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Haddadi G, Lam B, Akhtar S, Yavelberg L, Jamnik V, Roudier E. The MDM2 SNP309 differentially impacts cardiorespiratory fitness in young healthy women and men. Eur J Appl Physiol 2025; 125:1371-1383. [PMID: 39681743 DOI: 10.1007/s00421-024-05682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 11/25/2024] [Indexed: 12/18/2024]
Abstract
PURPOSE Maximal oxygen consumption (VO2max), the predominant index of cardiorespiratory fitness (CRF), is a predictor of whole-body function and longevity in humans. The central cardiac function and the skeletal muscle's capacity to use oxygen are key determinants of VO2max. Murine Double Minute 2 (MDM2), mainly known as an oncogene, could regulate myocardial hypertrophy, skeletal muscle angiogenesis, and oxidative phosphorylation. A prevalent single nucleotide polymorphism in the MDM2 promoter (SNP309) substitutes a T for a G, supporting a greater transcriptional activity. We aim to assess whether SNP309 impacts intrinsic CRF. METHODS 82 young healthy nonathletic male and female adults aged 23 ± 2 years performed cardiorespiratory exercise testing to determine their VO2max (mL kg-1 min-1). The genomic DNAs isolated from saliva were genotyped using Taqman-based qPCR. RESULTS A one-way ANOVA showed that SNP309 influenced relative VO2max in the whole cohort (p = 0.044) and in men (p = 0.009), remaining non-significant in women (p = 0.133). VO2max was higher in TT homozygotes than in GT heterozygotes (whole cohort, 47 ± 12 vs. 42 ± 6 mL kg-1 min-1, p = 0.030; men, 53 ± 8 vs. 45 ± 6 mL kg-1 min-1, p = 0.011). A contingency analysis revealed a positive association between SNP309 in men in which the TT genotype was more frequent in the high VO2max group (p = 0.006). When considering G as the dominant allele, men bearing a G allele had lower relative VO2max than TT homozygotes (47 ± 7 vs. 53 ± 8, GG/GT vs. TT, p = 0.010). Conversely, women bearing a G allele had a higher relative VO2max than TT homozygotes (39 ± 5 vs. 34 ± 7, GG/GT vs. TT, p = 0.047). CONCLUSION SNP309 impacts VO2max in a sex-dependent manner in our cohort.
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Affiliation(s)
- Ghazal Haddadi
- School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Brian Lam
- School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Sokaina Akhtar
- School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Loren Yavelberg
- School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Veronica Jamnik
- School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Emilie Roudier
- School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
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Li Y, Ren X, Jiang M, Han L, Zheng X. Association of estimated cardiorespiratory fitness in middle-aged and elderly people with cardiovascular disease: Evidence from the China health and retirement longitudinal study. Nutr Metab Cardiovasc Dis 2024; 34:2257-2265. [PMID: 38866620 DOI: 10.1016/j.numecd.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/11/2024] [Accepted: 04/21/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND AND AIM Cardiovascular diseases (CVD) is a major threat to public health, while cardiorespiratory fitness (CRF) is a key predictor of chronic disease. Given this, the purpose of this study was to investigate the relationship between estimated CRF (eCRF) and CVD in middle-aged and elderly Chinese people. METHODS AND RESULTS The China Health and Retirement Longitudinal Study (CHARLS) with 4761 individuals were included in analysis. Participants were divided into three groups according to eCRF quantile in sex subgroups. Cox proportional hazards regression models were used to explore the correlation of eCRF with CVD (stroke or cardiac events). In total, 4761 participants were included in this cohort study (2500 [52.51%] women). During a 7-year follow-up from 2011 to 2018, 796 CVDs (268 Strokes and 588 cardiac events) were recorded. In multivariable-adjusted analyses, for per 1 SD increase of eCRF, the age-adjusted risk of CVD was reduced by about 18% (HR = 0.82; 95% CI, 0.72-0.93) in men, and was reduced by about 29% (HR = 0.71; 95% CI, 0.62-0.81) in women. Similar associations were also found between eCRF and stroke and cardiac events. Both subgroup and interaction analyses showed that the interaction of age had a statistically significant effect on CVD risk. CONCLUSION ECRF was inversely associated with CVD risk (stroke or cardiac events) in both men and women. Remarkable sex and age differences exist in the effectiveness of increasing eCRF to reduce the risk of CVD. As a potential, efficient and cost-effective risk prediction tool, eCRF deserves further attention and wide application.
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Affiliation(s)
- Yiqun Li
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Xiao Ren
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Minglan Jiang
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Longyang Han
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Xiaowei Zheng
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214122, China.
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Singh B, Cadenas-Sanchez C, da Costa BGG, Castro-Piñero J, Chaput JP, Cuenca-García M, Maher C, Marín-Jiménez N, McGrath R, Molina-García P, Myers J, Gower B, Ortega FB, Lang JJ, Tomkinson GR. Comparison of objectively measured and estimated cardiorespiratory fitness to predict all-cause and cardiovascular disease mortality in adults: A systematic review and meta-analysis of 42 studies representing 35 cohorts and 3.8 million observations. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 14:100986. [PMID: 39271056 PMCID: PMC11809197 DOI: 10.1016/j.jshs.2024.100986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/29/2024] [Accepted: 06/11/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) is a powerful health marker recommended by the American Heart Association as a clinical vital sign. Comparing the predictive validity of objectively measured CRF (the "gold standard") and estimated CRF is clinically relevant because estimated CRF is more feasible. Our objective was to meta-analyze cohort studies to compare the associations of objectively measured, exercise-estimated, and non-exercise-estimated CRF with all-cause and cardiovascular disease (CVD) mortality in adults. METHODS Systematic searches were conducted in 9 databases (MEDLINE, SPORTDiscus, Embase, Scopus, PsycINFO, Web of Science, PubMed, CINAHL, and the Cochrane Library) up to April 11, 2024. We included full-text refereed cohort studies published in English that quantified the association (using risk estimates with 95% confidence intervals (95%CIs)) of objectively measured, exercise-estimated, and non-exercise-estimated CRF with all-cause and CVD mortality in adults. CRF was expressed as metabolic equivalents (METs) of task. Pooled relative risks (RR) for all-cause and CVD mortality per 1-MET (3.5 mL/kg/min) higher level of CRF were quantified using random-effects models. RESULTS Forty-two studies representing 35 cohorts and 3,813,484 observations (81% male) (362,771 all-cause and 56,471 CVD deaths) were included. The pooled RRs for all-cause and CVD mortality per higher MET were 0.86 (95%CI: 0.83-0.88) and 0.84 (95%CI: 0.80-0.87), respectively. For both all-cause and CVD mortality, there were no statistically significant differences in RR per higher MET between objectively measured (RR range: 0.86-0.90) and maximal exercise-estimated (RR range: 0.85-0.86), submaximal exercise-estimated (RR range: 0.91-0.94), and non-exercise-estimated CRF (RR range: 0.81-0.85). CONCLUSION Objectively measured and estimated CRF showed similar dose-response associations for all-cause and CVD mortality in adults. Estimated CRF could provide a practical and robust alternative to objectively measured CRF for assessing mortality risk across diverse populations. Our findings underscore the health-related benefits of higher CRF and advocate for its integration into clinical practice to enhance risk stratification.
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Affiliation(s)
- Ben Singh
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia.
