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Zatloukal J, Zylla S, Markus MRP, Ewert R, Gläser S, Völzke H, Albrecht D, Friedrich N, Nauck M, Peterson LR, Jiang X, Schaffer JE, Felix SB, Dörr M, Bahls M, Gross S. The Association Between C24:0/C16:0 Ceramide Ratio and Cardiorespiratory Fitness is Robust to Effect Modifications by Age and Sex. Adv Biol (Weinh) 2024; 8:e2300633. [PMID: 38342586 PMCID: PMC11149399 DOI: 10.1002/adbi.202300633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Indexed: 02/13/2024]
Abstract
Ceramides and cardiorespiratory (CR) fitness are both related to cardiovascular diseases. The associations of three blood plasma ceramides (C16:0, C22:0, and C24:0) with CR fitness in the population-based Study of Health in Pomerania (SHIP-START-1; n = 1,102; mean age 50.3 years, 51.5% women) are investigated. In addition, subgroup analysis according to age (≥54 years) and sex (female/male) is performed. Ceramides are quantified by liquid chromatography/mass spectrometry (LC/MS). CR fitness is assessed by a cardiopulmonary exercise test. Sex and age independent associations are found for higher levels of C24:0 and C24:0/C16:0 ratio with higher maximal oxygen consumption (VO2peak) kg-1 and oxygen consumption at the anaerobic threshold (VO2@AT1) as well as for the relation of C24:0/C16:0 with maximum workload (Wattmax kg-1). In contrast, age/sex subgroup specific inverse associations with Wattmax kg-1 are found in women <54 years for C22:0, while a positive association in men ≥54 years. Higher levels of C24:0 are associated with higher Wattmax kg-1, except for women <54 years, where no significant association can be found. The findings suggest that the use of single ceramides as cardiovascular biomarkers may be inferior, compared to ceramide ratio C24:0/C16:0. Therefore C24:0/C16:0 ratio may be a more suitable and robust cardiovascular biomarker and should be preferred over single ceramides.
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Affiliation(s)
- Jule Zatloukal
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
| | - Stephanie Zylla
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Marcello R P Markus
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
| | - Ralf Ewert
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Sven Gläser
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- Clinic for Internal Medicine, Vivantes Klinikum Spandau/Neukölln, 12351, Berlin, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
- Institute of Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Diana Albrecht
- Institute of Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
- Leibniz Institute for Plasma Science and Technology, 17489, Greifswald, Germany
| | - Nele Friedrich
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Matthias Nauck
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Linda R Peterson
- Division of Cardiology, Department of Medicine, Washington University, St Louis, MO, 63110, USA
| | - Xuntian Jiang
- Division of Cardiology, Department of Medicine, Washington University, St Louis, MO, 63110, USA
| | - Jean E Schaffer
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Stephan B Felix
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
| | - Marcus Dörr
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
| | - Martin Bahls
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
| | - Stefan Gross
- Dept. of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), 17475, Partner-site Greifswald, Germany
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Ittermann T, Ewert R, Habedank D, Kaczmarek S, Felix SB, Dörr M, Stubbe B, Bahls M. Proportional Internal Work-a New Parameter of Exercise Testing in Study of Health in Pomerania (SHIP). J Cardiopulm Rehabil Prev 2023; 43:460-466. [PMID: 37184451 DOI: 10.1097/hcr.0000000000000795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
PURPOSE Cardiopulmonary exercise testing usually requires a maximal exhaustive effort by the patient and is time consuming. The purpose of this study was to assess whether the cost to initiate exercise termed "proportional internal work" (PIW) was related to cardiovascular disease (CVD) risk factors, ventilatory parameters, and mortality. METHODS We used data from population-based Study of Health in Pomerania. A total of 2829 (49.5% female) study participants with a median age of 52 (42-62) yr were included. Standardized questionnaires were used to assess CV risk factors. The cardiopulmonary exercise testing was performed using a modified Jones protocol. Regression models adjusted for sex and age were used to relate PIW with CVD risk factors and ventilatory parameters. The PIW was calculated by the following formula: (Oxygen uptake at rest - Oxygen uptake without load)/V˙ o2peak ) × 100. Cox regression analysis was used to relate PIW and all-cause mortality. RESULTS We identified a nonlinear association between PIW and percent predicted V˙ o2peak . Women had a 2.96 (95% CI, 2.61-3.32) greater PIW than men. With each year of age and every point in body mass index, the PWI increased by 0.04 (95% CI, 0.03-0.05) and 0.16 (95% CI, 0.12-0.20), respectively. After adjustment for age, sex, smoking, and body mass index, a 1-point greater PIW was associated with a 5% higher risk to die (HR = 1.05; 95% CI, 1.01-1.07). CONCLUSIONS The PIW is a new cardiopulmonary exercise testing parameter related to CVD risk and all-cause mortality. Future studies should assess the prognostic relevance of PIW for CVD prevention.
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Affiliation(s)
- Till Ittermann
- Institute for Community Medicine (Dr Ittermann) and Department of Internal Medicine B (Drs Ewert, Habedank, Kaczmarek, Felix, Dörr, Stubbe, and Bahls), University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany (Drs Ittermann, Kaczmarek, Felix, Dörr, and Bahls); and Department of Internal Medicine, DRK Krankenhaus Berlin, Berlin, Germany (Dr Habedank)
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Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. Re: Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. Physical activity at work may not be health enhancing. A systematic review with meta-analysis on the association between occupational physical activity and cardiovascular disease mortality covering 23 studies with 655 892 participants. Scand J Work Environ Health. 2022;48(2):86-98. doi:10.5271/sjweh.3993. Scand J Work Environ Health 2023; 49:231-244. [PMID: 37000459 PMCID: PMC10621902 DOI: 10.5271/sjweh.4090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Indexed: 04/01/2023] Open
Abstract
Objectives Emerging evidence suggests contrasting health effects for leisure-time and occupational physical activity. In this systematic review, we synthesized and described the epidemiological evidence regarding the association between occupational physical activity and cardiovascular disease (CVD) mortality. Methods A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews, from database inception to 17 April 2020. Articles were included if they described original observational prospective research, assessing the association between occupational physical activity and CVD mortality among adult workers. Reviews were included if they controlled for age and gender and at least one other relevant variable. We performed meta-analyses on the associations between occupational physical activity and CVD mortality. Results We screened 3345 unique articles, and 31 articles (from 23 studies) were described in this review. In the meta-analysis, occupational physical activity showed no significant association with overall CVD mortality for both males [hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.84–1.12] and females (HR 0.97, 95% CI 0.82–1.15). Additional analysis showed that higher levels of occupational physical activity were non-significantly associated with a 9% increase in studies reporting on the outcome ischemic heart disease mortality (HR 1.09, 95% CI 0.82–1.43). Conclusions While the beneficial association between leisure-time physical activity and CVD mortality has been widely documented, occupational physical activity was not found to have a beneficial association with CVD mortality. This observation may have implications for our appreciation of the association between physical activity and health for workers in physically demanding jobs, as occupational physical activity may not be health enhancing.
