Association between self-reported and objectively measured physical fitness level in a middle-aged population in primary care

Improvements in Maternal Cardiovascular Health Over the Perinatal Period Longitudinally Predict Lower Postpartum Psychological Distress Among Individuals Who Began Their Pregnancies With Overweight or Obesity

BACKGROUND

Adverse cardiovascular events during pregnancy (eg, preeclampsia) occur at higher rates among individuals with overweight or obesity (body mass index ≥25 kg/m2) and have been associated with postpartum depression. The present study examined whether changes in cardiovascular health (CVH) during the perinatal period, as defined by the American Heart Association's Life's Essential 8 framework, predicted postpartum psychological functioning among individuals with prepregnancy body mass index ≥25 kg/m2.

METHODS AND RESULTS

Pregnant individuals (N = 226; mean ± SD age = 28.43 ± 5.4 years; mean body mass index = 34.17 ± 7.15 kg/m2) were recruited at 12 to 20 weeks of gestation (mean, 15.64 ± 2.45 weeks) for a longitudinal study of health and well-being. Participants completed ratings of depression and perceived stress and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6 months postpartum. Body mass index and CVH behaviors were used to calculate a composite CVH score at both time points. Linear regression analyses were performed to examine whether change in CVH related to postpartum symptom scores. Because sleep was measured in only a subset of participants (n = 114), analyses were conducted with and without sleep. Improved CVH was associated with lower postpartum depression (β = -0.18, P<0.01) and perceived stress (β = -0.13, P=0.02) scores. However, when including sleep, these relationships were no longer significant (all P>0.4).

CONCLUSIONS

Improvements in CVH from early pregnancy to 6 months postpartum were associated with lower postpartum depressive symptoms and perceived stress but not when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high-risk individuals.

Sex Differences in Physical Activity Levels and Sitting Time in Patients With Atrial Fibrillation

PURPOSE

While research demonstrates low levels of physical activity (PA) among adults living with atrial fibrillation (AF), there is limited evidence investigating sex differences in moderate to vigorous intensity physical activity (MVPA) and sedentary time in this population. The primary aim was to examine sex differences in MVPA levels and sitting time between women and men with AF. Secondary aims explored sex differences in sociodemographic factors, outcome expectations, and task self-efficacy toward PA levels.

METHODS

This was a subanalysis of the CHAMPLAIN-AF cohort study. Women and men with AF completed a survey, including the Short-Form International Physical Activity Questionnaire.

RESULTS

A total of 210 women (median = 66.0 yr: 95% CI, 63.5-68.0) and 409 men (median = 66.0 yr: 95% CI, 64.0-67.0) were included. No sex differences were observed in median weekly MVPA (60 min/wk: 95% CI, 0-120 in women vs 120 min/wk: 95% CI, 85-150 in men) and daily sitting time (5.5 hr/d: 95% CI, 5.0-6.0 in women vs 6.0 hr/d: 95% CI, 5.0-6.0 in men). Women engaged in significantly less vigorous-intensity PA than men (P = .03) and demonstrated significantly lower task self-efficacy (P < .01). Significant positive correlations in PA levels with outcome expectations (mostly weak) and task self-efficacy (mostly strong) were observed in both sexes.

CONCLUSION

Most women and men with AF did not meet the global MVPA guidelines but met the sitting time recommendation. Women presented with lower vigorous-intensity physical activity levels and confidence than men. Strategies to increase physical activity behavior, considering sociodemographic factors and task self-efficacy, are needed and may differ between sexes.

Effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of patients with hip fracture

INTRODUCTION

Telerehabilitation has emerged in the last decade as a promising alternative to conduct the rehabilitation process at home. However, there are no studies testing the effects of telerehabilitation interventions for patients with hip fracture on quality of life nor psychological factors, whereas the evidence on fitness level is scarce. Thus, the aim of this study is to test the effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of patients who had suffered a hip fracture.

METHODS

The present study is a non-randomized clinical trial that includes patients older than 65 years old with a hip fracture and their family caregivers (ClinicalTrials.gov; Identifier: NCT02968589). Per-protocol (64 participants) and intention-to-treat (71 participants) analyses were performed, the first being the main analysis. The intervention group received a home-based multidisciplinary telerehabilitation intervention, called @ctivehip, that lasted 12 weeks. The control group received the traditional care and rehabilitation provided by the Andalusian Public Health Care System. The outcomes measured were the patients' quality of life through the EuroQol Quality of Life Questionnaire (EQ-5D), physiological factors (anxiety and depression) using the Hospital Anxiety and Depression Scale (HADS) and the fitness level, assessed with the International Fitness Scale.