| | - Cristina Cadenas-Sanchez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18071, Spain; Department of Cardiology, Stanford University, Stanford, CA 94305, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Granada 18071, Spain
| | - Bruno G G da Costa
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC H2W 1S4, Canada
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real 11519, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz 11009, Spain
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8L1, Canada
| | - Magdalena Cuenca-García
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real 11519, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz 11009, Spain
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia
| | - Nuria Marín-Jiménez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18071, Spain; GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real 11519, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz 11009, Spain
| | - Ryan McGrath
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia; Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND 58102, USA; Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; Fargo VA Healthcare System, Fargo, ND 58102, USA; Department of Geriatrics, University of North Dakota, Grand Forks, ND 58202, USA
| | - Pablo Molina-García
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18071, Spain; Instituto de Investigación Biosanitaria ibs. Granada, Granada 18014, Spain
| | - Jonathan Myers
- Department of Cardiology, Stanford University, Stanford, CA 94305, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Bethany Gower
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18071, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Granada 18071, Spain; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä 40014, Finland
| | - Justin J Lang
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia; Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia
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Lerfald M, Allore H, Nilsen TIL, Eldholm RS, Martinez-Velilla N, Selbæk G, Ernstsen L. Longitudinal Patterns of Systolic Blood Pressure, Diastolic Blood Pressure, Cardiorespiratory Fitness, and Their Association With Dementia Risk: The HUNT Study. J Gerontol A Biol Sci Med Sci 2024; 79:glae161. [PMID: 38894618 PMCID: PMC11266981 DOI: 10.1093/gerona/glae161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND High blood pressure and poor cardiorespiratory fitness are independent risk factors for dementia. However, few studies have examined if combined longitudinal patterns of these modifiable risk factors are associated with dementia risk. METHODS In this prospective cohort study, we used data from the population-based Trøndelag Health (HUNT) Study, Norway. We applied group-based multidimensional trajectory modeling to identify age-specific multidimensional trajectories of SBP, DBP, and estimated cardiorespiratory fitness across 3 surveys (HUNT1, 1984-1986 to HUNT3, 2006-2008). Dementia was diagnosed in the HUNT4 70+ substudy in 2017-2019. We used multivariate logistic regression to estimate odds ratios (ORs) and risk differences (RDs) of dementia. RESULTS In total, 7 594 participants (54.9% women) were included, with a mean age of 44.7 (SD 6.3) years at HUNT1. Dementia was diagnosed in 1 062 (14.0%) participants. We identified 2 multidimensional trajectories throughout adulthood within 3 age groups: one with higher systolic blood pressure (SBP) and diastolic blood pressure (DBP), and lower estimated cardiorespiratory fitness (the poorer group), and one with lower SBP and DBP, and higher cardiorespiratory fitness (the better group). After adjustment for sex, apolipoprotein E ε4 status, education, marital status, and diabetes, the better group had consistently lower risk of dementia in all age groups with the lowest OR in the middle-aged group of 0.63 (95% confidence intervals [95% CI]: 0.51, 0.78) with corresponding RD of -0.07 (95% CI: -0.10, -0.04). CONCLUSIONS Having a beneficial multidimensional trajectory of SBP, DBP, and cardiorespiratory fitness in adulthood was associated with reduced dementia risk. Aiming for optimal SBP, DBP, and estimated cardiorespiratory fitness throughout adulthood may reduce dementia risk.
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Affiliation(s)
- Maren Lerfald
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Heather Allore
- Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Tom I L Nilsen
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Rannveig S Eldholm
- Department of Geriatrics, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Faculty of Medicine and Health Science, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Geir Selbæk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Linda Ernstsen
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Sagelv EH, Casolo A, Eggen AE, Heitmann KA, Johansen KR, Løchen ML, Mathiesen EB, Morseth B, Njølstad I, Osborne JO, Hagerupsen K, Pedersen S, Wilsgaard T. Females Display Lower Risk of Myocardial Infarction From Higher Estimated Cardiorespiratory Fitness Than Males: The Tromsø Study 1994-2014. Mayo Clin Proc Innov Qual Outcomes 2024; 8:62-73. [PMID: 38268988 PMCID: PMC10806283 DOI: 10.1016/j.mayocpiqo.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
Objective To examine the dose-response association between estimated cardiorespiratory fitness (eCRF) and risk of myocardial infarction (MI). Patients and Methods Adults who attended Tromsø Study surveys 4-6 (Janurary 1,1994-December 20, 2008) with no previous cardiovascular disease were followed up through December 31, 2014 for incident MI. Associations were examined using restricted cubic splines Fine and Gray regressions, adjusted for education, smoking, alcohol, diet, sex, adiposity, physical activity, study survey, and age (timescale) in the total cohort and subsamples with hyperlipidemia (n=2956), hypertension (n=8290), obesity (n=5784), metabolic syndrome (n=1410), smokers (n=3823), and poor diet (n=3463) and in those who were physically inactive (n=6255). Results Of 14,285 participants (mean age ± SD, 53.7±11.4 years), 979 (6.9%) experienced MI during follow-up (median, 7.2 years; 25th-75th, 5.3-14.6 years). Females with median eCRF (32 mL/kg/min) had 43% lower MI risk (subdistributed hazard ratio [SHR], 0.57; 95% CI, 0.48-0.68) than those at the 10th percentile (25 mL/kg/min) as reference. The lowest MI risk was observed at 47 mL/kg/min (SHR, 0.02; 95% CI, 0.01-0.11). Males had 26% lower MI risk at median eCRF (40 mL/kg/min; SHR, 0.74; 95% CI, 0.63-0.86) than those at the 10th percentile (32 mL/kg/min), and the lowest risk was 69% (SHR, 0.31; 95% CI, 0.14-0.71) at 60 mL/kg/min. The associations were similar in subsamples with cardiovascular disease risk factors. Conclusion Higher eCRF associated with lower MI risk in females and males, but associations were more pronounced among females than those in males. This suggest eCRF as a vital estimate to implement in medical care to identify individuals at high risk of future MI, especially for females.
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Affiliation(s)
- Edvard H. Sagelv
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Andrea Casolo
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Anne Elise Eggen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kim Arne Heitmann
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kristoffer R. Johansen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv B. Mathiesen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - John O. Osborne
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Karianne Hagerupsen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sigurd Pedersen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Liu Y, Zhu J, Guo Z, Yu J, Zhang X, Ge H, Zhu Y. Estimated cardiorespiratory fitness and incident risk of cardiovascular disease in China. BMC Public Health 2023; 23:2338. [PMID: 38001416 PMCID: PMC10675970 DOI: 10.1186/s12889-023-16864-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/29/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Limited evidence is available on the association between estimated cardiorespiratory fitness (e-CRF) and incidence of cardiovascular disease (CVD) in Chinese population. METHODS A total of 10,507 adults including 5084 men (48.4%) and 5423 (51.6%) women with a median age of 56.0 (25% quantile: 49, 75% quantile 63) years from the China Health and Retirement Longitudinal Study (CHARLS) was recruited in 2011 as baseline. The CVD incident events were followed-up until 2018. e-CRF was calculated from sex-specific longitudinal non-exercise equations and further grouped into quartiles. Cox proportional models were used to calculate hazard ratio (HR) and 95% confidence interval (CI) for incidence risks of CVD, heart disease and stroke. RESULTS During a median follow-up of 7 years, a total of 1862 CVD, 1409 heart disease and 612 stroke events occurred. In fully adjusted models, each one MET increment of e-CRF was associated with lower risk of CVD (HR = 0.91, 95%CI = 0.85-0.96 for males, HR = 0.87, 95%CI = 0.81-0.94 for females). Compared with the Quartile (Q)1 group, the HRs (95%CI) of the Q2, Q3 and Q4 groups were 0.84 (0.63-1.03), 0.72 (0.57-0.91) and 0.66 (0.51-0.87) for CVD in males. Females had HRs of 0.79 (0.66-0.96) in Q2, 0.71 (0.57-0.88) in Q3 and 0.58 (0.45-0.75) in Q4 for CVD. The associations between e-CRF and heart disease and stroke were slightly weaker than that for CVD in both males and females. CONCLUSIONS Higher e-CRF decreases the incident risk of CVD, heart disease and stroke.
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Affiliation(s)
- Yuanjiao Liu
- Department of Epidemiology & Biostatistics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jinghan Zhu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Ziye Guo
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiazhou Yu
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China
| | - Xuhui Zhang
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
| | - Huiqing Ge
- Department of Respiratory Care of Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Yimin Zhu
- Department of Epidemiology & Biostatistics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
- Cancer Center, Zhejiang University, Zhejiang, China.
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Vainshelboim B, Myers J, Matthews CE. Non-exercise estimated cardiorespiratory fitness and cancer incidence: The NIH-AARP diet and health study. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:739-746. [PMID: 36828228 PMCID: PMC10658321 DOI: 10.1016/j.jshs.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/18/2022] [Accepted: 01/11/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Non-exercise estimated cardiorespiratory fitness (NEE-CRF) has been shown to be associated with mortality, although its association with cancer incidence is unknown. The study aimed to assess the prospective association between NEE-CRF and cancer incidence in a large cohort of men and women. METHODS The National Institutes of Health-American Association of Retired Persons diet and health study is a prospective cohort that included 402,548 participants aged 50-71 years who were free from cancer at baseline (1995-1996) (men (n = 238,835) and women (n = 163,713)) and were followed until December 31, 2015. The exposure variable was NEE-CRF expressed in metabolic equivalents. NEE-CRF was estimated using a validated equation of self-reported predictors on demographics and lifestyle behaviors derived from baseline questionnaires. Primary outcomes were total cancer incidence and incidence of prostate, breast, lung, and colorectal cancers. Cox proportional hazards models were analyzed for the association between NEE-CRF and cancer incidence outcomes adjusted for established cancer risk factors. RESULTS During 13.7 ± 3.2 years of follow-up (mean ± SD), 64,344 men and 31,315 women developed a new cancer. For every 1-metabolic equivalent higher NEE-CRF, the hazard ratios and 95% confidence intervals (95%CIs) were 0.96 (95%CI: 0.94-0.97) and 0.88 (95%CI: 0.84-0.92) of total and colorectal cancer incidence among men, and 0.95 (95%CI: 0.93-0.97) and 0.94 (95%CI: 0.91-0.97) of total and breast cancer incidence among women, respectively (all p < 0.001). NEE-CRF was not associated with incidence of prostate and lung cancers in men or colorectal and lung cancers in women. CONCLUSION These results suggest that higher CRF levels, as assessed by the applied non-exercise estimated method, may provide preventive benefits against the development of cancer, while low CRF could potentially serve as a modifiable cancer risk factor. Integrating NEE-CRF into screening paradigms and referring low-fit individuals to improve CRF could complement the public health prevention strategy against cancer.