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Affiliation(s)
| | | | | | | | | | | | | | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre (VUmc), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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Hassan L, Huhndorf P, Mikolajczyk R, Kluttig A. Physical activity trajectories at older age and all-cause mortality: A cohort study. PLoS One 2023; 18:e0280878. [PMID: 36701298 PMCID: PMC9879516 DOI: 10.1371/journal.pone.0280878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND A physically active lifestyle is recognized as a precondition of healthy aging. However, the majority of studies exploring its association with mortality in cohorts of adults used single-time physical activity (PA) estimate, which do not consider its dynamic nature with changes that occur with aging. The aim of the present study is to explore the presence of different PA trajectories in a population-based cohort and their association with mortality. METHODS We used data of the population-based cohort study CARLA and included 1041 older adults (45-83 years at baseline) with self-reported physical activity at baseline (2002-2006), first follow-up (2007-2010) and second follow-up (2013). Trajectories were identified using growth mixture modelling. Cox proportional hazard models were used to assess the association between trajectories of PA and all-cause mortality during ~6 years since the second follow-up after adjusting for age, sex, lifestyle factors and comorbidities and after correction for classification error. In a sensitivity analysis we weighted the models to account for selection bias during follow-up. As a further sensitivity analysis, we excluded the first year of follow-up to account for reverse causation. RESULTS Three PA trajectories (categorized as consistently low, consistently moderate, and high at baseline but strongly decreasing PA across time) were identified, and 121 deaths due to all causes occurred. Compared with participants who had consistently low PA-levels throughout the follow-up period, participants who maintained moderate PA-levels were at a lower risk of all-cause mortality (hazard ratio [HR], 0.49; 95%CI, 0.30-0.70). Participants with high PA-levels at baseline but strongly decreasing PA across time, had similar mortality risk compared to the participants with consistently low PA-levels (hazard ratio [HR], 0.97; 95%CI, 0.50-1.80). The effects were strengthened in the analysis weighted for selection bias. CONCLUSIONS Our results suggest that, compared to those who had consistently low PA levels, those who maintained a moderate level of PA showed a protective effect in terms of their mortality risk but not those who displayed a decline from high PA levels.
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Affiliation(s)
- Lamiaa Hassan
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Peter Huhndorf
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- * E-mail:
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Body surface scan anthropometrics are related to cardiorespiratory fitness in the general population. Sci Rep 2022; 12:22185. [PMID: 36564547 PMCID: PMC9789061 DOI: 10.1038/s41598-022-26740-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
The assessment of cardiorespiratory fitness (CRF) is an important tool for prognosis evaluation of cardiovascular events. The gold standard to measure CRF is cardiopulmonary exercise testing (CPET) to determine peak oxygen uptake (VO2peak). However, CPET is not only time consuming but also expensive and is therefore not widely applicable in daily practice. The aim of our study was to analyze, whether and which anthropometric markers derived from a 3D body scanner were related to VO2peak in a general population-based study. We analyzed data (SHIP-START-3) from 3D body scanner and CPET of 1035 subjects (529 women; 51.1%, age range 36-93). A total of 164 anthropometric markers were detected with the 3D body scanner VITUS Smart XXL using the software AnthroScan Professional. Anthropometric measurements were standardized and associated with CRF by sex-stratified linear regression models adjusted for age and height. Anthropometric markers were ranked according to the - log- p values derived from these regression models. In men a greater left and right thigh-knee-ratio, a longer forearm-fingertip length, a greater left thigh circumference and greater left upper arm circumference were most strongly associated with a higher VO2peak. In women a greater left and right thigh circumference, left calf circumference, thigh thickness and right calf circumference were most strongly associated with a higher VO2peak. The detected VO2peak-related anthropometric markers could be helpful in assessing CRF in clinical routine. Commonly used anthropometric markers, e.g. waist and hip circumference, were not among the markers associated with VO2peak.
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Laukkanen JA, Isiozor NM, Kunutsor SK. Objectively Assessed Cardiorespiratory Fitness and All-Cause Mortality Risk: An Updated Meta-analysis of 37 Cohort Studies Involving 2,258,029 Participants. Mayo Clin Proc 2022; 97:1054-1073. [PMID: 35562197 DOI: 10.1016/j.mayocp.2022.02.029] [Citation(s) in RCA: 83] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 02/25/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To detail the magnitude and specificity of the association between cardiorespiratory fitness (CRF) and all-cause mortality risk. METHODS Cohort studies with at least 1 year of follow-up were sought from inception until December 2021 in MEDLINE, Embase, Web of Science, and a manual search of relevant articles. Relative risks (RRs) with 95% CIs were pooled using random-effects models. Quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS A total of 37 unique studies comprising of 2,258,029 participants with 108,613 all-cause mortality events were eligible. The pooled multivariable-adjusted RR for all-cause mortality comparing the top vs bottom tertiles of CRF levels was 0.55 (95% CI, 0.50 to 0.61). When CRF was expressed in metabolic equivalent task (MET) units, the corresponding pooled RR was 0.56 (95% CI, 0.50 to 0.62). For every 1-MET increase in CRF, the RR for all-cause mortality was 0.89 (95% CI, 0.86 to 0.92). Strength of the association did not differ by publication year, age, sex, follow-up duration, CRF assessment method, or risk of bias. CONCLUSION Aggregate analysis of observational cohort studies confirms a strong inverse and independent association between CRF and all-cause mortality risk. The results suggest that guideline bodies should consider the inclusion of CRF in standard risk panels for mortality risk assessment.
