[Fitness training and general population--a reply].
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Adult↗
Biomedical subjects
B Marti
Publications and source records attributed to B Marti.
Is excessive running predictive of degenerative hip disease? Controlled study of former elite athletes.
OBJECTIVE: To determine the effects of regular long distance running on the state of the hips in later life. DESIGN: Retrospective study of a cohort of elite athletes and a group of normal, healthy, untrained controls examined 15 years after initial testing. SETTING: Research project at school for physical education and sports. SUBJECTS: 27 Former long distance runners (mean age 42), nine former bobsleigh riders (mean age 42), and 23 normal, healthy, untrained men (mean age 35) who had been examined in 1973 and who agreed to re-examination in 1988. MAIN OUTCOME MEASURE: Radiological evidence of degenerative hip disease in 1988. RESULTS: Physiological and exercise characteristics of all subjects had been recorded in 1973, and in 1988 these measurements were repeated together with radiological examination of the hips. An additive radiological index of hip disease based on grades of subchondral sclerosis, osteophyte formation, and joint space narrowing was significantly increased among runners as compared with bobsleigh riders and untrained controls. After adjustment for age the significant effect of type of sports activity remained (p = 0.032). In multivariate analyses age and milage run in 1973 (97 km/week) emerged as independent, significant, and positive predictors of radiological signs of degenerative hip disease in 1988 (p = 0.017 and p = 0.024 respectively). Among runners alone running pace in 1973 rather than milage run was the stronger predictor of subsequent degenerative hip disease. The milage run in 1988 was not particularly predictive of the radiological index, but endurance in 1988 was inversely related to degenerative hip disease seen radiologically. CONCLUSION: Long term, high intensity, high milage running should not be dismissed as a potential risk factor for premature osteoarthritis of the hip.
Age Factors↗
Smoking and leanness: evidence for change in Finland.
Many studies have shown smokers to weigh less than non-smokers, which is plausible given the metabolic effects of cigarette smoke. The interrelation between smoking and relative body weight and its change over time were analysed by using data from Finnish population based surveys from 1982 and 1987. Among both men and women the inverse association between smoking and body mass index was clearly weakened between 1982 and 1987. In 1987 among men aged 25-44 smoking was positively related to body mass index. Moreover, the relation between smoking and waist to hip girth ratio was positive in both sexes at all ages. Years of smoking was nevertheless confirmed as a significant inverse predictor of relative weight. A cluster of unfavourable health habits, including high consumption of alcohol and saturated fats, especially emerged among younger smokers. This may have been due to different selection of smokers in Finland, where smoking increasingly seems to be a form of deviant or risk taking behaviour. It is concluded that at a population level the metabolic effects of smoking seem to be increasingly overridden by several other unfavourable health behaviours of smokers.
Adult↗
[Sudden death during mass running events in Switzerland 1978-1987: an epidemiologico-pathologic study].
Between 1984 and 1987 there were 7 cases of sudden cardiac death during organized mass runs in Switzerland, and between 1978 and 1987 there were 3 cases during the nine largest mass running events (total 8 cases of sudden death during the race). Based on numbers of participants in all events 1984-1987, or in the nine largest events 1978-1987, an incidence of 1 sudden death per 129,500 hrs. of running (95% confidence interval 1/62,500-1/263,000 hrs.), or 1 sudden death per 117,000 hrs. of running (1/45,000-1/311,000 hrs.) respectively, was estimated. This estimate is higher than the rate of 1 sudden death per 396,000 hrs. of noncompetitive jogging found in a study from the United States (Thompson et al.: J. Amer. med. Ass. 1982; 247: 2535-2538). The Swiss incidence of sudden cardiac death during organized mass runs was 50 to 1000 times higher than the incidence expected by chance alone (as estimated from national death register data). All 8 cases of the study were men, the younger four aged 23 yrs. on average (range 20-31 yrs.), the older four aged 49 yrs. (46-53 yrs.). Autopsy in three of the younger men identified hypertrophic cardiomyopathy in one instance whereas in the two other cases no plausible cause of death could be found. The two autopsies performed in older men both showed severe coronary heart disease. Only in 1 case out of the 8 were possible prodromal symptoms of the subsequent death, such as fatigue and nausea, observed, and the average prevalence of known cardiovascular risk factors was low. None of the 8 runners dying suddenly was completely untrained, but 6 out of 8 had only modest running experience, i.e. a low number of years of running. This study confirms that there is probably a clearly increased risk of sudden death during running events with a competitive character, but this acute elevation of risk should probably not be overstated in view of both its very low population - attributable risk and the important potential of regular exercise for overall coronary risk reduction and health promotion.
