Association between insufficiently physically active and the prevalence of obesity in the United States

BACKGROUND

Numerous public health organizations have adopted national physical activity recommendations. Despite these recommendations, over half of the US population does not meet the minimum recommendation for physical activity, with large variations across individual US states.

METHODS

Using the 2005 Behavioral Risk Factor Surveillance System (BRFSS) prevalence data for physical activity and obesity by state, we performed a weighted least squares regression using prevalence of obesity (BMI>or=30 kg/m2) as the dependent variable and insufficiently physically active (included completely sedentary), age, race, gender, and median household income as the independent variables.

RESULTS

The unadjusted weighted least squares regression revealed a strong correlation between a state's prevalence of obesity and the prevalence of insufficiently physically active (R=.76, R2=.58, P<.0001). After adjusting for age, gender, race, and median household income, the prevalence of insufficiently physically active is still a significant predictor of the state prevalence of obesity (partial R=.44, R2=.19 P=.004).

CONCLUSION

Macroenvironmental and sociopolitical disparities between individual US states that transcend simple state-level demographic factors need to be examined more rigorously to identify unique barriers and promoters of physical activity.

Effects of continuous versus intermittent exercise, obesity, and gender on growth hormone secretion

CONTEXT

Obesity attenuates spontaneous GH secretion and the GH response to exercise. Obese individuals often have low fitness levels, limiting their ability to complete a typical 30-min bout of continuous exercise. An alternative regimen in obese subjects may be shorter bouts of exercise interspersed throughout the day.

OBJECTIVE

The objective of the study was to examine whether intermittent and continuous exercise interventions evoke similar patterns of 24-h GH secretion and whether responses are attenuated in obese subjects or affected by gender.

DESIGN

This was a repeated-measures design in which each subject served as their own control.

SETTING

This study was conducted at the University of Virginia General Clinical Research Center.

SUBJECTS

Subjects were healthy nonobese (n = 15) and obese (n = 14) young adults.

INTERVENTIONS

Subjects were studied over 24 h at the General Clinical Research Center on three occasions: control, one 30-min bout of exercise, and three 10-min bouts of exercise.

MAIN OUTCOME MEASURES

Twenty-four hour GH secretion was measured.

RESULTS

Compared with unstimulated 24-h GH secretion, both intermittent and continuous exercise, at constant exercise intensity, resulted in severalfold elevation of 24-h integrated serum GH concentrations in young adults. Basal and pulsatile modes of GH secretion were attenuated both at rest and during exercise in obese subjects.

CONCLUSIONS

The present data suggest that continuous and intermittent exercise training should be comparably effective in increasing 24-h GH secretion.

Intensity of exercise recovery, blood lactate disappearance, and subsequent swimming performance

The aim of this study was to examine the effects of active versus passive recovery on blood lactate disappearance and subsequent maximal performance in competitive swimmers. Fourteen male swimmers from the University of Virginia swim team (mean age 20.3 years, s= 4.1; stature 1.85 m, s= 2.2; body mass 81.1 kg, s= 5.6) completed a lactate profiling session during which the speed at the lactate threshold (V(LT)), the speed at 50% of the lactate threshold (V(LT.5)), and the speed at 150% of the lactate threshold (V(LT1.5)) were determined. Participants also completed four randomly assigned experimental sessions that consisted of a 200-yard maximal-effort swim followed by 10 min of recovery (passive, V(LT.5), V(LT), V(LT1.5)) and a subsequent 200-yard maximal effort swim. All active recovery sessions resulted in greater lactate disappearance than passive recovery (P < 0.0001 for all comparisons), with the greatest lactate disappearance associated with recovery at V(LT) (P= 0.006 and 0.007 vs. V(LT.5) and V(LT1.5) respectively) [blood lactate disappearance was 2.1 mmol l(-1) (s= 2.0), 6.0 mmol l(-1) (s=2.6), 8.5 mmol l(-1) (s= 1.8), and 6.1 mmol l(-1) (s= 2.5) for passive, V(LT.5), V(LT), and V(LT1.5) respectively]. Active recovery at VLT and V(LT1.5) resulted in faster performance on time trial 2 than passive recovery (P=0.005 and 0.03 respectively); however, only active recovery at V(LT) resulted in improved performance on time trial 2 (TT2) relative to time trial 1 (TT1) [TT2- TT1: passive +1.32 s (s= 0.64), V(LT.5) +1.01 s (s= 0.53), V(LT) -1.67 s (s= 0.26), V(LT1.5) -0.07 s (s = 0.51); P < 0.0001 for V(LT)). In conclusion, active recovery at the speed associated with the lactate threshold resulted in the greatest lactate disappearance and in improved subsequent performance in all 14 swimmers. Our results suggest that coaches should consider incorporating recovery at the speed at the lactate threshold during competition and perhaps during hard training sessions.