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Affiliation(s)
- Jari A Laukkanen
- Central Finland Health Care District Hospital District, Department of Medicine, Jyväskylä, Finland; Institute of Clinical Medicine, Department of Internal Medicine, and the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
| | - Nzechukwu M Isiozor
- Institute of Clinical Medicine, Department of Internal Medicine, and the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Setor K Kunutsor
- Central Finland Health Care District Hospital District, Department of Medicine, Jyväskylä, Finland; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
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Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. Physical activity at work may not be health enhancing. A systematic review with meta-analysis on the association between occupational physical activity and cardiovascular disease mortality covering 23 studies with 655 892 participants. Scand J Work Environ Health 2022; 48:86-98. [PMID: 34656067 PMCID: PMC9045238 DOI: 10.5271/sjweh.3993 10.5271/sjweh.4090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVES Emerging evidence suggests contrasting health effects for leisure-time and occupational physical activity. In this systematic review, we synthesized and described the epidemiological evidence regarding the association between occupational physical activity and cardiovascular disease (CVD) mortality. METHODS A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews, from database inception to 17 April 2020. Articles were included if they described original observational prospective research, assessing the association between occupational physical activity and CVD mortality among adult workers. Reviews were included if they controlled for age and gender and at least one other relevant variable. We performed meta-analyses on the associations between occupational physical activity and CVD mortality. RESULTS We screened 3345 unique articles, and 31 articles (from 23 studies) were described in this review. In the meta-analysis, occupational physical activity showed no significant association with overall CVD mortality for both males [hazard ratio (HR) 1.00, 95% confidence interval (CI) 0.87-1.15] and females (HR 0.95, 95% CI 0.82-1.09). Additional analysis showed that higher levels of occupational physical activity were non-significantly associated with a 15% increase in studies reporting on the outcome ischemic heart disease mortality (HR 1.15, 95% CI 0.88-1.49). CONCLUSIONS While the beneficial association between leisure-time physical activity and CVD mortality has been widely documented, occupational physical activity was not found to have a beneficial association with CVD mortality. This observation may have implications for our appreciation of the association between physical activity and health for workers in physically demanding jobs, as occupational physical activity may not be health enhancing.
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Affiliation(s)
- Bart Cillekens
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre (VUmc), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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Drzyzga CJ, Bahls M, Ittermann T, Völzke H, Bülow R, Hammer F, Ewert R, Gläser S, Felix SB, Dörr M, Markus MRP. Lower Cardiorespiratory Fitness Is Associated With Right Ventricular Geometry and Function - The Sedentary's Heart: SHIP. J Am Heart Assoc 2021; 10:e021116. [PMID: 34743534 PMCID: PMC8751926 DOI: 10.1161/jaha.120.021116] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background Lower cardiorespiratory fitness (CRF) is associated with an increased risk for cardiovascular disease. However, very little information is available about the association between lower CRF and right ventricular (RV) remodeling. We investigated the relationship between CRF and RV structure and function in a large, aging, and largely sedentary adult population–based cohort. Methods and Results We used cross‐sectional data of 2844 subjects (1486 women; median age, 51 years; interquartile range, 40–62 years) from the population‐based cohort SHIP (Study of Health in Pomerania) with echocardiography, of which 941 also had cardiac magnetic resonance imaging. We analyzed the associations of peak oxygen uptake with RV parameters determined by both imaging techniques using multivariable‐adjusted linear regression models. In echocardiography, a 1 L/min lower peak oxygen uptake was associated with a 1.18 mm (95% CI, 0.66–1.71; P<0.001) smaller RV end‐diastolic diameter and a 1.41 mm (95% CI, 0.90–1.92; P<0.001) narrower RV end‐diastolic outflow tract diameter. Similarly, using cardiac magnetic resonance imaging measurements, a 1 L/min lower peak oxygen uptake was associated with a 23.5 mL (95% CI, 18.7–28.4; P<0.001) smaller RV end‐diastolic volume, a 13.0 mL (95% CI, 9.81–16.2; P<0.001) lower RV end‐systolic volume, and a 10.7 mL/beat (95% CI, 8.10–13.3; P<0.001) lower RV stroke volume. Conclusions Our results indicate a significant association between CRF and RV remodeling. Lower CRF was associated with smaller RV chamber and lower RV systolic function, stroke volume, and cardiac output.
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Affiliation(s)
- Christine J Drzyzga
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany.,German Centre for Cardiovascular Research (DZHK)partner site Greifswald Greifswald Germany
| | - Martin Bahls
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany.,German Centre for Cardiovascular Research (DZHK)partner site Greifswald Greifswald Germany
| | - Till Ittermann
- German Centre for Cardiovascular Research (DZHK)partner site Greifswald Greifswald Germany.,Department of Study of Health in Pomerania/Clinical-Epidemiological Research Institute for Community Medicine University Medicine Greifswald Greifswald Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK)partner site Greifswald Greifswald Germany.,Department of Study of Health in Pomerania/Clinical-Epidemiological Research Institute for Community Medicine University Medicine Greifswald Greifswald Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and NeuroradiologyUniversity Medicine Greifswald Greifswald Germany
| | - Fabian Hammer
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany
| | - Ralf Ewert
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany
| | | | - Stephan B Felix
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany.,German Centre for Cardiovascular Research (DZHK)partner site Greifswald Greifswald Germany
| | - Marcus Dörr
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany.,German Centre for Cardiovascular Research (DZHK)partner site Greifswald Greifswald Germany
| | - Marcello R P Markus
- Department of Internal Medicine B University Medicine Greifswald Greifswald Germany.,German Centre for Cardiovascular Research (DZHK)partner site Greifswald Greifswald Germany.,German Center for Diabetes Research (DZD)partner site Greifswald Greifswald Germany
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9
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Bahls M, Leitzmann MF, Karch A, Teumer A, Dörr M, Felix SB, Meisinger C, Baumeister SE, Baurecht H. Physical activity, sedentary behavior and risk of coronary artery disease, myocardial infarction and ischemic stroke: a two-sample Mendelian randomization study. Clin Res Cardiol 2021; 110:1564-1573. [PMID: 33774696 PMCID: PMC8484185 DOI: 10.1007/s00392-021-01846-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 03/15/2021] [Indexed: 12/19/2022]
Abstract
AIMS Observational evidence suggests that physical activity (PA) is inversely and sedentarism positively related with cardiovascular disease risk. We performed a two-sample Mendelian randomization (MR) analysis to examine whether genetically predicted PA and sedentary behavior are related to coronary artery disease, myocardial infarction, and ischemic stroke. METHODS AND RESULTS We used single nucleotide polymorphisms (SNPs) associated with self-reported moderate to vigorous PA (n = 17), accelerometer based PA (n = 7) and accelerometer fraction of accelerations > 425 milli-gravities (n = 7) as well as sedentary behavior (n = 6) in the UK Biobank as instrumental variables in a two sample MR approach to assess whether these exposures are related to coronary artery disease and myocardial infarction in the CARDIoGRAMplusC4D genome-wide association study (GWAS) or ischemic stroke in the MEGASTROKE GWAS. The study population included 42,096 cases of coronary artery disease (99,121 controls), 27,509 cases of myocardial infarction (99,121 controls), and 34,217 cases of ischemic stroke (404,630 controls). We found no associations between genetically predicted self-reported moderate to vigorous PA, accelerometer-based PA or accelerometer fraction of accelerations > 425 milli-gravities as well as sedentary behavior with coronary artery disease, myocardial infarction, and ischemic stroke. CONCLUSIONS These results do not support a causal relationship between PA and sedentary behavior with risk of coronary artery disease, myocardial infarction, and ischemic stroke. Hence, previous observational studies may have been biased.
