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Effect of individual counseling on physical activity fitness and health: a randomized controlled trial in a workplace setting.

BACKGROUND: Physical inactivity and obesity are major public health problems. Our objective was to investigate the effectiveness of an individual counseling intervention at the workplace on physical activity fitness and health. Counseling content derived from the Patient-centered Assessment and Counseling for Exercise and Nutrition (PACE) program. METHODS: A total of 299 employees of three municipal services in the Dutch town of Enschede were randomly allocated into intervention (n =131) and control group (n =168). Over a 9-month period, intervention group subjects were offered seven counseling sessions. Counseling was based on the individual's stage of behavioral change using PACE physical activity and nutrition protocols. Subjects in both the intervention and control group received written information about several lifestyle factors. Primary outcome measures were physical activity (total energy expenditure, during sports activities, during physical activity leisure time other than sports, and meeting the moderate-intensity public health recommendations); cardiorespiratory fitness; and prevalence of musculoskeletal symptoms. Secondary outcome measures were body composition (body mass index [BMI], and percentage of body fat measured via skinfold thicknesses); blood pressure; and blood cholesterol. RESULTS: There were significant positive effects on total energy expenditure, physical activity during sports, cardiorespiratory fitness, percentage of body fat, and blood cholesterol. No effects were found for the proportion of subjects meeting the public health recommendation of moderate-intensity physical activity, physical activity during leisure time other than sports, prevalence of musculoskeletal symptoms, body mass index, and blood pressure. CONCLUSIONS: Individual face-to-face counseling at the workplace based on PACE protocols positively influenced physical activity levels and some components of physical fitness. The implementation of workplace counseling programs for individuals should therefore be promoted.

Adult↗

Effect of total hip arthroplasty on cardiovascular fitness.

Thirty patients who underwent total hip arthroplasty and 18 patients with medically treated arthritis participated in this study. Both groups of patients underwent a cardiovascular fitness exercise test on entering the study and 6 months, 1 year, and 2 years later. Fitness was assessed by patient performance on a graded maximal exercise test using a bicycle ergometer and metabolic cart. In the group of total hip arthroplasty patients, significant improvements in exercise duration (P = .011), maximum workload (P = .0013), peak oxygen consumption (P = .0036), and percentage of predicted maximum oxygen uptake achieved (P = .0002) were observed during the follow-up evaluation. In the group of control patients, decreases in exercise duration (P = .0001), maximum workload (P = .0001), and workload at anaerobic threshold (P = .0108) occurred without a significant change in the other measures of cardiovascular fitness. The results indicate that resumption of routine physical activities after total hip arthroplasty is associated with a corresponding improvement in cardiovascular fitness.

Activities of Daily Living↗

Physical activity, physical fitness, and all-cause and cancer mortality: a prospective study of men and women.

We studied physical fitness and physical activity in relation to all-cause and cancer mortality in a cohort of 7080 women and 25,341 men examined at the Cooper Clinic in Dallas, Texas, during 1970 to 1989. Physical fitness was assessed at baseline by a maximal treadmill exercise test, while physical activity was self-reported on the attendant health habits questionnaire. Both men and women averaged about 43 years of age at baseline (range, 20 to 88 years), and they were followed for approximately 8 years on average. Through the end of 1989, the women contributed 52,982 person-years of observation and incurred 89 deaths, including 44 deaths due to cancer. The men contributed 211,996 person-years and incurred 601 deaths, with 179 due to cancer. After adjustment for baseline differences in age, examination year, cigarette habit, chronic illnesses, and electrocardiogram abnormalities, we found a strong inverse association between risk of all-cause mortality and level of physical fitness in both men and women (P for trend < 0.001). Physically active men also were at lower risk of all-cause mortality than were sedentary ones (P for trend = 0.01). Among women, however, self-reported physical activity was not significantly related to risk of death from all causes. The risk of mortality from cancer declined sharply across increasing levels of fitness among men (P for trend < 0.001), whereas among women the gradient was suggestive but not significant (P for trend = 0.07). Physically active men also were at lower risk of death from cancer than were sedentary men (P for trend = 0.002), but among women physical activity was unrelated to cancer mortality.