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Affiliation(s)
- Baruch Vainshelboim
- Center for Tobacco Research, Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH 43214, USA.
| | - Jonathan Myers
- Cardiology Division, Veterans Affairs Palo Alto Health Care System/Stanford University, Palo Alto, CA 94304, USA
| | - Charles E Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
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Nystøyl BTS, Letnes JM, Nes BM, Slagsvold KH, Wisløff U, Wahba A. Cardiorespiratory fitness and the incidence of surgery for aortic valve stenosis-the HUNT study. Eur J Cardiothorac Surg 2023; 64:ezad322. [PMID: 37725362 PMCID: PMC10634520 DOI: 10.1093/ejcts/ezad322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 07/06/2023] [Accepted: 09/20/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVES Aortic valve stenosis (AVS) shares many risk factors with coronary disease, the latter being strongly and inversely associated with physical activity (PA) and cardiorespiratory fitness (CRF). However, the relationship between PA, CRF and AVS needs to be established. We explored whether PA habits and estimated CRF affect the risk of developing AVS demanding aortic valve replacement (AVR) and how these factors affect postoperative mortality. METHODS Participants from the second and third waves of Trøndelag Health Study were cross-linked with a local heart surgery registry and the Norwegian Cause of Death Registry. Estimated CRF was calculated through a developed algorithm based on clinical and self-reported data. Fine-Gray competing risk analyses were used to investigate how PA habits and estimated CRF were associated with the risk of AVR across CRF quintiles, PA groups and per 1-metabolic equivalent task (MET) (3.5 ml/min/kg). RESULTS In a study population of 57 214 participants, we found a 15% [95% confidence interval (CI) 1-27] reduced risk of AVR per 1-MET estimated CRF increment. Those in the highest CRF quintile had a 56% (95% CI 14-77) lower risk of surgery compared to the lowest quintile. Analyses on PA groups did not show significant results. Finally, we found a 37% (95% CI 17-53) lower risk of postoperative mortality per 1-MET increased estimated CRF. CONCLUSIONS Our findings indicate a strong and inverse relationship between estimated CRF and incidence of AVR due to AVS. Higher estimated CRF was associated with lower mortality after surgery.
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Affiliation(s)
| | - Jon Magne Letnes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Clinic of Cardiology, St Olavs University Hospital, Trondheim, Norway
| | - Bjarne Martens Nes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Katrine Hordnes Slagsvold
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Clinic of Cardiothoracic Surgery, St. Olavs University Hospital, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
| | - Alexander Wahba
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Clinic of Cardiothoracic Surgery, St. Olavs University Hospital, Trondheim, Norway
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9
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Havnen A, Zotcheva E, Bjerkeset O, Sui X, Ernstsen L. Cardiorespiratory fitness and incident use of anxiolytics and antidepressants in adults. A linkage study between HUNT and the Norwegian Prescription Database. J Affect Disord 2023; 339:111-117. [PMID: 37437717 DOI: 10.1016/j.jad.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/11/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND We investigated the association between cardiorespiratory fitness (CRF) and incident use of antidepressants or anxiolytics in the general adult population. METHODS A non-exercise prediction model was used to estimate CRF in 32,603 participants in the third wave of the Trøndelag Health Study (HUNT3; 2006-08). Data on first purchase of antidepressants and anxiolytics were obtained from the Norwegian Prescription Database. Cox regression was used to estimate hazard ratios (HRs). RESULTS Each 1- metabolic equivalent of task (MET) increase in CRF was associated with 4 % reduced risk of purchasing antidepressant or anxiolytic medication during follow-up (HR 0.96, 95 % Confidence interval [CI] 0.94-0.98). Compared to the low CRF tertile, participants in intermediate (HR 0.93, 95 % CI 0.87-0.98) and high (HR 0.92, 95 % CI 0.86-0.98) CRF tertiles had reduced risk of medication purchase. Men in intermediate and high CRF tertile had lower risk of medication purchase (intermediate HR 0.87, 95 % CI 0.79-0.96; high HR 0.87, 95 % CI 0.78-0.96). Intermediate and high CRF tertiles were associated with reduced risk of medication use for younger adults (20 to <30 years old; intermediate HR 0.74, 95 % CI 0.61-0.91, high HR 0.78, 95 % CI 0.64-0.95) and middle-aged adults (30 to <65 years old; intermediate HR 0.90, 95 % CI 0.83-0.97, high HR 0.90, 95 % CI 0.84-0.98), but not in older adults (≥65 years old). LIMITATIONS Only information about medication purchase and not actual use was available. CONCLUSION Increased CRF is associated with reduced risk of anxiolytics and antidepressants purchase, with stronger effects for men and younger adults.
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Affiliation(s)
- Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology, Norway; Division of Psychiatry, St. Olavs Hospital, Trondheim, Norway.
| | - Ekaterina Zotcheva
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway; Department of Physical Health and Ageing, Norwegian Institute of Public Health, Norway
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway; Department of Mental Health, Faculty of Medicine and Health Sciences, Norway
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Linda Ernstsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway
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10
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Berlanga LA, Matos-Duarte M, Abdalla P, Alves E, Mota J, Bohn L. Validity of the two-minute step test for healthy older adults. Geriatr Nurs 2023; 51:415-421. [PMID: 37146558 DOI: 10.1016/j.gerinurse.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND In healthy older adults, the two-minute step test (2MST) does not have its concurrent validity tested against the six-minute walk test (6MWT), which is a valid cardiorespiratory fitness test frequently applied in geriatric samples. OBJECTIVE To derive an equation to predict 6MWT from 2MST and to observe the agreement between observed and estimated 6MWT distances. METHODS 6MWT and 2MST were measured in 51 older adults (72.9±4.6 years) from community multicomponent exercise programs. Multiple linear regression derives the predictive equation of 6MWT walked distance (dependent outcome) from steps obtained in 2MST, age, sex, and body mass index (independent outcomes). RESULTS Correlation between 6MWT and 2MST was strong (r=0.696, p<0.001). The regression equation showed good agreement with measured values, when 6MWT was below 600 m. CONCLUSION The equation stands as a novel approach to obtaining a valid 6MWT estimation from the 2MST. 2MST is easier and faster, representing an alternative approach when time and space are limited.
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Affiliation(s)
- Luis A Berlanga
- Department of Physical Activity and Sport, Centro de Estudios Universitarios Cardenal Spínola CEU, Sevilla, Spain; Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Pedro Abdalla
- Study and Research Group in Anthropometry, Training, and Sport (GEPEATE), School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil; Research Center in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), Porto, Portugal
| | - Emília Alves
- Departament of Sport, Higher Institute of Educational Sciences of the Douro, Penafiel, Portugal; Research Center in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), Porto, Portugal
| | - Jorge Mota
- Research Center in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
| | - Lucimere Bohn
- Research Center in Physical Activity, Health, and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
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11
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Kourek C, Karatzanos E, Raidou V, Papazachou O, Philippou A, Nanas S, Dimopoulos S. Effectiveness of high intensity interval training on cardiorespiratory fitness and endothelial function in type 2 diabetes: A systematic review. World J Cardiol 2023; 15:184-199. [PMID: 37124974 PMCID: PMC10130888 DOI: 10.4330/wjc.v15.i4.184] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/22/2023] [Accepted: 03/29/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a chronic metabolic syndrome characterized by insulin resistance and hyperglycemia that may lead to endothelial dysfunction, reduced functional capacity and exercise intolerance. Regular aerobic exercise has been promoted as the most beneficial non-pharmacological treatment of cardiovascular diseases. High intensity interval training (HIIT) seems to be superior than moderate-intensity continuous training (MICT) in cardiovascular diseases by improving brachial artery flow-mediated dilation (FMD) and cardiorespiratory fitness to a greater extent. However, the beneficial effects of HIIT in patients with T2DM still remain under investigation and number of studies is limited. AIM To evaluate the effectiveness of high intensity interval training on cardiorespiratory fitness and endothelial function in patients with T2DM. METHODS We performed a search on PubMed, PEDro and CINAHL databases, selecting papers published between December 2012 and December 2022 and identified published randomized controlled trials (RCTs) in the English language that included community or outpatient exercise training programs in patients with T2DM. RCTs were assessed for methodological rigor and risk of bias via the Physiotherapy Evidence Database (PEDro). The primary outcome was peak VO2 and the secondary outcome was endothelial function assessed either by FMD or other indices of microcirculation. RESULTS Twelve studies were included in our systematic review. The 12 RCTs resulted in 661 participants in total. HIIT was performed in 310 patients (46.8%), MICT to 271 and the rest 80 belonged to the control group. Peak VO2 increased in 10 out of 12 studies after HIIT. Ten studies compared HIIT with other exercise regimens (MICT or strength endurance) and 4 of them demonstrated additional beneficial effects of HIIT over MICT or other exercise regimens. Moreover, 4 studies explored the effects of HIIT on endothelial function and FMD in T2DM patients. In 2 of them, HIIT further improved endothelial function compared to MICT and/or the control group while in the rest 2 studies no differences between HIIT and MICT were observed. CONCLUSION Regular aerobic exercise training has beneficial effects on cardiorespiratory fitness and endothelial function in T2DM patients. HIIT may be superior by improving these parameters to a greater extent than MICT.
