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PubMed1993

American College of Sports Medicine. Position Stand. Physical activity, physical fitness, and hypertension.

Hypertension is present in epidemic proportions in adults of industrialized societies and is associated with a markedly increased risk of developing numerous cardiovascular pathologies. There is a continuing debate as to the efficacy of aggressive pharmacological therapy in individuals with mild to moderate elevations in blood pressure. This has led to a search for nonpharmacological therapies, such as exercise training, for these individuals. The available evidence indicates that endurance exercise training by individuals at high risk for developing hypertension will reduce the rise in blood pressure that occurs with time. Thus, it is the position of the American College of Sports Medicine that endurance exercise training is recommended as a nonpharmacological strategy to reduce the incidence of hypertension in susceptible individuals. A large number of studies indicate that endurance exercise training will elicit a 10 mm Hg average reduction in both systolic and diastolic blood pressures in individuals with mild essential hypertension (blood pressures 140-180/90-105 mm Hg). Endurance exercise training also has the capacity to improve other risk factors for cardiovascular disease in hypertensive individuals. Endurance exercise training appears to elicit even greater reductions in blood pressure in patients with secondary hypertension due to renal dysfunction. The mode (large muscle activities), frequency (3-5 d.wk-1), duration (20-60 min), and intensity (50-85% of maximal oxygen uptake) of the exercise recommended to achieve this effect are generally the same as those prescribed for developing and maintaining cardiovascular fitness in healthy adults. Exercise training at somewhat lower intensities (40-70% VO2max) appears to lower blood pressure as much, or more, than exercise at higher intensities, which may be important in specific hypertensive populations. Physically active and fit individuals with hypertension have markedly lower rates of mortality than sedentary, unfit hypertensive individuals. Thus, it seems reasonable to recommend exercise as the initial treatment strategy for individuals with mild to moderate essential hypertension. A follow-up period should assess the efficacy of the patient's exercise program, and adjunct therapies should be implemented according to the individual patient's blood pressure and CAD risk factor goals. Individuals with more marked elevations in blood pressure (> 180/105 mm Hg) should add endurance exercise training to their treatment regimen only after initiating pharmacologic therapy. Resistive, or strength, exercise training is not recommended to lower blood pressure in individuals with hypertension when done as their only form of exercise training.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2003

The effectiveness of worksite physical activity programs on physical activity, physical fitness, and health.

OBJECTIVE: To critically review the literature with respect to the effectiveness of worksite physical activity programs on physical activity, physical fitness, and health. DATA SOURCES: A search for relevant English-written papers published between 1980 and 2000 was conducted using MEDLINE, EMBASE, Sportdiscus, CINAHL, and Psychlit. The key words used involved a combination of concepts regarding type of study, study population, intervention, and outcome measure. In addition, a search was performed in our personal databases, as well as a reference search of the studies retrieved. STUDY SELECTION: The following criteria for inclusion were used: 1) randomized, controlled trial or nonrandomized, controlled trial; 2) working population; 3) worksite intervention program to promote employees' physical activity or physical fitness; and 4) physical activity, physical fitness, or health-related outcomes. DATA EXTRACTION: Two reviewers independently evaluated the quality of relevant studies using a predefined set of nine methodological criteria. Conclusions regarding the effectiveness of a worksite physical activity programs were based on a rating system consisting of five levels of evidence. DATA SYNTHESIS: Fifteen randomized, controlled trials and 11 nonrandomized, controlled trials met the criteria for inclusion and were reviewed. Six randomized, controlled trials and none of the nonrandomized, controlled trials were of high methodological quality. Strong evidence was found for a positive effect of a worksite physical activity program on physical activity and musculoskeletal disorders. Limited evidence was found for a positive effect on fatigue. For physical fitness, general health, blood serum lipids, and blood pressure, inconclusive or no evidence was found for a positive effect. CONCLUSIONS: To increase the level of physical activity and to reduce the risk of musculoskeletal disorders, we support implementation of worksite physical activity programs. For the other outcome measures, scientific evidence of the effectiveness of such a program is still limited or inconclusive, which is mainly the result of the small number of high-quality trials. Therefore, we recommend performing more randomized, controlled trials of high methodological quality, taking into account criteria such as randomization, blinding, and compliance.