Adult↗

Fitness testing and career progression in AFL football.

Relationships between fitness testing and career progression in the Australian Football League (AFL) are under-explored. This study investigated relationships between anthropometric and fitness tests conducted at the annual AFL National Draft Camp and subsequent career progression of players. A total of 283 players was tested over three consecutive camps (1999-2001). The anthropometric and fitness measures were: height, mass, sum of skinfolds, 20-m sprint test, vertical jump (standing and bilateral running), agility run and a multi-stage incremental shuttle run. The five outcome variables were: drafted (yes/no), AFL debut (yes/no), number of AFL games played to the end of 2003, and subjective ratings of career potential and career value (5-point scale). Of 205 players (72%) subsequently drafted, 166 (59%) eventually made their AFL debut. Players drafted to AFL clubs were faster over 5 m, 10 m and 20 m, ran further in the shuttle run and ran marginally faster in the agility test than players not drafted. Multi-regression analysis showed small to moderate correlations (r = 0.27-0.31) between the designated outcome variables and selected fitness tests: 20-m sprint time (faster), agility run test (faster), and running vertical jump (higher absolute height and smaller difference between left and ride sides). Regression analysis for the standing vertical jump relative to standing reach height showed a counterintuitive negative correlation with positive outcomes, possibly reflecting non-compliance with testing procedures by the less successful athletes. We conclude that the 20-m sprint, jump, agility and shuttle run tests have a small but important association with career progression of AFL footballers.

Adolescent↗

Methods of the NSW Schools Fitness and Physical Activity Survey, 1997.

Physical fitness, participation in physical activity, fundamental motor skills and body composition are important contributors to the health and the development of a healthy lifestyle among children and youth. The New South Wales Schools Fitness and Physical Activity Survey, 1997, was conducted to fill some of the gaps in our knowledge of these aspects of the lives of young people in New South Wales. The survey was conducted in February and March, 1997 and collected data on a randomly-selected sample of students (n = 5518) in Years 2, 4, 6, 8 and 10. Measures were taken on body composition (height and weight, waist and hip girths, skinfolds), health-related fitness (aerobic capacity, muscular strength, muscular endurance, flexibility), fundamental motor skills (run, vertical jump, catch, overhand throw, forehand strike and kick), self-reported physical activity, time spent in sedentary recreation, and physical education (PE) classes. The methods are described to assist in the development of surveys of other populations and to provoke debate relevant to the development and dissemination of standard approaches to monitoring the fitness, physical activity habits and body composition of Australian children and youth. Finally, we offer comments on some of the strengths and limitations of the methods employed.

Anthropometry↗

Socio-economic determinants of health and physical fitness in southern Ethiopia.

The dependence of health and physical fitness on the socio-economic factors of rural families in southern Ethiopia is investigated, with particular emphasis on the role of inequality. This paper contributes to our knowledge of the effect of inequality on health in several ways: it compares the results of objective and subjective health measures, it distinguishes between wealth inequality and nutrition inequality, and it evaluates the impact of nutrition inequality both at the village level and at the household level. The subjective health measures are the number of days respondents were ill during the last month, their ability to walk distances, their ability to carry heavy loads, and their ability to work in the field. The objective health measure is having Body Mass Index (BMI) lower than 18.5. Males are healthier than females. Height has a positive and significant effect on health and fitness and the same is true for per-capita wealth measured at the village level. Availability of satisfactory health facilities has a negative effect on morbidity. Per-capita wealth inequality is positively associated with morbidity and with a low BMI. Within-household nutrition inequality has a complex effect on health and physical fitness: the effect is negative, but only for household members whose nutritional status is above the household mean. The results indicate a clear positive effect of economic well-being on health and physical fitness. The role of inequality is less clear, and certainly deserves further analyses at both the theoretical and empirical levels.

Adolescent↗

Life events, fitness, hardiness, and health: a simultaneous analysis of proposed stress-resistance effects.

