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PubMed2007

Physical activity, cardiorespiratory fitness and insulin resistance: a short update.

PURPOSE OF REVIEW: High levels of cardiorespiratory fitness and/or habitual physical activity are associated with reduced risk of cardiovascular disease. The responsible mechanisms are multifarious, but effects on insulin sensitivity are likely to play an important role. The purpose of this review is to highlight some recent evidence on the interrelationships between physical activity, fitness, obesity, genotype and insulin resistance. RECENT FINDINGS: Effects on cardiorespiratory fitness and abdominal obesity are both likely to contribute to the insulin-sensitizing effects of regular physical activity. Recent data suggest that at least in older adults, the intensity of an exercise intervention may influence the magnitude of changes in insulin sensitivity, and emerging data suggest that individual changes in insulin sensitivity following an exercise programme may, in part, be influenced by genotype. SUMMARY: Increasing physical activity reduces insulin resistance. As both intensity of exercise and genetic factors may modulate the magnitude of this effect, current physical activity for health guidelines that emphasize engagement in moderate-intensity physical activity in a 'one-size-fits-all' approach may need revision in the future to optimize the potential benefits accrued from individuals becoming more active.

Exercise↗
PubMed2001

How should we define fitness in structured metapopulation models? Including an application to the calculation of evolutionarily stable dispersal strategies.

We define a fitness concept applicable to structured metapopulations consisting of infinitely many equally coupled patches. In addition, we introduce a more easily calculated quantity Rm that relates to fitness in the same manner as R0 relates to fitness in ordinary population dynamics: the Rm of a mutant is only defined when the resident population dynamics converges to a point equilibrium and Rm is larger (smaller) than 1 if and only if mutant fitness is positive (negative). Rm corresponds to the average number of newborn dispersers resulting from the (on average less than one) local colony founded by a newborn disperser. Efficient algorithms for calculating its numerical value are provided. As an example of the usefulness of these concepts we calculate the evolutionarily stable conditional dispersal strategy for individuals that can account for the local population density in their dispersal decisions. Below a threshold density x, at which staying and leaving are equality profitable, everybody should stay and above x everybody should leave, where profitability is measured as the mean number of dispersers produced through lines of descent consisting of non-dispersers.

Algorithms↗
PubMed2003

Blood pressure and muscle sympathetic nerve activity during cold pressor stress: fitness and gender.

We examined putative autonomic and hemodynamic mechanisms that might explain our prior finding that cardiorespiratory fitness mitigates blood pressure responses by normotensive women during the hand cold pressor test. We report that fitness level was inversely related to increases in systolic and diastolic blood pressures and muscle sympathetic nerve activity (MSNA) during the cold pressor among women but not men. The pattern of responses among fitter women was consistent with decreased central sympathetic outflow resulting in reduced stroke volume or dampened peripheral resistance in vascular beds other than calf skeletal muscle. Fitter men and women had slightly larger increases in blood pressure during mental arithmetic, but otherwise fitness was not directly related to stress responses. The results further encourage consideration of cardiorespiratory fitness as a modifying covariate when the hand cold pressor test is used as a predictor of future hypertension among women.

Adult↗
PubMed1981

Coronary risk factors and physical fitness in healthy middle-aged men.

In 1832 healthy men aged 40-59 years subjected to a near maximal bicycle exercise test, physical fitness decline with age. Higher levels of physical fitness were in all age groups associated with lower cigarette consumption, blood pressure, serum triglycerides, hemoglobin and with better pulmonary function. Serum cholesterol, however, was independent of changes in physical fitness. In view of the beneficial effect of high physical activity on the well-known coronary risk factors, it is surprising that it has proved so difficult to show a protective effect of increased physical fitness and activity in coronary heart disease and its manifestations.

Adult↗
PubMed2006

Physical fitness, functional ability and quality of life in children with severe haemophilia: a pilot study.