Health Promotion↗
PubMed1991

Physical activity, physical fitness, and psychological characteristics of medical students.

Exercise habits, cardiovascular fitness, and selected psychological characteristics were assessed in a sample of over 200 men and women at entrance to medical school. Fitness was measured with a step test, and other variables were measured with standardized questionnaires. Anger ('anger-in') showed the strongest negative correlation with both exercise and fitness. Anger suppression, Type A behavior, and daily stress showed significant negative correlations with both exercise and fitness variables, although the strengths of these associations were uniformly weak. Associations of exercise/fitness with depression and total anger inventory were nonsignificant. Few gender differences were found. Both exercise and fitness showed similar patterns of association with psychological variables. Both exercise and fitness were associated with a style of anger expression that has been found to be related to cardiovascular risk in other studies.

Adaptation, Psychological↗
PubMed2000

Methodologic issues in measuring physical activity and physical fitness when evaluating the role of dietary supplements for physically active people.

Physical activity and physical fitness are complex entities comprising numerous diverse components that present a challenge in terms of accurate, reliable measurement. Physical activity can be classified by its mechanical (static or dynamic) or metabolic (aerobic or anaerobic) characteristics and its intensity (absolute or relative to the person's capacity). Habitual physical activity can be assessed by using a variety of questionnaires, diaries, or logs and by monitoring body movement or physiologic responses. Selection of a measurement method depends on the purpose of the evaluation, the nature of the study population, and the resources available. The various components of physical fitness can be assessed accurately in the laboratory and, in many cases, in the field by using a composite of performance tests. Most coaches and high-level athletes would accept as very beneficial a dietary supplement that would increase performance in a competitive event by even 3%; for example, lowering a runner's time of 3 min, 43 s in the 1500 m by 6.7 s. To establish that such small changes are caused by the dietary supplement requires carefully conducted research that involves randomized, placebo-controlled, double-blind studies designed to maximize statistical power. Statistical power can be increased by enlarging sample size, selecting tests with high reliability, selecting a potent but safe supplement, and maximizing adherence. Failure to design studies with adequate statistical power will produce results that are unreliable and will increase the likelihood that a true effect will be missed.

Data Collection↗
PubMed2005

Past physical activity, current physical activity, and risk of coronary heart disease.

PURPOSE: Middle-aged and older women who are physically active have decreased risk of coronary heart disease (CHD); however, little is known about how physical activity during young adulthood influences activity during middle age and older, and CHD risk. We examined the relationship between 1) physical activity during young adulthood and middle age, and 2) physical activity during each time period and CHD occurring in middle age or older. METHODS: Cohort study of 39,876 healthy U.S. female health professionals, age > or = 45 yr, in the Women's Health Study. Physical activity was reported at baseline. Additionally, physical activity in high school and age 18-22 yr was reported on the 24-month follow-up survey. Women were followed for an average of 9 yr, after the 24-month survey, for CHD occurrence (N = 477). RESULTS: Among 37,169 eligible participants at baseline, the most active women (vigorous physical activity 10-12 months x yr) during high school and age 18-22 yr were more than twice as likely to meet physical activity recommendations at baseline than the least active women (no vigorous activity) during high school and age 18-22 yr (multivariate-adjusted odds ratio = 2.43; 95% C.I. 2.24, 2.63). At baseline, the most active women (> or = 1500 kcal x wk(-1)) had a 39% lower risk of CHD during follow-up than the least active (<200 kcal x wk(-1)) (multivariate-adjusted relative risk = 0.61; 95% C.I. 0.46, 0.81). However, physical activity during young adulthood was not associated with risk of CHD occurring during middle age and older. CONCLUSION: Women who are physically active during young adulthood are more likely to be active when middle-aged and older, when rates of CHD increase, and physical activity during middle-age predicts lower risk of CHD.

