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Fortuin-de Smidt MC, Sewe MO, Lassale C, Weiderpass E, Andersson J, Huerta JM, Ekelund U, Aleksandrova K, Tong TY, Dahm CC, Tjønneland A, Kyrø C, Steindorf K, Schulze MB, Katzke V, Sacerdote C, Agnoli C, Masala G, Tumino R, Panico S, Boer JM, Onland-Moret NC, Wendel-Vos GW, van der Schouw YT, Borch KB, Agudo A, Petrova D, Chirlaque MD, Conchi MI, Amiano P, Melander O, Heath AK, Aune D, Forouhi NG, Langenberg C, Brage S, Riboli E, Wareham NJ, Danesh J, Butterworth AS, Wennberg P. Physical activity attenuates but does not eliminate coronary heart disease risk amongst adults with risk factors: EPIC-CVD case-cohort study. Eur J Prev Cardiol 2022; 29:1618-1629. [PMID: 35403197 DOI: 10.1093/eurjpc/zwac055] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 02/02/2023]
Abstract
AIMS This study aimed to evaluate the association between physical activity and the incidence of coronary heart disease (CHD) in individuals with and without CHD risk factors. METHODS AND RESULTS EPIC-CVD is a case-cohort study of 29 333 participants that included 13 582 incident CHD cases and a randomly selected sub-cohort nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Self-reported physical activity was summarized using the Cambridge physical activity index (inactive, moderately inactive, moderately active, and active). Participants were categorized into sub-groups based on the presence or the absence of the following risk factors: obesity (body mass index ≥30 kg/m2), hypercholesterolaemia (total cholesterol ≥6.2 mmol/L), history of diabetes, hypertension (self-reported or ≥140/90 mmHg), and current smoking. Prentice-weighted Cox regression was used to assess the association between physical activity and incident CHD events (non-fatal and fatal).Compared to inactive participants without the respective CHD risk factor (referent), excess CHD risk was highest in physically inactive and lowest in moderately active participants with CHD risk factors. Corresponding excess CHD risk estimates amongst those with obesity were 47% [95% confidence interval (CI) 32-64%] and 21% (95%CI 2-44%), with hypercholesterolaemia were 80% (95%CI 55-108%) and 48% (95%CI 22-81%), with hypertension were 80% (95%CI 65-96%) and 49% (95%CI 28-74%), with diabetes were 142% (95%CI 63-260%), and 100% (95%CI 32-204%), and amongst smokers were 152% (95%CI 122-186%) and 109% (95%CI 74-150%). CONCLUSIONS In people with CHD risk factors, moderate physical activity, equivalent to 40 mins of walking per day, attenuates but does not completely offset CHD risk.
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Affiliation(s)
- Melony C Fortuin-de Smidt
- Department of Public Health and Clinical Medicine, Umeå University, Universitetstorget 4, 901 87, Umeå, Sweden
| | - Maquins Odhiambo Sewe
- Department of Public Health and Clinical Medicine, Umeå University, Universitetstorget 4, 901 87, Umeå, Sweden
| | - Camille Lassale
- Cardiovascular epidemiology and genetics, Hospital del Mar Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, C. de Melchor Fernández Almagro, 3, 28029 Madrid, Spain
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, France
| | - Jonas Andersson
- Department of Public Health and Clinical Medicine, Skellefteå Research Unit, Umeå University, Lasarettsvägen 29, 931 41, Skellefteå, Sweden
| | - José María Huerta
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, 30120 El Palmar, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C. de Melchor Fernández Almagro, 3, 28029 Madrid, Spain
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Science, Sognsveien 220, 0863 Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Lovisenberggata 8, 0456, Oslo, Norway
| | - Krasimira Aleksandrova
- Department Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany
- Faculty of Human and Health Sciences, University of Bremen, Grazer Straße 2, 28359, Bremen, Germany
| | - Tammy Yn Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, United Kingdom
| | - Christina C Dahm
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
- Institute for Nutritional Science, University of Potsdam, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Via Santena 7, 10126, Turin, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo II Vecchio 2, 50139, Florence, Italy
| | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE-ONLUS, Via Giuseppe di Vittoria 49, 97100, Ragusa, Italy
| | - Salvatore Panico
- Dipartimento di medicina clinica e chirurgia, Federico II University, Corso Umberto I 40, 80138, Naples, Italy
| | - Jolanda Ma Boer
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Gc Wanda Wendel-Vos
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Kristin Benjaminsen Borch
- Department of Community Medicine, UiT, The Arctic University of Norway, Hansine Hansens veg 18, 9019, Tromsø, Norway
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, L'Hospitalet de Llobregat, Avinguda de la Granvia de l'Hospitalet, 199-203, 08908, Barcelona, Spain
- Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care Program; Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Avinguda de la Granvia de l'Hospitalet, 199, 08908, Barcelona, Spain
| | - Dafina Petrova
- Escuela Andaluza de Salud Pública (EASP), Cta. del Observatorio 4,18011 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Av. De Madrid 15, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), C/ Montforte de Lemos 3-5, 28029 Madrid, Spain
| | - María Dolores Chirlaque
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, 30120 El Palmar, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C. de Melchor Fernández Almagro, 3, 28029 Madrid, Spain
| | - Moreno Iribas Conchi
- Navarra Public Health Institute, IdiSNA, C. de Irunlarrea, 3, 31008, Pamplona, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), C. de Irunlarrea, 3, 31008 Pamplona, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C. de Melchor Fernández Almagro, 3, 28029 Madrid, Spain
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, 20013 San Sebastian, Spain
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, Paseo Dr Bergiristain, s/n, 20014, San Sebastián, Spain
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, Malmö, Sweden
- Department of Emergency and Internal Medicine, Skåne University Hospital, Carl-Bertil Laurells gata 9, 214 28, Malmö, Sweden
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, United Kingdom
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, United Kingdom
- Department of Nutrition, Bjørknes University College, Lovisenberggata 13, 0456, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Trondheimsveien 235, 0586, Oslo, Norway
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 6, 171 77, Stockholm, Sweden
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom
- Computational Medicine, Berlin Institute of Health, Charité-University Medicine Berlin, Anna-Louisa-Karsch-Straße 2, 10178, Berlin, Germany
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, United Kingdom
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, United Kingdom
| | - John Danesh
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, 2 Worts's Causeway, Cambridge CB1 8RN, United Kingdom
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, 2 Worts's Causeway, Cambridge CB1 8RN, United Kingdom
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Hills Road, Cambridge CB2 0QQ, United Kingdom
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Saffron Walden CB10 1SA, United Kingdom
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, CB10 1SA, United Kingdom
| | - Adam S Butterworth
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, 2 Worts's Causeway, Cambridge CB1 8RN, United Kingdom
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, 2 Worts's Causeway, Cambridge CB1 8RN, United Kingdom
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Hills Road, Cambridge CB2 0QQ, United Kingdom
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Saffron Walden CB10 1SA, United Kingdom
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Umeå University, Universitetstorget 4, 901 87, Umeå, Sweden
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Current Evidence of Measurement Properties of Physical Activity Questionnaires for Older Adults: An Updated Systematic Review. Sports Med 2021; 50:1271-1315. [PMID: 32125670 PMCID: PMC7305082 DOI: 10.1007/s40279-020-01268-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Questionnaires provide valuable information about physical activity (PA) behaviors in older adults. Until now, no firm recommendations for the most qualified questionnaires for older adults have been provided. OBJECTIVES This review is an update of a previous systematic review, published in 2010, and aims to summarize, appraise and compare the measurement properties of all available self-administered questionnaires assessing PA in older adults. METHODS We included the articles evaluated in the previous review and conducted a new search in PubMed, Embase, and SPORTDiscus from September 2008 to December 2019, using the following inclusion criteria (1) the purpose of the study was to evaluate at least one measurement property (reliability, measurement error, hypothesis testing for construct validity, responsiveness) of a self-administered questionnaire; (2) the questionnaire intended to measure PA; (3) the questionnaire covered at least one domain of PA; (4) the study was performed in the general, healthy population of older adults; (5) the mean age of the study population was > 55 years; and (6) the article was published in English. Based on the Quality Assessment of Physical Activity Questionnaires (QAPAQ) checklist, we evaluated the quality and results of the studies. The content validity of all included questionnaires was also evaluated using the reviewers' rating. The quality of the body of evidence was evaluated for the overall construct of each questionnaire (e.g., total PA), moderate-to-vigorous physical activity (MVPA) and walking using a modified Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. RESULTS In total, 56 articles on 40 different questionnaires (14 from the previous review and 26 from the update) were included. Reliability was assessed for 22, measurement error for four and hypotheses testing for construct validity for 38 different questionnaires. Evidence for responsiveness was available for one questionnaire. For many questionnaires, only one measurement property was assessed in only a single study. Sufficient content validity was considered for 22 questionnaires. All questionnaires displayed large measurement errors. Only versions of two questionnaires showed both sufficient reliability and hypotheses testing for construct validity, namely the Physical Activity Scale for the Elderly (PASE; English version, Turkish version) for the assessment of total PA, and the Physical Activity and Sedentary Behavior Questionnaire (PASB-Q; English version) for the assessment of MVPA. The quality of evidence for these results ranged from very low to high. CONCLUSIONS Until more high-quality evidence is available, we recommend the PASE for measuring total PA and the PASB-Q for measuring MVPA in older adults. However, they are not equally qualified among different languages. Future studies on the most promising questionnaires should cover all relevant measurement properties. We recommend using and improving existing PA questionnaires-instead of developing new ones-and considering the strengths and weaknesses of each PA measurement instrument for a particular purpose.
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Abstract
Hypertension is a fatal yet preventable risk factor for cardiovascular disease and is responsible for majority of cardiovascular mortality. Hypertension is closely associated with inactive lifestyle. Physical activity and/or exercise are shown to delay development of hypertension. Both aerobic and resistance exercise have been proven to reduce blood pressure (BP) effectively. Since brisk walking is an easy, inexpensive, simple, and effective way of exercise, this type of an aerobic workout can be recommended to society. All professional organizations and government bodies recommend moderate-intensity aerobic exercise for at least 30 min on at least 3 days of the week or resistance exercise on 2-3 days of the week. Exercise sessions can either be continuous for 30 min or be composed of at least 10 min of short exercise duration to a daily total of 30 min. After an exercise session, BP decreases, and this decline continues for up to 24 h; which is called post-exercise hypotension. Overall 5 mmHg decrease in BP with regular exercise may be ensured. With a decrease of 5 mmHg in systolic BP, mortality due to coronary heart disease decreases by 9%, mortality due to stroke decreases by 14% and all-cause mortality decreases by 7%. Regular exercise should therefore be recommended for all individuals including normotensives, prehypertensives, and hypertensives.
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Affiliation(s)
- Şeref Alpsoy
- Faculty of Medicine, Department of Cardiology, Namık Kemal University, Tekirdag, Turkey.