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Affiliation(s)
- Martin Bahls
- Department of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany.
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany.
| | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Alexander Teumer
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Stephan B Felix
- Department of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Christa Meisinger
- Chair of Epidemiology, LMU München, UNIKA-T Augsburg, Augsburg, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum Muenchen, Munich, Germany
| | - Sebastian E Baumeister
- Chair of Epidemiology, LMU München, UNIKA-T Augsburg, Augsburg, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum Muenchen, Munich, Germany
- Institute of Health Services Research in Dentistry, University of Muenster, Muenster, Germany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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Paudel S, Subedi N, McLachlan CS, Smith BJ, Kallestrup P, Neupane D. Active commuting and leisure-time physical activity among adults in western Nepal: a cross-sectional study. BMJ Open 2021; 11:e051846. [PMID: 34385256 PMCID: PMC8362701 DOI: 10.1136/bmjopen-2021-051846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/28/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine the prevalence and sociodemographic factors associated with active commuting and leisure-time physical activity (LTPA) among adults in western Nepal. DESIGN Cross-sectional study. SETTING Adults from semiurban areas in western Nepal. PARTICIPANTS 2815 adults aged 25-65 years who participated in the 'Community-Based Management of Hypertension in Nepal (COBIN)' Study. Multiple logistic regression analysis was used to identify the sociodemographic factors associated with active commuting and LTPA. OUTCOME Self-reported participation in active commuting and LTPA. RESULTS Most study participants (96%) commuted actively (walked or cycled) from one place to another. Our results showed that only a small proportion (3.7%) of participants engaged in moderate or vigorous LTPA. Compared with those in paid employment, the odds of commuting actively were higher among people working in agriculture or as labourers (OR: 4.57, 95% CI: 2.46 to 8.48), those retired/unemployed (OR: 2.98, 95% CI: 1.42 to 6.25) and those in unpaid employment (OR: 1.85, 95% CI: 1.06 to 3.22). Adults who were overweight or had obesity were less likely to commute actively. Compared with adults aged 25-34 years, older adults were less likely (OR: 0.35, 95% CI: 0.17 to 0.72) to engage in LTPA. Women were 0.46 times less likely to engage in LTPA compared with men. CONCLUSION Most adults engaged in active commuting for work or travel. Less than 5% participated in any form of moderate or vigorous LTPA. Longitudinal studies incorporating objective assessment of physical activity and a range of individual, interpersonal, and environmental factors will help understand how to promote active commuting and LTPA among Nepalese adults.Trial registration number: ClinicalTrials.gov NCT02428075.
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Affiliation(s)
- Susan Paudel
- Nepal Development Society, Bharatpur, Bagmati, Nepal
| | - Narayan Subedi
- Nepal Development Society, Bharatpur, Bagmati, Nepal
- School of Exercise and Nutrition Sciences, Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Craig S McLachlan
- Torrens University Australia-Sydney Campus Pyrmont, Pyrmont, New South Wales, Australia
| | - Ben J Smith
- The University of Sydney, Sydney, New South Wales, Australia
| | - Per Kallestrup
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Dinesh Neupane
- Nepal Development Society, Bharatpur, Bagmati, Nepal
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
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11
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Paudel S, Owen AJ, Smith BJ. Socio-ecological influences of leisure-time physical activity among Nepalese adults: a qualitative study. BMC Public Health 2021; 21:1443. [PMID: 34294069 PMCID: PMC8296660 DOI: 10.1186/s12889-021-11484-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 07/06/2021] [Indexed: 01/01/2023] Open
Abstract
Background With economic and social changes, participation in occupational and transport-related physical activity is declining among Nepalese adults, highlighting the growing importance of leisure-time physical activity. However, limited information is available to guide public health policies and interventions to promote leisure-time physical activity in Nepal. This study aimed to qualitatively explore the socioecological influences of participation in leisure-time physical activity among Nepalese adults aged 40 years and above. Methods A total of 51 adults (30 females and 21 males) participated in one of the nine focus groups conducted in Kathmandu, Nepal. A semi-structured guide based on the social-ecological model of physical activity was used to facilitate these focus groups. Data were analysed using a reflexive thematic analysis approach in NVivo 12. Results Participation in leisure-time physical activity was minimal and leisure time was mostly spent resting, socialising, or engaging in sedentary activities such as watching television. Walking was the most common form of leisure-time physical activity, and men reported being more active than women. Individual-level barriers included lack of knowledge, lack of skill, lack of motivation, considering oneself as sufficiently active and engagement in sedentary screen activities. Family and household responsibilities, lack of support and fear of being judged constituted the interpersonal barriers while environmental barriers included an absence of a supportive social norm, lack of open spaces, weather conditions and perceived lack of safety. Health benefits, prioritising physical activity, social support, provision of group-based activities and age-appropriate public exercise facilities were identified as major facilitators. Conclusion Critical issues that need to be addressed to increase leisure-time physical activity among Nepalese adults include traditional gender roles, family and social support, and social norms. Modifications of the built environment, such as public exercise facilities, offer further opportunities and will require coordination beyond the health sector. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11484-3.