RESULTS

The quality of life of the telerehabilitation group increased, while the control group scored worsened at the 3-month follow-up (medium effect size: 0.66 SDs; p  =  0.006). The telerehabilitation group demonstrated a greater decrease than the control group in the total HADS score (medium effect size: -0.50 SDs; p  =  0.015). Lastly, the telerehabilitation group recovered a fitness level close to the pre-hip fracture in comparison with the control group (small effect size: 0.49 SDs; p  =  0.022).

DISCUSSION

The @ctivehip telerehabilitation program seems to be a promising treatment to improve the quality of life and psychological factors (i.e. anxiety and depression) of older adults after a hip fracture, as well as to recover their previous fitness level.

The impact of cardiorespiratory fitness and physical workload on disability pension-a cohort study of Swedish men

OBJECTIVE

Understanding the impact of physical capacity in combination with high physical workload could be beneficial for the prevention of health-related exits from work. Therefore, the aim of this study was to investigate the separate and combined effects of low cardiorespiratory fitness and high physical workload on disability pension (DP) due to any cause, musculoskeletal disorders (MSD), and cardiovascular diseases (CVD).

METHODS

A total of 279 353 men born between 1951 and 1961 were followed regarding DP between 2006 and 2020, ages 45-64. Cardiorespiratory fitness was assessed during military conscription, using an ergometer bicycle test. Physical workload was based on a job-exposure matrix (JEM) linked to occupational title in 2005. Cox regression models estimated separate and combined associations with DP.

RESULTS

Low cardiorespiratory fitness and high physical workload were associated with increased risk of DP. For all cause DP, the fully adjusted hazard ratio and 95% confidence interval for those with low cardiorespiratory fitness was 1.38 (1.32-1.46) and for those with high physical workload 1.48 (1.39-1.57). For all cause and MSD DP, but not for CVD DP, the combination of low cardiorespiratory fitness and high physical workload resulted in higher risks than when adding the effect of the single exposures.

CONCLUSION

Both low cardiorespiratory fitness in youth and later exposure to high physical workload were associated with an increased risk of DP, where workers with the combination of both low cardiorespiratory fitness and a high physical workload had the highest risks (all-cause and MSD DP).

Improvements in cardiovascular health over the perinatal period predicts lower postpartum psychological distress

Background

Adverse cardiovascular events during pregnancy (e.g., pre-eclampsia) occur at higher rates among individuals with pre-pregnancy overweight or obesity (body mass index [BMI]≥25kg/m2) and have been associated with postpartum depression. However, it is unclear whether cardiovascular health (CVH), defined more holistically than the absence of cardiovascular conditions in pregnancy, relates to postpartum psychological functioning. The present study examined whether changes in CVH during the perinatal period predicted postpartum psychological functioning among individuals with pre-pregnancy BMI≥25kg/m2.

Methods

Individuals (N=226; Mage=28.43±5.4 years; MBMI=34.17±7.15kg/m2) were recruited when their pregnancies were 12-20 weeks gestation (M=15.64±2.45 weeks) for a longitudinal study of health and well-being. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and Perceived Stress Scale (PSS) and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6-months postpartum. BMI and CVH behaviors were coded according to the American Heart Association's Life's Essential 8 to create a CVH score at both timepoints. Linear regression analyses were performed to examine whether change in CVH related to postpartum CES-D and PSS scores. Because sleep was only measured in a subset of participants (n=114), analyses were conducted with and without sleep included. Baseline CVH, CES-D and PSS scores, and demographic factors were included as covariates in all models.

Results

Improved CVH was associated with lower postpartum CES-D (β=-0.18, p<0.01) and PSS (β=-0.13, p=0.02) scores when excluding sleep. Compared to those whose CVH improved by >1SD from pregnancy to 6-months postpartum, individuals whose CVH worsened by >1SD scored 6.42 points higher on the CESD (MCESD=15.25±10.92 vs. 8.52±6.90) and 6.12 points higher on the PSS (MPSS=24.45±8.29 vs. 17.83±8.70). However, when including sleep, these relationships were no longer significant (ps>0.4).

Conclusions

Improvements in CVH from early pregnancy to 6-months postpartum were associated with lower postpartum depressive symptoms and perceived stress. However, these relationships were no longer significant when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high-risk individuals.

Level of Overestimation Among Dutch Recreational Skiers: Unskilled Tourists in the Mountains

OBJECTIVE

To examine the level of overestimation (LO), associated factors, and identify the group of severe overestimators, among recreational skiers.

DESIGN

Cross-sectional observational study.

SETTING

An intermediate difficulty slope in an artificial snow indoor ski hall, and one in the mountains (Flachau, Austria).