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Aggio D, Papachristou E, Papacosta O, Lennon LT, Ash S, Whincup P, Wannamethee SG, Jefferis BJ. Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality. J Epidemiol Community Health 2019; 74:130-136. [PMID: 31704805 PMCID: PMC6993021 DOI: 10.1136/jech-2019-212706] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/09/2019] [Accepted: 10/19/2019] [Indexed: 01/18/2023]
Abstract
Introduction It is well established that physical activity (PA) protects against mortality and morbidity, but how long-term patterns of PA are associated with mortality and cardiovascular disease (CVD) remains unclear. Methods 3231 men recruited to the British Regional Heart Study, a prospective cohort study, reported usual PA levels at baseline in 1978–1980 (aged 40–59 years) and at 12-year, 16-year and 20-year follow ups. Twenty-year trajectories of PA, spanning from 1978/1980 to 2000, were identified using group-based trajectory modelling. Men were subsequently followed up until 30 June 2016 for mortality through National Health Service central registers and for non-fatal CVD events through primary and secondary care records. Data analyses were conducted in 2019. Results Three PA trajectories were identified: low/decreasing (22.7%), light/stable (51.0%) and moderate/increasing (26.3%). Over a median follow-up of 16.4 years, there were 1735 deaths. Compared with the low/decreasing group, membership of the light/stable (HR 0.83, 95% CI 0.74 to 0.94) and moderate/increasing (HR 0.76, 95% CI 0.66 to 0.88) groups was associated with a lower risk of all-cause mortality. Similar associations were observed for CVD mortality, major coronary heart disease and all CVD events. Associations were only partially explained by a range of confounders. Sensitivity analyses suggested that survival benefits were largely driven by most recent/current PA. Conclusions A dose-response relationship was observed, with higher levels of PA from midlife to old age associated with additional benefits. However, even fairly modest and sustained PA was protective and may be more achievable for the most inactive.
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Affiliation(s)
- Daniel Aggio
- Primary Care and Population Health, University College London, London, UK
| | | | - Olia Papacosta
- Primary Care and Population Health, University College London, London, UK
| | - Lucy T Lennon
- Primary Care and Population Health, University College London, London, UK
| | - Sarah Ash
- Primary Care and Population Health, University College London, London, UK
| | - Peter Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - S Goya Wannamethee
- Primary Care and Population Health, University College London, London, UK
| | - Barbara J Jefferis
- Primary Care and Population Health, University College London, London, UK
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Jee Y, Cho Y. Health behaviors and health status of Korean middleaged men by marital status: Korea Community Health Study, 2015. Epidemiol Health 2019; 41:e2019019. [PMID: 31096748 PMCID: PMC6759495 DOI: 10.4178/epih.e2019019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 05/15/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Previous studies have shown that marital status is associated with household composition and living arrangements, which partially explain observed differences in health status according to marital status. However, due to the rapid socioeconomic and demographic transformations of the last few decades, the distribution of marital status among middle-aged adults has become more diverse. Therefore, this study aimed to obtain up-to-date information on the associations between marital status and health and to investigate the implications of these findings for conventional explanations of the health effects of marriage. METHODS The data for this study were obtained from the 2015 Korean Community Health Study. We compared 4 modifiable lifestyle behaviors—smoking, alcohol consumption, physical activity, and self-rated health status—as outcome variables in association with marital status in Korean middle-aged men (age 40-44) living in Seoul and other regions. RESULTS Married men showed the lowest cigarette smoking prevalence and the highest subjective health status both before and after adjusting for education and income. The odds of engaging in vigorous physical activity did not show a major difference before and after adjustment for income and education. CONCLUSIONS In married men, the prevalence of cigarette smoking was lowest and subjective health status was highest, similar to previous studies. However, the prevalence of engaging in physical activity was highest in divorced/widowed/separated men. The health behaviors and health status of Korean middle-aged adults should be more closely followed, since they are representative of demographic changes in the Korean population.
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Affiliation(s)
- Yongho Jee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Youngtae Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
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Al-Sari UA, Tobias JH, Clark EM. Impact of mild and moderate/severe vertebral fractures on physical activity: a prospective study of older women in the UK. Osteoporos Int 2019; 30:155-166. [PMID: 30194466 DOI: 10.1007/s00198-018-4692-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/28/2018] [Indexed: 02/08/2023]
Abstract
UNLABELLED Little is known about the long-term impact of vertebral fractures on physical activity. There is also uncertainty over the clinical significance of mild vertebral fracture. We showed that women with moderate/severe but not mild vertebral fracture do less walking duration and housework than those without fracture after 5.4 years of follow-up. INTRODUCTION Little is known about the long-term impact of vertebral fractures on physical activities. There is also uncertainty over the clinical significance of mild fracture. Therefore, the aim of this study was to evaluate the prospective association between vertebral fracture and future physical activity. METHODS This is a 5-year prospective study of a mixed community and secondary care cohort of women aged > 50 from the UK. Vertebral fractures were identified at baseline on radiographs or DXA-based Vertebral Fracture Assessment by a Quantitative Morphometric approach and defined as moderate/severe (≥ 25% height decrease) or mild (20-24.9% height decrease). Physical activity data were collected 5.4 years later by self-completion questionnaires. Multivariable logistic regression was used to determine the association between presence of fracture and various physical activities while adjusting for potential confounders. RESULTS Two hundred eighty-six women without, 58 with mild, and 69 with moderate/severe fracture were recruited. Those with mild and moderate/severe fracture were older than women without fracture and had more concomitant diseases at baseline. At 5.4 years follow-up, women with moderate/severe fracture self-reported shorter walking duration compared to those without fracture, even after adjusting for potential confounders (OR 2.96, 95%CI 1.11-7.88, P = 0.030). No independent association was seen between the presence of mild fractures and reduced physical activity at follow-up. CONCLUSION This is the first study of older women from the UK that explored the prospective association between vertebral fracture and physical activity duration. Moderate/severe fractures were associated with reduced walking duration. Mild fractures had no impact on future physical ability.
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Affiliation(s)
- U A Al-Sari
- Academic Rheumatology, Musculoskeletal Research Unit, Bristol Medical School, Southmead Hospital, University of Bristol, Westbury-on-Trym, Bristol, BS10 5NB, UK.
- Department of Medicine, College of Medicine, Wasit University, Kut, Iraq.
| | - J H Tobias
- Academic Rheumatology, Musculoskeletal Research Unit, Bristol Medical School, Southmead Hospital, University of Bristol, Westbury-on-Trym, Bristol, BS10 5NB, UK
| | - E M Clark
- Academic Rheumatology, Musculoskeletal Research Unit, Bristol Medical School, Southmead Hospital, University of Bristol, Westbury-on-Trym, Bristol, BS10 5NB, UK
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Aggio D, Papacosta O, Lennon LT, Ash S, Whincup PH, Goya Wannamethee S, Jefferis BJ. Tracking of sport and exercise types from midlife to old age: a 20-year cohort study of British men. Eur Rev Aging Phys Act 2018; 15:16. [PMID: 30546481 PMCID: PMC6284285 DOI: 10.1186/s11556-018-0205-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/23/2018] [Indexed: 01/22/2023] Open
Abstract
Background Previous physical activity (PA) tracking studies have examined the stability of overall PA and/or PA types, but few have investigated how specific types of sport/exercise track over the life course. The aim of this study was to determine how specific sports/exercises in midlife track and predict future sport/exercise and PA in men transitioning to old age. Methods Seven thousand seven hundred thirty-five men (aged 40–59 years) recruited in 1978–80 were followed up after 12, 16 and 20 years. At each wave men self-reported participation in sport/exercise. Frequent sport/exercise participants (> 1/month) reported the types of sport/exercise they engaged in. Men also reported total PA, health status, lifestyle behaviours and socio-demographic characteristics. Stability of each sport/exercise was assessed using kappa statistics and intraclass correlation coefficients. Logistic regression estimated the odds of participating in sport/exercise and being active at 20-year follow up according to specific types of sport/exercise in midlife. Results Three thousand three hundred eighty-four men with complete data at all waves were included in analyses. Tracking of specific sports/exercises ranged from fair to substantial, with golf being the most common and most stable. Bowls was the most frequently adopted. Odds of participating in sport/exercise and being active in old age varied according to sport/exercise types in midlife. Golf and bowls in midlife were the strongest predictors of sport/exercise participation in old age. Golf, cricket and running/jogging in midlife were among the strongest predictors of being active in old age. Compared to participating in just one sport/exercise in midlife, sampling multiple sports/exercises was more strongly associated with sport/exercise participation and being active in old age. Conclusion The stability of sport/exercise participation from midlife to old age varies by type. Specific sports/exercises in midlife may be more likely to predict future PA than others. However, participating in a range of sports/exercises may be optimal for preserving PA into old age. Electronic supplementary material The online version of this article (10.1186/s11556-018-0205-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniel Aggio
- 1UCL Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK.,UCL Physical Activity Research Group, London, UK
| | - Olia Papacosta
- 1UCL Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK
| | - Lucy T Lennon
- 1UCL Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK
| | - Sarah Ash
- 1UCL Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK
| | - Peter H Whincup
- 3Population Health Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE UK
| | - S Goya Wannamethee
- 1UCL Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK
| | - Barbara J Jefferis
- 1UCL Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF UK.,UCL Physical Activity Research Group, London, UK
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Aggio D, Papachristou E, Papacosta O, Lennon LT, Ash S, Whincup PH, Wannamethee SG, Jefferis BJ. Association Between 20-Year Trajectories of Nonoccupational Physical Activity From Midlife to Old Age and Biomarkers of Cardiovascular Disease: A 20-Year Longitudinal Study of British Men. Am J Epidemiol 2018; 187:2315-2323. [PMID: 30124747 PMCID: PMC6211233 DOI: 10.1093/aje/kwy157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 01/31/2023] Open
Abstract
The trajectories of physical activity (PA) from midlife into old age and their associations with established and novel cardiovascular disease (CVD) risk factors in later life remain unclear. This study examined associations between 20-year nonoccupational PA trajectories and a range of CVD biomarkers at ages 60-79 years. We used data from a sample of 3,331 men (mean baseline age = 50.2 ± 5.8 years) recruited in 1978-1980, with follow-up after 12, 16, and 20 years, reporting habitual nonoccupational PA at each wave. At the 20-year follow-up, surviving men attended a physical examination and provided a fasting blood sample. Group-based trajectory modeling was used to identify trajectories. Adjusted regression analyses examined the association between trajectory-group membership and several cardiometabolic, cardiac, and inflammatory markers at follow-up. Three distinct 20-year trajectories were identified: low/decreasing (21.3%), light/stable (51.8%), and moderate/increasing (27.0%). Compared with the low/decreasing group, membership in the light/stable and moderate/increasing trajectory groups was associated with a more favorable cardiometabolic profile and lower levels of inflammation and endothelial dysfunction. Although following a moderate-increasing PA trajectory was most favorable, more modest but sustained doses of PA into old age may be sufficient to lower CVD risk.