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Affiliation(s)
- Christos Kourek
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1 Critical Care Medicine Department, Evangelismos Hospital, Athens 10676, Greece
- Department of Cardiology, 417 Army Share Fund Hospital of Athens, Athens 11521, Greece
| | - Eleftherios Karatzanos
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1 Critical Care Medicine Department, Evangelismos Hospital, Athens 10676, Greece
| | - Vasiliki Raidou
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Ourania Papazachou
- Department of Cardiology, "Helena Venizelou" Hospital, Athens 10676, Greece
| | - Anastassios Philippou
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1 Critical Care Medicine Department, Evangelismos Hospital, Athens 10676, Greece
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Serafim Nanas
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1 Critical Care Medicine Department, Evangelismos Hospital, Athens 10676, Greece
| | - Stavros Dimopoulos
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1 Critical Care Medicine Department, Evangelismos Hospital, Athens 10676, Greece
- Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece.
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12
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Ernstsen L, Zotcheva E, Sui X, Engstrøm M, Martínez-Velilla N, Bjerkeset O, Bjorvatn B, Havnen A. Association Between Cardiorespiratory Fitness and Incident Purchase of Hypnotic Drugs in Adults: The HUNT Study. Mayo Clin Proc 2023; 98:229-238. [PMID: 36244824 DOI: 10.1016/j.mayocp.2022.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To assess whether cardiorespiratory fitness (CRF) is associated with first purchase of a prescribed hypnotic drug in the adult population. METHODS A total of 34,357 adult participants (53.9% women) with a mean age of 51.5 years (SD 15.6 years) from the third Trøndelag Health Study (HUNT) of 2006 to 2008 were observed until January 1, 2018. Cardiorespiratory fitness was estimated from a validated nonexercise algorithm. Data on first hypnotics prescription were obtained through linkage to the National Norwegian Prescription Database. Cox regression with 95% CIs was used to estimate hazard ratios (HRs). RESULTS After 304,899 person-years of follow-up, 5791 participants had their first registered purchase of prescribed hypnotics, corresponding to an incidence rate of 1.90 per 100 person-years. Each 1-metabolic equivalent of task increase in CRF was significantly associated with 5% (HR, 0.95; 95% CI, 0.91 to 0.99; P=.02) and 4% (HR, 0.96; 95% CI, 0.92 to 1.00; P=.046) risk reduction for incident use of hypnotics in men and women, respectively. When CRF was categorized into tertiles with lowest CRF as the reference group, reduced risk was 13% (HR, 0.87; 95% CI, 0.79 to 0.96; P=.006) and 15% (HR, 0.85; 95% CI, 0.77 to 0.95; P=.003) for men in the intermediate and highest CRF category, respectively. In women with highest CRF, the reduced risk was 5% (HR, 0.95; 95% CI, 0.87 to 1.03; P=.22). CONCLUSION Cardiorespiratory fitness in adulthood is associated with incident purchase of prescription medication commonly used for sleep problems. These findings suggest that fitness should be considered a target for preventing sleep problems in adults.
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Affiliation(s)
- Linda Ernstsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway.
| | - Ekaterina Zotcheva
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway; Department of Physical Health and Aging, Norwegian Institute of Public Health, Norway
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Morten Engstrøm
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Norway; Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Norway
| | - Nicolás Martínez-Velilla
- Geriatrics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Ottar Bjerkeset
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway; Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Bjørn Bjorvatn
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology, Norway; Division of Psychiatry, St. Olavs Hospital, Trondheim University Hospital, Norway
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13
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Sánchez-Delgado A, Pérez-Bey A, Izquierdo-Gómez R, Jimenez-Iglesias J, Marcos A, Gómez-Martínez S, Girela-Rejón MJ, Veiga OL, Castro-Piñero J. Fitness, body composition, and metabolic risk scores in children and adolescents: the UP&DOWN study. Eur J Pediatr 2023; 182:669-687. [PMID: 36443504 PMCID: PMC9899179 DOI: 10.1007/s00431-022-04707-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/27/2022] [Accepted: 11/08/2022] [Indexed: 11/30/2022]
Abstract
We aimed to analyse the longitudinal association between physical fitness (PF) and body composition (BC) with a metabolic risk score (Met4) in children and adolescents and to elucidate whether the association between PF and Met4 differs when using relativized or absolute fitness variables. A total of 188 children (86 females) and 195 adolescents (97 females) were included. Cardiorespiratory fitness (CRF) was determined by the 20-m shuttle run test, and muscular fitness (MF) was determined by hand grip and standing long jump tests. Height and weight were measured, and the body mass index (Kg/m2) was calculated. Triceps and subscapular skinfolds were assessed to compute body fat percentage. Met4 was computed from systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and glucose levels. Relative CRF was longitudinally and negatively associated with Met4 in female children (β = -0.031, p = 0.025), while absolute CRF was positively associated with Met4 in male children and adolescents (β = 0.000, p < 0.05). Relative upper and lower-body MF were longitudinally and negatively associated with Met4 in female adolescents (β = -1.347, β = -0.005, p < 0.05), while absolute lower-body MF was positively associated with Met4 in male children (β = 0.000, p = 0.019). BC was longitudinally and positively associated with Met4 in male children (β-ranging from 0.011 to 0.055, all p < 0.05) and male adolescents (β-ranging from 0.011 to 0.046, all p < 0.05). Conclusion: BC is more strongly associated with Met4 than PF in children and adolescents. An optimal body weight status should be considered the main objective of health-promoting programs at childhood and adolescence. Furthermore, the way of expressing the fitness variables determines the direction of the association with Met4. What is Known: • Physical fitness is an important health indicator in children and adolescents, with great amount of previous evidence supporting the preventive role of maintaining optimal levels of both cardiorespiratory and muscular fitness for future cardiometabolic issues. What is New: • The way of reporting physical fitness variables can affect the associations between physical fitness features and cardiometabolic outcomes. Since body composition variables have a great impact on both physical fitness and cardiometabolic health, relativizing physical fitness performance by body composition could lead to erroneous conclusions.
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Affiliation(s)
- Alejandro Sánchez-Delgado
- grid.7759.c0000000103580096GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519 Puerto Real, Cádiz, Spain
| | - Alejandro Pérez-Bey
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519, Puerto Real, Cádiz, Spain. .,Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain.
| | - Rocío Izquierdo-Gómez
- grid.7759.c0000000103580096GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519 Puerto Real, Cádiz, Spain ,grid.512013.4Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - José Jimenez-Iglesias
- grid.7759.c0000000103580096GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519 Puerto Real, Cádiz, Spain ,grid.512013.4Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Ascensión Marcos
- grid.4711.30000 0001 2183 4846Department of Metabolism and Nutrition (DMN) , Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, 28040 Spain
| | - Sonia Gómez-Martínez
- grid.4711.30000 0001 2183 4846Department of Metabolism and Nutrition (DMN) , Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, 28040 Spain
| | - María José Girela-Rejón
- grid.4489.10000000121678994Physical Activity for HEaLth Promotion research group (PA-HELP), Faculty of Education Sciences, Department of Didactic of Corporal Expression, University of Granada, Granada, Spain
| | - Oscar L Veiga
- grid.5515.40000000119578126EstiLIFE Research Group, Department of Physical Education, Sports and Human Movement, Autonomous University of Madrid, Madrid, Spain
| | - José Castro-Piñero
- grid.7759.c0000000103580096GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519 Puerto Real, Cádiz, Spain ,grid.512013.4Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
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Wang J, Mai XM, Sun YQ. Estimated cardiorespiratory fitness in relation to overall, breast and prostate cancer incidence: the Norwegian HUNT study. Ann Epidemiol 2023; 77:103-109. [PMID: 36496149 DOI: 10.1016/j.annepidem.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/17/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE To investigate the relationships between the estimated cardiorespiratory fitness (eCRF) and the incidence of overall, breast, and prostate cancer in a large prospective cohort study. METHODS We included 46,968 cancer-free adults who participated in the second survey of the Trøndelag Health Study in Norway. Sex-specific non-exercise algorithms were used to estimate CRF. eCRF was classified into sex and age-specific tertiles, that is, into low, medium and high levels. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Over a median of 22.1 years' follow-up, there were 7752 overall, 858 breast and 1376 prostate cancer cases. Medium and high levels of eCRF were associated with a reduced incidence of overall cancer in a dose-response manner in all participants (HR 0.96; 95% CI, 0.90-1.01 and HR 0.85; 95% CI, 0.79-0.91, respectively, and P-value for trend <.001). No association was observed between eCRF and breast cancer incidence in women. Only the high level of eCRF seemed to be associated with a reduced incidence of prostate cancer in men (HR 0.85; 95% CI, 0.72-1.02). CONCLUSIONS eCRF may be a practical and cost-effective means of investigating the association between the CRF and cancer incidence.
