PubMed · 15187017
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Stuart A Levy. 2004-06-15. Repeatability of spirometry.. https://doi.org/10.1164/ajrccm.169.12.962
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OBJECTIVE: Maternal obesity is likely a risk factor for neural tube defects (NTDs). By late 1997, it became mandatory in Canada that all refined wheat flour be fortified with folic acid. Because overweight women may consume greater quantities of refined wheat flour, we questioned whether their risk of NTD changed after flour fortification. METHODS: A retrospective population-based study was conducted between 1994 and late 2000. We included all Ontarian women who underwent antenatal maternal screening at 15 to 20 weeks of gestation. Self-declared maternal date of birth, ethnicity, current weight, and the presence of pregestational diabetes mellitus were recorded in a standardized fashion on the maternal screening requisition sheet. The presence of NTDs was systematically detected both antenatally and postnatally. The risk of open NTD was evaluated across maternal weight quartiles and deciles, and an interaction between greater maternal weight and the presence of flour fortification was tested using multiple logistic regression analysis. RESULTS: A total of 292 open NTDs were detected among 420,362 women. The adjusted odds ratio (OR) for NTD was 1.2 (95% confidence interval [CI] 1.1-1.3) per 10-kg incremental rise in maternal weight. Comparing the highest with the lowest quartile of maternal weight, the adjusted OR for NTD was 2.6 (95% CI 1.8-4.0). A similar finding was observed for the highest compared with lowest weight deciles (adjusted OR 3.3, 95% CI 1.7-6.2). The interaction between elevated maternal weight and the presence of folic acid flour fortification was of borderline significance (P = .09). Before fortification, greater maternal weight was associated with a modestly increased risk of NTD (adjusted OR 1.4, 95% CI 1.0-1.8); after flour fortification, this effect was more pronounced (adjusted OR 2.8, 95% CI 1.2-6.6). CONCLUSION: These data emphasize the higher risk of NTD associated with increased maternal weight, even after universal folic acid flour fortification. Beyond periconceptional folic acid use, consideration should be given to testing whether prepregnancy weight reduction is an independent means of preventing NTD. LEVEL OF EVIDENCE: II-2.
The aim of the present study was to investigate cross-sectionally the association of postmenopausal muscle strength with simple performance tests. A random sample of 1,166 naturally postmenopausal women (born 1932-1941) was selected from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study cohort. Grip and quadriceps strength were measured with strain gauge dynamometers and reported in both absolute values (KPa and kg) and per kilogram of body mass (N cm(-2) kg(-1) and N kg(-1)). In addition, two performance tests, 'ability to stand on one foot' and 'ability to squat down to touch the floor' were carried out. A five-category self-assessment of overall health ('very good', 'good', 'moderate', 'bad', and 'very bad') was obtained by postal questionnaire. The women that were able to stand on one foot and able to squat down to touch the floor had greater grip and quadriceps strength than their counterparts ( P<0.001 and P<0.03 in ANOVA, respectively). In addition, self-assessed health had a strong positive association with muscle strength in the grip and leg extensor muscles in ANOVA ( P<0.001 between 'very good' and 'moderate' or poorer state of health) and regression model ( P<0.001). Adjustment for age, duration of menopause, body mass, height, physical activity level, use of HRT, and number of diseases and medications did not change any of the main effects. Also, there were no differences in results between absolute measurement values and values reported per kilogram of body mass. According to the present study, a simple performance test may be useful in the prediction of postmenopausal muscle strength. Furthermore, self-assessed state of health is strongly associated with muscle strength in postmenopausal women.
The purpose of this review is to explore existing research on the physiological aspects of difficult rock climbing. Findings will be categorized into the areas of an athlete profile and an activity model. An objective here is to describe high-level climbing performance; thus the focus will primarily be on studies that involve performances at the 5.11/6c (YDS/French) level of difficulty or higher. Studies have found climbers to be small in stature with low body mass and low body fat. Although absolute strength values are not unusual, strength to body mass ratio is high in accomplished climbers. There is evidence that muscular endurance and high upper body power are important. Climbers do not typically possess extremely high aerobic power, typically averaging between 52-55 ml.kg(-1).min(-1) for maximum oxygen uptake. Performance time for a typical ascent ranges from 2 to 7 min and oxygen uptake (VO2) averages around 20-25 ml.kg(-1).min(-1) over this period. Peaks of over 30 ml.kg(-1).min(-1) for VO2 have been reported. VO2 tends to plateau during sustained climbing yet remains elevated into the post-climb recovery period. Blood lactate accumulates during ascent and remains elevated for over 20 min post-climbing. Handgrip endurance decreases to a greater degree than handgrip strength with severe climbing. On the basis of this review, it appears that a specific training program for high-level climbing would include components for developing high, though not elite-level, aerobic power; specific muscular strength and endurance; ATP-PC and anaerobic glycolysis system power and capacity; and some minimum range of motion for leg and arm movements.