PARTICIPANTS

Dutch recreational skiers.

INDEPENDENT VARIABLES

Participants were asked to rate themselves (SRSS, self-reported skill score). While skiing downhill they were objectively evaluated by 2 expert assessors (OSS, observed skill score). Potential associated factors and predictors for severe overestimation were assessed by a questionnaire.

MAIN OUTCOME MEASURES

The LO, calculated by subtracting the OSS from the SRSS, was categorized into "no," "mild," and "severe." Potential differences between these groups were analyzed, and regression analyses were performed to identify the factors associated with severe overestimation. To construct a profile of severe overestimators, the dataset was stratified based on 3 variables.

RESULTS

Overestimation was largely present (79.8%), and was severe in 32%. The LO decreased toward the more skilled skiers. Severe overestimators were mainly male, skied the least hours per day, were more avoidant, and showed the highest proportions of beginners and slightly advanced skiers. The profile of "severe overestimator" is characterized by physically unprepared males, avoidant for certain weather circumstances.

CONCLUSIONS

Overestimation among recreational Dutch skiers is largely present, particularly among physically unprepared males, avoidant of certain snow and weather conditions. These features may function as a proxy to identify "severe overestimators" in comparable populations. Preventive strategies should focus to increase awareness particularly among these subjects.

Factors in early pregnancy predicting pregnancy-related pain in the second and third trimester

INTRODUCTION

Pain during pregnancy affects women's well-being, causes worry and is a risk factor for the child and the mother during labor. The aim was to investigate the relative importance of an extensive set of pregnancy-related physiological symptoms and psychosocial factors assessed in the first trimester compared with the occurrence of pregnancy-related pain symptoms later in the pregnancy.

MATERIAL AND METHODS

Included were all women who booked an appointment for a first prenatal visit in one of 125 randomly selected general practitioner practices in Eastern Denmark from April 2015 to August 2016. These women answered an electronic questionnaire containing questions on the occurrence of five pregnancy-related pain symptoms: back pain, leg cramps, pelvic cavity pain, pelvic girdle pain and uterine contractions. The questionnaire also included sociodemographic questions and questions on chronic diseases, physical symptoms, mental health symptoms, lifestyle and reproductive background. The questionnaire was repeated in each trimester. The relative importance of this set of factors from the first trimester on the five pregnancy-related pain symptoms compared with the second and third trimesters was assessed in a dominance analysis.

RESULTS

A total of 1491 women were included. The most important factor for pregnancy-related pain in the second trimester and third trimester is the presence of the corresponding pain in the first trimester. Parity was associated with pelvic cavity pain and uterine contractions in the following pregnancies. For back pain and pelvic cavity pain, the odds increased as the women's estimated low self-assessed fitness decreased and had low WHO-5 wellbeing scores.

CONCLUSIONS

When including physical risk factors, sociodemographic factors, psychological factors and clinical risk factors, women's experiences of pregnancy-related pain in the first trimester are the most important predictors for pain later in pregnancy. Beyond the expected positive effects of pregnancy-related pain, notably self-assessed fitness, age and parity were predictive for pain later in pregnancy.

Body composition and physical fitness in adults born small for gestational age at term: a prospective cohort study

There is lack of research on body composition and physical fitness in individuals born small for gestational age (SGA) at term entering mid-adulthood. We aimed to investigate these outcomes in adults born SGA at term. This population-based cohort study included 46 adults born SGA with birth weight < 10th percentile at term (gestational age ≥ 37 weeks) (22 women, 24 men) and 61 adults born at term with birth weight ≥ 10th percentile (35 women, 26 men) at 32 years. Body composition was examined anthropometrically and by 8-polar bioelectrical impedance analysis (Seca® mBCA 515). Fitness was measured by maximal isometric grip strength by a Jamar hand dynamometer, 40-s modified push-up test and 4-min submaximal step test. Participants born SGA were shorter than controls, but other anthropometric measures did not differ between the groups. Men born SGA had 4.8 kg lower grip strength in both dominant (95% CI 0.6 to 9.0) and non-dominant (95% CI 0.4 to 9.2) hand compared with controls. Grip strength differences were partly mediated by height. In conclusion, body composition and physical fitness were similar in adults born SGA and non-SGA at term. Our finding of reduced grip strength in men born SGA may warrant further investigation.