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Affiliation(s)
- Jin Wang
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China; Department of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Xiao-Mei Mai
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Yi-Qian Sun
- Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pathology, Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim, Norway; Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway.
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15
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van der Schoot GG, Ormel HL, Westerink NDL, May AM, Elias SG, Hummel YM, Lefrandt JD, van der Meer P, van Melle JP, Poppema BJ, Stel JM, van der Velden AW, Vrieling AH, Wempe JB, ten Wolde MG, Nijland M, de Vries EG, Gietema JA, Walenkamp AM. Optimal Timing of a Physical Exercise Intervention to Improve Cardiorespiratory Fitness. JACC CardioOncol 2022; 4:491-503. [DOI: 10.1016/j.jaccao.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/13/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
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16
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Klevjer M, Nordeidet AN, Hansen AF, Madssen E, Wisløff U, Brumpton BM, Bye A. Genome-Wide Association Study Identifies New Genetic Determinants of Cardiorespiratory Fitness: The Trøndelag Health Study. Med Sci Sports Exerc 2022; 54:1534-1545. [PMID: 35482759 DOI: 10.1249/mss.0000000000002951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Low cardiorespiratory fitness (CRF) is a major risk factor for cardiovascular disease (CVD) and a stronger predictor of CVD morbidity and mortality than established risk factors. The genetic component of CRF, quantified as peak oxygen uptake (V̇O 2peak ), is estimated to be ~60%. Unfortunately, current studies on genetic markers for CRF have been limited by small sample sizes and using estimated CRF. To overcome these limitations, we performed a large-scale systematic screening for genetic variants associated with V̇O 2peak . METHODS A genome-wide association study was performed with BOLT-LMM including directly measured V̇O 2peak from 4525 participants in the HUNT3 Fitness study and 14 million single-nucleotide polymorphisms (SNP). For validation, similar analyses were performed in the United Kingdom Biobank (UKB), where CRF was assessed through a submaximal bicycle test, including ~60,000 participants and ~60 million SNP. Functional mapping and annotation of the genome-wide association study results was conducted using FUMA. RESULTS In HUNT, two genome-wide significant SNP associated with V̇O 2peak were identified in the total population, two in males, and 35 in females. Two SNP in the female population showed nominally significant association in the UKB. One of the replicated SNP is located in PIK3R5 , shown to be of importance for cardiac function and CVD. Bioinformatic analyses of the total and male population revealed candidate SNP in PPP3CA , previously associated with CRF. CONCLUSIONS We identified 38 novel SNP associated with V̇O 2peak in HUNT. Two SNP were nominally replicated in UKB. Several interesting genes emerged from the functional analyses, among them one previously reported to be associated with CVD and another with CRF.
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Affiliation(s)
| | - Ada N Nordeidet
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, NORWAY
| | - Ailin F Hansen
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, NORWAY
| | | | | | - Ben M Brumpton
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, NORWAY
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Zhao Y, Sun H, Qie R, Han M, Zhang M, Shi X, Yang Y, Lu J, Hu D, Sun L. Association between cardiorespiratory fitness and risk of all-cause and cause-specific mortality. Eur J Clin Invest 2022; 52:e13770. [PMID: 35294786 DOI: 10.1111/eci.13770] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/17/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The association of cardiorespiratory fitness (CRF) with all-cause and cause-specific mortality remains unclear in Chinese population. This study aimed to evaluate the risk of all-cause, cardiovascular disease (CVD), cancer and other-cause mortality in Chinese adults using estimated CRF (eCRF). PATIENTS AND METHODS We analysed data for 15,566 participants aged ≥20 years recruited in The Rural Chinese Cohort Study during 2007 to 2008 and followed for mortality during 2013 to 2014. eCRF was calculated with sex-specific longitudinal non-exercise algorithms. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality risk according to baseline eCRF. RESULTS During a median of 6.01 years of follow-up, 859 deaths occurred, including 359 from CVD, 221 from cancer, and 279 from other causes. Each 1 metabolic equivalent increment in eCRF was associated with decreased risk of all-cause mortality (men: HR 0.70, 95% CI [0.66-0.74]; women: 0.59, [0.54-0.64]); CVD mortality (men: 0.70 [0.64-0.77]; women: 0.55, [0.48-0.62]); and other-cause mortality (men: 0.68 [0.62-0.75]; women: 0.57, [0.49-0.66]). The area under receiver operating characteristic curve was significantly higher for eCRF than its modifiable components (waist circumference, body mass index and resting heart rate) in predicting all-cause and cause-specific mortality incidence (all p < .001). CONCLUSION eCRF was inversely associated with all-cause, CVD and other-cause mortality.
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Affiliation(s)
- Yang Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Haohang Sun
- Cardiovascular Department, Zhengzhou Yihe Hospital, Zhengzhou, China
| | - Ranran Qie
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Minghui Han
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| | - Xuezhong Shi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yongli Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jie Lu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Dongsheng Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Liang Sun
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, China
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18
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Vainshelboim B, Myers J, Matthews CE. Non-exercise estimated cardiorespiratory fitness and mortality from all-causes, cardiovascular disease, and cancer in the NIH-AARP diet and health study. Eur J Prev Cardiol 2022; 29:599-607. [PMID: 33624091 PMCID: PMC8489355 DOI: 10.1093/eurjpc/zwaa131] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/24/2020] [Accepted: 11/11/2020] [Indexed: 04/23/2024]
Abstract
AIMS Impractical methods and relatively small cohort have limited the applications of non-exercise estimated cardiorespiratory fitness (NEE-CRF). This study aimed to assess the association between a pragmatic NEE-CRF method and mortality outcomes in a large prospective cohort. METHODS AND RESULTS A total of 330 769 participants [men (n = 186 469) and women (n = 144 300)] aged 50-71 years from the NIH-AARP Diet and Health Study were assessed at baseline (1995-96) and prospectively followed until 31 December 2015 (14.9 ± 2.1 years). Non-exercise estimated cardiorespiratory fitness was estimated using pragmatic and previously validated equation, and Cox hazard analysis for mortality was conducted. Non-exercise estimated cardiorespiratory fitness was 9.9 ± 1.5 metabolic equivalents (METs) in men and 7.2 ± 1.6 METs in women. In total, 34 317 men and 20 295 women died during the follow-up. Higher NEE-CRF was associated with lower mortality risk from all-causes, cardiovascular disease, and cancer. Compared to the lowest quartile of NEE-CRF, the hazard ratios and 95% confidence interval for all-cause mortality in the second, third, and fourth quartiles were: 0.82 (0.79-0.84), 0.74 (0.72-0.77), and 0.70 (0.67-0.73) for men, and 0.84 (0.81-0.88), 0.78 (0.75-0.82), and 0.72 (0.68-0.77) for women (P trend <0.001 for all). For each 1-MET increase in NEE-CRF, risks for mortality due to cardiovascular disease and cancer were 0.85 (0.82-0.88) and 0.89 (0.87-0.91) in men, and 0.84 (0.81-0.88) and 0.89 (0.87-0.91) in women, respectively (P < 0.001 for all). CONCLUSION Higher NEE-CRF is independently associated with lower mortality risk in a large prospective cohort of men and women. These results support the utility of the applied NEE-CRF method for risk stratification, prevention, and rehabilitation programs and application in large epidemiological studies.