The effects of exercise participation, self-perceived fitness level, and dispositional hardiness for promoting stress resistance were examined in a sample of 373 college students. Self-report measures of stressful life experience and recent physical illness were positively correlated, and fitness and hardiness were negatively correlated with illness as expected. Multiple regression analyses indicated that neither fitness nor hardiness provided a stress-moderator effect because neither was found to significantly interact with stress in the prediction of illness scores. Structural equation analyses suggested that hardiness may affect health indirectly by first influencing either the occurrence or subjective interpretation of stressful life events. No direct effect on health was found for exercise participation, although exercise may reduce illness indirectly by improving fitness. Implications for the multivariate modeling of proposed stress-resistance-enhancing effects are discussed.

Adaptation, Psychological↗

Blocks in choice responding as a function of age and physical fitness.

Although both physical fitness and aspects of cognitive functioning are known to be poorer among older people, there is conflicting evidence about the interaction between age and fitness. Is greater age more strongly associated with impaired cognition among less fit people than it is among more fit people? In a sample of employed men aged 17-63 years, it is shown that this interaction is significant with respect to the occurrence of exceptionally slow responses but is not significant for mean reaction time. Multiple regression analyses suggest that the former measure may be interpreted as an inability to maintain concentration over time rather than as an index of response speed.

Adolescent↗

Evaluation of the influence of cardiorespiratory fitness on diverse health risk factors, independent of waist circumference, in 40-year-old Flemish males.

OBJECTIVE: To examine whether cardiorespiratory fitness is associated with health risk factors, independent of abdominal obesity (waist circumference). RESEARCH METHODS AND PROCEDURES: Data from 141 40-year-old Flemish male subjects were used in a cross-sectional design. The main outcome measure in this study was the health risk profile, composed of lipid parameters, blood pressure, and body composition parameters. Data were analyzed by regression analysis and by means of analysis of covariance with waist circumference (WC) as covariate and cardiorespiratory fitness as source of variance. RESULTS: The data demonstrated that cardiorespiratory fitness was significantly associated with triglycerides, with the ratio of total cholesterol/serum high density lipoprotein cholesterol, and with percent body fat, independent of an association with WC. DISCUSSION: Major findings of the present cross-sectional study indicate that a high WC is associated with adverse health-related lipid profile and body composition characteristics and that relatively high levels of aerobic fitness attenuate the health risk associated with a large WC.

Adipose Tissue↗

Physical fitness and physical activity in obese and nonobese Flemish youth.

OBJECTIVE: To assess different aspects of physical fitness and physical activity in obese and nonobese Flemish youth. RESEARCH METHODS AND PROCEDURES: A random sample of 3214 Flemish schoolchildren was selected and divided into an "obese" and "nonobese" group based on body mass index and sum of skinfolds. Physical fitness was assessed by the European physical fitness test battery. Physical activity was estimated by a modified version of the Baecke Questionnaire. RESULTS: Obese subjects had inferior performances on all tests requiring propulsion or lifting of the body mass (standing-broad jump, sit-ups, bent-arm hang, speed shuttle run, and endurance shuttle run) compared with their nonobese counterparts (p < 0.001). In contrast, the obese subjects showed greater strength on handgrip (p < 0.001). Both groups had similar levels of leisure-time physical activity; however, nonobese boys had a higher sport index than their obese counterparts (p < 0.05). DISCUSSION: Results of this study show that obese subjects had poorer performances on weight-bearing tasks, but did not have lower scores on all fitness components. To encourage adherence to physical activity in obese youth, it is important that activities are tailored to their capabilities. Results suggest that weight-bearing activities should be limited at the start of an intervention with obese participants and alternative activities that rely more on static strength used.

Adolescent↗

Insulin sensitivity, cardiorespiratory fitness, and physical activity in overweight Hispanic youth.