Adolescent↗
PubMed2004

Habitual physical activity and physical activity intensity: their relation to body composition in 5.0-10.5-y-old children.

BACKGROUND: Concerns of a decrease in physical activity levels (PALs) of children and a concurrent increase in childhood obesity exist worldwide. The exact relation between these two parameters however has as yet to be fully defined in children. OBJECTIVE: This study examined the relation in 47 children, aged 5-10.5 y (mean age 8.4+/-0.9 y) between habitual physical activity, minutes spent in moderate, vigorous and hard intensity activity and body composition parameters. DESIGN: Total energy expenditure (TEE) was calculated using the doubly labelled water technique and basal metabolic rate (BMR) was predicted from Schofield's equations. PAL was determined by PAL=TEE/BMR. Time spent in moderate, vigorous and hard intensity activity was determined by accelerometry, using the Tritrac-R3D. Body fatness and body mass index (BMI) were used as the two measures of body composition. RESULTS: Body fat and BMI were significantly inversely correlated with PAL (r=-0.43, P=0.002 and r=-0.45, P=0.001). Times spent in vigorous activity and hard activity were significantly correlated to percentage body fat (r=-0.44, P=0.004 and r=-0.39, P=0.014), but not BMI. Children who were in the top tertiles for both vigorous activity and hard activity had significantly lower body fat percentages than those in the middle and lowest tertiles. Moderate intensity activity was not correlated with measures of body composition. CONCLUSIONS: As well as showing a significant relation between PAL and body composition, these data intimate that there may be a threshold of intensity of physical activity that is influential on body fatness. In light of world trends showing increasing childhood obesity, this study supports the need to further investigate the importance of physical activity for children.

Adipose Tissue↗
PubMed2004

Public health and clinical recommendations for physical activity and physical fitness: special focus on overweight youth.

Numerous physical activity and physical fitness recommendations exist for youth. To date, however, no investigator has systematically reviewed these public health and clinical guidelines to determine whether the recommendations address overweight youth. This review examines youth-oriented physical activity and physical fitness recommendations for both the public health community and the clinical community, and assesses how overweight youth are specifically targeted by each of these two groups. Our review determined the extent to which the recommendations assessed four components of physical activity (i.e. frequency, intensity, duration and type) and four components of physical fitness (i.e. cardiorespiratory capacity, strength, flexibility and body composition). We further reviewed clinical recommendations to determine how they included two facets of the physician-patient encounter: assessment and counselling. After identifying all current physical activity and physical fitness recommendations for youth, we evaluated whether public health (n = 13) and clinical recommendations (n = 12) addressed physical activity and physical fitness for overweight youth. Findings revealed inconsistent, yet explicit, recommendations for the public health community where most organisations (12 of 13, 92%) included > or =3 physical activity components. In addition, organisations encouraged volumes of daily moderate- to vigorous-intensity physical activity for youth ranging from 30-60 or more minutes. Recommendations for the clinical community generally did not provide explicit physical activity and fitness recommendations to advise physicians on the assessment and counselling of patients and their families. Overweight youth were addressed within some recommendations (6 of 12, 50%) for the clinical community, but within few recommendations (2 of 13, 15%) for the public health community. To best inform public health and clinical communities, organisations developing future recommendations should include information fully documenting the decision-making processes used to develop the recommendations. In cases where mutual goals exist, public health and clinical communities should consider collaborating across agencies to develop joint recommendations.

Adolescent↗
PubMed1998

Older women's beliefs about physical activity.