Adult↗
[Health benefits and risks in sports: the other side of the coin].
Regular exercise has varied health effects, ranging from well-documented benefits to suggested risks. Probably the most important benefit is the reduction of the risk of coronary death by approximately one half among male exercisers, who also have a slightly elevated life-expectancy. This cardioprotective effect of physical exercise is not offset by the immediate increase in risk of sudden death during strenuous exercise. Sports-related complaints and injuries of the locomotor system must however also be born in mind. Different sports have different injury rates, but often a dose-effect relationship can be seen within one type of activity. The long-term effects of exercise on bones and joints are of uncertain dignity, since they may range from desirable prevention of osteoporosis to sports-induced premature osteoarthritis. The potentially important health effects of exercise at old age are largely unknown. From a prevention perspective, one to two weekly hours of vigorous exercise or an additional energy expenditure of at least 1000 kcal per week (also with moderate-intensity exercise such as walking) can safely be recommended. At present, only one third to one half of the adult Swiss population are physically that active.
Coronary Disease↗
[Physical occupational activity and colonic carcinoma mortality in Swiss men 1979-1982].
Colorectal cancers are the second most frequent cause of cancer death among men. To our knowledge, approximately six studies have been able to show an inverse relationship between occupational physical activity and colon cancer mortality. Information drawn from the mortality statistics for the years 1979-1982 was used to study this hypothetical association among Swiss men aged 15-79. At-risk-populations were calculated based on 1980 national census data on occupation of all Swiss men. Estimates of occupational physical activity (OPA) were based on job titles of death certificates and were "blindly" classified into three groups of low, moderate and high OPA by three independent experts. Among the cohort of 1.86 million men, 1995 deaths of colon cancer and 1066 deaths of rectal cancer occurred during the four study years. The standardized mortality ratio showed a significant, graded and inverse relationship between OPA and mortality from colon cancer but not from rectal cancer. The estimated relative risk for colon cancer of the physically inactive, as compared to those active, was 1.3 to 1.4, slightly influenced by minor differences in the way of classification of OPA. For several reasons this estimate of excess risk is probably on the low side. The subgroup of men with jobs with very high OPA showed no further reduction in risk of colon cancer, which suggests that other etiologic factors, such as diet, may play an important role. As sedentary lifestyle and colon cancer are both frequent in central Europe the hypothesized protective effect of habitual physical activity against colon cancer would seem important, especially from the public health point of view.
Adolescent↗
Anthropometric and lifestyle correlates of serum lipoprotein and apolipoprotein levels among normal non-smoking men and women.