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Affiliation(s)
- Baruch Vainshelboim
- Cardiology Division, Veterans Affairs Palo Alto Health Care System/ Stanford University, Palo Alto, CA
| | - Jonathan Myers
- Cardiology Division, Veterans Affairs Palo Alto Health Care System/ Stanford University, Palo Alto, CA
| | - Charles E. Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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19
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Smenes BT, Nes BM, Letnes JM, Slagsvold KH, Wisløff U, Wahba A. OUP accepted manuscript. Eur J Cardiothorac Surg 2022; 62:6547722. [PMID: 35278066 PMCID: PMC9422753 DOI: 10.1093/ejcts/ezac126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/27/2022] [Accepted: 02/17/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Benedikte Therese Smenes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Corresponding author. Benedikte Therese Smenes. NTNU, Faculty of Medicine and Health Sciences, Department of Circulation and Medical Imaging, Postbox 8905, 7491 Trondheim, Norway. Tel: (+47) 92666428; e-mail:
| | - Bjarne Martens Nes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Jon Magne Letnes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Clinic of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Norway
- Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Norway
| | - Katrine Hordnes Slagsvold
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Clinic of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
| | - Alexander Wahba
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Clinic of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Norway
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20
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Liff MH, Hoff M, Wisloff U, Videm V. Reduced cardiorespiratory fitness is a mediator of excess all-cause mortality in rheumatoid arthritis: the Trøndelag Health Study. RMD Open 2021; 7:rmdopen-2020-001545. [PMID: 33685930 PMCID: PMC7942264 DOI: 10.1136/rmdopen-2020-001545] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/08/2021] [Accepted: 02/17/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives Investigate if low cardiorespiratory fitness (CRF) was associated with and acted as a mediator of excess all-cause mortality rate in persons suffering from rheumatoid arthritis (RA) compared with the general population. Methods All-cause mortality was analysed using Cox regression modelling in patients with RA (n=348) and controls (n=60 938) who took part in the second (1995–1997) and third (2006–2008) waves of the longitudinal population-based Trøndelag Health Study in Norway. A mediation analysis was performed to investigate if excess relative risk of mortality in RA was mediated by low estimated CRF (eCRF). Results During the follow-up until 31 December 2018 (mean 19.3 years), the mortality rate among patients with RA (n=127, 36.5%) was higher than among controls (n=12 942, 21.2%) (p<0.001). Among controls and patients with RA, 51% and 26%, respectively, had eCRF above the median for their age and sex (p<0.001). The final Cox model included RA status and eCRF, adjusted for hypertension, body mass index, smoking, cholesterol, diabetes and creatinine. eCRF below median for sex and age category was associated with increased mortality (p<0.001). The total excess relative risk of mortality in patients with RA was 28% (95% CI 2% to 55%, p=0.035), in which RA itself contributed 5% and the direct and indirect contributions of low eCRF accounted for 23%. Conclusions Low eCRF was an important mediator of the increased all-cause mortality rate found in RA. Our data indicate that patients with RA should be given advice to perform physical activity that increases CRF, along with optimised treatment with antirheumatic drugs, from the time of diagnosis.
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Affiliation(s)
- Marthe Halsan Liff
- Clinic of Orthopaedics, Rheumatology and Dermatology, St Olavs University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Mari Hoff
- Department of Neuromedicine and Movement Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Department of Rheumatology, St Olavs University Hospital, Trondheim, Norway
| | - Ulrik Wisloff
- Department of Circulation and Medical Imaging, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,School of Human Movement & Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Vibeke Videm
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway .,Department of Immunology and Transfusion Medicine, St Olavs University Hospital, Trondheim, Norway
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21
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Qiu S, Cai X, Sun Z, Wu T, Schumann U. Is estimated cardiorespiratory fitness an effective predictor for cardiovascular and all-cause mortality? A meta-analysis. Atherosclerosis 2021; 330:22-28. [PMID: 34225102 DOI: 10.1016/j.atherosclerosis.2021.06.904] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/17/2021] [Accepted: 06/23/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Estimated cardiorespiratory fitness (eCRF) derived from algorithm correlates well with exercise testing-measured CRF, yet its clinical use for mortality risk stratification has not been systematically evaluated. This meta-analysis with dose-response analysis was conducted to quantify its association with risk of cardiovascular and all-cause mortality. METHODS Electronic databases were searched for prospective cohort studies that investigated the association of eCRF with risk of cardiovascular and all-cause mortality. Study-specific multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) per 1-metabolic equivalent (MET) higher of eCRF were pooled using a random-effects model. RESULTS Twenty-five datasets from 8 cohort studies that enrolled more than 170,000 participants were included. The summary HR per 1-MET higher of eCRF was 0.83 (95% CI 0.80 to 0.86) for cardiovascular mortality (11 datasets) and 0.83 (95% CI 0.78 to 0.88) for all-cause mortality (14 datasets) in the general population. These associations showed no sex-difference and were all linearly shaped (all pnonlinearity ≥ 0.27). The performance of eCRF (assessed by the area under the curve) in discriminating future risk of cardiovascular and all-cause mortality was higher than all its components (such as physical activity, resting heart rate, and body mass index, all p < 0.05), but slightly lower than exercise testing-measured CRF. CONCLUSIONS Higher eCRF was independently associated with lower risk of cardiovascular and all-cause mortality in the general population, indicating that eCRF might hold the potential as an effective and practical risk prediction tool in epidemiological or population research.
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Affiliation(s)
- Shanhu Qiu
- Institute of Diabetes, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China; Department of Endocrinology, Shenzhen People's Hospital (The Second Clinical Medical College of Jinan University; The First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, China
| | - Xue Cai
- Institute of Diabetes, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zilin Sun
- Institute of Diabetes, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China; Department of Endocrinology, Zhongda Hospital, Southeast University, Nanjing, China.
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia
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22
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Langland JT, Sathnur N, Wang Q, Olson APJ. Do assessments of cardiorespiratory and muscular fitness influence subsequent reported physical activity? A randomized controlled trial. BMC Sports Sci Med Rehabil 2021; 13:69. [PMID: 34130756 PMCID: PMC8205209 DOI: 10.1186/s13102-021-00295-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 06/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Regular physical activity and exercise provide many health benefits. These health benefits are mediated in large part through cardiorespiratory fitness and muscular strength. As most individuals have not had an assessment of their personal cardiorespiratory fitness or muscular strength we investigated if measurements of cardiorespiratory fitness and muscular strength would influence an individual's subsequent self-reported exercise and physical activity. METHODS Volunteer subjects at a State Fair were randomized in 1:1 parallel fashion to control and intervention groups. The baseline Exercise Vital Sign (EVS) and type of physical activity were obtained from all subjects. The intervention group received estimated maximum oxygen uptake (VO2max) using a step test and muscular strength using a hand grip dynamometer along with age-specific norms for both measurements. All subjects were provided exercise recommendations. Follow up surveys were conducted at 3, 6 and 12 months regarding their EVS and physical activity. RESULTS One thousand three hundred fifteen individuals (656 intervention, 659 control) were randomized with 1 year follow up data obtained from 823 subjects (62.5%). Baseline mean EVS was 213 min/week. No change in EVS was found in either group at follow-up (p = 0.99). Subjects who were less active at baseline (EVS < 150) did show an increase in EVS (86 to 146) at 6 months (p < 0.05). At 3 months the intervention group increased resistance training (29.1 to 42.8%) compared to controls (26.3 to 31.4%) (p < 0.05). Lifestyle physical activity increased in the intervention group at 3 months (27.7 to 29.1%) and 6 months (25%) whereas it declined in the control group at 3 months (24.4 to 20.1%) and 6 months (18.7%) (p < 0.05). CONCLUSION Providing VO2max estimates and grip strength did not produce an increase in overall physical activity. The EVS and exercise recommendations did however produce an increase in physical activity in less active individuals. In a very active population the VO2max estimate and measured grip strength did increase lifestyle activity and resistance training. Wider adoption of these measures could be effective in promoting physical activity and resistance training. TRIAL REGISTRATION clinicaltrials.gov NCT03518931 Registered 05/08/2018 -retrospectively registered.
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Affiliation(s)
- James T Langland
- Department of Medicine, Division of General Internal Medicine, University of Minnesota, 420 Delaware St SE, MMC 784, Minneapolis, MN, 55455, USA.
| | - Neeraj Sathnur
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Qi Wang
- Clinical/Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - Andrew P J Olson
- Department of Medicine, Division of General Internal Medicine, University of Minnesota, 420 Delaware St SE, MMC 784, Minneapolis, MN, 55455, USA
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23
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Association between type 2 diabetes and non-exercise estimated cardiorespiratory fitness among adults: evidences from a middle-income country. Public Health 2020; 189:110-114. [PMID: 33212348 DOI: 10.1016/j.puhe.2020.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/16/2020] [Accepted: 09/24/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The objective of this study is to assess the association between type 2 diabetes (T2D) and cardiorespiratory fitness (CRF) estimated through a non-exercise model in a large representative group of Brazilian adults. STUDY DESIGN The study design of this study is a cross-sectional population-based study. METHODS The presence of T2D was assessed through self-report in 42,631 individuals aged 20-59 years. The CRF was predicted from a non-exercise equation containing the following data: sex, age, body mass index, and physical activity level. The corresponding metabolic equivalent (MET) value was used to classify participants into the following four groups based on the cutpoints: <6, 6-9, 10-11, and ≥12 METs. Crude and multivariable-adjusted logistic regressions were carried out to determine the association between CRF and the presence of diabetes. RESULTS Significant linear trends were observed in diabetes across different categories of CRF in men. In women, however, linear trends were not observed in T2D across '10-11' and '≥12' categories. A 1-MET increase in estimated CRF was associated with 29% lower odds of diabetes in men and 14% in women after adjusting all the potential confounders (P < 0.001). CONCLUSIONS The presence of T2D was inversely associated with every CRF level in men and with 6-9 METs when comparing with <6 METs in women, through a non-exercise model in Brazilian adults. This finding suggests that a practical, viable, and low-cost measurement of CRF could be applied in lower income countries to assess the relationship between CRF and T2D. However, new non-exercise models are needed to better detect T2D in women.