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Affiliation(s)
- Daniel Aggio
- Department of Primary Care and Population Health, University College London, London, United Kingdom
- University College London Physical Activity Research Group, London, United Kingdom
| | - Efstathios Papachristou
- Department of Psychology and Human Development, University College London, London, United Kingdom
| | - Olia Papacosta
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Lucy T Lennon
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Sarah Ash
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Peter H Whincup
- Population Health Research Institute, St George’s University of London, London, United Kingdom
| | - S Goya Wannamethee
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Barbara J Jefferis
- Department of Primary Care and Population Health, University College London, London, United Kingdom
- University College London Physical Activity Research Group, London, United Kingdom
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Aggio D, Papachristou E, Papacosta O, Lennon LT, Ash S, Whincup PH, Wannamethee SG, Jefferis BJ. Twenty-Year Trajectories of Physical Activity Types from Midlife to Old Age. Med Sci Sports Exerc 2018; 51:481-489. [PMID: 30303936 DOI: 10.1249/mss.0000000000001802] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Correlates of physical activity (PA) vary according to type. However, predictors of long-term patterns of PA types into old age are unknown. This study aimed to identify 20-yr trajectories of PA types into old age and their predictors. METHODS Seven thousand seven hundred thirty-five men (age, 40-59 yr) recruited from UK towns in 1978 to 1980 were followed up after 12, 16, and 20 yr. Men reported participation in sport/exercise, recreational activity and walking, health status, lifestyle behaviors and socio-demographic characteristics. Group-based trajectory modeling identified the trajectories of PA types and associations with time-stable and time-varying covariates. RESULTS Men with ≥3 measures of sport/exercise (n = 5116), recreational activity (n = 5085) and walking (n = 5106) respectively were included in analyses. Three trajectory groups were identified for sport/exercise, four for recreational activity and three for walking. Poor health, obesity and smoking were associated with reduced odds of following a more favorable trajectory for all PA types. A range of socioeconomic, regional and lifestyle factors were also associated with PA trajectories but the magnitude and direction were specific to PA type. For example, men with manual occupations were less likely to follow a favorable sport/exercise trajectory but more likely to follow an increasing walking trajectory compared to men with nonmanual occupations. Retirement was associated with increased PA but this was largely due to increased sport/exercise participation. CONCLUSIONS Physical activity trajectories from middle to old age vary by activity type. The predictors of these trajectories and effects of major life events, such as retirement, are also specific to the type of PA.
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Affiliation(s)
- Daniel Aggio
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UNITED KINGDOM.,UCL Physical Activity Research Group, London, UNITED KINGDOM
| | - Efstathios Papachristou
- Department of Psychology & Human Development, UCL Institute of Education, London, UNITED KINGDOM
| | - Olia Papacosta
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UNITED KINGDOM
| | - Lucy T Lennon
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UNITED KINGDOM
| | - Sarah Ash
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UNITED KINGDOM
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London, UNITED KINGDOM
| | - S Goya Wannamethee
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UNITED KINGDOM
| | - Barbara J Jefferis
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, UNITED KINGDOM.,UCL Physical Activity Research Group, London, UNITED KINGDOM
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10
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Aggio D, Papachristou E, Papacosta O, Lennon LT, Ash S, Whincup PH, Wannamethee SG, Jefferis BJ. Trajectories of self-reported physical activity and predictors during the transition to old age: a 20-year cohort study of British men. Int J Behav Nutr Phys Act 2018; 15:14. [PMID: 29415729 PMCID: PMC5803992 DOI: 10.1186/s12966-017-0642-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 12/21/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Maintenance of physical activity (PA) during later life is associated with optimal health; however, the long-term trajectories of PA into old age and their predictors have not been extensively researched using latent class methods. This study aimed to identify trajectories of self-reported PA and their predictors in men transitioning from midlife to old age. METHODS 7735 men (aged 40-59 years) recruited in 1978-80 were followed up after 12, 16 and 20 years, reporting PA, health status, lifestyle behaviours and socio-demographic characteristics. Group-based trajectory modelling identified the trajectories of PA and associations with time-stable and time-varying covariates. We considered a range of sociodemographic and health and lifestyle factors as potential covariates. RESULTS 4952 men (mean baseline age 49.1 ± 5.6 years) providing PA data at ≥3 time points were included in analyses. Three distinct 20-year trajectories were identified: low decreasing (24.6%, n = 1218), light stable (51.1%, n = 2530) and moderate increasing (24.3%, n = 1204). Being older, having a manual occupation, having never married or had children, residing in the midlands or North of England, suffering from a range of health conditions, being a smoker/ex-smoker and never consuming breakfast cereal or alcohol were independently associated with reduced odds of belonging to the moderate increasing trajectory group compared to the low decreasing group. Of the time-varying covariates considered, leaving employment was associated with a decrease in PA in the low decreasing group (β -0.306, p < 0.001) but an increase in the light stable (β 0.324, p < 0.001) and moderate increasing groups (β 0.847, p < 0.001). Developing cardiovascular-related conditions was associated with a decrease in PA in the low decreasing (β -0.408, p < 0.001) and light stable groups (β -0.118, p < 0.001) but no association was observed in the moderate increasing group (β -0.060, p = 0.313). CONCLUSIONS Three distinct trajectories of PA were identified in men transitioning from midlife to old age, of which nearly a quarter had persistently low levels of PA. Promotion efforts may need to focus attention prior to middle age and consider a number of sociodemographic, health and lifestyle factors to sustain PA into old age. The effects of retirement and development of cardiovascular disease may vary according to PA trajectories.
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Affiliation(s)
- Daniel Aggio
- UCL Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
- UCL Physical Activity Research Group, London, UK
| | - Efstathios Papachristou
- UCL Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
- Department of Psychology & Human Development, UCL Institute of Education, London, WC1H 0 AA UK
| | - Olia Papacosta
- UCL Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
| | - Lucy T. Lennon
- UCL Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
| | - Sarah Ash
- UCL Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
| | - Peter H. Whincup
- Population Health Research Institute, St George’s University of London, Cranmer Terrace, London, SW17 0RE UK
| | - S. Goya Wannamethee
- UCL Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
- UCL Physical Activity Research Group, London, UK
| | - Barbara J. Jefferis
- UCL Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
- UCL Physical Activity Research Group, London, UK
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11
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Aggio D, Papacosta O, Lennon L, Whincup P, Wannamethee G, Jefferis BJ. Association between physical activity levels in mid-life with physical activity in old age: a 20-year tracking study in a prospective cohort. BMJ Open 2017; 7:e017378. [PMID: 28935690 PMCID: PMC5724234 DOI: 10.1136/bmjopen-2017-017378] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES This study aims to examine the tracking and predictability of physical activity in old age from overall physical activity and participation in sport, recreational activity and walking in mid-life. DESIGN Prospective population-based cohort study. SETTING British Regional Heart Study participants recruited from primary care centres in the UK in 1978-1980. PARTICIPANTS AND OUTCOME MEASURES Men (n=3413) self-reported their physical activity at baseline, 12, 16 and 20-year follow-ups and were categorised as inactive or active and having high or low participation in sport, walking and recreational activities. Tracking was assessed using kappa statistics and random effects models. Logistic regression estimated the odds of being active at 20-year follow-up according to physical activity participation in mid-life. RESULTS Among 3413 men (mean age at baseline 48.6±5.4 years) with complete data, tracking of overall physical activity was moderate (kappa: 0.23-0.26). Tracking was higher for sports participation (kappa: 0.35-0.38) compared with recreational activity (kappa: 0.16-0.24) and walking (kappa: 0.11-0.15). Intraclass correlation coefficients demonstrated similar levels of stability and only marginally weakened after controlling for covariates. Compared with inactive men, being active at baseline was associated with greater odds of being active at 20-year follow-up (OR 2.7, 95% CI 2.4 to 3.2) after adjusting for sociodemographic, health and lifestyle variables. Playing sport in mid-life was more strongly associated with being active at 20-year follow-up than other domains, particularly when sport participation began earlier in life. CONCLUSION Being physically active in mid-life increases the odds of being active in old age. Promoting physical activity in later life might be best achieved by promoting sport participation earlier in the life course.
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Affiliation(s)
- Daniel Aggio
- UCL Department of Primary Care and Population Health, UCL Medical School, London, UK
- UCL PA Research Group, London, UK
| | - Olia Papacosta
- UCL Department of Primary Care and Population Health, UCL Medical School, London, UK
| | - Lucy Lennon
- UCL Department of Primary Care and Population Health, UCL Medical School, London, UK
| | - Peter Whincup
- Population Health Research Institute, St George’s University of London, London, UK
| | - Goya Wannamethee
- UCL Department of Primary Care and Population Health, UCL Medical School, London, UK
| | - Barbara J Jefferis
- UCL Department of Primary Care and Population Health, UCL Medical School, London, UK
- UCL PA Research Group, London, UK
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12
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Boyington J, Joseph L, Fielding R, Pate R. Sedentary Behavior Research Priorities--NHLBI/NIA Sedentary Behavior Workshop Summary. Med Sci Sports Exerc 2016; 47:1291-4. [PMID: 25222819 DOI: 10.1249/mss.0000000000000516] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Josephine Boyington
- 1National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD; 2National Institute on Aging, National Institutes of Health, Bethesda, MD; 3Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA; and 4Arnold School of Public Health, University of South Carolina, Columbia, SC
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13
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Jefferis BJ, Sartini C, Ash S, Lennon LT, Wannamethee SG, Whincup PH. Validity of questionnaire-based assessment of sedentary behaviour and physical activity in a population-based cohort of older men; comparisons with objectively measured physical activity data. Int J Behav Nutr Phys Act 2016; 13:14. [PMID: 26847215 PMCID: PMC4743260 DOI: 10.1186/s12966-016-0338-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 01/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older adults are the most inactive age group and self-reporting of activities may be complicated by age-related reductions in structured activities and misclassification or recall biases. We investigate the validity of simple questionnaires about sedentary behaviour (SB), (including the widely used proxy television (TV) viewing), and physical activity (PA) in comparison with objective measures. METHODS Community dwelling men aged 71-93 years, from a UK population-based cohort wore a GT3X accelerometer over the right hip for 7 days and self-completed a questionnaire including information about SB (TV, reading, computer use and car use) and PA (leisure and sporting domains). RESULTS 1566/3137 surviving men (mean age 79 years) attended. 1377 ambulatory men provided questionnaire and accelerometer data. Questionnaires under-estimated mean daily sedentary time; 317 minutes total SB (TV, computer use, reading or driving), 176 minutes (TV) vs 619 minutes (objectively measured). Correlations between objective measures and self-reports were 0.18 (total SB) and 0.17 (TV), both P < 0.001. Objective SB levels were similar across the lowest three quartiles of self-reported SB but raised in the highest quartile. Correlations between steps/day or moderate to vigorous PA with self-reported total PA were both 0.49, P < 0.001 and measured PA levels were progressively higher at higher levels of self-reported PA. CONCLUSIONS Among older men, simple SB questions performed poorly for identifying total SB time, although simple PA questions were associated with a graded increase with objectively measured PA. Future studies of health effects of SB in older men would benefit from objective measures of SB.