Relationship between self-reported and objectively measured physical fitness in young men and women

Self-reported physical fitness has advantages in cost and time over objective methods, but previous studies demonstrate equivocal conclusions regarding validity. Methods for self-reporting are usually based on subjective judgements, while another approach includes performing field tests at home. The Norwegian military relies on the latter method for conscript selection, but its validity is unknown and should be investigated. In total 14,166 young men and women were included in the study. During conscript selection step one, the subjects were requested to perform 3,000 m run, push-up, pull-up and standing long jump tests at home, and report the results online ("self-reported measurements"). Step two took place at a conscript selection centre 1-18 months later. Here, the subjects completed a maximal treadmill test, seated medicine ball throw, pull-up and standing long jump tests ("objective measurements"). The results demonstrated correlation coefficients from 0.29 to 0.82 (P < 0.05) for self-reported vs. objective measurements, with the highest association found for self-reported and objectively measured pull-ups. Kappa values ranged from 0.05 to 0.34 (P < 0.05), with pull-ups demonstrating the highest agreement. More women than men over-reported their physical fitness. Among men and women indicating similar self-reported fitness, men's objective fitness was higher for all objective tests (effect sizes from 0.5 to 3.0). In conclusion, large variations in correlation coefficients were observed between self-reported and objectively measured physical fitness, while the kappa values indicated poor to fair agreement. The finding that more women than men over-reported their fitness level contradicts most previous studies.Highlights Low, moderate, and high correlations, and poor to fair agreements (kappa values), were observed between self-reported and objectively measured endurance and muscle strength variables.More women than men overreported their actual fitness level.Self-reported fitness based on performing field tests at home may be a feasible alternative to traditional methods which rely on self-perceived fitness.

The Compatibility of Children with Obesity to Self-Report Aspects of Physical Activity Domains

Questions about the different aspects of physical activity (PA) are commonly asked in the clinical setting, yet their compatibility for use with children, particularly children with obesity (OB) is uncertain. Our aim was to investigate different PA-related questions when compared to an objective maximal cardiopulmonary exercise test (CPET) or validated questionnaires. For this study, 33 normal-weight (NW) (5 to less than 85% BMI percentile) and 35 OB (≥95% BMI percentile) children responded to three self-report PA questions evaluating PA domains (exercise capacity, limitations, and the maintenance of an active lifestyle); they also completed a maximal CPET and two validated questionnaires: the New York Heart Association (NYHA) questionnaire and the international physical activity questionnaire (IPAQ). The results regarding the NW children were highly compatible with their self-reports about exercise capacity (85%), whereas the compatibility was low (40%) in the OB group (p < 0.001). Both OB and NW groups had moderate compatibility between the self-report and objective findings regarding their exercise limitations and lifestyle with no significant differences between the groups. These findings suggest that it is inadvisable to rely on a single-item question by which to assess PA in OB children, and no definite conclusions regarding PA status should be drawn. NW children are more compatible with self-reporting their overall exercise capacity, with more limited compatibilities observed when self-reporting their limitations or lifestyle.

Effects of Indoor Plants on Human Functions: A Systematic Review with Meta-Analyses

The influences of indoor plants on people have been examined by only three systematic reviews and no meta-analyses. The objective of this study was therefore to investigate the effects of indoor plants on individuals’ physiological, cognitive, health-related, and behavioral functions by conducting a systematic review with meta-analyses to fill the research gap. The eligibility criteria of this study were (1) any type of participants, (2) any type of indoor plants, (3) comparators without any plants or with other elements, (4) any type of objective human function outcomes, (5) any type of study design, and (6) publications in either English or Chinese. Records were extracted from the Web of Science (1990–), Scopus (1970–), WANFANG DATA (1980–), and Taiwan Periodical Literature (1970–). Therefore, at least two databases were searched in English and in Chinese—two of the most common languages in the world. The last search date of all four databases was on 18 February 2021. We used a quality appraisal system to evaluate the included records. A total of 42 records was included for the systematic review, which concluded that indoor plants affect participants’ functions positively, particularly those of relaxed physiology and enhanced cognition. Separate meta-analyses were then conducted for the effects of the absence or presence of indoor plants on human functions. The meta-analyses comprised only 16 records. The evidence synthesis showed that indoor plants can significantly benefit participants’ diastolic blood pressure (−2.526, 95% CI −4.142, −0.909) and academic achievement (0.534, 95% CI 0.167, 0.901), whereas indoor plants also affected participants’ electroencephalography (EEG) α and β waves, attention, and response time, though not significantly. The major limitations of this study were that we did not include the grey literature and used only two or three records for the meta-analysis of each function. In brief, to achieve the healthy city for people’s health and effective functioning, not only are green spaces needed in cities, but also plants are needed in buildings.