The relationship between serologic predictors of coronary risk and anthropometric as well as lifestyle characteristics was investigated in 61 men (37.5 +/- 8.5 yrs) and 33 women (40.1 +/- 9.0 yrs). All subjects were healthy non-smokers, mostly middle-class bank employees. In bivariate analysis, among both genders the ratio of waist-to-hip circumference (WHR) was the single best predictor of levels of serum LDL-cholesterol, apolipoprotein B, VLDL-cholesterol and triglycerides (positive association) as well as HDL-cholesterol and apolipoprotein A-I (inverse association). In men, body fat as estimated from bioelectrical impedance measurement was the second best predictor of lipoprotein and apoprotein concentrations, whereas in women it was the body mass index (BMI). The additional independent predictive power of WHR and body fat for the lipid profile was tested in multivariate analysis by adding WHR and body fat sequentially to regression models containing already BMI, endurance capacity, exercise, alcohol consumption and age. For example, explained variance of triglyceride distribution rose from 26.3 to 35.1% (P = 0.01 for increase) when body fat was entered into the regression equation, or inclusion of WHR into a model already containing age, the behavioral variables, BMI, and body fat increased the explained variance of LDL/HDL-cholesterol ratio from 20.9 to 27.6% (P = 0.04 for increase). In women, the same regression models were even slightly more predictive for the serum lipid profile. Endurance capacity was related to a low atherogenic risk lipid profile in bivariate analysis but lost much of its predictive power in multivariate analysis, which confirms that the effect of fitness on lipid levels is probably mediated in part by a low body fat content. It is concluded from this cross-sectional investigation that studies which focus on associations between lifestyle and serologic predictors of atherogenic risk should possibly include the WHR and a measure of body fat, since the latter two appear to be closer correlates of serum lipoprotein and apolipoprotein levels than BMI or single behavioral factors, at least among male non-smokers.
Adipose Tissue↗
Association of physical activity with coronary risk factors and physical ability: twenty-year follow-up of a cohort of Finnish men.
The association of physical activity with coronary risk factors and self-reported physical ability was studied in a cohort of 331 healthy Finnish men aged 45-64 years at entry, representing the survivors of a 20-year longitudinal study from 1964 to 1984. Baseline physical activity was not significantly related to levels of coronary risk factors at subsequent 5-year, 10-year or 20-year follow-up examinations. The 72 who increased their physical activity during the study period smoked less at 20-year follow-up than those who remained sedentary (p = 0.03). No other significant associations between 20-year changes of physical activity and coronary risk factors were seen. Although baseline physical activity was not, physical activity and exercise at 20-year follow-up were positively related to indices of functional capacity assessed at the end of the study period, when the subjects had reached a mean age of 73 years. It is concluded from this long-term study that a relative increase of physical activity between middle and old age is associated with both less smoking and a maintained high level of physical ability.
Aged↗
Relation between leisure time exercise and cardiovascular risk factors among 15-year-olds in eastern Finland.
STUDY OBJECTIVE: To examine the associations between frequency of leisure time exercise and cardiovascular risk factors in adolescents. DESIGN: Cross sectional survey carried out over a 3 month period in 1984. SETTING: All 24 schools in North Karelia province and 16 randomly selected schools in Kuopio province. PARTICIPANTS: A total of 1142 boys and girls aged 15, randomly selected from 40 schools (16 boys and 16 girls from each), participated out of a possible total sample of 1280. Main reason for non-participation was absence from school but a small number refused to participate. MEASUREMENTS AND MAIN RESULTS: The investigation comprised a medical examination, including anthropometry, a self administered questionnaire checked by interview, a parental questionnaire, and a blood sample for biochemical estimations. The main findings were: (1) Leisure time exercise was inversely related to daily smoking (Spearman's rho, boys -0.16, p less than 0.01; girls -0.13, p less than 0.01) but was not related to serum lipoproteins or blood pressure. The inverse association between exercise and smoking was independent of socioeconomic family background. (2) Body mass index and sexual maturation were associated with systolic blood pressure, and among boys they were inversely related to high density lipoprotein cholesterol. (3) The lack of linear trends between exercise and biological risk factors may be explained by the high prevalence of leisure time exercise in the sample (72% of boys and 71% of girls exercised at least 2-3 times per week, in addition to physical education classes at school). CONCLUSIONS: Among 15-year-old eastern Finnish boys and girls, leisure time exercise is favourably associated with the main behavioural cardiovascular risk factor, smoking, but not with serum total cholesterol or blood pressure.