OBJECTIVE: To determine whether cardiorespiratory fitness and/or physical activity (PA) were related to measures of insulin sensitivity and secretion independent of body composition in overweight Hispanic children. RESEARCH METHODS AND PROCEDURES: Ninety-five Hispanic children (n = 55 boys; n = 40 girls; 8 to 13 years old) participated in this investigation. The frequently sampled intravenous glucose tolerance test was used to determine the insulin sensitivity index (SI), the acute insulin response, and the disposition index. Cardiorespiratory fitness [maximal oxygen uptake (VO(2max))] was evaluated using a treadmill protocol, and PA was determined by an interviewer-administered questionnaire. Body composition was measured using DXA. RESULTS: Unadjusted correlations indicated that VO(2max) (milliliters of O(2) per minute) was negatively related to SI (r = -0.46, p < 0.05) and disposition index (r = -0.31, p < 0.05) and positively associated with fasting insulin (r = 0.29, p < 0.05), but these relationships were no longer significant once gender, Tanner stage, fat mass, and soft lean tissue mass were included as covariates (all p > 0.05). Multivariate linear regression analysis showed that body fat mass explained 53% of the variance in SI and that VO(2max) (milliliters of O(2) per minute) was not independently related to SI. Cardiorespiratory fitness was positively related to both fat mass (r = 0.43, p < 0.001) and soft lean tissue mass (r = 0.89, p < 0.001). PA was not related to any measure of insulin sensitivity and secretion. DISCUSSION: Cardiorespiratory fitness, as determined by VO(2max) (milliliters of O(2) per minute), was not independently related to insulin sensitivity or secretion, suggesting that VO(2max) influences insulin dynamics indirectly through fat mass.

Adolescent↗

Transition of physical fitness in wheelchair marathon competitors over several years.

Twenty eight stress tests for 14 wheelchair marathon competitors were performed to determine their physical fitness just before the Oita International wheelchair marathon since 1984. All the subjects were wheelchair-bound Japanese males and workers at Sun Industry. Oxygen consumption at the maximal workload was significantly larger than that of non-athletic paraplegics and the mean values were 35.0 +/- 4.8 ml/kg in competitors and 22.6 +/- 5.0 ml/min/kg in non-athletic paraplegics. Eight competitors had more than 2 stress tests and 6 of them had 3 tests from 1984 to 1987. The oxygen consumption at the maximal workload of their third test was very high (46.5 +/- 6.8 ml/min/kg) equal to highly trained paraplegics, and was larger than the result of the first test significantly. Their physical fitness was reduced significantly during the off season, however their physical fitness was maintained at a satisfactory higher level than that of non-athletes. This study demonstrated that individual training for wheelchair marathoners had improved the competitors' physical fitness over several years.

Adult↗

Central and total adiposity are lower in overweight and obese children with high cardiorespiratory fitness.

OBJECTIVE: To examine the influence of cardiorespiratory fitness on total and truncal fatness in children. It was hypothesised that high cardiorespiratory fitness would result in lower total and central obesity. DESIGN: Observational cohort study. SETTING: Primary and secondary schools in Athens, Greece. SUBJECTS: A total of 1362 healthy children aged 6-13 y (742 boys and 620 girls). METHODS: Anthropometric data (height, body mass, four skinfolds thickness) were collected and per cent body fat was calculated. Body mass index (BMI) sex- and age-specific cutoff points were used for overweight and obesity definition and children were placed in two groups: overweight/obese and nonoverweight. Cardiorespiratory fitness (CRF) was assessed with the endurance shuttle-run test. Participants were grouped into high (upper two quintiles) and low (lower two quintiles) CRF based on age and sex distributions. T-test and Mann-Whitney test were used for comparisons between fit and unfit children within each BMI category. RESULTS: Sum of skinfolds, subscapular and truncal skinfold thickness, BMI and per cent body fat were lower in overweight and obese youths with high CRF in comparison with youths at the same BMI category with low CRF (P<0.01). The beneficial effect of high CRF was also presented in nonoverweight children (P<0.01). The influence of CRF on body composition remained even after correcting body fatness for BMI. CONCLUSIONS: Central and total obesity were lower in overweight and obese children with high CRF. This is the first study to show that a high CRF may reduce the hazards of obesity in children.

Abdomen↗

Improvements in cardiorespiratory fitness attenuate age-related weight gain in healthy men and women: the Aerobics Center Longitudinal Study.