Self-Perceived and Self-Tested Endurance: Associations with Objective Measures

Use of self-report (questionnaires) is often the most realistic means of screening physical fitness in large participant samples because this method is quicker and cheaper than objective testing. Yet, previous studies have reported equivocal validity to reports of self-perceived fitness. A hybrid self-report variant is the use of self-administered/reported objective measurement. We sought to investigate the relative validity of this variant method compared to self-perception reports. In total 26,452 young Norwegian men and women participated in this study. We collected data during obligatory selection for military conscript service. Approximately half of the participants were asked to rate their endurance level on a five-point Likert scale in an online questionnaire. The other half performed a self-administered 3000 m run and reported the result online. Within 18 months, all participants completed an objective maximal treadmill test at a conscript selection center. We used Spearman correlations (r_s) and analyses of variance (ANOVAs) to investigate the relationships between these two self-report methods and the observed objective treadmill performance. Self-perceived and self-tested endurance were both identically correlated with the other-observed treadmill run for men (r_s = 0.59; p < .001) and for women (r_s = 0.50, p < .001); and ANOVAs revealed significant effects of self-perceived and self-tested endurance on treadmill run time, with higher self-reported endurance related to higher treadmill run time. In conclusion, self-perceived and self-tested endurance produced the same correlation coefficients with objectively measured treadmill run time. While there was a moderate relationship between self-reported and objectively measured endurance at the group level, there was substantial individual measurement error that should be considered for individual reports.

Reference data on anthropometrics, aerobic fitness and muscle strength in young Norwegian men and women

Purpose

Anthropometrics, aerobic fitness and muscle strength are measured in one-third of all 18-year-old Norwegian men and women during yearly selection for compulsory military service. The large sample size and geographical representativity make these data valuable for reference. The main purpose of this study was to present reference data for anthropometrics and physical fitness in young Norwegian men and women.

Methods

All 154,659 subjects (66% men and 34% women, 17–21 years old) who completed physical examinations at conscript selection from 2011 to 2019 were included in the study. Body mass index (BMI) was calculated from height and weight measurements. Peak oxygen uptake (VO_2peak) was estimated from performance on a maximal treadmill test. Muscle strength was measured by isometric chest and leg press, or seated medicine ball throw, standing long jump and pull-ups.

Results

Mean BMI (SD) was 23.1 (3.4) and 22.9 (3.3) kg·m⁻² in men and women, respectively (P < 0.001), and 24% of men and 21% of women had a BMI ≥ 25 kg·m⁻². Estimated VO_2peak was 52.9 (4.6) and 42.7 (3.9) mL·kg⁻¹·min⁻¹ in men and women, respectively (P < 0.001). Men performed significantly better than women on all muscle strength tests, with corresponding effect sizes varying from 1.14 for isometric leg press to 2.96 for seated medicine ball throw.

Conclusion

The presented reference data on physical fitness in young Norwegian men and women can be used to evaluate population health, serve as reference material for future studies and describes sex differences in several physical fitness parameters.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00421-021-04784-4.

Questionnaires for assessing self-perceived physical fitness: A systematic review

This systematic review aimed to identify and summarize the reliability and validity of the questionnaires that have been designed for assessing self-perceived physical fitness (PF) in elderly people. Three electronic databases (MEDLINE/PubMed, SPORTDiscuss and Scopus) were searched systematically from their inception until March 2021 in order to find investigations that provided information on the reliability and/or validity of questionnaires used for identifying self-perceived PF in this population. Nine studies fulfilled these criteria, and seven questionnaires were found, five of them being specifically designed for the elderly. Concurrent validity was mostly obtained by correlating the items of the questionnaires with PF field-based tests, and poor to moderately strong associations were obtained. Test-retest reliability was informed in five questionnaires, and high values were generally observed. The SRFit questionnaire showed the best rates of concurrent validity and test-retest reliability, although these results were partially affected by the mean age of the sample. The lack of a rigorous methodological approach when designing these questionnaires detected in this review, asks for further studies using quantitative and qualitative approaches in order to create more solid and valid measurement tools.

Physiological Changes, Activity, and Stress During a 100-km-24-h Walking-March

Background

Long-endurance exercises like ultramarathons are known to elicit various metabolic and physiological changes in the human body. However, little is known about very long-duration exercise at low intensities regarding healthy human subjects.

Aim

The purpose of this study was to evaluate changes in body composition and metabolism in long-endurance but low-intensity events.