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Affiliation(s)
- Susan Paudel
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Ben J Smith
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, Australia
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12
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Prince SA, Rasmussen CL, Biswas A, Holtermann A, Aulakh T, Merucci K, Coenen P. The effect of leisure time physical activity and sedentary behaviour on the health of workers with different occupational physical activity demands: a systematic review. Int J Behav Nutr Phys Act 2021; 18:100. [PMID: 34284795 PMCID: PMC8290554 DOI: 10.1186/s12966-021-01166-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/30/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Although it is generally accepted that physical activity reduces the risk for chronic non-communicable disease and mortality, accumulating evidence suggests that occupational physical activity (OPA) may not confer the same health benefits as leisure time physical activity (LTPA). It is also unclear if workers in high OPA jobs benefit from LTPA the same way as those in sedentary jobs. Our objective was to determine whether LTPA and leisure time sedentary behaviour (LTSB) confer the same health effects across occupations with different levels of OPA. METHODS Searches were run in Medline, Embase, PsycINFO, ProQuest Public Health and Scopus from inception to June 9, 2020. Prospective or experimental studies which examined the effects of LTPA or LTSB on all-cause and cardiovascular mortality and cardiovascular disease, musculoskeletal pain, diabetes, metabolic syndrome, arrhythmias and depression among adult workers grouped by OPA (low OPA/sitters, standers, moderate OPA/intermittent movers, high OPA/heavy labourers) were eligible. Results were synthesized using narrative syntheses and harvest plots, and certainty of evidence assessed with GRADE. RESULTS The review includes 38 papers. Across all outcomes, except cardiovascular mortality, metabolic syndrome and atrial fibrillation, greater LTPA was consistently protective among low OPA, but conferred less protection among moderate and high OPA. For cardiovascular mortality and metabolic syndrome, higher levels of LTPA were generally associated with similar risk reductions among all OPA groups. Few studies examined effects in standers and none examined effects of LTSB across OPA groups. CONCLUSIONS Evidence suggests that LTPA is beneficial for all workers, but with larger risk reductions among those with low compared to high OPA jobs. This suggests that, in our attempts to improve the health of workers through LTPA, tailored interventions for different occupational groups may be required. More high-quality studies are needed to establish recommended levels of LTPA/LTSB for different OPA groups. PROTOCOL REGISTRATION PROSPERO # CRD42020191708 .
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, Ontario, K1A 0K9, Canada.
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | | | - Aviroop Biswas
- Institute for Work & Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Tarnbir Aulakh
- School of Kinesiology and Health Studies, Queen's University, Kingston, Canada
| | | | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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13
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Mediano MFF, Mok Y, Coresh J, Kucharska-Newton A, Palta P, Lakshminarayan K, Rosamond WD, Matsushita K, Koton S. Prestroke Physical Activity and Adverse Health Outcomes After Stroke in the Atherosclerosis Risk in Communities Study. Stroke 2021; 52:2086-2095. [PMID: 33784831 PMCID: PMC8154698 DOI: 10.1161/strokeaha.120.032695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/26/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE The association of physical activity (PA) before stroke (prestroke PA) with long-term prognosis after stroke is still unclear. We examined the association of prestroke PA with adverse health outcomes in the ARIC study (Atherosclerosis Risk in Communities). METHODS We included 881 participants with incident stroke occurring between 1993 and 1995 (visit 3) and December 31, 2016. Follow-up continued until December 31, 2017 to allow for at least 1-year after incident stroke. Prestroke PA was assessed using a modified version of the Baecke questionnaire in 1987 to 1989 (visit 1) and 1993 to 1995 (visit 3), evaluating PA domains (work, leisure, and sports) and total PA. We used Cox proportional hazards models to quantify the association between tertiles of accumulated prestroke PA levels over the 6-year period between visits 1 and 3 and mortality, risk of cardiovascular disease, and recurrent stroke after incident stroke. RESULTS During a median follow-up of 3.1 years after incident stroke, 676 (77%) participants had adverse outcomes. Highest prestroke total PA was associated with decreased risks of all-cause mortality (hazard ratio, 0.78 [95% CI, 0.63-0.97]) compared with lowest tertile. In the analysis by domain-specific PA, highest levels of work PA were associated with lower risk for all-cause (hazard ratio, 0.77 [95% CI, 0.62-0.96]) and cardiovascular mortality (hazard ratio, 0.45 [95% CI, 0.29-0.70]), and highest levels of leisure PA were associated with lower all-cause mortality (hazard ratio, 0.72 [95% CI, 0.58-0.89]) compared with lowest tertile of PA. No significant associations for sports PA were observed. CONCLUSIONS Higher levels of total prestroke PA as well as work and leisure PA were associated with lower risk of mortality after incident stroke. Public health strategies to increase lifetime PA should be encouraged to decrease long-term mortality after stroke.
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Affiliation(s)
- Mauro F. F. Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, Brazil
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Yejin Mok
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Anna Kucharska-Newton
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Priya Palta
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Kamakshi Lakshminarayan
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Wayne D. Rosamond
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Silvia Koton
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
- Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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14
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Allesøe K, Lau CJ, Buhelt LP, Aadahl M. Physical activity, self-rated fitness and stress among 55,185 men and women in the Danish Capital Region Health survey 2017. Prev Med Rep 2021; 22:101373. [PMID: 33868905 PMCID: PMC8044425 DOI: 10.1016/j.pmedr.2021.101373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/27/2021] [Accepted: 03/28/2021] [Indexed: 11/25/2022] Open
Abstract
Previous studies have indicated that both low physical activity and low physical fitness are associated with a higher level of stress but the influence of age and health status on the associations is unknown. This was examined in a cross-sectional study based on data from the Danish Capital Region Health Survey 2017. Among all adults ≥ 16 years residing in the largest of five regions in Denmark 1. January 2017 a random sample of 104,950 was invited to participate. Hereof, 55.185 responded (52,6%). Physical activity during leisure time, fitness, self-rated health and stress (Cohens Perceived Stress Scale) was self-reported by questionnaire. Logistic regression weighted for size of municipality and non-response was used. Age modified the associations. In all age-groups odds ratio (OR) for a high level of stress was increasingly higher the lower the level of physical activity. The association was strongest among the 16-24-year-olds and persisted after adjustment for self-rated health, that otherwise attenuated the associations to an increasing extent the older the age-group. Similar models investigating the modifying effect of age on the association between self-rated fitness and stress showed the same patterns and tendencies. This study showed that physical activity and self-rated fitness were both associated with stress. The OR for a high level of stress was increasingly higher the lower the level of physical activity or self-rated fitness. This was found in all age-groups, but most pronounced among the 16-24-year-olds. Furthermore, findings suggest that health condition explains the associations to an increasing extent with increasing age.