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Affiliation(s)
- Barbara J Jefferis
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK. .,UCL Physical Activity Research Group, University College London, London, UK.
| | - Claudio Sartini
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK.,UCL Physical Activity Research Group, University College London, London, UK
| | - Sarah Ash
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK
| | - Lucy T Lennon
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK
| | - S Goya Wannamethee
- UCL Department of Primary Care & Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
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14
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Sharman JE, La Gerche A, Coombes JS. Exercise and cardiovascular risk in patients with hypertension. Am J Hypertens 2015; 28:147-58. [PMID: 25305061 DOI: 10.1093/ajh/hpu191] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Evidence for the benefits of regular exercise is irrefutable and increasing physical activity levels should be a major goal at all levels of health care. People with hypertension are less physically active than those without hypertension and there is strong evidence supporting the blood pressure-lowering ability of regular exercise, especially in hypertensive individuals. This narrative review discusses evidence relating to exercise and cardiovascular (CV) risk in people with hypertension. Comparisons between aerobic, dynamic resistance, and static resistance exercise have been made along with the merit of different exercise volumes. High-intensity interval training and isometric resistance training appear to have strong CV protective effects, but with limited data in hypertensive people, more work is needed in this area. Screening recommendations, exercise prescriptions, and special considerations are provided as a guide to decrease CV risk among hypertensive people who exercise or wish to begin. It is recommended that hypertensive individuals should aim to perform moderate intensity aerobic exercise activity for at least 30 minutes on most (preferably all) days of the week in addition to resistance exercises on 2-3 days/week. Professionals with expertise in exercise prescription may provide additional benefit to patients with high CV risk or in whom more intense exercise training is planned. Despite lay and media perceptions, CV events associated with exercise are rare and the benefits of regular exercise far outweigh the risks. In summary, current evidence supports the assertion of exercise being a cornerstone therapy in reducing CV risk and in the prevention, treatment, and control of hypertension.
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Affiliation(s)
- James E Sharman
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia;
| | - Andre La Gerche
- St Vincent's Hospital Department of Medicine, University of Melbourne, Fitzroy, Australia
| | - Jeff S Coombes
- The University of Queensland, Brisbane, Queensland, Australia
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15
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Preventive Cardiology: The Effects of Exercise. Coron Artery Dis 2015. [DOI: 10.1007/978-1-4471-2828-1_28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Harrington JM, Dahly DL, Fitzgerald AP, Gilthorpe MS, Perry IJ. Capturing changes in dietary patterns among older adults: a latent class analysis of an ageing Irish cohort. Public Health Nutr 2014; 17:2674-86. [PMID: 24564930 PMCID: PMC10282272 DOI: 10.1017/s1368980014000111] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 10/07/2013] [Accepted: 01/10/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Data-driven approaches to dietary patterns are under-utilized; latent class analyses (LCA) are particularly rare. The present study used an LCA to identify subgroups of people with similar dietary patterns, explore changes in dietary patterns over a 10-year period and relate these dynamics to sociodemographic factors and health outcomes. DESIGN The 1998 baseline and 2008 follow-up of the Cork and Kerry Diabetes and Heart Disease Study. Diets were assessed with a standard FFQ. LCA, under the assumption of conditional independence, was used to identify mutually exclusive subgroups with different dietary patterns, based on food group consumption. SETTING Republic of Ireland. SUBJECTS Men and women aged 50-69 years at baseline (n 923) and at 10-year follow-up (n 320). RESULTS Three dietary classes emerged: Western, Healthy and Low-Energy. Significant differences in demographic, lifestyle and health outcomes were associated with class membership. Between baseline and follow-up most people remained 'stable' in their dietary class. Most of those who changed class moved to the Healthy class. Higher education was associated with transition to a healthy diet; lower education was associated with stability in an unhealthy pattern. Transition to a healthy diet was associated with higher CVD risk factors at baseline: respondents were significantly more likely to be smokers, centrally obese and to have hypertension (non-significant). CONCLUSIONS LCA is useful for exploring dietary patterns transitions. Understanding the predictors of longitudinal stability/transitions in dietary patterns will help target public health initiatives by identifying subgroups most/least likely to change and most/least likely to sustain a change.
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Affiliation(s)
- Janas M Harrington
- Department of Epidemiology & Public Health, University College Cork, Fourth Floor, Western Gateway Building, Western Road, Cork, Republic of Ireland
| | - Darren L Dahly
- Department of Epidemiology & Public Health, University College Cork, Fourth Floor, Western Gateway Building, Western Road, Cork, Republic of Ireland
| | - Anthony P Fitzgerald
- Department of Epidemiology & Public Health, University College Cork, Fourth Floor, Western Gateway Building, Western Road, Cork, Republic of Ireland
| | - Mark S Gilthorpe
- Centre for Epidemiology & Biostatistics, University of Leeds, Leeds, UK
| | - Ivan J Perry
- Department of Epidemiology & Public Health, University College Cork, Fourth Floor, Western Gateway Building, Western Road, Cork, Republic of Ireland
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17
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The Effectiveness of a General-Practice-Based Physical Activity Intervention on Patient Physical Activity Status. BEHAVIOUR CHANGE 2014. [DOI: 10.1017/s0813483900005039] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Physical inactivity is a risk factor for a number of chronic diseases, including cardiovascular disease. Interventions designed to reduce the prevalence of physical inactivity have focused primarily on either adoption of physical activity or noncompliance and relapse, and no interventions have been reported which cover adoption, compliance, maintenance, and relapse, particularly within the clinical setting. TheFresh Startprogram, a multiple risk factor intervention program for the reduction of cardiovascular disease risk factors in general practice patients, was developed to cover all aspects of the adoption and maintenance of habitual physical activity, using Prochaska and DiClemente's Transtheoretical model. The evaluation of the program on cardiovascular disease risk factors and behaviours provided the opportunity to evaluate the impact of a staged program on patient physical activity behaviour. The program was evaluated in a randomised controlled trial in Sydney's Western, South-western, and Wentworth regions with 80 volunteer general practitioners and 758 volunteer patients between January 1991 and January 1993. Self-reported physical activity data were used as the basis for estimating energy expenditure due to leisure-time physical activity. The results failed to show any differences between groups over time, as a function of patients' baseline stages of change, and as a function of baseline activity levels. There were some indications, however, that the least active would respond to doctor-based advice to increase their physical activity, and that doctor advice would lead to a progression inintention to changein approximately 20% of patients. Limitations of the study, the program, and physical activity intervention in the clinical setting are discussed.
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18
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Noé JG, Dósa A, Ránky M, Pavlik G. Cardiovascular results of an individually controlled complex prevention. ACTA ACUST UNITED AC 2014; 101:1-12. [PMID: 24631792 DOI: 10.1556/aphysiol.101.2014.1.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
UNLABELLED Lifestyle modifications (increased level of physical activity, favourable nutrition, and stress management) are important factors in the prevention of and the therapy for cardiovascular (CV) diseases. OBJECTIVES The effects of an individualized, half-year long exercise program on CV risk factors were investigated in 50 patients with moderately high CV risk factors. PATIENTS AND METHODS 75 subjects participated in the study. After the eleventh week of regular training, members of Group A performed 55-65 minutes of exercise at 4-5 times a week, while patients in Group B took part in 45-55 minute training sessions at 2-3 times a week. Activities were monitored using POLAR devices and controlled by a cardiologist and an exercise training expert. Members of the control group (C)were also affected by risk factors, they, however, were not involved in any physical activity. RESULTS A marked improvement was seen in performance level (62% in Group A, 38% in Group B). There was a decrease in the LDL cholesterol level (30% and 21%), total cholesterol (16% and 14%), triglyceride (23% in both groups), and an increase in the HDL-cholesterol level (53% and 26%). Body mass (BM) decreased in both groups (8.7% and 5%).In addition, a decrease was also seen in the resting heart rate (HR) (9.6% and 4.5%) and blood pressure (BP: systolic 8.5% and 5.5 %, diastolic 7% and 4.7%). CONCLUSIONS In persons affected by CV risk factors, lifestyle modification with personal, HR controlled complex (cardio and resistance) aerobic training effectively decreased CV risk factors and strongly improved state of health and quality of life.
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Affiliation(s)
- J G Noé
- University of Pannonia Veszprém Hungary Sorompó u. 18 H-8200 Veszprém Hungary
| | - A Dósa
- Csolnoky Ferenc Hospital Diabetes and Metabolism Centre Veszprém Hungary
| | - M Ránky
- Eötvös Loránd University Institute of Health Promotion and Sport Sciences, Faculty of Education and Psychology Budapest Hungary
| | - G Pavlik
- Semmelweis University Faculty of Physical Education and Sports Sciences Budapest Hungary
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Jefferis BJ, Whincup PH, Lennon LT, Papacosta O, Goya Wannamethee S. Physical activity in older men: longitudinal associations with inflammatory and hemostatic biomarkers, N-terminal pro-brain natriuretic peptide, and onset of coronary heart disease and mortality. J Am Geriatr Soc 2014; 62:599-606. [PMID: 24635212 PMCID: PMC4283726 DOI: 10.1111/jgs.12748] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine associations between habitual physical activity (PA) and changes in PA and onset of coronary heart disease (CHD) and the pathways linking PA to CHD. DESIGN British Regional Heart Study population-based cohort; men completed questionnaires in 1996 and 1998 to 2000, attended rescreen in 1998 to 2000, and were followed up to June 2010. SETTING Community. PARTICIPANTS Of 4,252 men recruited from primary care centers (77% of those invited and eligible) who were rescreened in 1998 to 2000, 3,320 were ambulatory and free from CHD, stroke, and heart failure and participated in the current study. MEASUREMENTS Usual PA (regular walking and cycling, recreational activity and sport). Outcome was first fatal or nonfatal myocardial infarction. RESULTS In 3,320 ambulatory men, 303 first and 184 fatal CHD events occurred during a median of 11 years of follow-up; 9% reported no usual PA, 23% occasional PA, and 68% light or more-intense PA. PA was inversely associated with novel risk markers C-reactive protein, D-dimer, von Willebrand Factor and N-terminal pro-brain natriuretic peptide (NT-proBNP). Compared with no usual PA, hazard ratios (HRs) for CHD events, adjusted for age and region, were 0.52 (95% confidence interval (CI) = 0.34-0.79) for occasional PA, 0.47 (95% CI = 0.30-0.74) for light PA, 0.51 (95% CI = 0.32-0.82) for moderate PA, and 0.44 (95% CI = 0.29-0.65) for moderately vigorous or vigorous PA (P for linear trend = .004). Adjustment for established and novel risk markers somewhat attenuated HRs and abolished linear trends. Compared with men who remained inactive, men who maintained at least light PA had an HR for CHD events of 0.73 (95% CI = 0.53-1.02) and men whose PA level increased had an HR of 0.86 (95% CI = 0.55-1.35). CONCLUSION Even light PA was associated with significantly lower risk of CHD events in healthy older men, partly through inflammatory and hemostatic mechanisms and cardiac function (NT-proBNP).