Methods

Twenty-five male and 18 female healthy recreational athletes (age 34.6 ± 8.8 years; BMI: 22.4 ± 2.0 kg/m²) of the "100 km Mammutmarsch" were recruited for participation during the events in 2014-2016. Other than classical ultramarathons, the "Mammutmarsch" is a hiking event, in which participants were required to walk but not run or jog. It was expected to complete the 100-km distance within 24 h, resulting in a calculated mean speed of 4.17 km/h, which fits to the mean speed observed (4.12 ± 0.76 km/h). As not all participants reached the finish line, comparison of finishers (FIN, n = 11) and non-finishers (NON, n = 21) allowed differential assessment of performance. Body composition measured through bioelectrical impedance analysis (BIA) was determined pre- and post-event, and serum samples were taken pre-event, at 30, 70, and 100 km to determine NT-pro-BNP, troponin T, C-reactive protein (CRP), cortisol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, total creatine kinase (CK), CK-MB, aminotransferase (AST), ALT, and sodium levels. Nineteen participants wore actimeter armbands (SenseWear^®) to gain information about body activity and exercise intensity [metabolic equivalent of task (MET)]. Sixteen participants wore mobile heart rate monitors to assess mean heart rate during the race. Serum parameter alterations over the course of the race were analyzed with mixed-effects ANOVA and additional t-tests. All serum parameters were analyzed for correlation concerning different MET levels, speed, age, BMI, baseline NT-pro-BNP, mean heart rate during the race, and sex with linear regression analysis.

Results

We found significant elevations for muscle and cardiac stress markers (CRP, CK, CK-MB, AST, ALT, cortisol, and NT-pro-BNP) as well as decreasing markers of lipid metabolism (cholesterol, triglycerides, LDL). Although the intensity level demanded from our participants was low compared with other studies on (ultra-) marathons, the alteration of tested parameters was similar to those of high-intensity exercise, e.g., NT-pro-BNP showed a fourfold increase (p < 0.01) and LDL decreased by 20% (p = 0.05). Besides the duration of exercise, age, BMI, training status, and sex are relevant parameters that influence the elevation of stress factors. Notably, our data indicate that NT-pro-BNP might be a marker for cardiovascular fitness also in healthy adults.

Conclusion

This low-intensity long-endurance walk evoked a strong systemic reaction and large cell stress and shifted to a favorable lipid profile, comparable to higher intensity events. Despite increasing cardiac stress parameters, there were no indications of cardiac cell damage. Remarkably, the duration seems to have a greater influence on stress markers and metabolism than intensity.

Self-rated physical fitness and measured cardiorespiratory fitness, muscular strength, and body composition

The purpose was to examine the correlation and association between a single-item question of self-rated physical fitness and objective measures of fitness and cardiometabolic risk factors in a large population-based study. Participants were 3441 men and women aged 18-85 years who filled in a questionnaire and participated in a clinical health examination in the Danish Health Examination Survey 2007-2008. Cardiorespiratory fitness was estimated by an indirect maximal exercise test. Muscle strength was measured by (a) sit-to-stand test, (b) handgrip strength, and (c) bent arm strength. Body mass index and fat percentage were used as measures for body composition. Associations were derived from regression analyses, correlations were calculated using Spearman's correlation test, and agreement was tested by kappa statistics. Within categories of self-rated physical fitness moving from lowest to highest, objectively measured cardiorespiratory fitness increased. Self-rated physical fitness was strongly correlated to cardiorespiratory fitness (r_men  = 0.69 and r_women  = 0.65) and moderately correlated to the sit-to-stand test (r_men  = 0.49 and r_women  = 0.48), bent arm strength (r = 0.45) and fat percentage (r = 0.46) among men, and handgrip strength among women (r =0.41). Mutually adjusted analysis showed a significant association between self-reported physical fitness and cardiorespiratory fitness for men and women and bent arm strength for women. The single-item question of physical fitness was correlated to cardiorespiratory fitness, muscle strength, and body composition. However, this study suggests that it mainly captures cardiorespiratory fitness. At the population level, the single-item question could be a useful tool to identify and monitor variation in fitness levels.

Doctor, ask your perimenopausal patient about her physical fitness; association of self-reported physical fitness with cardiometabolic and mental health in perimenopausal women: the FLAMENCO project

OBJECTIVE

The aim of this study was to explore the association of self-reported physical fitness (PF) and its components with cardiometabolic and mental health in perimenopausal women.

METHODS

These cross-sectional analyses included 191 participants (53 ± 4 y old) from the FLAMENCO project. Self-reported PF was assessed with the International Fitness Scale (IFIS). Body mass index (BMI), fat mass (FM), waist circumference (WC), systolic and diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglycerides, C-reactive protein (CRP), and glucose were measured. The Beck's Depression Inventory, State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, Life Orientation Test Revised, and Positive and Negative Affect Schedule were used to assess mental health.

