Physical activity and physical fitness as protection against premature disease or death

Exercise effects on physiological function during aging

The decrease in cognitive/motor functions and physical abilities severely affects the aging population in carrying out daily activities. These disabilities become a burden on individuals, families and society in general. It is known that aging conditions are ameliorated with regular exercise, which attenuates the age-associated decline in maximal oxygen uptake (VO2max), production of reactive oxygen species (ROS), decreases in oxidative damage to molecules, and functional impairment in various organs. While benefits of physical exercise are well-documented, the molecular mechanisms responsible for functional improvement and increases in health span are not well understood. Recent findings imply that exercise training attenuates the age-related deterioration in the cellular housekeeping system, which includes the proteasome, Lon protease, autophagy, mitophagy, and DNA repair systems, which beneficially impacts multiple organ functions. Accumulating evidence suggests that exercise lessens the deleterious effects of aging. However, it seems unlikely that systemic effects are mediated through a specific biomarker. Rather, complex multifactorial mechanisms are involved to maintain homeostatic functions that tend to decline with age.

Self-rated physical fitness and estimated maximal oxygen uptake in relation to all-cause and cause-specific mortality

This study investigated the longitudinal associations of self-rated physical fitness and estimated maximal oxygen uptake (VO2max) with all-cause and cause-specific mortality. A total of 59 741 participants in the Finnish National FINRISK Study Cohort had data on self-rated physical fitness and covariates. A subsample of 4823 participants had estimated VO2max data. Follow-up ranged from 3 to 38 years. Associations of self-rated physical fitness and VO2max with mortality were analyzed using multivariate Cox proportional hazard models. The study showed that poor self-rated physical fitness was related to all-cause mortality (hazard ratio [HR] 1.9; 95% confidence interval [CI] 1.8-2.0) and mortality due to cardiovascular (HR 2.0, 95% CI 1.9-2.2), cerebrovascular (HR 1.9, 95% CI 1.6-2.2) and respiratory diseases (HR 2.1, 95% CI 1.9-2.4), trauma (HR 1.7, 95% CI 1.3-2.0), infections (HR 1.8, 95% CI 1.3-2.7), dementia (HR 1.9, 95% CI 1.6-2.3), and cancer (HR 1.7, 95% CI 1.5-1.9). Coexisting higher age, physical inactivity, male gender, and severe chronic conditions further increased the risk. In men, higher VO2max was associated with a lower risk of lung cancer mortality (HR 0.8, 95% CI 0.7-0.96). Based on the results, self-rated physical fitness reflects a combination of unfavorable biological and lifestyle-related factors, which increase mortality risk. A simple question about perceived physical fitness may reveal at-risk individuals who would benefit from more intensive treatment of chronic conditions and other interventions aiming to promote better fitness and well-being.

Physical activity is independently associated with reduced mortality: 15-years follow-up of the Hordaland Health Study (HUSK)

Background

Physical activity (PA) is associated with lower risk for non-communicable diseases and mortality. We aimed to investigate the prospective association between PA and all-cause and cause-specific mortality, and the impact of other potentially contributing factors.

Method

Data from the community-based Hordaland Health Study (HUSK, 1997–99) were linked to the Norwegian Cause of Death Registry. The study included 20,506 individuals born 1950–1957 and 2,225 born in 1925–1927 (baseline age 40–49 and 70–74). Based on self-report, individuals were grouped as habitually performing low intensity, short duration, low intensity, longer duration or high intensity PA. The hazard ratios (HR) for all-cause and cause-specific mortality during follow-up were calculated. Measures of socioeconomic status, physical health, mental health, smoking and alcohol consumption were added separately and cumulatively to the model.

Results

PA was associated with lower all-cause mortality in both older (HR 0.75 (95% CI 0.67–0.84)) and younger individuals (HR 0.82 (95% CI 0.72–0.92)) (crude models, HR: risk associated with moving from low intensity, short duration to low intensity, longer duration PA, and from low intensity, longer duration to high intensity). Smoking, education, somatic diagnoses and mental health accounted for some of the association between physical activity and mortality, but a separate protective effect of PA remained in fully adjusted models for cardiovascular (HR 0.78 (95% CI 0.66–0.92)) and respiratory (HR 0.45 (95% CI 0.32–0.63) mortality (both age-groups together), as well as all-cause mortality in the older age group (HR 0.74, 95%CI 0.66–0.83).