OBJECTIVE: To determine the longitudinal relation of change in cardiopulmonary fitness to subsequent change in body weight in a cohort of healthy middle-aged adults. DESIGN: Prospective cohort study. SUBJECTS: Participants were 4599 men and 724 women (43 +/- 9 y) receiving at least three medical examinations between 1970 and 1994. Examinations included assessment of cardiorespiratory fitness by maximal exercise tests and measurement of body weight. MEASUREMENTS: Change in fitness was calculated as the difference in maximal treadmill time between the first and second examination (mean interval, 1.8 y). Weight change was calculated as the difference in body weight between the first and last examination (mean follow-up, 7.5 y). RESULTS: There was a small, yet statistically significant weight gain over the follow-up (0.61 +/- 5.29 kg for men and 1.51 +/- 4.67 kg for women; P << 0.001). Estimates from the multiple linear regression modeling show that each 1 min improvement in treadmill time, significantly attenuated weight gain in both men (b = -0.60; P << 0.001) and women (b = -0.60; P << 0.001), respectively. Moreover, each 1 min improvement in treadmill time, reduced the odds of a > or = 5 kg gain by 14% in men (odds ratios (OR)) = 0.86; 95% confidence interval (CI): 0.83-0.89) and by 9% in women (OR = 0.91; 95% CI:0.83-1.00) and the odds of a > or = 10 kg gain by 21% in both men (OR = 0.79;95% CI:0.75-0.84) and women (OR = 0.79;95% CI:0.67-0.93) CONCLUSIONS: Improvements in fitness, appear important in attenuating age-related weight gain in healthy middle-aged adults. Thus, an active life-style should be promoted early and maintained through adulthood to prevent substantial weight gain and obesity with age.

Adult↗

Lipoprotein subfractions in women athletes: effects of age, visceral obesity and aerobic fitness.

OBJECTIVE: To examine whether lipoprotein subfractions are associated with age-related changes in visceral obesity and maximal aerobic fitness in women athletes. SUBJECTS AND MEASUREMENTS: Body composition was measured using dual energy X-ray absorptiometry (DEXA) and a single slice computed tomography (CT) scan of the abdomen of 39 women athletes (age: 18-69y, body mass index (BMI): 19-24 kg/m2). Lipoprotein lipids were measured in plasma drawn after a 12 h fast using nuclear magnetic resonance (NMR) spectroscopy, which quantifies lipoprotein subfractions by the spectroscopic differences exhibited by lipoprotein particles of various sizes. RESULTS: Total cholesterol (r=0.42; P<0.01) and low-density lipoprotein cholesterol (LDL-C) (r=0.32; P=0.05) correlated positively with age, even after adjustment for age-related decreases in maximal aerobic fitness (VO2 max) and increases in the intra-abdominal fat area. There were no relationships between any of the lipoprotein subfractions or sizes with age. Very-low-density lipoprotein (VLDL) size and VLDL2-TG correlated with total fat mass (r = 0.40 and r= -0.43, respectively; P < 0.05) and with intra-abdominal fat area (r = -0.47 and r = 0.43, respectively; P < 0.01), but not independently of total fat mass. Total cholesterol and LDL-C were negatively related to maximal aerobic fitness (VO2max) (r = -0.37 and r = -0.33, respectively; P < 0.05), while low-density-lipoprotein (LDL) size was positively related to VO2max (r = 0.35, P < 0.05). CONCLUSIONS: These results suggest that age-associated changes in lipoprotein concentrations are probably, in part, due to primary aging, rather than age-related changes in abdominal obesity and aerobic fitness.

Abdomen↗

Aerobic fitness, body mass index, and CVD risk factors among adolescents: the Québec family study.