In the Netherlands comparable levels of sports-participation between persons with haemophilia and healthy controls have been reported. This raises the question if children with haemophilia under the currently available prophylaxis do reach comparable levels of physical fitness and health-related quality of life (HRQoL) as their healthy peers. The aim of this study was to investigate the level of physical fitness, functional ability and quality of life and to determine the feasibility to safely test the exercise capacity of boys with severe haemophilia A. Thirteen subjects participated in this study. Physical fitness was determined using the measurement of maximal oxygen uptake (VO2peak) attained during a graded maximal exercise test to volitional exhaustion. Joint health, physical activity levels and health-related quality of life (Haemo-Qol) were also measured. Mean VO2peak was 1.86+/-0.77 L min-1 (Z-score: -0.39+/-1.61) which was not significantly different from reference values. Relative VO2peak was 47.42+/-8.29 mL min-1 kg-1 (Z-score: -0.52+/-1.43), which did not differ significantly from reference values either. One boy suffered a joint bleeding one day after the test. Haemo-Qol scores in parents and children ranged from 3.2% to 36.7% (100% reflects poor outcome). Relationship between the child or parent reports of Haemo-QoL and both absolute and relative VO2peak ranged from R=0.00 and R=0.4. Exercise testing in children with severe haemophilia A was a safe procedure. Patients with severe haemophilia A with good joint health and no limitations of activities have comparable physical fitness and physical active lifestyle with healthy peers and good HRQoL.

Adolescent↗
PubMed1994

Blood pressure, physical fitness and physical activity in 17-year-old Danish adolescents.

OBJECTIVE: To test the relationship between physical activity and physical fitness, and the relationship between these variables and the primordial risk factor blood pressure (BP). DESIGN: A cross-sectional study of all Danish pupils in the same grade at 'gymnasium' (the Danish upper secondary school). SETTING: Tests and questionnaires were administered by physical education and biology teachers according to a prescribed scheme. SUBJECTS: Study subjects were 13810 adolescents with a mean age of 17.1 years. Physical activity, smoking habits, and physical performance were measured in 4862 boys and 6573 girls. Blood pressure was measured in 2474 boys and 3535 girls. No difference was found in BP, physical activity and fitness variables between this group and a representative group of Danish school children at the same age. MAIN OUTCOME: Blood pressure and health-related physical performance such as strength, muscle endurance, flexibility and maximal oxygen uptake (VO2max) estimated from heart rate at submaximal workload were measured. Sports activity, other physical activity and smoking habits were assessed by questionnaires. RESULTS: There was a negative relationship between BP and VO2max up to the 50% percentile (50 ml min-1 kg-1) in boys and up to the upper 80-90% percentile (45 ml min-1 kg-1) in girls. In a multiple regression model with BP as dependent variable, VO2max related highly significant, also after adjustment for body weight and physical activity (P < 0.001). Other performance variables only explained a small part of the variance in BP. No relationship was found between BP and total physical activity or sports activity. CONCLUSION: In the adolescent population VO2max related negatively to BP after adjustment for body weight, physical activity, other fitness measures and sex, but physical activity or other fitness measures did not relate. Lower blood pressure was found with higher VO2max until levels of 50 and 45 ml min-1 kg-1 in boys and girls, respectively.

Adolescent↗
PubMed1996

Effects of exercise on intraocular pressure in physically fit subjects.

1. Several studies have shown that exercise reduces intraocular pressure (IOP) in sedentary subjects, but the effects of exercise in physically fit subjects are not fully known. Accordingly, the present study was planned to investigate the effects of exercise on intraocular pressure in physically fit subjects after elimination of those factors that can affect intraocular pressure and have been neglected by previous studies. 2. Thirty-two sedentary males of the same age group were categorized equally into control and experimental groups. Intraocular pressures were measured during and after exercise with the Goldmann applanation tonometer. The experimental group took a supervised exercise programme of 3 months duration. Physical fitness was evaluated by the measurements of maximum oxygen uptake. Each subject was tested twice by the same exercise protocol at an interval of 3 months. 3. After 3 months, resting IOP values decreased by 0.31 +/- 0.11 (P < 0.05) and 1.37 +/- 0.15 mmHg (P < 0.001) in control and experimental groups, respectively. The acute decreases following the first exercise test were 4.18 +/- 0.41 and 4.38 +/- 0.47 mmHg, while after 3 months these values were 4.12 +/- 0.45 and 2.69 +/- 0.28 mmHg in control and experimental groups, respectively. After exercise conditioning, the mean recovery time was reduced by 43.03%. 4. The results are relevant to planning trials in glaucoma. Physical fitness reduces IOP and causes significant attenuation in the IOP response to physical exercise. It would seem reasonable at present not to discourage patients who have glaucoma from light exercise; perhaps, on the contrary, it should be encouraged.

Adult↗
PubMed2005

Physical fitness in rural children compared with urban children in Turkey.