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24
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Liff MH, Hoff M, Fremo T, Wisløff U, Videm V. An Estimation Model for Cardiorespiratory Fitness in Adults with Rheumatoid Arthritis. Med Sci Sports Exerc 2020; 52:1248-1255. [PMID: 31977641 DOI: 10.1249/mss.0000000000002250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE Cardiopulmonary exercise testing of peak oxygen uptake (V˙O2peak) is the gold standard to measure cardiorespiratory fitness (CRF). For resource-intensive evaluation, equations estimating CRF (eCRF) may be used. The purpose was to investigate if an eCRF equation from a healthy population is useful in persons with rheumatoid arthritis (RA), and if necessary, develop new equations for eCRF in this group. METHODS V˙O2peak results from 93 persons with RA were compared with eCRF calculated by an established equation for healthy individuals including age, sex, physical activity (PA index), resting HR (RHR), and waist circumference. Because of deviation from the observed V˙O2peak, new equations for eCRF in persons with RA were developed from regression analysis of variables associated with observed V˙O2peak. RESULTS The established equation overestimated CRF (R = 0.48, root mean square error [RMSE] = 7.07). The new RA equation more accurately estimated CRF (R = 0.81, RMSE = 4.44) (female = 0, male = 1; never smoked = 0, ever smoked = 1): eCRF = 77.961 + (sex × 28.791) - (age × 0.358) - (age-sex interaction × 0.326) - (body mass index [BMI] × 0.700) - (RHR × 0.125) - (smoking × 1.854) + (PA index × 0.211) - (patient global RA assessment × 0.071). Alternative new RA equation (R = 0.79, RMSE = 4.63): eCRF = 77.851 + (sex × 25.460) - (age × 0.381) - (age-sex interaction × 0.254) - (BMI × 0.743) - (RHR × 0.115) - (smoking × 2.154) + (PA index × 0.209). CONCLUSIONS The new RA equations better predicted CRF in individuals with RA, preventing overestimation in low-fit persons. The new equation should be preferred when estimating CRF in individuals with RA. The alternative equation, without patient global assessment, is useful for individuals with RA in population-based studies.
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Affiliation(s)
| | | | - Thomas Fremo
- Department of Circulation and Medical Imaging, NTNU - Norwegian University of Science and Technology, Trondheim, NORWAY
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25
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Liff MH, Hoff M, Wisløff U, Videm V. Faster age-related decline in cardiorespiratory fitness in rheumatoid arthritis patients: an observational study in the Trøndelag Health Study. Rheumatol Int 2020; 41:369-379. [PMID: 33037488 PMCID: PMC7835174 DOI: 10.1007/s00296-020-04713-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/24/2020] [Indexed: 11/04/2022]
Abstract
Primary aim: Compare change in estimated cardiorespiratory fitness (eCRF change) in rheumatoid arthritis (RA) patients with population-based age- and sex-matched controls during ~ 11-year follow-up and identify variables associated with eCRF change. Secondary aim: Compare eCRF level in RA patients and controls. eCRF change from the second (HUNT2 1995–1997) to the third (HUNT3 2006–2008) surveys of the Norwegian Trøndelag Health Study was compared between RA patients (n = 188) and controls (n = 26,202) attending both surveys. Predictors of eCRF change were identified by Lasso regression followed by multiple linear regression. Mean eCRF level in RA patients (n = 436) and controls (n = 67,910) was compared using age-adjusted linear regression stratified on sex, as well as two-sample t tests including RA patients (n = 432) and controls (n = 59,124) who attended either HUNT2, HUNT3 or both HUNT2 and HUNT3. The mean eCRF decline from HUNT2 to HUNT3 in RA patients was 8.3 mL min−1 kg−1 versus 6.7 mL min−1 kg−1 in controls (p < 0.001). The decline was faster in RA patients and larger with higher baseline age (standardized regression coefficient for RA patients: (− 0.482 × age + 0.044); controls: (− 0.367 × age, p < 0.001). The decline was also associated with smoking, cardiovascular disease, increasing body mass index, asthma, and hypertension. Mean differences in age-adjusted eCRF level for RA patients versus controls (p < 0.001): women HUNT2: − 3.2 mL min−1 kg−1; HUNT3: − 5.0 mL min−1 kg−1; men HUNT2: − 1.8 mL min−1 kg−1; HUNT3: − 4.0 mL min−1 kg−1. Higher age at baseline was associated with faster decline in eCRF. This change was more pronounced in RA patients than controls, indicating a larger negative effect on fitness of aging in RA. RA patients had lower eCRF compared to healthy individuals.
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Affiliation(s)
- Marthe Halsan Liff
- Clinic of Orthopaedics, Rheumatology and Dermatology, St. Olavs University Hospital, Trondheim, Norway.,Department of Rheumatology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.,Department of Clinical and Molecular Medicine, Lab Center 3 East, St. Olavs University Hospital, NTNU-Norwegian University of Science and Technology, 7006, Trondheim, Norway
| | - Mari Hoff
- Department of Neuromedicine and Movement Science, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.,Department of Public Health and Nursing, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.,Department of Rheumatology, St. Olavs University Hospital, Trondheim, Norway
| | - Ulrik Wisløff
- Cardiac Exercise Research Group, Department of Circulation and Medical Imaging, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Vibeke Videm
- Department of Clinical and Molecular Medicine, Lab Center 3 East, St. Olavs University Hospital, NTNU-Norwegian University of Science and Technology, 7006, Trondheim, Norway. .,Department of Immunology and Transfusion Medicine, St. Olavs University Hospital, Trondheim, Norway.
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26
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Nesti L, Pugliese NR, Sciuto P, Natali A. Type 2 diabetes and reduced exercise tolerance: a review of the literature through an integrated physiology approach. Cardiovasc Diabetol 2020; 19:134. [PMID: 32891175 PMCID: PMC7487838 DOI: 10.1186/s12933-020-01109-1] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/29/2020] [Indexed: 12/14/2022] Open
Abstract
The association between type 2 diabetes mellitus (T2DM) and heart failure (HF) is well established. Early in the course of the diabetic disease, some degree of impaired exercise capacity (a powerful marker of health status with prognostic value) can be frequently highlighted in otherwise asymptomatic T2DM subjects. However, the literature is quite heterogeneous, and the underlying pathophysiologic mechanisms are far from clear. Imaging-cardiopulmonary exercise testing (CPET) is a non-invasive, provocative test providing a multi-variable assessment of pulmonary, cardiovascular, muscular, and cellular oxidative systems during exercise, capable of offering unique integrated pathophysiological information. With this review we aimed at defying the cardiorespiratory alterations revealed through imaging-CPET that appear specific of T2DM subjects without overt cardiovascular or pulmonary disease. In synthesis, there is compelling evidence indicating a reduction of peak workload, peak oxygen assumption, oxygen pulse, as well as ventilatory efficiency. On the contrary, evidence remains inconclusive about reduced peripheral oxygen extraction, impaired heart rate adjustment, and lower anaerobic threshold, compared to non-diabetic subjects. Based on the multiparametric evaluation provided by imaging-CPET, a dissection and a hierarchy of the underlying mechanisms can be obtained. Here we propose four possible integrated pathophysiological mechanisms, namely myocardiogenic, myogenic, vasculogenic and neurogenic. While each hypothesis alone can potentially explain the majority of the CPET alterations observed, seemingly different combinations exist in any given subject. Finally, a discussion on the effects -and on the physiological mechanisms-of physical activity and exercise training on oxygen uptake in T2DM subjects is also offered. The understanding of the early alterations in the cardiopulmonary response that are specific of T2DM would allow the early identification of those at a higher risk of developing HF and possibly help to understand the pathophysiological link between T2DM and HF.