Carbohydrate quantity and quality in relation to body mass index

The increased prevalence of overweight and obesity in the United States since approximately 1980 is temporally associated with an increase in carbohydrate intake, with no appreciable change in absolute intake of fat. Despite speculation that both carbohydrate quantity and quality have contributed significantly to excess weight gain, the relationship between carbohydrate intake and body mass index (BMI) is controversial. A review of relevant literature indicates that most epidemiologic studies show an inverse relationship between carbohydrate intake and BMI, even when controlling for potential confounders. These observational studies are supported by results from a number of dietary intervention studies wherein modest reductions in body weight were observed with an ad libitum, low-fat, high-carbohydrate diet without emphasis on energy restriction or weight loss. With few exceptions, high glycemic load is associated with lower BMI, even when adjusted for total energy intake. Data on the association between glycemic index and BMI are not as consistent, with more studies showing either no association or an inverse relationship, rather than a positive relationship. Whole-grain intake is generally inversely associated with BMI; refined grain intake is not. Because overall dietary quality tends to be higher for high-carbohydrate diets, a low-fat dietary strategy with emphasis on fiber-rich carbohydrates, particularly cereal fiber, may be beneficial for health and weight control.

Heart rate recovery does not predict endothelial function in obese women

The purpose of the present study was to examine the relationship between heart rate recovery (HR(REC)) and endothelial function in obese women with the metabolic syndrome. The metabolic syndrome has been associated with increased cardiometabolic risk including endothelial dysfunction. However, measurement of endothelial function via flow-mediated dilation (FMD) requires expensive equipment and qualified medical personnel, and therefore may be impractical in some healthcare settings. Heart rate recovery (HR(REC)) has predictive utility with respect to endothelial function in individuals with suspected coronary artery disease and individuals with the metabolic syndrome also have elevated risk for developing coronary artery disease. Thirty-one obese, sedentary women (age: 47.7±11.2 yr, mean±SD) who met the International Diabetes Federation criteria for the metabolic syndrome underwent a brachial artery ultrasound to determine FMD and nitroglycerine-mediated dilation (NTG). HR(REC) was assessed during 5 min of active recovery following a standardized VO(2 Peak) treadmill protocol. Results revealed that the %FMD was not correlated to HR(REC) when examined across all participants (r= 0.067, p=0.72). However, this relationship was significant in participants with impaired FMD (n=16, %FMD<6%) (r=0.71, p=0.002). Although HR(REC) may be a significant correlate of FMD in women with the metabolic syndrome and with prevalent endothelial dysfunction, it was not a significant correlate across all women with the metabolic syndrome. The present data do not support the use of HR(REC) as a possible screening tool for endothelial dysfunction in obese women with the metabolic syndrome.

The metabolic syndrome, hypertriglyceridemic waist, and cardiometabolic risk factor profile in obese women

The hypertriglyceridemic waist (HTGW) and metabolic syndrome (MS) are associated with increased cardiometabolic risk. We evaluated the impact of the HTGW on cardiometabolic risk factors in obese women diagnosed with the MS. Thirty-six abdominally obese women with the MS as defined by the International Diabetes Federation (IDF) [(mean (SD); age 49 (11) y, ht 165 (6) cm, wt 95 (16) kg] participated. The HTGW was defined as follows: a waist circumference ≥80 cm and triglycerides ≥1.7 mM. Unpaired t-tests and Analysis of Covariance (ANCOVA) were employed to detect mean differences between women with MS plus or minus HTGW. Women with the MS plus HTGW had higher total cholesterol (16%, p=0.015), VLDL-cholesterol (97%, p<0.001), non-HDL-cholesterol (16%, p=0.002), insulin (40%, p=0.043), and abdominal visceral fat (24%, p=0.100), and lower total HDL-cholesterol (6%, p=0.024), HDL(3) (11%, p=0.031) and Quantitative Insulin Sensitivity Check Index (QUICKI) (5%, p=0.068) compared with women with the MS minus HTGW. Thus, the presence of the HTGW was accompanied by a worsened cardiometabolic risk factor profile in these obese women with the MS. In particular, women with the MS plus HTGW were more insulin resistant compared to women with the MS minus HTGW. In conclusion, the presence of the HTGW in obese women with the MS exacerbates insulin resistance and cardiometabolic risk factors.

NIH ImageJ and Slice-O-Matic computed tomography imaging software to quantify soft tissue

OBJECTIVE

To compare reliability and limits of agreement of soft tissue cross-sectional areas obtained using Slice-O-Matic and NIH ImageJ medical imaging software packages.

RESEARCH METHODS AND PROCEDURES

Abdominal and midthigh images were obtained using single-slice computed tomography. Two trained investigators analyzed each computed tomography image in duplicate. Adipose tissue and skeletal muscle cross-sectional areas (centimeters squared) were calculated using standard Hounsfield unit ranges (adipose tissue: -190 to -30 and skeletal muscle: -29 to 150). Regions of interest included abdominal total area, total fat area, subcutaneous fat area, visceral fat area (AVF), and right and left thigh total area, fat area, and skeletal muscle area.

