0.05).不同年校运会次数、每周体育课节数、体育课喜好、长跑意愿和每天体育锻炼时间学生体质得分差异均有统计学意义(F值分别为8.090,13.328,4.289,10.236,4.421,P值均<0.01).结论 纳西族中小学生体质现状喜忧参半.建议纳西族学生体质促进应注重学段和性别差异,确保体育活动时间,引导学生树立积极的体育锻炼态度.     

Inconsistencies between self-reported ethnicity and ethnicity recorded in a health maintenance organization

PURPOSE: Information on patient ethnicity in hospital admissions databases is often used in epidemiologic and health services research. However, the extent of consistency of these data with self-reported ethnicity is not well studied, particularly for specific Asian subgroups. We examined agreement between ethnicity in records of a sample of members of five Northern California Kaiser Permanente medical centers with self-reported ethnicity. METHODS: Subjects were 3168 cases and 2413 controls aged 45 years and older from a study of fractures. Ethnicity recorded in the Kaiser admissions database (primarily inpatient) was compared with self-reported ethnicity from the study interviews. RESULTS: Among study subjects with available Kaiser ethnicity, sensitivities and positive predictive values of the Kaiser classification were high among blacks (0.95 for both measures) and whites (0.98 and 0.94, respectively), slightly lower among Asians (0.88 and 0.95, respectively), and considerably lower among Hispanics (0.55 and 0.81, respectively) and American Indians (0.47 and 0.50, respectively). Among Asian subgroups, the proportion classified as Asian was high among Chinese (0.94) and Japanese (0.99) but lower among Filipinos (0.79) and other Asians (0.74). Among the 228 (4%) subjects who self-identified with multiple ethnicities, 13 of 18 white + Hispanic subjects were classified as being white, and of the 77 subjects identifying as part American Indian, only one was classified as being American Indian in the Kaiser database. CONCLUSIONS: Given the importance of ethnicity information, medical facilities should be encouraged to adopt policies toward collecting high quality data.     

Twenty year trends in hospital discharges for asthma among members of a health maintenance organization.

We examined trends in hospitalizations for asthma from 1967 to 1987 among members of a large health maintenance organization. During this time asthma discharges increased significantly among children, and especially among boys under the age of 5 years. Ninety-five percent of the increase in discharges among boys was explained by a corresponding increase in the number of boys who were hospitalized. Increased readmissions did not account for the rise. Changes in the International Classification of Diseases coding of asthma and diagnostic shift by physicians accounted for only part of the increase. A decline in hospitalizations since 1984 may reflect changes in the management of asthma in the emergency room and not a decline in severe asthma episodes.     

The relationship between physical fitness and motor competence in children

Background This study examined the relationship between physical fitness and motor competence in children aged 9–10 years. Methods A sample of 67 children (mean age 9.7, SD 0.3 year) participated in the study. To assess motor competence, each child completed the Movement Assessment Battery for Children. Physical fitness was measured by the Test of Physical Fitness, comprising nine different tasks including running, jumping, throwing and climbing. Results The results show a strong and significant correlation between motor competence and physical fitness within the sample. Conclusions These results are relevant to the work of maintaining and developing both sufficient physical fitness and motor competence in children as these factors are important contributors to their health and well‐being.     

Increased prevalence of chronic physical health disorders in Australians with diagnosed mental illness

Objective: To compare chronic physical health disorder prevalence amongst Australian adults with and without mental illness. Method: Total n=1,716 participants (58% female) with a mean age of 52 ± 13 years (range: 18 to 89 years) completed an online survey of Australian adults in 2010. Outcome measures including prevalence of chronic physical conditions and self‐reported body mass index (BMI) in n=387 (23%) with a self‐reported mental illness diagnosis were compared to respondents without mental illness. Results: A significantly higher proportion of participants with mental illness were obese (BMI ≥ 30; 31 vs 24%, p=0.005). Adjusted odds ratios (OR) for coronary heart disease, diabetes, chronic bronchitis or emphysema, asthma, irritable bowel syndrome, and food allergies or intolerances (OR range: 1.54–3.19) demonstrated that chronic physical disorders were significantly more common in participants with a mental illness. Conclusion: Australian adults with a diagnosis for mental illness have a significantly increased likelihood of demonstrating chronic physical health disorders compared to persons without mental illness. Implications: Health professionals must be alert to the increased likelihood of comorbid chronic physical disorders in persons with a mental illness and should consider the adoption of holistic approaches when treating those with either a mental or physical illness.     

Strong inverse association between physical fitness and overweight in adolescents: a large school-based survey

Background  

Studies examining the relationship between physical fitness and obesity in children have had mixed results despite their interrelationship making intuitive sense. We examined the relationship between physical fitness and overweight and obesity in a large sample of adolescents in the Republic of Seychelles (Indian Ocean, African region).