PURPOSE: The purpose of this study was to examine the association of body mass index (BMI) and aerobic fitness on cardiovascular disease (CVD) risk factors in adolescents. METHODS: The sample included 416 boys and 345 girls 9-18 y of age from the Québec Family Study. Participants were cross-tabulated into four groups using a median split of age-adjusted physical working capacity (PWC) and body mass index (BMI). Group differences in age-adjusted CVD risk factors (blood pressures, fasting total cholesterol (CHOL), LDL -C, HDL-C, HDL/CHOL, triglycerides, glucose, and a composite risk factor score) were examined by two-way ANOVA. RESULTS: Several CVD risk factors showed significant main effects for PWC, BMI and/or the PWC by BMI interaction. In general, low fit males and females had higher blood lipids and glucose compared to their high fit counterparts within BMI categories although none of the differences reached statistical significance. The high fit/low BMI group showed the best CVD risk factor profile while the low fit/high BMI showed a poorer profile as evidenced by several significant differences between these two groups. Other significant differences occurred for various risk factors between groups. CONCLUSION: Both aerobic fitness and BMI show an independent association with CVD risk factors in adolescents.

Adolescent↗

Influence of extracurricular sport activities on body composition and physical fitness in boys: a 3-year longitudinal study.

OBJECTIVE: To analyse the effect of extracurricular physical activities on fat mass accumulation and physical fitness during growth in early pubertal males. DESIGN: Longitudinal study. SUBJECTS: A total of 42 male children (9.4+/-1.4 years, Tanner I-II and 12.7+/-1.5 years, Tanner III-IV, before and after the 3.3 years follow-up, respectively), randomly sampled from the population of Gran Canaria (Spain), 26 of them physically active (PA, at least 3 h per week during 3 years) and 16 non-physically active (non-PA). MEASUREMENTS: Body composition (dual-energy X-ray absorptiometry), anthropometrics (body circumferences and skinfolds) and physical fitness variables (dynamic and isometric force, anaerobic capacity and maximal aerobic power) were determined in all subjects. RESULTS: Both groups had comparable body sizes at the start and the end of the study. Body mass index increased with growth more in the PA than in the non-PA group (P<0.05). However, fat mass accumulation with growth was lower in the PA than in the non-PA (P<0.05). There was a positive relationship between the increment of total and trunkal fat mass, especially in non-active children (r2=0.93). In contrast, there was an inverse relationship between the total lean mass growth and the accumulation of total and regional fat mass (r=-0.37 to -0.41, all P<0.05). Physical fitness was maintained in the PA, while it worsened in the non-PA children. CONCLUSIONS: Without any dietary intervention, children who regularly participate in at least 3 h per week of sports activities are more protected against total and regional fat mass accumulation. They also increase their total lean and bone mass to a greater extent than children who do not participate in extracurricular sport activities. In addition, PA children maintain their physical fitness during growth, while it deteriorates in the non-PA children.

Absorptiometry, Photon↗

Cardiorespiratory fitness is associated with diminished total and abdominal obesity independent of body mass index.

OBJECTIVE: To determine whether, for a given body mass index (BMI), men and women with high cardiorespiratory fitness (HIGH CRF) have lower waist circumference (WC), sum of trunk skinfolds (SUM2) and sum of five skinfolds (SUM5), by comparison to those with LOW CRF. DESIGN: Observational cohort study. SETTING: 1981 Canada Fitness Survey (CFS). PARTICIPANTS: A total of 3719 men and 3854 women 20-59 y of age from the 1981 CFS for whom anthropometric and physical fitness measures were available. MAIN OUTCOME MEASURES: BMI, waist circumference, skinfolds, cardiorespiratory fitness. RESULTS: For a given BMI, men and women in the HIGH CRF group had lower WC, SUM2 and SUM5 by comparison to those with LOW CRF (P<0.001). A significant main effect for CRF group remained for SUM2 in both men (P=0.0001) and women (P=0.007), after statistical control for the effects of extremity fat. In women, but not men, there were significant interaction effects for WC (P=0.0023) and SUM5 (P=0.01), indicating that the difference between the LOW CRF and HIGH CRF groups increased with increasing BMI. CONCLUSIONS: HIGH CRF is associated with lower levels of total and abdominal obesity for a given BMI by comparison to those with LOW CRF, independent of gender. This finding suggests a mechanism by which exercise attenuates the health risks attributed to obesity as measured by BMI. It is suggested that the routine measurement of WC and CRF would substantially improve the ability to identify those at health risk.

Abdomen↗