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Affiliation(s)
- Barbara J Jefferis
- Department of Primary Care and Population Health, University College London, London, UK; Population Health Domain Physical Activity Research Group, University College London, London, UK
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Kumar KRV, Ranganath V, Naik R, Banu S, Nichani AS. Assessment of high-sensitivity C-reactive protein and lipid levels in healthy adults and patients with coronary artery disease, with and without periodontitis - a cross-sectional study. J Periodontal Res 2014; 49:836-44. [DOI: 10.1111/jre.12172] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2014] [Indexed: 12/13/2022]
Affiliation(s)
- K. R. V. Kumar
- Department of Periodontology; AECS Maaruti College of Dental Sciences and Research Centre; Bangalore Karnataka India
| | - V. Ranganath
- Department of Periodontology; AECS Maaruti College of Dental Sciences and Research Centre; Bangalore Karnataka India
| | - R. Naik
- Department of Periodontology; AECS Maaruti College of Dental Sciences and Research Centre; Bangalore Karnataka India
| | - S. Banu
- Department of Biochemistry; Sri Jayadeva Institute of Cardiovascular Sciences and Research; Bangalore India
| | - A. S. Nichani
- Department of Periodontology; AECS Maaruti College of Dental Sciences and Research Centre; Bangalore Karnataka India
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Jefferis BJ, Whincup PH, Papacosta O, Wannamethee SG. Protective Effect of Time Spent Walking on Risk of Stroke in Older Men. Stroke 2014; 45:194-9. [DOI: 10.1161/strokeaha.113.002246] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Older adults have the highest risks of stroke and the lowest physical activity levels. It is important to quantify how walking (the predominant form of physical activity in older age) is associated with stroke.
Methods—
A total of 4252 men from a UK population-based cohort reported usual physical activity (regular walking, cycling, recreational activity, and sport) in 1998 to 2000. Nurses took fasting blood samples and made anthropometric measurements.
Results—
Among 3435 ambulatory men free from cardiovascular disease and heart failure in 1998 to 2000, 195 first strokes occurred during 11-year follow-up. Men walked a median of 7 (interquartile range, 3–12) hours/wk; walking more hours was associated with lower heart rate, D-dimer, and higher forced expiratory volume in 1 second. Compared with men walking 0 to 3 hours/wk, men walking 4 to 7, 8 to 14, 15 to 21, and >22 hours had age- and region-adjusted hazard ratios (95% confidence intervals) for stroke of 0.89 (0.60–1.31), 0.63 (0.40–1.00), 0.68 (0.35–1.32), and 0.36 (0.14–0.91), respectively,
P
(trend)=0.006. Hazard ratios were somewhat attenuated by adjustment for established and novel risk markers (inflammatory and hemostatic markers and cardiac function [N-terminal pro-brain natriuretic peptide]) and walking pace, but linear trends remained. There was little evidence for a dose–response relationship between walking pace and stroke; comparing average pace or faster to a baseline of slow pace, the hazard ratio for stroke was 0.65 (95% confidence interval, 0.44–0.97), which was fully mediated by time spent walking.
Conclusions—
Time spent walking was associated with reduced risk of onset of stroke in dose–response fashion, independent of walking pace. Walking could form an important part of stroke-prevention strategies in older people.
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Affiliation(s)
- Barbara J. Jefferis
- From the Department of Primary Care and Population Health (B.J.J., O.P., S.G.W.) and Physical Activity Research Group (B.J.J.), UCL, London, United Kingdom; and Division of Population Health Sciences and Education, SGUL, London, United Kingdom (P.H.W.)
| | - Peter H. Whincup
- From the Department of Primary Care and Population Health (B.J.J., O.P., S.G.W.) and Physical Activity Research Group (B.J.J.), UCL, London, United Kingdom; and Division of Population Health Sciences and Education, SGUL, London, United Kingdom (P.H.W.)
| | - Olia Papacosta
- From the Department of Primary Care and Population Health (B.J.J., O.P., S.G.W.) and Physical Activity Research Group (B.J.J.), UCL, London, United Kingdom; and Division of Population Health Sciences and Education, SGUL, London, United Kingdom (P.H.W.)
| | - S. Goya Wannamethee
- From the Department of Primary Care and Population Health (B.J.J., O.P., S.G.W.) and Physical Activity Research Group (B.J.J.), UCL, London, United Kingdom; and Division of Population Health Sciences and Education, SGUL, London, United Kingdom (P.H.W.)
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22
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Neville CE, Young IS, Gilchrist SECM, McKinley MC, Gibson A, Edgar JD, Woodside JV. Effect of increased fruit and vegetable consumption on physical function and muscle strength in older adults. AGE (DORDRECHT, NETHERLANDS) 2013; 35:2409-22. [PMID: 23543264 PMCID: PMC3825010 DOI: 10.1007/s11357-013-9530-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/18/2013] [Indexed: 06/02/2023]
Abstract
Fruit and vegetable (FV) intake, which is often low in older people, may be associated with improved muscle strength and physical function. However, there is a shortage of intervention trial evidence to support this. The current study examined the effect of increased FV consumption on measures of muscle strength and physical function among healthy, free-living older adults. A randomized controlled intervention study was undertaken. Eighty-three participants aged 65-85 years, habitually consuming ≤ 2 portions of FV/day, were randomised to continue their normal diet (≤ 2 portions/day), or to consume ≥ 5 portions of FV/day for 16 weeks. FV were delivered to all participants each week, free of charge. Compliance was monitored at baseline, 6, 12 and 16 weeks by diet history and by measuring biomarkers of micronutrient status. Grip strength was measured by a hand-held dynamometer, while lower-extremity physical function was assessed by performance-based measures. Eighty-two participants completed the intervention. The 5 portions/day group showed greater change in daily FV consumption compared to the 2 portions/day group (P < 0.001). This was reflected in significant increases in biomarkers of micronutrient status. No significant differences were evident in change in physical function between the two groups. However, there was a trend towards a greater change in grip strength in the 5 portions/day compared to the 2 portions/day group (mean change at 16 weeks ± SD, 2.04 ± 5.16 and 0.11 ± 3.26 kg, respectively, P = 0.06). Increased FV consumption may modestly increase grip strength but has no effect on physical function in healthy older adults.
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Affiliation(s)
- Charlotte E. Neville
- />Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, BT12 6BJ UK
| | - Ian S. Young
- />Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, BT12 6BJ UK
| | - Sarah E. C. M. Gilchrist
- />Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, BT12 6BJ UK
| | - Michelle C. McKinley
- />Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, BT12 6BJ UK
| | - Andrew Gibson
- />Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, BT12 6BJ UK
| | - J. David Edgar
- />Regional Immunology Service, Belfast Health and Social Care Trust, Belfast, BT12 6BN UK
| | - Jayne V. Woodside
- />Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, BT12 6BJ UK
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23
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Vogel T, Lang PO, Schmitt E, Kaltenbach G, Geny B. Bénéfices pour la santé de la pratique d’une activité physique chez le sujet âgé. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s12612-013-0360-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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24
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Hilberg T, Menzel K, Wehmeier UF. Endurance training modifies exercise-induced activation of blood coagulation: RCT. Eur J Appl Physiol 2012; 113:1423-30. [PMID: 23238930 DOI: 10.1007/s00421-012-2564-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 11/27/2012] [Indexed: 10/27/2022]
Abstract
Randomized controlled trials (RCTs) on the topic of physical training and blood coagulation are rare and the effects are unclear. The aim of this study was to investigate whether endurance training adjusts blood coagulation and fibrinolysis at rest and after exercise. The study included 50 healthy untrained non-smokers randomized into training (TR 49 ± 6 years) or control group (CO 48 ± 6 years). Each subject performed an exercise test adjusted at 80 % individual anaerobic threshold (IAT) for 60 min before and after 12 weeks (80 % IAT: before TR 123 ± 20, CO 125 ± 26 W; after TR 148 ± 23 W, CO 127 ± 25 W; mean ± SD). Blood was taken at rest and after exercise to determine coagulation (e.g., aPTT, thrombin potential, TAT, F1+2, several coagulation factors) and fibrinolytic (e.g., tPA, PAI) parameters. The training intervention induced an elevation of physical capacity in TR by 17 % (rel. VO2max) that led to a statistical relevant prolongation of aPTT at rest. Although absolute power output during the second exercise test was 20 % higher in TR, we detected an attenuated exercise-induced decrease of aPTT and attenuated increase of F1+2 after training. Resting levels of tPA- and PAI-Ag decreased slightly but not significantly after training. Exercise-induced changes were comparable after training in spite of higher power output in TR. Although the effects are small in healthy men, training modifies exercise-induced blood coagulation positively. The fact that exercise-induced changes in blood coagulation and fibrinolysis are rather attenuated or unchanged in the training group, in spite of a 20 % higher absolute power output during exercise, substantiates the adjusting effect of endurance training and the importance of physical fitness in primary prevention.
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Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Pauluskirchstr. 7, 42285 Wuppertal, Germany.
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25
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Abstract
This paper reviews succinctly the evidence for a role of regular exercise in the prevention and the treatment of obesity and of its metabolic complications. Seventeen propositions relevant to an understanding of the topic are considered. The evidence suggests that regular exercise can be an important factor in the development of sustained negative energy balance conditions provided the volume of activity is high. This implies a program of low to moderate intensity exercise performed on an almost daily basis for at least one hour per session. To induce significant weight and fat losses and to treat overweight and obese patients, compliance to the program for several years becomes a necessity. Exercise increases lipid substrate oxidation and may favor carbohydrate intake for the same amount of energy intake. The acute effects of exercise on resting metabolic rate are well documented, but the long-term influences of exercise training seem to be small and are rapidly suppressed with the cessation of training. The obese benefits also from a regular exercise regimen in terms of improved insulin sensitivity, lipid and lipoprotein profile, and blood pressure, as well as reduced risk of death. Regular exercise, such as walking, is a healthy course of action for the overweight or the obese patients.
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Affiliation(s)
- C Bouchard
- Physical Activity Sciences Laboratory, Laval University, Ste-Foy, Quebec, Canada
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26
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Jefferis BJ, Whincup PH, Lennon L, Wannamethee SG. Longitudinal associations between changes in physical activity and onset of type 2 diabetes in older British men: the influence of adiposity. Diabetes Care 2012; 35:1876-83. [PMID: 22751959 PMCID: PMC3424991 DOI: 10.2337/dc11-2280] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine how much physical activity (PA) is needed to protect against diabetes onset in older adults, whether protection is greater among overweight individuals, and whether taking up moderate activity in later life is beneficial. RESEARCH DESIGN AND METHODS Men (4,252) from a U.K. population-based cohort self-reported usual PA (regular walking and cycling, recreational activity, and sport) in 1996 and in 1998-2000, alongside other health behaviors and medical history. Fasting blood lipids were measured. Median follow-up was 7.1 years, during which 135 cases of type 2 diabetes (validated self-report) occurred. RESULTS Among 3,012 men free from cardiovascular disease and diabetes in 1998-2000, 9% reported no usual leisure-time PA, 23% occasional PA, and 15% vigorous PA. Compared with men reporting no activity, men reporting occasional, light, moderate, moderately vigorous, and vigorous PA had lower diabetes risks: hazard ratio (HR) 0.58 (95% CI 0.33-1.02), 0.39 (0.20-0.74), 0.38 (0.19-0.73), 0.39 (0.20-0.77), and 0.33 (0.16-0.70), respectively; P (trend) = 0.002, adjusted for age, social class, tobacco, alcohol, diet, and blood lipids. Adjustment for BMI, waist circumference, or fasting insulin attenuated HRs. HRs were stronger in men with BMI ≥28 vs. <28 kg/m(2) (interaction P = 0.02). Compared with men reporting light activity or less in 1996 and 2000, men who became at least moderately active by 2000 or remained at least moderately active at both times had adjusted HRs of 0.62 (0.34-1.12) and 0.51 (0.31-0.82), respectively. CONCLUSIONS Even light PA markedly reduced diabetes risk in older men, especially among the overweight or obese. Taking up or maintaining at least moderate PA in older adulthood strongly protected against diabetes.