Adolescent↗
[Physiological, social and motivational characteristics of fitness center clients].
Physiological, social and motivational characteristics of attendants to a fitness club. Little is known on the epidemiology of exercisers not engaging into competitive sports events, such as those attending fitness clubs. We investigated 85 regular attendants to a fitness club in Zurich, Switzerland: 44 men and 41 women, with a mean age of 35 (+/- 10) years. All subjects carried out the club-based fitness-test and answered additional questions on sports activity, lifestyle, and their motives to exercise. As anticipated, fitness club attendants smoked less and were more active and more educated than the general population. Among fitness club attendants themselves, known and plausible interrelationships between endurance capacity, body fat content, and habitual exercise could be confirmed as highly significant. Body fat content, as estimated from bioimpedance measurement, was more closely related to important dependent variables than the body mass index, for example to female endurance capacity (r = -0.33 vs. -0.03), or to age in men (r = 0.48 vs. 0.22). Unexpectedly, social factors were only poor predictors of differences in fitness and exercise levels within the study sample. Compared with joggers, fitness club attendants seemed to be motivated relatively more by targets of health promotion, e.g. weight control, and less motivated by "intrinsic" joy and fun with sports activity itself. Further studies will have to demonstrate whether fitness clubs are actually able to promote "lifetime exercise".
Adult↗
Effects of long-term, moderate exercise on body composition and serum lipid profile: a controlled study in middle-aged Swiss men and women.
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Adult↗
[Do joggers live longer? 3 current epidemiologic studies of the effect of physical activity on life expectancy].
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Adult↗
[Body weight and athletic activities of the Swiss adult population: an evaluation of national trends 1977-1985].
Based on available data, an attempt is made to describe 10-year trends in body weight and exercise in the Swiss population. There appears to have been a steady but rather small increase in mean body weight among both genders. The health risks of this modest increase cannot readily be evaluated, since in the light of recent studies it may be necessary to raise the threshold level for the suggested negative effects of overweight. Further, the importance of fat distribution has not yet been investigated appropriately in a sufficient number of epidemiologic surveys. The increase in exercise, which was paralleled by a decrease in the sedentary population segment during the same period is probably relevant to prevention. Men aged 45-64 and women aged 25-44 increased their physical activity most. However, only a cohort study could document the true importance of obesity and physical inactivity as etiological factors in chronic diseases among the Swiss population.
Adult↗
Smoking, alcohol consumption, and endurance capacity: an analysis of 6,500 19-year-old conscripts and 4,100 joggers.
Using data from two Swiss studies, a 20% random sample (n = 6,592) of all 19-year-old army conscripts and all male participants in a 16-km popular race (n = 4,358), we studied the relationships among smoking, alcohol consumption, and endurance capacity using univariate and multivariate analyses. Alcohol was significantly correlated with endurance capacity among joggers in univariate analysis, but lost its significance in multivariate analysis. Among army conscripts, the distance covered in a 12-min endurance run was inversely related to daily cigarette consumption and years of smoking (P less than 0.001). This association was apparent even among light smokers who had been smoking for less than 2 years when they were compared with nonsmokers. Among joggers, even when the lower training activity of the smokers was controlled for, smoking retained a negative, independent association with endurance capacity, as measured by 16-km race time. In multiple regression analysis of endurance capacity, the standardized regression coefficient for smoking was -0.14 for distance covered in the 12-min run and 0.10 for 16-km running time, the latter despite the low prevalence (6.9%) of regular cigarette smokers among the joggers. Seventy percent of the 16-km race participants who smoked around the time they took up jogging quit smoking as joggers. Within the limits of this cross-sectional study design, these results suggest that smoking exerts a direct, biologically mediated, deleterious effect on endurance capacity. The lower levels of exercise of the smokers did not entirely explain the difference in endurance between smokers and nonsmokers. This observation of a short-term negative association between even light smoking and endurance capacity may have implications for health education and promotion efforts.