RESULTS

After adjusting for potential confounders, greater overall PF was associated with lower BMI, FM, WC (P < 0.001), DBP and CRP, and higher HDL-C (P < 0.05). Cardiorespiratory fitness (CRF), speed-agility, and flexibility were associated with lower BMI, WC, and FM (P < 0.001), and muscle strength (MS) with lower WC and FM (P < 0.05). In addition, CRF, MS, and speed-agility were associated with lower CRP (P < 0.01), and flexibility with enhanced triglycerides and HDL-C (P < 0.05). Overall PF and all its components were associated with lower depression, anxiety, and negative affect (P≤0.01), and greater positive affect (P≤0.05). Overall PF and MS were associated with better sleep quality (P < 0.05), and CRF, MS, and speed-agility with greater optimism (P≤0.05). Finally, overall PF showed evidence of significant association with less pharmaceutical expenditure (B = -7.2, β=-0.145, P = 0.08).

CONCLUSIONS

Self-reported PF was associated with better cardiometabolic and mental health in perimenopausal women. The IFIS might be proposed as an inexpensive, quick, and easy tool in clinical settings.

Self-Reported vs Measured Physical Fitness in Older Women

Purpose

The main purpose of the study was to determine the level of correlation between self-reported and measured physical fitness.

Patients and Methods

In this cross-sectional study, we recruited 120 older women aged ≥60 years. Self-reported physical fitness was assessed on a scale from 1 to 10, where higher score indicated better physical fitness perception. Objective measure included seven physical fitness tests: 1) waist circumference, 2) chair stand in 30 sec, 3) arm curl in 30 sec, 4) 2-min step test, 5) chair sit-and-reach test, 6) back scratch test and 7) 8-feet up-and-go test. Correlation between the two measures was analyzed by using Spearman coefficient (p≤0.05).

Results

In the whole sample, self-reported physical fitness was associated with chair stand in 30 sec (r=0.39, p<0.001), arm curl in 30 sec (r=0.54, p<0.001), 2-min step test (r=0.43, p<0.001), chair sit-and-reach test (r=0.39, p<0.001), back scratch test (r=0.36, p<0.001) and 8-feet up-and-go test (r=−0.29, p<0.001). No significant correlation between self-reported physical fitness and waist circumference was found (r=0.03, p=0.786). Overall physical fitness (sum of all physical fitness z-scores) was strongly correlated with self-reported physical fitness (r=0.63, p<0.001).

Conclusion

This study shows that self-reported measure of physical fitness is moderately correlated to objectively measured physical fitness in relatively healthy older women.

Active and Fit Communities. Associations between Neighborhood Walkability and Health-Related Fitness in Adults

There are many health benefits of regular physical activity and improving physical fitness levels can reduce the risk of chronic disease. Accumulating evidence suggests the neighborhood built environment is important for supporting physical activity; however, few studies have investigated the contribution of the neighborhood built environment to fitness levels. We examined the associations between objectively-determined and self-reported neighborhood walkability and overall and specific components of perceived health-related fitness (cardiorespiratory, muscular strength, and flexibility) in a random sample of 592 adults from two areas of Calgary (Canada). Participants provided complete data to an online questionnaire capturing perceived cardiorespiratory fitness (CRF), muscular strength (MST), flexibility, moderate-to-vigorous intensity physical activity (MVPA), resistance training, and sociodemographic characteristics. The questionnaire also captured participant’s perceptions of their neighborhood’s walkability (Physical Activity Neighborhood Environment Scale; PANES) and the physical activity supportiveness of neighborhood parks (Park Perceptions Index; PPI). Objectively-measured neighborhood walkability was estimated using Walk Score^®. The average (SD) age of participants was 46.6 (14.8) years and 67.2% were female. Participants, on average, participated in at least 30-minutes of MVPA on 3.4 (2.1) days/week and undertook resistance training 2.0 (1.8) days/week. Adjusting for covariates, Walk Score^® was not associated with any fitness outcomes. Adjusting for covariates, the PANES index was positively associated (p < 0.05) with CRF, MST, flexibility, and overall fitness and the PPI was positively associated (p < 0.05) with all fitness outcomes except MST. Our findings provide novel preliminary evidence suggesting the neighborhood built environment may be important for supporting higher health-related fitness levels in adults.

The Garmin-RUNSAFE Running Health Study on the aetiology of running-related injuries: rationale and design of an 18-month prospective cohort study including runners worldwide

INTRODUCTION

Running injuries affect millions of persons every year and have become a substantial public health issue owing to the popularity of running. To ensure adherence to running, it is important to prevent injuries and to have an in-depth understanding of the aetiology of running injuries. The main purpose of the present paper was to describe the design of a future prospective cohort study exploring if a dose-response relationship exists between changes in training load and running injury occurrence, and how this association is modified by other variables.