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Affiliation(s)
- Karen Allesøe
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Hovedvejen, Entrance 5, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.,Department of Occupational and Social Medicine, Holbæk Hospital, part of Copenhagen University Hospital Holbæk, Holbæk, Denmark
| | - Cathrine Juel Lau
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Hovedvejen, Entrance 5, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Lone Prip Buhelt
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Hovedvejen, Entrance 5, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Mette Aadahl
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Hovedvejen, Entrance 5, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, 1014 København K, Denmark
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15
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Stubbe B, Ittermann T, Kaczmarek S, Obst A, Bahls M, Bollmann T, Gläser S, Völzke H, Dörr M, Ewert R. A 10-year follow-up of key gas exchange exercise parameters in a general population: results of the Study of Health in Pomerania. ERJ Open Res 2021; 7:00350-2020. [PMID: 33778050 PMCID: PMC7983208 DOI: 10.1183/23120541.00350-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/13/2020] [Indexed: 11/06/2022] Open
Abstract
Background Cardiopulmonary exercise testing (CPET) is a frequently used method for the evaluation of the cardiorespiratory system. The prognostic relevance of the measured parameters is commonly known. Longitudinal data on cardiorespiratory fitness in a large sample of well-characterised healthy volunteers are rare in the literature. Methods CPET data of 615 healthy individuals who voluntarily took part in the Study of Health in Pomerania (SHIP) at three different measurement times were analysed. The median observation time was 10.5 years. The age range was 25–85 years. Results Over the observed timeframe and with increasing age, a decline in maximum power, peak oxygen uptake (V′O2peak) and oxygen uptake at anaerobic threshold (V′O2@AT) was detectable. This decline was aggravated with increasing age. For the minute ventilation (V′E)/carbon dioxide production (V′CO2) slope, an increase was measured in individuals aged ≥50 years only. Conclusion The present study affirms the decrease in aerobic capacity with increasing age in a selected, well-characterised, healthy study sample, which seems to be less pronounced in females. A 10-year follow-up of the Study of Health in Pomerania affirms the decrease in aerobic capacity with increasing age in a selected, well-characterised, healthy study sample, which seems to be less pronounced in femaleshttps://bit.ly/3pIJmpM
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Affiliation(s)
- Beate Stubbe
- Cardiology, Pneumology, Infectious Diseases and Intensive Care Medicine, Dept of Internal Medicine B, University Hospital Greifswald, Greifswald, Germany.,These authors contributed equally
| | - Till Ittermann
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University of Greifswald, Greifswald, Germany.,These authors contributed equally
| | - Sabine Kaczmarek
- Cardiology, Pneumology, Infectious Diseases and Intensive Care Medicine, Dept of Internal Medicine B, University Hospital Greifswald, Greifswald, Germany
| | - Anne Obst
- Cardiology, Pneumology, Infectious Diseases and Intensive Care Medicine, Dept of Internal Medicine B, University Hospital Greifswald, Greifswald, Germany
| | - Martin Bahls
- Cardiology, Pneumology, Infectious Diseases and Intensive Care Medicine, Dept of Internal Medicine B, University Hospital Greifswald, Greifswald, Germany
| | - Tom Bollmann
- Pneumologie, Helios Hanse Hospital Stralsund, Stralsund, Germany
| | - Sven Gläser
- Pneumologie, Vivantes Hospital Berlin-Neukölln, Berlin, Germany
| | - Henry Völzke
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University of Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Cardiology, Pneumology, Infectious Diseases and Intensive Care Medicine, Dept of Internal Medicine B, University Hospital Greifswald, Greifswald, Germany
| | - Ralf Ewert
- Cardiology, Pneumology, Infectious Diseases and Intensive Care Medicine, Dept of Internal Medicine B, University Hospital Greifswald, Greifswald, Germany
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16
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The Influence of Occupational Categories on Overall and Domain-Specific Physical Activity and the Association with Chronic Diseases. An Analysis Using the Austrian Health Interview Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042148. [PMID: 33671784 PMCID: PMC7926308 DOI: 10.3390/ijerph18042148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 12/14/2022]
Abstract
Background: The performance of physical activity (PA) in different domains varies between different occupational groups and they contribute differently to the prevention and management of chronic diseases. This study aimed to give a fuller picture of the potential influence occupational categories have on the different domains of PA among the Austrian population of working age. Methods: A total of 8251 gainfully employed persons in 9 major and 39 sub-major occupational groups from the Austrian Health Interview Survey 2014 were analyzed. PA was measured with the Physical Activity Questionnaire of the European Health Interview Survey (EHIS-PAQ) and the prevalence of 17 chronic diseases was obtained. Results: A total of 48.2% were mostly active when working, 18.4% reported transport-related PA in the upper quintile, 50.4% performed at least 150 min per week of moderate PA or cycling, 32.7% performed muscle-strengthening PA at least twice a week, and 76.3% were either mostly physically active when working or complied with the aerobic PA guidelines. As a general rule, people in physically active occupational groups tended to perform less PA in their leisure time and vice versa. Occupational groups with especially low amount of PA were Information Technology workers, directors, and secretarial staff. People with a chronic disease tended to perform less PA, but there was an interaction between occupation and chronic disease on PA. Conclusions: Domain-specific programs to promote PA should be developed for various occupational categories.
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17
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Bahls M, Ittermann T, Ewert R, Stubbe B, Völzke H, Friedrich N, Felix SB, Dörr M. Physical activity and cardiorespiratory fitness-A ten-year follow-up. Scand J Med Sci Sports 2020; 31:742-751. [PMID: 33205518 DOI: 10.1111/sms.13882] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/21/2020] [Accepted: 11/15/2020] [Indexed: 12/29/2022]
Abstract
Physical activity (PA) may influence cardiorespiratory fitness (CRF). Yet, PA takes place in different domains (i.e., sports-related physical activity [SPA], leisure time related physical activity [LTPA], and work-related physical activity [WPA]) and not all domain-specific PA may help to maintain high CRF levels throughout life. We assessed the relationship between changes in domain-specific PA and the age-related decline in CRF. We analyzed data of 353 men (median age 50 years; inter-quartile range [IQR] 40 to 60) and 335 women (median age 50 years; IQR 41 to 59) with data for domain-specific PA as well as CRF testing measured ten years apart. CRF was assessed with cardiorespiratory exercise testing. Domain-specific PA was measured using the Baecke questionnaire. During the 10-year follow-up, CRF decreased in men from 29.3 (IQR 25.0 to 34.7) mL/min/kg to 24.3 (IQR 20.8 to 27.3) mL/min/kg. In women, CRF declined from 26.0 (IQR 21.0 to 30.9) to 21.4 (IQR 18.3 to 25.6) mL/min/kg. A one point higher SPA at baseline was related to a 1.14 (95% confidence interval [CI] -1.50 to -0.53) mL/min/kg greater decrease in VO2peak . A one point greater SPA and LTPA over time was associated with a 1.68 (95% CI 1.06 to 2.29) mL/min/kg and 1.24 (95% CI 0.57 to 1.90) mL/min/kg lower decrease in VO2peak , respectively. Neither baseline values nor changes of WPA were associated with CRF. Sports and leisure time related PA may attenuate the age-related decline in CRF.