BACKGROUND: In a crowded modern world it is vital that the promotion of sport and exercise should be compatible with environmental and public health outcomes. This study aims to investigate the effects of environmental factors, lifestyle and leisure time activities on physical fitness in rural and urban children. METHODS: A cross-sectional observational study of 98 rural and 74 urban healthy children (aged 9-11 years) was conducted in Turkey. A questionnaire was used in collecting information about the children's physical activity habits and their school's facilities. The physical fitness of children was evaluated with EUROFIT test battery. RESULTS: The rural children preferred to play football and volleyball while the urban children had a tendency to prefer indoor sports. The percent of urban children not involved in any sports activity was 35%, while this rate was 30.6% for rural children. It was also found that the urban children watched TV more than the rural children (13.4 +/- 2.7 h/week, 10.9 +/- 2.7 h/week, respectively). The results showed that body mass index and skinfolds thickness were higher in the urban children (P < 0.05). There were no significant differences in the hip-waist ratio or the hip and waist circumference between the two groups. In cardiopulmonary and motor fitness, no difference was found between the two groups. In contrast, flexibility and muscle endurance were significantly higher in the rural children. CONCLUSION: The children living in the urban areas were more inactive and obese, which resulted in a decrease in their flexibility and muscle endurance fitness.

Body Mass Index↗
PubMed2003

Contact lens fitting following corneal graft surgery.

Contact lens fitting may be required following keratoplasty for either optical or therapeutic reasons. Optical indications for contact lens fitting include the correction of irregular astigmatism, high regular astigmatism, anisometropia and secondary aniseikonia, as well as simple ametropia, where the patient desires to wear contact lenses in preference to spectacles. Therapeutic lenses are not routinely fitted following keratoplasty, although this management is advised in certain cases, such as when there are protruding sutures or epithelial healing is impaired. Designing a contact lens for a patient who has undergone keratoplasty will require the practitioner to carefully assess all the relevant features of the corneal graft. In this regard, there are many factors that need to be considered including the diameter of the graft zone, the topographical relationship between the host cornea and donor cornea, the corneal (graft) toricity and the location of the graft. Special designs, such as reverse geometry lenses, or more complex contact lens modalities, such as piggyback contact lens systems, may be required to achieve success in fitting.

Contact Lenses↗
PubMed2006

Cardiorespiratory fitness and laboratory stress: a meta-regression analysis.

We performed a meta-regression analysis of 73 studies that examined whether cardiorespiratory fitness mitigates cardiovascular responses during and after acute laboratory stress in humans. The cumulative evidence indicates that fitness is related to slightly greater reactivity, but better recovery. However, effects varied according to several study features and were smallest in the better controlled studies. Fitness did not mitigate integrated stress responses such as heart rate and blood pressure, which were the focus of most of the studies we reviewed. Nonetheless, potentially important areas, particularly hemodynamic and vascular responses, have been understudied. Women, racial/ethnic groups, and cardiovascular patients were underrepresented. Randomized controlled trials, including naturalistic studies of real-life responses, are needed to clarify whether a change in fitness alters putative stress mechanisms linked with cardiovascular health.

Cardiovascular Physiological Phenomena↗
PubMed1996

Leisure time activity and physical fitness in patients with epilepsy.

PURPOSE: To assess social and physical activity by means of a controlled study based on a questionnaire and standardized clinical tests of physical fitness. METHODS: In this controlled study, we assessed several issues of social and physical activity in 136 patients with epilepsy and 145 controls by using a questionnaire. In addition, we investigated physical fitness based on physical parameters such as body mass index and body composition and standardized tests of aerobic and muscle strength endurance and physical flexibility in 35 adult patients and 36 healthy controls. RESULTS: Leisure time habits both at home and outside the home were mainly similar except for visits of friends, which were significantly reduced in patients. Although the general attitude toward sports and physical activity was positive in both groups, and although controls judged sports to be dangerous significantly more often (p = 0.007), controls participated in regular sports significantly more frequently (p = 0.005). The clinical study demonstrated a lack of physical fitness, as suggested by the questionnaire data. Statistical analysis demonstrated significant differences of aerobic endurance (p < 0.001), muscle strength endurance (p < 0.001), and physical flexibility (p < 0.001) in favor of the control subjects. The body mass index was significantly higher in patients (p = 0.03), whereas the body composition revealed a higher body fat ratio only in female patients (p = 0.04). CONCLUSIONS: We conclude that patients with epilepsy suffer from a considerable lack of physical fitness that might have an important impact on their general health and quality of life. In addition to overprotection and reduced mobility, the questionnaire revealed insufficient knowledge among health professionals and sport instructors as a major factor contributing to these results.