Conclusion

Low intensity, longer duration and high intensity physical activity was associated with reduced all-cause, respiratory and cardiovascular mortality, indicating that physical activity is beneficial also among older individuals, and that a moderate increase in PA can be beneficial.

Skin Cancer Risk and Other Health Risk Behaviors: A Scoping Review

Purpose. To present results of a scoping review focused on skin cancer risk behaviors and other related health risk behaviors. Skin cancer is highly preventable, yet it is the most common form of cancer in the United States with melanoma rates increasing. Limited research has been conducted examining the relationship between skin cancer prevention behaviors and other health risks, yet multiple behavioral health risk interventions have shown great promise for health promotion and reduced health care costs. Methods. Online databases were searched for research articles on skin cancer risk behaviors and related health risk behaviors. Results. Thirty-seven articles met inclusion criteria examining skin cancer behaviors including risk, sun protection behaviors, sunburn, and indoor tanning. The majority of existing studies focused on the relationship between skin cancer prevention behaviors and physical activity, body mass index, smoking, and alcohol abuse. Adults were the primary population of interest with some studies of adolescents. Conclusions. Poor skin cancer prevention behaviors were associated with alcohol use, marijuana use, and smoking among adolescents and adults. Studies on body mass index and physical activity had mixed relationships with skin cancer prevention behaviors and warrant further investigation. Indoor tanning was associated with other risky behaviors but other skin cancer prevention behaviors were not studied.

The rate of training response to aerobic exercise affects brain function of rats

There is an increasing volume of data connecting capacity to respond to exercise training with quality of life and aging. In this study, we used a rat model in which animals were selectively bred for low and high gain in running distance to test t whether genetic segregation for trainability is associated with brain function and signaling processes in the hippocampus. Rats selected for low response (LRT) and high response training (HRT) were randomly divided into control or exercise group that trained five times a week for 30 min per day for three months at 70% VO2max. All four groups had similar running distance before training. With training, HRT rats showed significantly greater increases in VO2max and running distance than LRT rats (p < 0.05). On the reverse Morris Maze test HRT-trained rats outperformed HRT control ones. Significant difference was noted between LRT and HRT groups in redox milieu as assessed by levels of reactive oxygen species (ROS), carbonylation of proteins, nNOS and S-nitroso-cysteine. Moreover the silent information regulator 1 (SIRT1), brain-derived neurotrophic factor (BDNF), ratio of phospho and total cAMP-response element binding protein (CREB), and apoptotic index, also showed significant differences between LRT and HRT groups. These findings suggest that aerobic training responses are not localized to skeletal muscle, but differently involve signaling processes in the brain of LRT and HRT rats.

Impact of health professionals' contact frequency on response to a lifestyle intervention with individuals at high risk for diabetes

AIM

To determine the independent effects of total and each health professional's frequency of contacts, on changes in anthropometric measures and physical capacity following a lifestyle intervention offered by a multi-disciplinary team in adults at high risk for type 2 diabetes.

MATERIALS AND METHODS

A 12-month lifestyle intervention was performed in 48 adults with prediabetes. Participants were randomly assigned to either an individual counselling group (every six weeks)+an optional series of 25 group seminars (every week) or to the group seminars only. Physical activity level, energy intake, anthropometric measures, and physical capacity were assessed.

RESULTS

Total frequency of contacts with any professional was associated with change in body weight, BMI and, waist circumference (all P ≤.05). However, no frequency of contacts with a specific professional was associated with the studied outcomes, except for changes in physical capacity. The latest was significantly improved in participants who attended at least two group sessions with the kinesiologist (P=.02).

DISCUSSION

To improve anthropometric measures, total contact frequency seems to be more important than contact frequency with any specific professionals. However, to improve physical capacity, meeting with a kinesiologist for two or more occasions, in group sessions, seems to be an effective strategy.