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Affiliation(s)
- Martin Bahls
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Till Ittermann
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Beate Stubbe
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Stephan B Felix
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
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18
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The Relation between Domain-Specific Physical Behaviour and Cardiorespiratory Fitness: A Cross-Sectional Compositional Data Analysis on the Physical Activity Health Paradox Using Accelerometer-Assessed Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217929. [PMID: 33137943 PMCID: PMC7662405 DOI: 10.3390/ijerph17217929] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 12/11/2022]
Abstract
In contrast to leisure time physical activity (LTPA), occupational physical activity (OPA) does not have similar beneficial health effects. These differential health effects might be explained by dissimilar effects of LTPA and OPA on cardiorespiratory fitness (CRF). This study investigated cross-sectional associations between different physical behaviours during both work and leisure time and CRF by using a Compositional Data Analysis approach. Physical behaviours were assessed by two accelerometers among 309 workers with various manual jobs. During work time, more sedentary behaviour (SB) was associated with higher CRF when compared relatively to time spent on other work behaviours, while more SB during leisure time was associated with lower CRF when compared to other leisure time behaviours. Reallocating more time to moderate-to-vigorous physical activity (MVPA) from the other behaviours within leisure time was positively associated with CRF, which was not the case for MVPA during work. The results of our study are in line with the physical activity health paradox and we call for further study on the interaction between LTPA and OPA by implementing device-worn measures in a longitudinal design. Our results highlight the need for recommendations to take into account the different effects of OPA and LTPA on CRF.
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19
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Feter N, Alt R, Häfele CA, Silva MC, Rombaldi AJ. Effect of combined physical training on cognitive function in people with epilepsy: Results from a randomized controlled trial. Epilepsia 2020; 61:1649-1658. [DOI: 10.1111/epi.16588] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Natan Feter
- Centre for Research on Exercise, Physical Activity, and Health School of Human Movement and Nutritional Sciences University of Queensland Brisbane Queensland Australia
- Superior School of Physical Education Federal University of Pelotas Pelotas Brazil
| | - Ricardo Alt
- Superior School of Physical Education Federal University of Pelotas Pelotas Brazil
| | - César A. Häfele
- Superior School of Physical Education Federal University of Pelotas Pelotas Brazil
| | - Marcelo C. Silva
- Superior School of Physical Education Federal University of Pelotas Pelotas Brazil
| | - Airton J. Rombaldi
- Superior School of Physical Education Federal University of Pelotas Pelotas Brazil
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20
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Zeiher J, Duch M, Kroll LE, Mensink GBM, Finger JD, Keil T. Domain-specific physical activity patterns and cardiorespiratory fitness among the working population: Findings from the cross-sectional German Health Interview and Examination Survey. BMJ Open 2020; 10:e034610. [PMID: 32345698 PMCID: PMC7213860 DOI: 10.1136/bmjopen-2019-034610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 03/06/2020] [Accepted: 03/12/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES This study aimed to investigate associations between occupational physical activity patterns (physical work demands linked to job title) and leisure time physical activity (assessed by questionnaire) with cardiorespiratory fitness (assessed by exercise test) among men and women in the German working population. DESIGN Population-based cross-sectional study. SETTING Two-stage cluster-randomised general population sample selected from population registries of 180 nationally distributed sample points. Information was collected from 2008 to 2011. PARTICIPANTS 1296 women and 1199 men aged 18-64 from the resident working population. OUTCOME MEASURE Estimated low maximal oxygen consumption ([Formula: see text]), defined as first and second sex-specific quintile, assessed by a standardised, submaximal cycle ergometer test. RESULTS Low estimated [Formula: see text] was strongly linked to low leisure time physical activity, but not occupational physical activity. The association of domain-specific physical activity patterns with low [Formula: see text] varied by sex: women doing no leisure time physical activity with high occupational physical activity levels were more likely to have low [Formula: see text] (OR 6.54; 95% CI 2.98 to 14.3) compared with women with ≥2 hours of leisure time physical activity and high occupational physical activity. Men with no leisure time physical activity and low occupational physical activity had the highest odds of low [Formula: see text] (OR 4.37; 95% CI 2.02 to 9.47). CONCLUSION There was a strong association between patterns of leisure time and occupational physical activity and cardiorespiratory fitness within the adult working population in Germany. Women doing no leisure time physical activity were likely to have poor cardiorespiratory fitness, especially if they worked in physically demanding jobs. However, further investigation is needed to understand the relationships between activity and fitness in different domains. Current guidelines do not distinguish between activity during work and leisure time, so specifying leisure time recommendations by occupational physical activity level should be considered.
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Affiliation(s)
- Johannes Zeiher
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Maurice Duch
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
- Department of Sports and Health Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
| | - Lars E Kroll
- Department for Health Services Research, System Analysis and Data Science, Central Research Institute of Ambulatory Health Care, Berlin, Germany
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Jonas D Finger
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Thomas Keil
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Bayern, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
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21
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Brüssau T, Oehring R, Felix SB, Dörr M, Bahls M. Cardiorespiratory and metabolic responses to exercise testing during lower-body positive pressure running. J Appl Physiol (1985) 2020; 128:778-784. [PMID: 32053417 DOI: 10.1152/japplphysiol.00328.2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Exercise reduces the future cardiometabolic disease risk. However, not everyone can participate in routine physical activity because of obesity or orthopedic impairments. Body weight-supported (BWS) exercise may be an option for these individuals. Unfortunately, very little data are available with regard to BWS running in untrained healthy individuals. Yet, this information is important to assess the potential use of lower-body positive pressure (LBPP) treadmill running for the prevention of cardiometabolic disease. Twenty healthy but untrained participants (10 females, mean age 31.5 yr) were included in this study. Participants completed two exercise tests (one with 100% and one with 60% body wt) in randomized order on a LBPP treadmill. Expired gas data and heart rate (HR) were collected continuously. Blood lactate, blood pressure (BP), pulse wave velocity (PWV), and rating of perceived exertion (RPE) were measured during a 2-min break after each stage. Oxygen uptake increased significantly independent of BWS but was lower with BWS. Furthermore, we identified a significant correlation between HR and RPE independent of BWS. BP and PWV showed a large heterogeneity in response to BWS. The lower O2 requirement when running with BWS may help untrained individuals to adapt to an exercise regimen. Future research needs to explore the heterogenetic response of blood pressure and pulse wave velocity to LBPP BWS between individuals.NEW & NOTEWORTHY Lower-body positive pressure body weight-supported exercise has a lower metabolic and cardiovascular demand. Furthermore, heart rate and rating of perceived exertion are highly correlated independent of body weight support. Our data support the further examination of lower-body positive pressure exercise training for cardiovascular disease risk groups.