Adolescent↗
PubMed1995

Alcohol consumption and physical fitness among young adults.

The relationship between alcohol consumption and physical fitness was analyzed using data from the baseline examination of the Coronary Artery Disease Risk Development In Young Adults study (CARDIA), a longitudinal study of the evolution of risk factors for cardiovascular disease in Black and White men and women aged 18-30 years. Two parameters of submaximal exercise treadmill testing were evaluated: time to heart rate 130 and duration of the treadmill test. In men and women qualified for treadmill testing, time to reach heart rate 130 was positively associated with ethanol intake. The relationship between fitness and ethanol intake persisted in sex-specific analysis after adjustment for age, ethnicity, systolic blood pressure, sum of subscapular and triceps skinfolds, and physical activity level. The magnitude and strength of the relationship were greater in women than in men. A negative interaction between ethanol intake and smoking status was evident. Linear regression coefficients in men were 0.29 sec to heart rate 130/ml ethanol/day in nonsmokers and -0.06 sec to heart rate 130/ml ethanol/day in smokers. Linear regression coefficients in women were 1.07 sec to heart rate 130/ml ethanol/day in nonsmokers and 0.23 sec to heart rate 130/ml ethanol/day in smokers. Men and women who smoked showed 31 sec longer time to heart rate 130, regardless of ethanol intake. Mean daily ethanol intake was positively associated with duration of treadmill testing in women, but weakly associated with duration in men. These results show increased physical fitness as ethanol intake increased in women and nonsmoking men and mildly decreased physical fitness as ethanol consumption increases among men who smoke.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2005

Contribution of physical education and sport to health-related fitness in high school students.

This study compared health-related fitness variables of high school students (14 to 19-years-old; 120 males, 67 females) participating in physical education (PE) and school-sponsored sports (SSS) to students participating solely in PE. Cardiovascular fitness, the primary variable of interest, was measured using the 20-Meter Shuttle Run (number of completed laps, 20OMST). Secondary analysis compared upper body strength (90 degrees push-ups), flexibility (sit and reach), and body mass index (BMI kg/m2). Comparisons were made between students participating in 1-2 SSS and > or = 3 SSS for males and 1 SSS and > or = 2 for females to students participating solely in PE. Males participating in 1-2 SSS (mean (+/- SD) 20MST 63.80 +/- 25.61) and > or = 3 SSS (81.13 28.26) completed significantly (p < .001) more laps than males participating solely in PE (44.18 +/- 19.09). Females participating in 1 SSS (37.33 +/- 15.53) and > or = 2 SSS (49.48 +/- 19.83) completed significantly (p = .02) more laps than females participating solely in PE (23.50 +/- 7.96). Significant differences in number of 90 degrees push-ups was observed between males participating in > or = 3 SSS (49.41 +/- 12.90) and males participating solely in PE (37.63 +/- 11.79, p = .006). No significant differences existed for males on BMI (p = .223) or the sit and reach (p = .145), and for females on 90 degrees push-ups (p = .79), sit and reach (p = .579), and BMI (p = . 122). As the number of SSS increase, significant increases are observed in cardiovascular fitness, with youth participating solely in PE exhibiting the lowest levels of cardiovascular fitness in comparison to youth participating in PE and SSS.

Adolescent↗
PubMed1994

Effects of fit and bonding characteristics of femoral stems on adaptive bone remodeling.

Bone atrophy caused by stress-shielding may cause serious complications for the long-term fixation of hip stems. In particular, uncemented total hip arthroplasty is threatened by this problem, because the stems are usually larger and, as a consequence, stiffer than those of cemented implants. In the present study, the effects of fit and bonding characteristics of femoral hip stems were investigated, using the (nonlinear) finite element method in combination with adaptive bone remodeling theory to predict the bone density distribution in a bone or bone/implant configuration. Unknown parameters used in the theory, such as a reference equilibrium loading stimulus and a threshold (dead) zone of this stimulus, were established (triggered) by using the method to predict the density distributions in the natural femur and around fully coated uncemented implants. The computer simulation method can provide long term predictions of remodeling patterns around various implant configurations. Several cases were analyzed, whereby the coating conditions (fully, partly, or noncoated) and the fit characteristics (press fitted or overreamed) were varied. The computer predictions showed that partly coating can only significantly reduce bone atrophy relative to fully coated stems, when the coating is applied at a small region at the utmost proximal part of the stem. For smooth press-fit stems the predicted amount of bone loss (35 percent in the proximal medial region) was less than for a one-third proximally coated or a fully coated stem (50 to 54 percent predicted bone loss in the proximal medial region).(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed1994

The relationship between cardiorespiratory fitness, physical activity, and dietary quality.