Physical activity may contribute to important health and well-being outcomes among older adults. Efforts to understand determinants of physical activity are necessary to plan effective interventions. The theory of planned behavior has been successfully applied to a variety of health behaviors. Previous research using the theory of planned behavior has not addressed beliefs about overall physical activity among community-dwelling older women. Qualitative interviews were conducted with 30 older women to identify behavioral beliefs, perceived control beliefs, and normative beliefs, which influence physical activity decisions. Content analyses of responses revealed three major themes: social influences on physical activity, psychosocial benefits of activity, and joint problems and fatigue as factors that interfere with activity. These findings about physical activity were compared with published findings about episodic exercise among 30 similar women who took part in an episodic exercise study. The result was the discovery that the women in this study talked about physical activity as embedded in their social lives while the women in the episodic exercise study viewed exercise as separate from their daily lives. These findings of beliefs about overall physical activity suggest a social model may be useful in planning public health interventions to increase activity among older women.

Aged↗
PubMed2006

Physical activity and physical self-concept: comparison between children with and without asthma.

AIM: This paper reports a study comparing levels of physical activity and physical self-concepts between children with and without asthma. BACKGROUND: Childhood asthma has become one of the world's most prevalent chronic illnesses. Its symptoms are thought to prevent children from participating in some forms of physical activity. However, asthma treatment guidelines are increasingly suggesting that children with asthma can participate in the same physical activities as healthy children for the same reasons-- to promote normal growth, physical development and psychological health. METHOD: Between October 2001 and May 2002, 120 children between the ages of 9 and 11 with mild and moderate asthma were recruited from three paediatric asthma clinics in Taiwan, and 309 non-asthmatic children in the same age group were selected from four elementary schools in Taiwan's three largest cities. Participants were asked to record physical activity levels for 3 days out of the past 7 days and to fill out a 29-item Physical Self-Concept Inventory. Physical activities were classified as moderate-to-vigorous physical activity or vigorous physical activity. Physical self-concept was measured in terms of perceived flexibility, endurance, appearance, agility, obesity and strength. RESULTS: Asthma was the primary factor determining vigorous physical activity levels, but gender was the primary factor determining physical self-concept, especially in terms of endurance, obesity and strength. No statistically significant relationships were noted between asthma and gender in terms of effects on physical activity and physical self-concept. CONCLUSIONS: Asthma interferes with children's ability to participate in vigorous physical activity but not in moderate-to-vigorous physical activity. Gender determines primary differences in physical self-concept. Appropriate exercise recommendations are necessary to encourage children with asthma to engage in vigorous physical activity for normal growth.

Asthma↗
PubMed2001

Anthropometric indices and physical fitness in university undergraduates with different physical activity.

Physical activity and fitness have important health promoting effects with respect to arterosclerosis and coronary heart disease in particular. An intervention study of physical status and physical activity in university undergraduates (University of Tartu) has been carried out. The physically inactive (Group I) consisted of 310 undergraduates (235 females and 75 males) of the Faculty of Medicine. The physically active (Group II) was recruited from among undergraduates (22 females and 23 males) of the Faculty of Exercise and Sport Sciences, who participated in training sessions regularly, 3 to 5 times per week. Anthropometric body measurements, arm force, vital capacity and exercise test on the bicycle ergometer (PWC170) were performed. There were no statistically significant differences between the mean values of anthropometric indices in case of physically inactive and physically active female subjects. In the group of physically active male undergraduates, weight and shoulder width were larger than in students with physically sedentary life style (p < 0.05). Most of the female and male students had normal BMI. There were statistically significant differences in the mean values of vital capacity, arm force and aerobic working capacity between the study groups, while physically active students had higher physical capacity (p < 0.001). Mean anthropometric indices demonstrated a statistically significant increase in both female and male university undergraduates after the interval of 30 years. Normal BMI and anthropometric indices do not serve a as guarantee of physical fitness for university undergraduates who are involved in sedentary life style. Regular physical activity has a strong positive impact on physical fitness, particularly on aerobic capacity which is the most important health promoting component of physical fitness with respect to coronary heart disease.

Adult↗