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Affiliation(s)
- Tim Brüssau
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - Robert Oehring
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - Stephan B Felix
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - Martin Bahls
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
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22
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Physical performances show conflicting associations in aged manual workers. Sci Rep 2020; 10:2254. [PMID: 32042126 PMCID: PMC7010773 DOI: 10.1038/s41598-020-59050-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 01/14/2020] [Indexed: 12/13/2022] Open
Abstract
Ageing is associated with a decrease in physical performance implying that aged manual workers may be unable to match the physical requirements of their jobs. In this cross-sectional study, 96 male manual workers aged 51–72 years were recruited. Outcomes included handgrip strength (HGS), fat-free mass (FFM), fat percentage, cardiorespiratory fitness (\documentclass[12pt]{minimal}
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\begin{document}$$\dot{{\rm{V}}}$$\end{document}V˙O2max), forced vital capacity (FVC), forced expiratory volume after 1 s (FEV1), spinal flexibility, sit-to-stand test performance and static balance. Covariates included height, smoking habits, leisure-time physical activity and systemic inflammation from blood samples. Outcomes were also compared with general populations. Age was negatively related to FFM and FEV1, whereas static balance (velocity of displacement) was positively associated with age. Greater HGS, but poorer \documentclass[12pt]{minimal}
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\begin{document}$$\dot{{\rm{V}}}$$\end{document}V˙O2max and FEV1/FEV ratio were found compared with general populations. Age was negatively related with physical performances although a large part of the variance in performance could be explained by factors other than age such as smoking and systemic inflammation. The manual workers had greater muscle strength but had poorer cardiorespiratory fitness and lung function when compared with general populations. Specific health interventions targeting specifically cardiorespiratory fitness, lung function, and balance may be needed to maintain physical performances among manual workers.
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Finger JD, Banzer W, Baumeister SE, Brandes M, Bös K, Gabrys L, Gößwald A, Härtel S, Kluttig A, Kuhnert R, Leitzmann M, Löllgen HH, Manz K, Mensink GM, Niessner C, Rosario AS, Kurth BM. [Reference Values for Cardiorespiratory Fitness of the General Population: The German National Health Interview and Examination Survey for Adults (DEGS1) 2008-2011]. DAS GESUNDHEITSWESEN 2019; 83:114-121. [PMID: 31746446 DOI: 10.1055/a-1026-6220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM OF STUDY This study aims to provide population-based reference values for heart rate-based indicators of cardiorespiratory fitness for adults with physical activity readiness aged 18 to 64 years living in Germany. METHODS Based on data on 2,826 individuals who participated in a submaximal cycle ergometer exercise test as part of the German National Health Interview and Examination Survey for Adults (DEGS1) between 2008 and 2011, we calculated the following indicators: physical working capacity at 150 and 130 beats/min and at 75% of estimated maximum heart rate (PWC150, PWC130 and PWC75%) as well as heart rate-based estimated maximum oxygen uptake (VO2max). We used the LMS method by Cole & Green 1992 to calculate reference values. RESULTS 25th, 50th and 75th percentiles of PWC150 were 1.5, 1.77 and 2.08 watts/kg among men and 1.18, 1.44 and 1.69 among women. 25th, 50th and 75th percentiles of PWC130 were 1.16, 1.41 and 1.68 watts/kg among men and 0.81, 1.05 and 1.29 among women. Age-dependent median PWC75% values among men and women were 1.87 - age in years× 0.01 and 1.31 - (age in years/100)2× 0.98, respectively, and VO2max among men is 41.7 - age× 0.15. CONCLUSIONS The references values presented can be used for individual rating of cardiorespiratory fitness among adults living in Germany. Furthermore, they can serve as a basis for regular monitoring purposes.
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Affiliation(s)
- Jonas David Finger
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - WinfriedE Banzer
- Institut für Sportwissenschaften, Goethe-Universität Frankfurt am Main, Frankfurt am Main
| | | | - Mirko Brandes
- Abteilung für Prävention und Evaluation, Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS GmbH, Bremen
| | - Klaus Bös
- Karlsruher Institut für Technologie (KIT), Institut für Sport und Sportwissenschaft, Karlsruhe
| | - Lars Gabrys
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin.,Abteilung für Gesundheitssport und Prävention, Fachhochschule für Sport und Management Potsdam, Potsdam
| | - Antje Gößwald
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - Sascha Härtel
- Karlsruher Institut für Technologie (KIT), Institut für Sport und Sportwissenschaft, Karlsruhe
| | - Alexander Kluttig
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle
| | - Ronny Kuhnert
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - MichaelF Leitzmann
- Institut für Epidemiologie und Präventivmedizin, Universität Regensburg, Regensburg
| | - Herbert H Löllgen
- European Federation of Sports Medicine Associations (EFSMA), S&E Commission, Remscheid
| | - Kristin Manz
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - GertB M Mensink
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin
| | - Claudia Niessner
- Karlsruher Institut für Technologie (KIT), Institut für Sport und Sportwissenschaft, Karlsruhe
| | | | - Bärbel-Maria Kurth
- Leiterin der Abt. für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Insitut, Berlin
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24
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The Association of Cardiorespiratory Fitness on Memory Function: Systematic Review. ACTA ACUST UNITED AC 2019; 55:medicina55050127. [PMID: 31075908 PMCID: PMC6572478 DOI: 10.3390/medicina55050127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 04/27/2019] [Accepted: 05/07/2019] [Indexed: 01/02/2023]
Abstract
Background and Objectives: Cardiorespiratory fitness is an important predictor of cardiovascular and cardiometabolic health. To extend our knowledge on the health effects associated with cardiorespiratory fitness, the objective of this study was to evaluate the association of cardiorespiratory fitness on memory function. Materials and Methods: Embase/PubMed, Web of Science, Google Scholar, Sports Discus, and PsychInfo databases were searched. Inclusionary criteria included: (1) were conducted among adult humans (18+ years), (2) evaluated cardiorespiratory fitness as the independent variable, (3) measured cardiorespiratory fitness with an objective device (e.g., indirect calorimetry), (4) evaluated memory function (any type) as the outcome measure, and (5) included either a cross-sectional, prospective, or experimental-study design. Information on the participant’s characteristics, study design, cardiorespiratory fitness assessment, memory type, whether the study statistically controlled for exercise behavior, and study results were extracted. The relationship between cardiorespiratory fitness and memory was synthesized while considering the data extraction parameters. Results: In total, 17 articles met the inclusionary criteria, including two prospective cohort studies and 15 cross-sectional studies. The main findings of this review are twofold: (1) across the 17 evaluated studies, 15 (88.2%) studies demonstrated some evidence of a positive association between cardiorespiratory fitness (CRF) and memory function, and (2) none of these 17 studies statistically controlled for physical activity behavior. Conclusion: CRF appears to be positively associated with memory function, however, it is uncertain as to whether this association occurs independently of physical activity or is mediated via physical activity behavior.
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