METHODS AND ANALYSIS

In this protocol, the design of an 18-month observational prospective cohort study is described that will include a minimum of 20 000 consenting runners who upload their running data to Garmin Connect and volunteer to be a part of the study. The primary outcome is running-related injuries categorised into the following states: (1) no injury; (2) a problem; and (3) injury. The primary exposure is change in training load (eg, running distance and the cumulative training load based on the number of strides, ground contact time, vertical oscillation and body weight). The change in training load is a time-dependent exposure in the sense that progression or regression can change many times during follow-up. Effect-measure modifiers include, but is not limited to, other types of sports activity, activity of daily living and demographics, and are assessed through questionnaires and/or by Garmin devices.

ETHICS AND DISSEMINATION

The study design, procedures and informed consent have been evaluated by the Ethics Committee of the Central Denmark Region (Request number: 227/2016 - Record number: 1-10-72-189-16).

Sex and age correlations of reported and estimated physical fitness in adolescents

The main purpose of the study was to explore sex and age specific correlations between self-reported and estimated physical fitness. In this cross-sectional study, we recruited 1 036 secondary-school students (55.3% girls). Self-reported physical fitness was assessed on a 10-point scale, with a higher score indicating better physical fitness. We measured waist circumference, sit-ups in 1 minute, standing long jump and sit-and-reach test and calculated z-scores to obtain objective physical fitness index. Boys performed better in sit-ups in 1 minute and standing long jump tests and had higher waist circumference values. Girls performed better in sit-and-reach test. Overall, boys had higher physical fitness z-score values, compared to girls. Younger boys had better physical fitness perception (r_{1st grade} = 0.61, p<0.001), compared to older ones (r = 0.40–0.50, p<0.001). In girls, correlation coefficient was the highest in the 3^rd grade (r = 0.46, p<0.001), followed by the 2^ndgrade (r = 0.43, p<0.001), the 1^stgrade (r = 0.41, p<0.001) and the 4^th grade (r = 0.37, p<0.001). Our study shows moderate sex and age specific correlation between self-reported and estimated physical fitness in a large sample of adolescents.

Challenges in profiling Australian scuba divers through surveys

INTRODUCTION

This study aimed to compare the results from three Australian scuba diver surveys. As the surveys differed in recruitment methods, the expectation was that respondents would differ in some important characteristics.

METHODOLOGY

Anonymous, online, cross-sectional surveys of the demographics, health, diving practices and outcomes were distributed to: (1) Divers Alert Network Asia-Pacific (DAN AP) members; (2) Professional Association of Diving Instructors (PADI) Asia-Pacific members; and (3) divers who had received any PADI non-leadership certification within the previous four years. Only data from divers resident in Australia were analysed.

RESULTS

A total of 2,275 responses were received from current Australian residents, comprising 1,119 of 4,235 (26.4%) DAN members; 350 of 2,600 (13.5%) PADI members; and 806 of 37,000 (2.2%) PADI divers. DAN and PADI members had similar diving careers (medians 14 and 15 years, respectively). PADI members had undertaken more dives (median 800) than DAN members (330) and PADI divers (28). A total of 692 respondents reported suffering from diabetes or a cardiovascular, respiratory, neurological or psychological condition and included 34% of the DAN members and 28% of each of the PADI cohorts. Eighty-four divers had been treated for decompression illness (approximately 5% of DAN and PADI member groups and 1% of the PADI divers). Eighty-seven of 1,156 (7.5%) PADI respondents reported a perceived life-threatening incident while diving.

CONCLUSIONS

Despite low response rates, this study indicates clear differences in the characteristics of the divers in the three cohorts. Therefore, a survey of a single cohort may represent that diving population alone and the findings may be misleading. This bias needs to be clearly understood and any survey findings interpreted accordingly.

Gender Differences in Performance Predictions: Evidence from the Cognitive Reflection Test

This paper studies performance predictions in the 7-item Cognitive Reflection Test (CRT) and whether they differ by gender. After participants completed the CRT, they predicted their own (i), the other participants' (ii), men's (iii), and women's (iv) number of correct answers. In keeping with existing literature, men scored higher on the CRT than women and both men and women were too optimistic about their own performance. When we compare gender-specific predictions, we observe that men think they perform significantly better than other men and do so significantly more than women. The equality between women's predictions about their own performance and their female peers cannot be rejected. Our findings contribute to the growing literature on the underpinnings of behavior in economics and in psychology by uncovering gender differences in confidence about one's ability relative to same and opposite sex peers.