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Affiliation(s)
- Barbara J Jefferis
- Department of Primary Care and Population Health, UCL Medical School, London, UK.
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27
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Mok Y, Won S, Kimm H, Nam C, Ohrr H, Jee SH. Physical activity level and risk of death: the severance cohort study. J Epidemiol 2012; 22:494-500. [PMID: 22850543 PMCID: PMC3798560 DOI: 10.2188/jea.je20110110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Physical activity decreases deaths from cardiovascular disease and other causes; however, it is unclear whether physical activity is associated with cancer incidence and death in Asian populations. Methods Data from 59 636 Koreans aged 30 to 93 years were collected using a questionnaire and medical examination at the Severance Hospital Health Promotion Center between 1994 and 2004. Study participants were followed for a mean duration of 10.3 years. Results In the exercising group, the multivariate Cox proportional hazards model showed a lower risk of cancer death (hazard ratio [HR] = 0.72, 95% CI = 0.62–0.85) in men but not in women. Those who exercised, as compared with those who did not, had lower risks of all-cause death (men: HR = 0.68, 95% CI = 0.60–0.76; women: HR = 0.65, 95% CI = 0.53–0.79) and noncancer death (men: 0.63, 0.53–0.75; women: 0.52, 0.39–0.69). Physical activity was inversely associated with risk of noncancer death among men and women. Conclusions Physical activity was associated with lower risks of cancer death and noncancer death.
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Affiliation(s)
- Yejin Mok
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
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28
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Rankin AJ, Rankin AC, Macintyre P, Hillis WS. Walk or run? is high-intensity exercise more effective than moderate-intensity exercise at reducing cardiovascular risk? Scott Med J 2011; 57:99-102. [DOI: 10.1258/smj.2011.011284] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The benefits of exercise in the prevention of cardiovascular disease are irrefutable. However, the optimum ‘dose’ of exercise in order to derive the maximum cardiovascular benefit is not certain. Current national and international guidelines advocate the benefits of moderate-intensity exercise. The relative benefits of vigorous versus moderate-intensity exercise have been studied in large epidemiological studies, addressing coronary heart disease and mortality, as well as smaller randomized clinical trials which assessed effects on cardiovascular risk factors. There is evidence that exercise intensity, rather than duration or frequency, is the most important variable in determining cardioprotection. Applying this evidence into practice must take into account the impact of baseline fitness, compliance and the independent risk associated with a sedentary lifestyle. This review aims to evaluate the role of exercise intensity in the reduction of cardiovascular risk, and answer the question: should you be advising your patients to walk or run?
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Affiliation(s)
- A J Rankin
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - A C Rankin
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - P Macintyre
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - W S Hillis
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
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29
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Abstract
We report the case of a 27-year-old male athlete presenting with severe dyspnoea 24 hours after completing an "Ironman Triathlon." Subsequent chest radiology excluded pulmonary embolus but confirmed an acute lung injury (ALI). Echocardiography corroborated a normal brain natriuretic peptide level by demonstrating good biventricular systolic function with no regional wall motion abnormalities. He recovered well, without requiring ventilatory support, on supplemental oxygen therapy and empirical antibiotics. To date, ALI following severe physical exertion has never been described. Exercise is a form of physiological stress resulting in oxidative stress through generation of reactive oxygen/nitrogen species. In its extreme form, there is potential for an excessive oxidative stress response--one that overwhelms the body's protective antioxidant mechanisms. As our case demonstrated, oxidative stress secondary to severe physical exertion was the most likely factor in the pathogenesis of ALI. Further studies are necessary to explore the pathological consequences of exercise-induced oxidative stress. Although unproven as of yet, further research may be needed to demonstrate if antioxidant therapy can prevent or ameliorate potential life-threatening complications in the acute setting.
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30
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The influence of physical activity performed at 20-40 years of age on cardiovascular outcomes in medical patients aged 65-75. ITALIAN JOURNAL OF MEDICINE 2011. [DOI: 10.1016/j.itjm.2011.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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31
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Assessing the impact of medication use on trends in major coronary risk factors in older British men: a cohort study. ACTA ACUST UNITED AC 2011; 17:502-8. [PMID: 20386311 DOI: 10.1097/hjr.0b013e3283378865] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS To investigate the role of medication in 20-year trends in blood pressure (BP) and blood lipids in older British men. METHODS AND RESULTS BP and lipids were measured in 4231 men from a representative cohort at baseline (1978-1980, aged 40-59 years) and after 20 years (1998-2000). Cohort-wide age-adjusted 20-year mean changes were as follows: systolic BP -7.6 mmHg (95% confidence interval: -9.7 to -5.4); diastolic BP +3.3 mmHg (+2.2 to +4.5); non-high-density lipoprotein (HDL)-cholesterol -0.4 mmol/l (-0.5 to -0.2); HDL-cholesterol +0.16 mmol/l (+0.13 to +0.19). Much (79%) of the systolic BP fall occurred only among 1561 men (37%) reporting the use of BP-lowering medication during the follow-up; systolic BP changed by -12.3 mmHg (-14.7 to -9.9) and -1.6 mmHg (-3.7 to +0.5) among medication users and men not using medication, respectively (P<0.001 for medication-time interaction). One-third of the non-HDL-cholesterol fall occurred only among 302 men (8%) reporting the use of lipid-regulating drugs; non-HDL-cholesterol changed by -1.8 mmol/l (-2.0 to -1.6) and -0.2 mmol/l (-0.4 to -0.1) among medication users and men not using medication, respectively (P<0.001 for interaction). The HDL-cholesterol increase was not associated with lipid-regulating drug use (P=0.15 for interaction). CONCLUSION Decreases in BP were largely confined to medication users and overall changes in non-HDL-cholesterol were modest, suggesting the need for greater efforts to reduce BP and cholesterol among the general population. HDL-cholesterol increased among all men, likely reflecting cohort-wide improvements in associated health behaviours.
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32
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Shojaei EA, Farajov A, Jafari A. Effect of moderate aerobic cycling on some systemic inflammatory markers in healthy active collegiate men. Int J Gen Med 2011; 4:79-84. [PMID: 21403796 PMCID: PMC3048343 DOI: 10.2147/ijgm.s15065] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Based on the inconsistency of some previous results related to moderate exercise effects on systemic inflammatory responses, this study was conducted to determine the effects of 45 minutes of moderate aerobic cycling on inflammatory markers, interleukin-6 (IL-6), interleukin-10 (IL-10), C-reactive protein (CRP), and leucocyte counts in young active men. METHODS Ten healthy, active collegiate men (aged 21.03 ± 1.2 years, body fat 12.04 ± 2.72% and VO(2)max 59.6 ± 2.4 mL/kg/min) in a quasiexperimental pre/post design, participated in an acute, moderate cycling protocol at an intensity of 50% VO(2)max for 45 minutes. The inflammatory markers (serum IL-6, IL-10, CRP, and peripheral blood leucocyte counts), along with cortisol and epinephrine, were examined before and after the protocol. Data were expressed as mean (± SD) and analyzed by paired t-test using SPSS15 at α ≤ 0.05. RESULTS The results showed that serum IL-6, IL-10, CRP, total leukocyte counts, and stress hormones (epinephrine and cortisol) were significantly increased following 45 minutes of moderate cycling in active collegiate men (P < 0.001). However, all pre- and post-measurements were in the population range. CONCLUSION Based on the present results, it can be concluded that moderate cycling is not only sufficient to induce systemic inflammation in active collegiate men, but also appears to be safe from an immunological point of view.
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Affiliation(s)
- Ebrahim Akhtari Shojaei
- Tuberculosis and Lung Diseases Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
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33
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Blair SN, Davey Smith G, Lee IM, Fox K, Hillsdon M, McKeown RE, Haskell WL, Marmot M. A tribute to Professor Jeremiah Morris: the man who invented the field of physical activity epidemiology. Ann Epidemiol 2010; 20:651-60. [PMID: 20696405 DOI: 10.1016/j.annepidem.2010.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 06/04/2010] [Indexed: 11/17/2022]
Affiliation(s)
- Steven N Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
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34
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Pavlik G, Major Z, Varga-Pintér B, Jeserich M, Kneffel Z. The athlete’s heart Part I (Review). ACTA ACUST UNITED AC 2010; 97:337-53. [DOI: 10.1556/aphysiol.97.2010.4.1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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35
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Wannamethee SG, Shaper AG. Cigarette smoking and serum liver enzymes: the role of alcohol and inflammation. Ann Clin Biochem 2010; 47:321-6. [PMID: 20511375 DOI: 10.1258/acb.2010.009303] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND AIMS Smoking may affect the liver through inflammatory pathways and may aggravate the pathogenic effects of alcohol on the liver. We have examined the relationship between cigarette smoking and liver enzymes and the role of alcohol and C-reactive protein (CRP), a marker of inflammation. METHODS The subjects consisted of 4595 men aged 40-59 y with no history of coronary heart disease drawn from general practices in 24 British towns. RESULTS Cigarette smoking was significantly associated with increased levels of gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) (P < 0.0001) and was inversely associated with increased aspartate aminotransferase (AST) after adjustment for alcohol intake, body mass index and physical activity. Compared with never smokers, heavy cigarette smokers (> or =40/day) were associated with increased odds of elevated GGT (> or =23 IU/L) (adjusted odds ratio [OR] 1.56 [1.08, 2.27]), which was abolished after adjustment for CRP (adjusted OR 1.27 [0.87, 1.86]). There was a significant interaction between smoking and alcohol on GGT. In the absence of heavy drinking, there was no association between smoking and GGT after adjustment for CRP. Among heavy drinkers, smoking was associated with increased levels of GGT independent of CRP. Smoking was associated with increased odds of elevated ALP (> or =11 IU/L) (adjusted OR 3.95 [2.77, 5.62]), which persisted after adjustment for CRP and white cell count (adjusted OR 2.90 [1.99-4.23]), possibly reflecting increased bone cell activity. CONCLUSION The findings suggest that cigarette smoking does not cause liver injury, but may enhance the effects of alcohol on liver cell injury in heavy drinkers.
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Affiliation(s)
- S Goya Wannamethee
- Department of Primary Care and Population Health, UCL Medical School, Royal Free Campus, London, UK.