Seasonal reduction in physical activity and flow-mediated dilation in children

PURPOSE

cardiovascular disease is a process that has its origins in childhood. Endothelial dysfunction is the earliest detectable manifestation of cardiovascular disease. This study aimed to assess the impact of seasonal changes in physical activity (PA) and body composition on conduit artery endothelial function in children.

METHOD

we studied 116 children (70 girls aged 10.7 ± 0.3 yr and 46 boys aged 10.7 ± 0.3 yr) on two occasions; in the northern summer (June) and late autumn (November). We assessed flow-mediated dilation (FMD) using high-resolution Doppler ultrasound. Body composition was measured by dual-energy x-ray absorptiometry. PA was assessed using accelerometry.

RESULTS

FMD (10.0% ± 4.3% to 7.9% ± 3.9%, P < 0.001) and PA (94.1 ± 34.8 to 77.8 ± 33.7 min·d, P < 0.01) decreased, while percentage body fat increased (27.6% ± 6.8% to 28.0% ± 6.6%, P < 0.001) between summer and autumn. Decreases in FMD correlated with decreases in high-intensity PA (r = 0.23, P = 0.04), and change in high-intensity PA was the only predictor of change in FMD. No relationships were evident between changes in body composition and FMD.

CONCLUSIONS

vascular function decreased between summer and autumn in this cohort. There were no relationships between change in FMD and changes in body composition or low/moderate-intensity PA. The associations between FMD and high-intensity PA suggests that future interventions should encourage this form of behavior, particularly at the times of year associated with lower PA.

A fatigue questionnaire (QFES) for child athletes: a four-year follow-up study in young skiers

BACKGROUND

The use of a fatigue monitoring questionnaire is an increasingly widespread practice in sports medicine.

OBJECTIVE

To evaluate variations in the QFES fatigue questionnaire score according to periods of rest, training or competition.

METHODS

Sixty-six skiers (either alpine or cross-country skiers, aged between 11 and 14 years and training for between 12 and 18 hours per week) filled out a total of 400 fatigue questionnaires over a four-year follow-up period.

RESULTS

Our analysis of the QFES fatigue scores showed that only a small proportion of the skiers (5.25%, on average) exceeded the fatigue alert threshold at some point during the longitudinal follow-up; periods of competition correspond to rising fatigue scores, in comparison with the beginning of season and girls always have higher scores than boys (25.32+/-0.90 versus 20.46+/-0.91, respectively; p<0.0002). In contrast, there was no correlation between fatigue levels and the type of skiing discipline practiced.

CONCLUSION

Our main results show that the QFES fatigue questionnaire is a sensitive tool for tracking down particular periods of fatigue (competition, intense training). Even though the mechanism of fatigue is still not fully understood (highlighting the complexity of this syndrome), the systematic use of a fatigue questionnaire when monitoring children performing competitive sport and high volumes of training confirms the possible preventive role of this type of tool.

Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance- and combined training

This review summarizes the existing knowledge regarding the effects of physical exercise in patients suffering from multiple sclerosis (MS). Furthermore, recommendations are given regarding exercise prescription for MS patients and for future study directions. Previously, MS patients were advised not to participate in physical exercise. During recent years, it has been increasingly acknowledged that exercise benefits MS patients. The requirement for exercise in MS patients is emphasized by their physiological profile, which probably reflects both the effects of the disease per se and the reversible effects of an inactive lifestyle. To date the effects of exercise have only been studied in moderately impaired MS patients with an EDSS score of less than 7. Evidence exists for recommending participation in endurance training at low to moderate intensity, as the existing literature demonstrates that MS patients can both tolerate and benefit from this training modality. Also, resistance training of moderate intensity seems to be well tolerated and to have beneficial effects on MS patients, but the methodological quality of the existing evidence is in general low and the number of studies is limited. Only two studies have evaluated the effects of combined resistance- and endurance training, making solid conclusions regarding this training modality impossible.

[Cardiovascular benefits and hazard of physical practice]

The benefits of regular physical activity have been demonstrated in numerous epidemiologic studies in primary and secondary prevention of coronary artery disease. However, even high level physical activity is not an absolute guarantee against complications of coronary artery disease. Sudden death remains a major complication of sports. Beyond 35-40 years of age, coronary artery disease is the main cause of sudden death during physical activity. In normotensive as well as hypertensive subjects, physical activity lowers blood pressure. It also has beneficial effects on body fat and increases HDL-cholesterol. Likewise, physical activity has documented beneficial effects in diabetic patients, for type 1 as well as type 2 diabetes mellitus. Overall, the advantages of regular physical activity clearly exceed the potential risk of sudden death which is usually caused by heavy exertion in otherwise unaware coronary patients.