RESULTS

For all images, intra-investigator coefficients of variation ranged from 0.2% to 3.4% and from 0.4% to 5.6% and inter-investigator coefficients of variation ranged from 0.9% to 4.8% and 0.2% to 2.6% for Slice-O-Matic and NIH ImageJ, respectively, with intra- and inter-investigator coefficients of reliability of R(2) = 0.99. Mean AVF values for investigators A and B ranged from 168 to 170 cm(2) using Slice-O-Matic and NIH ImageJ. Bland-Altman analyses revealed that Slice-O-Matic and NIH ImageJ results were comparable. The mean differences (95% confidence intervals) between the AVF cross-sectional areas obtained using the Slice-O-Matic and NIH ImageJ medical imaging software were +2.5 cm(2) (-5.7, +10.8 cm(2)) or +1.4% (-3.4%, +6.4%).

DISCUSSION

These findings show that both the Slice-O-Matic and NIH ImageJ medical imaging software systems provide reliable measurements of adipose tissue and skeletal muscle cross-sectional areas.

Exercise for prevention and treatment of cardiovascular disease, type 2 diabetes, and metabolic syndrome

A considerable number of observational and intervention studies support the role of exercise as a cornerstone in prevention and treatment of cardiovascular disease (CVD), type 2 diabetes (T2D), and the metabolic syndrome. Physical activity and cardiorespiratory fitness are also associated with reduced mortality rates among persons with CVD, T2D, and metabolic syndrome. Exercise has definite acute effects on a number of risk markers for CVD and T2D, in addition to more substantial benefits with chronic training. Both aerobic and resistance exercise have therapeutic value, largely independent of weight loss, and should be included in excise programs.

Center of mass motion and the effects of ankle bracing on metabolic cost during submaximal walking trials

The goal of this research was to examine the relationship between center of mass (CoM) motion and metabolic cost and to assess secondarily the effects of equinus gait on metabolic cost during walking trials at various velocities. Twelve (n=12) healthy male adults walked in four brace conditions, including fixed equinus, at three different walking speeds. Metabolic measures and 3D kinematic data were collected during each trial. Significant main effects for velocity were observed on both dependent measures, net O2 cost (p<0.001), and CoM vertical excursion (CoMz) (p<0.01). Correlation analysis showed significant positive correlations between net O2 cost and CoMz that were strongest at fast velocities. Further, analysis revealed the cost of walking at a comfortable speed in the equine position was 28% greater than walking in braces without springs or springs in neutral position and 64% greater than walking in shoes alone. CoMz does correlate with metabolic cost as measured by net O2 cost. Also, normal subjects walking in equinus have an increased net O2 cost and increased CoMz when compared to walking with shoes alone or the other brace conditions at all velocities.

Comparison of Borg- and OMNI-RPE as Markers of the Blood Lactate Response to Exercise

PURPOSE

To examine the utility of the Borg (6-20) and adult OMNI walk/run (0-10) ratings of perceived exertion (RPE) scales as markers of the blood lactate response to exercise.

METHODS

Thirty-six (26 females and 10 males) individuals with the metabolic syndrome (mean+/-SEM: age, 45.8+/-2.0 yr; height, 168.4+/-1.3 cm; weight, 100.4+/-3.6 kg) completed a continuous peak oxygen uptake (VO2peak)/lactate threshold (LT) treadmill protocol. VO2 (mL.kg.min), blood lactate concentration (BLC, mM), and heart rate (bpm) were measured at the end of each stage. RPE were assessed at 2:15 and 2:45 of each 3-min stage using both RPE scales presented in a counterbalanced order. Participants were read standardized instructions specific to each scale. The LT and BLC of 2.5 and 4.0 mM were determined from the blood lactate-velocity relationship.

RESULTS

The mean Borg, OMNI, and standardized (to the Borg scale) OMNI-RPE values at the LT and BLC of 2.5 mM, 4.0 mM, and peak ranged from 10.1 to 16.9, 3.1 to 8.2, and 9.9 to 17.1, respectively. No differences were observed between Borg and standardized OMNI-RPE at any exercise intensity. The correlation within and between Borg- and OMNI-RPE and the velocities associated with LT, BLC of 2.5 mM, 4.0 mM, and peak ranged from r=0.82 to 0.93 (P<0.01). Mean differences (95% CI) between the Borg- and standardized OMNI-RPE at LT, and BLC of 2.5 mM, 4.0 mM, and peak were 0.27 (-2.26, 2.80), -0.48 (-3.14, 2.18), -0.29 (-2.92, 2.35), and 0.10 (-1.65, 1.84), respectively.

CONCLUSION

Both the Borg and OMNI walk/run scales demonstrate predictive utility as markers of the blood lactate response to incremental exercise in individuals with the metabolic syndrome.