Adult↗
Relationship of training and life-style to 16-km running time of 4000 joggers. The '84 Berne "Grand-Prix" Study.
To investigate running activity, life-style, and endurance capacity of joggers, all competitors of a popular 16-km race were surveyed by questionnaire. The response rate was 83.6%, yielding a study population of 4358 male runners over age 16. In univariate analysis, there were significant associations between 16-km running time and weekly training distance (average of 1 year), weekly training frequency, body mass index (BMI), age, cigarette smoking, years of regular running, and frequency of alcohol cosumption. A multiple regression analysis provided six significant, independent predictors of 16-km time, explaining 47% of its variance: weekly training distance (standardized regression coefficient = -0.46), age (0.37), BMI (0.23), years of regular running (-0.19), weekly training frequency (-0.11), and cigarette smoking (0.10). Based on laboratory treadmill testing of a subsample of runners, 16-km running times were transformed into maximum aerobic capacities (VO2 max equivalents) for all competitors. In comparison with the general population, even the slowest 5% of the runners showed a higher endurance capacity than the age-specific population mean. Application of the multivariate regression model for an estimation of the overall impact of training and life-style on endurance capacity showed that the great difference in mean endurance levels between joggers and the general population could entirely be attributed to differences in running activity, BMI, and smoking. We conclude that the joggers investigated were, on average, not selected concerning biological predisposition and genetic endowment since their behavior alone explained their high average endurance capacity.
Adolescent↗
Benefits and risks of running among women: an epidemiologic study.
To describe some of the suggested health benefits and risks of regular running in young and middle-aged women, a group of 428 Swiss female contestants in a popular 16-km race was studied by questionnaire (response rate 86%). The estimated endurance estimate capacity of female runners (VO2max equivalents, based on 16-km running time) was superior to the endurance capacity of both the female and the male general population. The strongest predictor of runners' VO2max was habitual weekly training distance. Training and life-style characteristics of the contestants were able to explain part of, but not the whole, difference in VO2max seen between runners and women of the general population. Running activity was positively associated with reported weight loss and quitting smoking. However, during the year preceding the race, 40% of the female contestants sustained running-related injuries or complaints, 17% sought medical help therefore, and 14% had to interrupt running for 6 weeks on average. Sites and types of running injuries showed specific female properties. Female runners had significantly less outpatient physician visits than the general population, but among runners the highly active (greater than or equal to 25 km/week) had more visits than the moderately active (less than 25 km/week), due to excess consultations because of running-related complaints. This cross-section study used epidemiologic methods to quantify some benefits and risks of running.
Adolescent↗
10-year trends in physical activity in the eastern Finnish adult population: relationship to socioeconomic and lifestyle characteristics.
In a large, community-based cardiovascular disease prevention study in Eastern Finland, independent random population samples were surveyed in 1972, 1977 and 1982. The leisure-time physical activity (LTPA), occupational physical activity (OPA), and socioeconomic and lifestyle characteristics were assessed. In men and women aged 30-59, the proportion with high LTPA increased from 1972 to 1982 by approximately one half (p less than 0.001), whereas that of high OPA decreased during the same period (p less than 0.001). In both sexes, high overall physical activity fell from 1972 to 1977 (p less than 0.001), but no more from 1977 to 1982. The proportion of entirely sedentary remained stable. Education, income and younger age showed a positive, body mass index, smoking and OPA a graded, negative association with high LTPA in 1972 and 1982. Significant (p less than 0.001) differences in 10-year trends of changes in LTPA were observed: men and women with low education or income increased LTPA more than those with high education and income. Socioeconomic factors, such as income and education, appear to have lost importance as determinants of population-wide exercise, whereas the clustering of low physical activity with overweight and smoking has increased.
Adult↗
[Relation of age, running practice, motivation and life style in 16 km joggers. Possibilities and limitations of a cross-sectional survey].
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Adolescent↗