Effects of long-term moderate exercise and increase in number of daily steps on serum lipids in women: randomised controlled trial [ISRCTN21921919]

BACKGROUND: This study was designed to evaluate the effects of a 24-month period of moderate exercise on serum lipids in menopausal women. METHODS: The subjects (40--60 y) were randomly divided into an exercise group (n = 14) and a control group (n = 13). The women in the exercise group were asked to participate in a 90-minute physical education class once a week and to record their daily steps as measured by a pedometer for 24 months. RESULTS: Mean of daily steps was significantly higher in the exercise group from about 6,800 to over 8,500 steps (P < 0.01). In the control group, the number of daily steps ranged from 5,700 to 6,800 steps throughout the follow-up period. A significant interaction between the exercise group and the control group in the changes og total cholesterol (TC), high-density lipoprotein cholesterol (HDLC) and TC : HDLC ratio could be observed (P < 0.05). By multiple regression analysis, the number of daily steps was related to HDLC and TC : HDLC levels after 24 months, and the changes in TC and HDLC concentrations. CONCLUSIONS: These results suggest that daily exercise as well as increasing the number of daily steps can improve the profile of serum lipids.

Physical activity in the prevention of cardiovascular disease: an epidemiological perspective

This review of the epidemiological evidence regarding physical activity and cardiovascular disease (CVD) provides substantial evidence from many different populations that leisure time physical activity is associated with reduced risk of coronary heart disease (CHD) and cardiovascular mortality in both men and women and in middle-aged and older individuals. Physical activity appears to be a critical factor in both primary and secondary prevention of CHD. The studies indicate a dose-response relationship between overall physical activity and CVD, which is linear at least up to a certain level of activity. Prospective studies suggest that physical activity is also associated with reduced risk of stroke. The mechanisms underlying the protective effect of physical activity on CVD are still unclear. In recent years. the view that physical activity has to be vigorous to achieve a reduction in risk of CHD has been questioned. Overall, the evidence points to the benefit of continued regular moderate physical activity which does not need to be strenuous or prolonged and includes daily leisure activities such as walking or gardening which are readily attainable by large sections of the population. Taking up regular light or moderate physical activity in middle or older age confers significant benefit for CVD and all-cause mortality.

Maintenance of exercise behavior for individuals at risk for cardiovascular disease

The purpose of the study was to examine psychological factors associated with maintenance of exercise behavior in a population of middle-aged individuals with elevated risk factors for cardiovascular disease. 191 males and 17 females took part in a one-year diet and/or exercise intervention during 1990-1991. Four years later questionnaires were sent out to the 200 former participants who were still available for contact. 67.9% of those who answered (n = 140) were categorized as exercisers, and 30.7% were categorized as nonexercisers. The majority of the exercisers had exercised at least one and a half years. A chi-squared analysis showed that whether the individuals were exercising or not at present was independent of whether they had exercised or not during the intervention study. Discriminant analyses were used to determine how well physical self-perceptions at different times would categorize exercisers and nonexercisers. Current physical self-perceptions categorized the Active Exercisers (86.9%) and the Nonexercisers (63.3%) the best (in total 79.1% correct classifications). Neither change in physical self-perceptions during the intervention not change in physical self-perceptions from the end of the intervention until four years later, classified the exercise behavior as well. Three social cognitive models, The Self-perception model, The Health Belief model, and The Self-efficacy model, were investigated as discriminators between Active Exercisers and Nonexercisers. Active Exercisers were classified better than Nonexercisers, and current physical self-perceptions showed the highest percentage of total correct classifications. The proposed models were also analyzed as predictors of the variance in self-rated Motivation for Exercise. Outcome Expectations, Compliance Self-efficacy, Perceived Fitness, and Exercise Mastery explained 45% of the variance in self-rated Motivation for Exercise.