This study evaluated the relationship between cardiorespiratory fitness, physical activity, and dietary quality in a group of 20- to 40-year-old women (n = 34) who varied widely in levels of physical activity. Nutrient intakes were determined using 10 repeated 24-hr diet records, randomly assigned, over a 10-week period. Physical activity was determined on the same randomly assigned days using the Caltrac Personal Activity Computer. Cardiorespiratory fitness was assessed by two maximal graded treadmill tests with continuous metabolic monitoring at both the beginning and end of the 10-week period. Neither physical activity nor cardiorespiratory fitness was significantly correlated with nutrient density (nutrient/1,000 kcal). Intake of energy (kcal/kg body weight) was higher for the more physically active and fit women, leading to a significant increase in most nutrients consumed per kilogram of body weight.

Adult↗
PubMed2006

Distance as a barrier to using a fitness-program benefit for managed Medicare enrollees.

This study evaluated the effect of distance on the likelihood of initiating and maintaining regular use of a fitness-program benefit in a population of managed Medicare seniors. We studied 8,162 participants and nonparticipants in a managed-care fitness-program benefit: a structured group exercise program or an unstructured health-club membership. Participants in both programs lived significantly closer to facilities than nonparticipants did (structured, p < .001; unstructured, p = .017). Participants living closer to unstructured-program sites attended more frequently than those farther away (p = .008). Distance was not correlated with frequency of use in the structured program (p = .49). Collectively, these analyses demonstrate that distance is related to uptake and, in some cases, continued use of a fitness-program benefit. Health systems providing fitness-program benefits as a way to increase physical activity levels of their plan members should consider location of program facilities in relation to members' home addresses to maximize use of the benefit.

Age Factors↗
PubMed2003

Physical activity and health related physical fitness in children with juvenile idiopathic arthritis.

OBJECTIVE: To obtain insight into the interaction between daily physical activity and components of health related physical fitness in children with juvenile idiopathic arthritis. METHODS: Forty five patients (10 male/35 female; mean (SD) age 8.9 (2.2) years) participated in the study. Body mass, height, skinfold thickness, number of swollen joints, and joint range of motion were determined. The maximal oxygen consumption (VO(2peak)) was assessed during a graded maximal bicycle exercise test. Daily physical activity levels were measured with a Caltrac activity monitor and a parental physical activity rating (PAL) on a five point Likert scale. RESULTS: Partial correlation coefficients (to control for age) between physical activity and indices of health related physical fitness showed significant relationships between Caltrac motion counts and absolute VO(2peak) (r=0.31) and relative VO(2peak) (r=0.34), but not with the indices of body composition. There was also a significant correlation between PAL and relative VO(2peak) (r=0.33). CONCLUSIONS: Physical activity was significantly related to cardiorespiratory fitness but not to body composition in children with juvenile idiopathic arthritis. A longitudinal follow up should show whether an active lifestyle protects for loss of aerobic fitness in this patient group.

Aging↗
PubMed2005

Contact lenses and special back surface design after penetrating keratoplasty to improve contact lens fit and visual outcome.

AIMS: To describe the fitting of patients with high or irregular astigmatism following penetrating keratoplasty with contact lenses and to answer the question whether or not contact lenses with special back surface design can improve visual acuity in complex cases after penetrating keratoplasty. METHODS: 28 eyes were included. They were fitted with contact lenses with a special back surface that was designed for optical rehabilitation after penetrating keratoplasty. Four different types of these lenses (tricurve, keratoconus, reverse, oblong) were used selectively depending on abnormal eccentricity determined by videokeratoscope. The patients were followed up for an average period of 15.5 months. Lens tolerance and corrected visual acuity were evaluated and compared with that corrected with spectacles. RESULTS: The visual acuity was significantly improved in nearly all eyes with an average increase of 3.6 lines (maximal nine lines) accompanied by good contact lens tolerance and satisfactory contact lens fit. No noticeable complications were observed. CONCLUSION: Contact lenses with special back surface design can improve visual results and lens tolerance, and minimise problems in contact lens fitting. This is in favour of contact lenses as an alternative to surgical procedures for correction of high or irregular astigmatism after penetrating keratoplasty. This procedure is recommended especially in cases of patients who decline further operative interventions.

Adult↗