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36
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Aijaz B, Brown TM, Sanderson BK, Bittner V. Exercise as a Treatment for the Risk of Cardiovascular Disease. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2010; 12:329-41. [DOI: 10.1007/s11936-010-0078-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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37
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Paterson DH, Jones GR, Rice CL. [Aging and physical activity data on which to base recommendations for exercise in older adults]. Appl Physiol Nutr Metab 2009; 32 Suppl 2F:S75-S171. [PMID: 19377547 DOI: 10.1139/h07-165] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
An abundance of epidemiological research confirms the benefits of physical activity in reducing risk of various age-related morbidities and all-cause mortality. Analysis of the literature focusing on key exercise variables (e.g., intensity, type, and volume) suggests that the requisite beneficial amount of activity is that which engenders improved cardiorespiratory fitness, strength, power, and, indirectly, balance. Age-related declines in these components are such that physical limitations impinge on functional activities of daily living. However, an exercise programme can minimize declines, thus preventing older adults (age 65+ years) from crossing functional thresholds of inability. Cross-sectional and longitudinal data demonstrate that cardiorespiratory fitness is associated with functional capacity and independence; strength and, importantly, power are related to performance and activities of daily living; and balance-mobility in combination with power are important factors in preventing falls. Exercise interventions have documented that older adults can adapt physiologically to exercise training, with gains in functional capacities. The few studies that have explored minimal or optimal activity requirements suggest that a threshold (intensity) within the moderately vigorous domain is needed to achieve and preserve related health benefits. Thus, physical activity and (or) exercise prescriptions should emphasize activities of the specificity and type to improve components related to the maintenance of functional capacity and independence; these will also delay morbidity and mortality. An appropriate recommendation for older adults includes moderately vigorous cardiorespiratory activities (e.g., brisk walking), strength and (or) power training for maintenance of muscle mass and specific muscle-group performance, as well as "balance-mobility practice" and flexibility (stretching) exercise as needed.
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Affiliation(s)
- Donald H Paterson
- Centre canadien pour l'activité et le vieillissement, Université Western Ontario, 1490, rue Richmond N., Londres, ON N6G 2M3, Canada.
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38
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Zheng H, Orsini N, Amin J, Wolk A, Nguyen VTT, Ehrlich F. Quantifying the dose-response of walking in reducing coronary heart disease risk: meta-analysis. Eur J Epidemiol 2009; 24:181-92. [PMID: 19306107 DOI: 10.1007/s10654-009-9328-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Accepted: 03/04/2009] [Indexed: 10/21/2022]
Abstract
The evidence for the efficacy of walking in reducing the risk of and preventing coronary heart disease (CHD) is not completely understood. This meta-analysis aimed to quantify the dose-response relationship between walking and CHD risk reduction for both men and women in the general population. Studies on walking and CHD primary prevention between 1954 and 2007 were identified through Medline, SportDiscus and the Cochrane Database of Systematic Reviews. Random-effect meta-regression models were used to pool the relative risks from individual studies. A total of 11 prospective cohort studies and one randomized control trial study met the inclusion criteria, with 295,177 participants free of CHD at baseline and 7,094 cases at follow-up. The meta-analysis indicated that an increment of approximately 30 min of normal walking a day for 5 days a week was associated with 19% CHD risk reduction (95% CI = 14-23%; P-heterogeneity = 0.56; I (2) = 0%). We found no evidence of heterogeneity between subgroups of studies defined by gender (P = 0.67); age of the study population (P = 0.52); or follow-up duration (P = 0.77). The meta-analysis showed that the risk for developing CHD decreases as walking dose increases. Walking should be prescribed as an evidence-based effective exercise modality for CHD prevention in the general population.
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Affiliation(s)
- Henry Zheng
- School of Public Health and Community Medicine, The University of New South Wales, Level 2, Samuels Building, Sydney, NSW, Australia.
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Boone-Heinonen J, Evenson KR, Taber DR, Gordon-Larsen P. Walking for prevention of cardiovascular disease in men and women: a systematic review of observational studies. Obes Rev 2009; 10:204-17. [PMID: 19207874 PMCID: PMC2782938 DOI: 10.1111/j.1467-789x.2008.00533.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In this systematic review, walking (a generally accessible activity for a largely sedentary population) was assessed as a preventive risk factor for development of fatal and non-fatal cardiovascular disease (CVD). PubMed, CINHAL and reference list searches identified 21 peer-reviewed publications examining walking in relation to CVD; studies assessing active transportation were excluded. Generally, there were dose-dependent reductions in CVD risk with higher walking duration, distance, energy expenditure and pace. Associations appeared to be stronger for ischaemic stroke than other CVD outcomes such as coronary heart disease or haemorrhagic stroke. Adjustment for clinical CVD risk factors, obesity or other types of physical activity generally attenuated but did not eliminate associations. Because functional status may be an important determinant of walking behaviour in adults, potential bias due to pre-existing illness is of concern in all studies reviewed, particularly in case-control studies which ascertain walking retrospectively and yielded the strongest associations. Study findings were consistent with current physical activity recommendations, but there is a need for improvements in measurement of walking and other CVD risk factors, more thorough control for pre-existing illness, examination of mediating or moderating conditions such as obesity and other analytical issues.
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Affiliation(s)
- J Boone-Heinonen
- Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516-3997, USA.
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Hayasaka S, Shibata Y, Ishikawa S, Kayaba K, Gotoh T, Noda T, Murata C, Yamada T, Goto Y, Nakamura Y, Ojima T. Physical activity and all-cause mortality in Japan: the Jichi Medical School (JMS) Cohort Study. J Epidemiol 2009; 19:24-7. [PMID: 19164869 PMCID: PMC3924092 DOI: 10.2188/jea.je20080043] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In April 2008, a new health check-up and health guidance system was introduced by the Japanese Government to promote increased physical activity. However, few studies have documented the health benefits of physical activity in Asian populations. We examined the association between all-cause mortality and level of physical activity in a Japanese multicommunity population-based study. METHODS The Jichi Medical School Cohort Study is a multicommunity, population-based study based in 12 districts in Japan. Baseline data from 4222 men and 6609 women (mean age, 54.8 and 55.0 years, respectively) were collected between April 1992 and July 1995. The participants were followed for a mean duration of 11.9 years. To determine the association between all-cause mortality and level of physical activity, crude mortality rates per 1000 person-years and hazard ratios (HRs) with 95% confidence intervals (CI) were determined using the Cox proportional hazards model. Physical activity was categorized by using physical activity index (PAI) quartiles. The lowest (first) PAI quartile was defined as the HR reference. RESULTS In men, the lowest mortality rate was observed in the third quartile, with 95 deaths and a crude mortality rate of 7.6; the age- and area-adjusted HR was 0.59 (95% CI, 0.45-0.76), and the mortality curve had a reverse J shape. In women, the lowest mortality rate was observed in the highest PAI quartile, with 69 deaths and a crude mortality rate of 3.5; the HR was 0.81 (95% CI, 0.58-1.12). CONCLUSION Our results suggest that increased physical activity lowers the risk for all-cause death in Japanese.
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Affiliation(s)
- Shinya Hayasaka
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
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Le Grande MR, Elliott PC, Worcester MUC, Murphy BM, Goble AJ. An Evaluation of Self-report Physical Activity Instruments Used in Studies Involving Cardiac Patients. J Cardiopulm Rehabil Prev 2008; 28:358-69. [DOI: 10.1097/hcr.0b013e31818c3d90] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hard drinking water does not protect against cardiovascular disease: new evidence from the British Regional Heart Study. ACTA ACUST UNITED AC 2008; 15:185-9. [PMID: 18391646 DOI: 10.1097/hjr.0b013e3282f15fce] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND It has been previously suggested that hard drinking water in general, and in particular high calcium and magnesium intake from drinking water, protect against cardiovascular disease. DESIGN Prospective study of men from 24 British towns, with widely differing levels of hardness in drinking water. METHODS A total of 7,735 men aged 40-59 years were recruited during 1978-1980. Estimates of town-level water hardness were available and tap water samples, taken from 947 participants who also answered a questionnaire about water consumption, were used to calculate individual calcium and magnesium intakes. Men were followed for incident of major coronary heart disease (CHD) and stroke, and CHD mortality for 25 years. RESULTS Water hardness varied from 0.27 to 5.28 mmol/l in the 24 towns. A weak inverse association was found between water hardness and incidence of cardiovascular disease (CVD) [hazard ratio (HR), 0.96 per two-fold increase, 95% confidence interval (CI), 0.91-1.01, P=0.08 after adjustment for age and seven established coronary risk factors]. No association was observed with CHD incidence (adjusted HR, 0.99, 95% CI, 0.94-1.04, P=0.62) or mortality (adjusted HR, 0.96, 95% CI, 0.90-1.02, P=0.18). Individual magnesium intake showed a positive, rather than an inverse, association with CHD incidence (adjusted HR, 1.10 per two-fold increase, 95% CI, 1.01-1.20, P=0.045); individual calcium intake was unrelated to CHD or CVD end points. CONCLUSIONS This study suggests that neither high water hardness, nor high calcium or magnesium intake appreciably protect against CHD or CVD. Initiatives to add calcium and magnesium to desalinated water cannot be justified by these findings.
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Knez WL, Sharman JE, Jenkins DG, Coombes JS. Central hemodynamics in ultra-endurance athletes. J Sci Med Sport 2008; 11:390-5. [PMID: 17368101 DOI: 10.1016/j.jsams.2006.11.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Revised: 09/01/2006] [Accepted: 11/09/2006] [Indexed: 11/24/2022]
Abstract
Central hemodynamics such as ascending aortic blood pressure (BP), wave reflection and myocardial perfusion are clinically important in the context of cardiovascular health. Ultra-endurance athletes may be at greater risk of cardiovascular abnormalities due to chronically increased physiological stress placed on the cardiovascular system. This study was a cross-sectional investigation that compared central hemodynamics in ultra-endurance athletes and matched controls. Forty-four athletes (36 males; aged mean+/-S.D., 34+/-8 years) undergoing ultra-endurance training (16.3+/-3.7 h/week) were compared to 44 matched recreationally active (1.2+/-0.9 h/week) controls (36 males; aged 34+/-8 years). Brachial BP was measured using an oscillometric device while central hemodynamics including ascending aortic BP, wave reflection (augmentation index, AIx), ejection duration, sub-endocardial perfusion (SEVR) and timing of the reflected wave (T(R)) were determined by applanation tonometry and pulse wave analysis. There were no significant (P>0.05) differences between groups in AIx (athletes and controls; 6+/-12% versus 6+/-13%, respectively), T(R) (athletes and controls; 165+/-22 ms versus 165+/-19 ms, respectively), brachial (athletes and controls; 51+/-9 mmHg versus 48+/-12 mmHg, respectively) or central pulse pressure (33+/-5 mmHg versus 31+/-7 mmHg). However, athletes had significantly increased SEVR (226+/-42% versus 198+/-46%; P<0.001) despite having a longer ejection duration (348+/-19 ms versus 339+/-18 ms; P<0.05). Furthermore, the amount of exercise training volume was significantly related to central (r=-0.46; P=0.002), but not brachial pulse pressure (r=-0.28; P>0.05). Ultra-endurance athletes had increased sub-endocardial perfusion capacity and the quantity of exercise training was associated with central rather than peripheral hemodynamics.
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Affiliation(s)
- Wade L Knez
- Institute of Sport and Exercise Science, James Cook University, Queensland, Australia.
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Villegas R, Kearney PM, Perry IJ. The cumulative effect of core lifestyle behaviours on the prevalence of hypertension and dyslipidemia. BMC Public Health 2008; 8:210. [PMID: 18554385 PMCID: PMC2442070 DOI: 10.1186/1471-2458-8-210] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Accepted: 06/13/2008] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Most cardiovascular disease (CVD) occurs in the presence of traditional risk factors, including hypertension and dyslipidemia, and these in turn are influenced by behavioural factors such as diet and lifestyle. Previous research has identified a group at low risk of CVD based on a cluster of inter-related factors: body mass index (BMI) < 25 Kg/m2, moderate exercise, alcohol intake, non-smoking and a favourable dietary pattern. The objective of this study was to determine whether these factors are associated with a reduced prevalence of hypertension and dyslipidemia in an Irish adult population. METHODS The study was a cross-sectional survey of 1018 men and women sampled from 17 general practices. Participants completed health, lifestyle and food frequency questionnaires and provided fasting blood samples for analysis of glucose and insulin. We defined a low risk group based on the following protective factors: BMI <25 kg/m2; waist-hip ratio (WHR) <0.85 for women and <0.90 for men; never smoking status; participants with medium to high levels of physical activity; light alcohol consumption (3.5-7 units of alcohol/week) and a "prudent" diet. Dietary patterns were assessed by cluster analysis. RESULTS We found strong significant inverse associations between the number of protective factors and systolic blood pressure, diastolic blood pressure and dyslipidemia. The prevalence odds ratio of hypertension in persons with 1, 2, 3, > or = 4 protective factors relative to those with none, were 1.0, 0.76, 0.68 and 0.34 (trend p < 0.01). The prevalence odds ratio of dyslipidemia in persons with 1, 2, 3, > or = 4 protective factors relative to those with none were 0.83, 0.98, 0.49 and 0.24 (trend p = 0.001). CONCLUSION Our findings of a strong inverse association between low risk behaviours and two of the traditional risk factors for CVD highlight the importance of 'the causes of the causes' and the potential for behaviour modification in CVD prevention at a population level.
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Affiliation(s)
- Raquel Villegas
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.
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Martin RM, Gunnell D, Whitley E, Nicolaides A, Griffin M, Georgiou N, Davey Smith G, Ebrahim S, Holly JMP. Associations of insulin-like growth factor (IGF)-I, IGF-II, IGF binding protein (IGFBP)-2 and IGFBP-3 with ultrasound measures of atherosclerosis and plaque stability in an older adult population. J Clin Endocrinol Metab 2008; 93:1331-8. [PMID: 18211967 DOI: 10.1210/jc.2007-2295] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Circulating IGF-I is inversely associated with ischemic heart disease incidence. Whether this association relates to alterations in plaque growth or stability, and the role of IGF-II and the major binding proteins [IGF binding protein (IGFBP)-2 and -3], is unclear. OBJECTIVE Our objective was to test the hypothesis that circulating IGF-I is inversely, and IGF-II is positively, associated with subclinical atherosclerosis and plaque stability. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional analysis based on 310 participants in the United Kingdom-based Boyd Orr cohort who were aged 63-82 yr. Cohort members from Aberdeen, Bristol, Dundee, Wisbech, and London were invited to clinics for fasted venepuncture and arterial ultrasound examination. MAIN OUTCOMES Arterial intima-media thickness, arterial plaque prevalence, and computerized assessment of plaque echogenicity (a measure of stability), undertaken using the gray scale median, were calculated. RESULTS In total, 269 of 310 (86.8%) participants had at least one carotid or femoral plaque. In models controlling for IGFBP-3, there was a 44% (95% confidence interval 12-64%) reduction in the odds of any plaque and a 28% lower (0-48%) odds of echolucent (unstable) plaques per sd increase in IGF-I. IGFBP-3 was positively associated with plaque instability (odds ratio: 1.38; 0.99-1.93). IGF-II was positively associated (0.05-mm increase per sd; 95% confidence interval 0.01-0.09), and IGFBP-2 was inversely associated, with carotid bifurcation intima-media thickness. Neither IGF-II nor IGFBP-2 was associated with plaque prevalence or echogenicity. CONCLUSION High-circulating IGF-I levels may promote arterial plaque stability. IGF-II and IGFBP-2 do not appear to play a role in plaque development or stability.
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Affiliation(s)
- Richard M Martin
- Department of Social Medicine, North Bristol, University of Bristol, Bristol BS8 2PR, United Kingdom.
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Wannamethee SG, Lennon L, Shaper AG. The value of gamma-glutamyltransferase in cardiovascular risk prediction in men without diagnosed cardiovascular disease or diabetes. Atherosclerosis 2008; 201:168-75. [PMID: 18378241 DOI: 10.1016/j.atherosclerosis.2008.01.019] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 01/31/2008] [Accepted: 01/31/2008] [Indexed: 12/19/2022]
Abstract
AIMS We have examined the relationship between gamma-glutamyltransferase (GGT) and major coronary heart disease (CHD) and stroke events and cardiovascular mortality in men free of cardiovascular disease (CVD). METHODS A prospective study of 6997 men aged 40-59 with no history of CVD (CHD or stroke) or diabetes drawn from general practices in 24 British towns and followed up for 24 years. RESULTS GGT was significantly and positively associated with increased risk of fatal (but not non-fatal CHD events), major stroke events and total CVD mortality after adjustment for established CVD risk factors. Risk of fatal CHD and CVD mortality was only elevated in the top quarter (22IU/L); risk of stroke tended to increase with increasing GGT. The adjusted relative risks (Q4 vs. Q1) were 1.43 (1.09,1.84) for fatal CHD events, 1.56 (1.20,2.04) for stroke incidence and 1.40 (1.16,1.70) for CVD mortality. When stratified by age groups stronger associations were seen between GGT and CVD mortality in the younger men (<55 years) (p=0.01 for interaction). GGT significantly predicted CVD outcomes especially in those at low and medium CHD risk based on Framingham risk score (FRS). CONCLUSION Elevated GGT is associated with significantly increased risk of stroke, fatal CHD events and CVD mortality independent of established CVD risk factors and may be a useful additional marker for long-term CVD risk.
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Affiliation(s)
- S G Wannamethee
- Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, UK.
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Cuthill JA, Fitzpatrick K, Glen J. Anaesthesia - a sedentary specialty? Accelerometer assessment of the activity level of anaesthetists while at work. Anaesthesia 2008; 63:279-83. [DOI: 10.1111/j.1365-2044.2007.05352.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hardoon SL, Whincup PH, Lennon LT, Wannamethee SG, Capewell S, Morris RW. How much of the recent decline in the incidence of myocardial infarction in British men can be explained by changes in cardiovascular risk factors? Evidence from a prospective population-based study. Circulation 2008; 117:598-604. [PMID: 18212284 DOI: 10.1161/circulationaha.107.705947] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The incidence of myocardial infarction (MI) in Britain has fallen markedly in recent years. Few studies have investigated the extent to which this decline can be explained by concurrent changes in major cardiovascular risk factors. METHODS AND RESULTS The British Regional Heart Study examined changes in cardiovascular risk factors and MI incidence over 25 years from 1978 in a cohort of 7735 men. During this time, the age-adjusted hazard of MI decreased by 3.8% (95% confidence interval 2.6% to 5.0%) per annum, which corresponds to a 62% decline over the 25 years. At the same time, after adjustment for age, cigarette smoking prevalence, mean systolic blood pressure, and mean non-high-density lipoprotein (HDL) cholesterol decreased, whereas mean HDL cholesterol, mean body mass index, and physical activity levels rose. No significant change occurred in alcohol consumption. The fall in cigarette smoking explained the greatest part of the decline in MI incidence (23%), followed by changes in blood pressure (13%), HDL cholesterol (12%), and non-HDL cholesterol (10%). In combination, 46% (approximate 95% confidence interval 23% to 164%) of the decline in MI could be explained by these risk factor changes. Physical activity and alcohol consumption had little influence, whereas the increase in body mass index would have produced a rise in MI risk. CONCLUSIONS Modest favorable changes in the major cardiovascular risk factors appear to have contributed to considerable reductions in MI incidence. This highlights the potential value of population-wide measures to reduce exposure to these risk factors in the prevention of coronary heart disease.
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Affiliation(s)
- Sarah L Hardoon
- Department of Primary Care and Population Sciences, UCL, London, United Kingdom.
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Churilla JR, Zoeller RF. Physical Activity: Physical Activity and the Metabolic Syndrome: A Review of the Evidence. Am J Lifestyle Med 2008. [DOI: 10.1177/1559827607311981] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Metabolic syndrome is a global public health problem identified as a seminal cause of cardiovascular disease and type 2 diabetes. The syndrome is characterized by the clustering of cardiovascular risk factors, including insulin resistance, central obesity, hypertension, and atherogenic dyslipidemia. Currently there are 5 working medical society definitions of metabolic syndrome. However, the majority of recent research focusing on metabolic syndrome has relied on the National Cholesterol Education Program (NCEP) definition because of its clinical utility. Studies of the association between physical activity and prevalence of metabolic syndrome using National Health And Nutrition Examination Survey (NHANES) data generally found the association to be reduced or attenuated by other lifestyle factors and is generally weaker in females. Other studies tracking physical activity over longer periods have generally found a stronger association between regular physical activity and lower prevalence or incidence of metabolic syndrome. Interventional studies are limited but suggest that regular exercise reduces the incidence of metabolic syndrome. The amount and intensity of physical activity required to prevent or reverse metabolic syndrome has yet to be definitely determined. Evidence suggests that regular, moderate-intensity physical activity may be preventive of metabolic syndrome and that activity of greater intensity may carry greater benefit. Greater cardiorespiratory fitness has demonstrated an even stronger negative association with metabolic syndrome. Strength training is recommended as an adjunct to regular aerobic exercise but is not the primary form of activity to prevent or manage metabolic syndrome.
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Affiliation(s)
- James R. Churilla
- Brooks College of Health, University of North Florida, Jacksonville,
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Hamer M, Chida Y. Walking and primary prevention: a meta-analysis of prospective cohort studies. Br J Sports Med 2007; 42:238-43. [PMID: 18048441 DOI: 10.1136/bjsm.2007.039974] [Citation(s) in RCA: 220] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To quantify the association between walking and the risk of cardiovascular disease (CVD) and all-cause mortality in healthy men and women. DATA SOURCES Medline, Cochrane Database of Systematic Reviews, and Web of Science databases were searched to May 2007. STUDY SELECTION Prospective epidemiological studies of walking and CVD and all-cause mortality. RESULTS 18 prospective studies were included in the overall analysis, which incorporated 459 833 participants free from CVD at baseline with 19 249 cases at follow-up. From the meta-analysis the pooled hazard ratio of CVD in the highest walking category compared with the lowest was 0.69, (95% CI 0.61 to 0.77, p<0.001), and 0.68 (0.59 to 0.78, p<0.001) for all-cause mortality. These effects were robust among men and women, although there was evidence of publication biases for the associations with CVD risk. Walking pace was a stronger independent predictor of overall risk compared with walking volume (48% versus 26% risk reductions, respectively). There was also evidence of a dose-response relationship across the highest, intermediate, and lowest walking categories in relation to the outcome measures. CONCLUSIONS The results suggest walking is inversely associated with clinical disease endpoints and largely support the current guidelines for physical activity. The mechanisms that mediate this relationship remain largely unknown and should be the focus of future research.
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Affiliation(s)
- M Hamer
- Department of Epidemiology and Public Health, University College London, London, UK.
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