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Affiliation(s)
- Lorenzo Nesti
- Metabolism, Nutrition and Atherosclerosis Lab, Dietologia Universitaria, Pisa, Italy. .,Cardiopulmonary Test Lab, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
| | - Nicola Riccardo Pugliese
- Cardiopulmonary Test Lab, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy
| | - Paolo Sciuto
- Metabolism, Nutrition and Atherosclerosis Lab, Dietologia Universitaria, Pisa, Italy
| | - Andrea Natali
- Metabolism, Nutrition and Atherosclerosis Lab, Dietologia Universitaria, Pisa, Italy
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Eslami O, Zarei M, Shidfar F. The association of dietary patterns and cardiorespiratory fitness: A systematic review. Nutr Metab Cardiovasc Dis 2020; 30:1442-1451. [PMID: 32513576 DOI: 10.1016/j.numecd.2020.04.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 12/19/2022]
Abstract
AIMS In comparison to the traditional risk factors of cardiovascular diseases, little is known about the interaction between diet and cardiorespiratory fitness (CRF). The present systematic review aimed to provide comprehensive evidence regarding the relationship between the dietary patterns (DPs) with CRF in both children and adults. DATA SYNTHESIS Databases of PubMed, Scopus, and Web of Science were searched from inception up to December 2019. All observational studies that had extracted DPs using a posteriori and/or a priori methods, as well as had assessed CRF as the outcome, were eligible for inclusion in the review. Eleven studies (1 longitudinal and 10 cross-sectional studies) comprising a total of 198,271 subjects were included. There was considerable heterogeneity between studies in terms of the extracted DPs, their food items as well as the statistical reporting outcomes; which all made comparisons between the studies difficult. Despite some inconsistent results, overall there was a positive association between the DPs that were highly loaded with fruits and vegetables, as well as closer adherence to the high-quality diets particularly the Mediterranean diet, with higher values of CRF. While, an inverse association was found for unhealthy DPs that were generally characterized by a high intake of refined grains, sweets, meats, processed foods, and high-fat dairy products. CONCLUSION Overall, the evidence indicates the high-quality diets that are highlighted in the national dietary guidelines are associated with an optimal CRF. However, these findings should be confirmed by rigorous prospective and interventional studies.
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Affiliation(s)
- Omid Eslami
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahtab Zarei
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Shigdel R, Dalen H, Sui X, Lavie CJ, Wisløff U, Ernstsen L. Cardiorespiratory Fitness and the Risk of First Acute Myocardial Infarction: The HUNT Study. J Am Heart Assoc 2020; 8:e010293. [PMID: 30991880 PMCID: PMC6512140 DOI: 10.1161/jaha.118.010293] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background The majority of studies evaluating cardiorespiratory fitness (CRF) as a cardiovascular risk factor use cardiovascular mortality and not cardiovascular disease events as the primary end point, and generally do not include women. The aim of this study was to investigate the association of estimated CRF (eCRF) with the risk of first acute myocardial infarction (AMI). Methods and Results We included 26 163 participants (51.5% women) from the HUNT study (Nord‐Trøndelag Health Study), with a mean age of 55.7 years, without cardiovascular disease at baseline. Baseline eCRF was grouped into tertiles. AMI was derived from hospital records and deaths from the Norwegian Cause of Death Registry. We used Fine and Gray regression modeling to estimate subdistribution hazards ratio (SHR) of AMI, accounting for competing risk of death. During a mean (range) follow‐up of 13 (0.02–15.40) years (347 462 person‐years), 1566 AMI events were recorded. In fully adjusted models men in the 2 highest eCRF had 4% (SHR: 0.96, 95% CI: 0.83–1.11) and 10% (SHR: 0.90, 95% CI: 0.77–1.05) lower SHR of AMI, respectively, when compared with men in the lowest tertile. The corresponding numbers in women were 12% (SHR: 0.88, 95% CI: 0.72–1.08) and 25% (SHR: 0.75, 95% CI: 0.60–0.95). Conclusions eCRF was inversely associated with risk of AMI event among women but not in men. Our data suggest that high eCRF may have substantial benefit in reducing the risk of AMI. Therefore, our data suggest that an increased focus on eCRF as a cardiovascular disease risk marker in middle‐aged and older adults is warranted.
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Affiliation(s)
- Rajesh Shigdel
- 1 Department of Public Health and Nursing Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Håvard Dalen
- 2 K.G. Jebsen Center for Exercise in Medicine Department of Circulation and Medical Imaging Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway.,3 Clinic of Cardiology St. Olav's University Hospital Trondheim Norway.,4 Department of Medicine Levanger Hospital Nord-Trøndelag Hospital Trust Levanger Norway
| | - Xuemei Sui
- 5 Department of Exercise Science Arnold School of Public Health University of South Carolina Columbia SC
| | - Carl J Lavie
- 6 Department of Cardiovascular Diseases John Ochsner Heart and Vascular Institute Ochsner Clinical School The University of Queensland School of Medicine New Orleans LA
| | - Ulrik Wisløff
- 2 K.G. Jebsen Center for Exercise in Medicine Department of Circulation and Medical Imaging Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway.,7 School of Human Movement & Nutrition Sciences University of Queensland Australia
| | - Linda Ernstsen
- 1 Department of Public Health and Nursing Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway
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Cabanas-Sánchez V, Artero EG, Lavie CJ, Higueras-Fresnillo S, García-Esquinas E, Sadarangani KP, Ortolá R, Rodríguez-Artalejo F, Martínez-Gómez D. Prediction of cardiovascular health by non-exercise estimated cardiorespiratory fitness. Heart 2020; 106:1832-1838. [DOI: 10.1136/heartjnl-2020-316871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022] Open
Abstract
ObjectiveTo estimate the incidence of major biological cardiovascular disease (CVD) risk factors in adults using non-exercise estimated cardiorespiratory fitness (eCRF).Methods200 039 healthy people (99 957 women), aged ≥18 years (38.5±12.1 years) from the Taiwan MJ Cohort. eCRF was estimated with validated algorithms. Biological CVD risk factors, including hypertension (HTN), hypercholesterolemia, atherogenic dyslipidaemia, type 2 diabetes mellitus (T2DM) and systemic inflammation, were assessed by standardised physical examinations and laboratory tests.ResultsIn a basic model, baseline eCRF was inversely associated with the incidence of each CVD risk factor in both men and women (HR per 1 metabolic equivalent (MET) increase in eCRF ranged from 0.53 for T2DM in women to 0.96 for hypercholesterolemia in women). In full adjusted models, the associations were attenuated but remained statistically significant, with the exception of hypercholesterolemia in women. In a subcohort of 116 313 individuals with two repeated exposure measurements, an increase in eCRF was associated in both sexes with a subsequent lower incidence of CVD risk factors (HR per 1-MET increase ranged from 0.58 to 0.91 in models adjusted for age, year of examination and baseline eCRF). Comparisons of predictive performance showed that the addition of eCRF to values of traditional CVD risk factors had relevant improvements in risk discrimination (C-index increased from 0.1% to 3.2%), mainly for HTN and T2DM risk prediction.ConclusionseCRF and its changes predict the incidence of biological CVD risk factors, especially HTN and T2DM. Routine assessment of eCRF in clinical settings is technically feasible and might be useful for CVD prevention.
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Jang WY, Kang DO, Park Y, Lee J, Kim W, Choi JY, Roh SY, Jang Y, Park SH, Kim WS, Na JO, Choi CU, Rha SW, Park CG, Seo HS, Kim EJ. Validation of FRIEND and ACSM Equations for Cardiorespiratory Fitness: Comparison to Direct Measurement in CAD Patients. J Clin Med 2020; 9:jcm9061889. [PMID: 32560313 PMCID: PMC7356312 DOI: 10.3390/jcm9061889] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/29/2020] [Accepted: 06/10/2020] [Indexed: 01/05/2023] Open
Abstract
The regression equation of the American College of Sports Medicine (ACSM) was a preferred method for estimating maximal oxygen consumption (VO2max). Recently, a more precise equation from the fitness registry and the importance of exercise national database (FRIEND) for healthy people was developed. This study compared VO2max estimated by the ACSM and FRIEND equations to VO2max directly measured in coronary artery disease (CAD) patients. Overall, 293 CAD patients who participated in cardiac rehabilitation between June 2015 and December 2018 were analyzed. Directly measured VO2max values were compared to the ACSM and FRIEND equations. The directly measured VO2max was significantly different from the estimated VO2max by ACSM equation (24.16 vs. 28.7 mL/kg/min, p < 0.001), which was overestimated by 20% in men and 16% in women. However, there was no statistically significant difference between the directly measured VO2max and the estimated VO2max by the FRIEND equation. (24.16 vs. 24.15 mL/kg/min, p = 0.986). In CAD patients, the estimated VO2max from the ACSM equation was significantly higher than the directly measured VO2max. In addition, estimated cardiorespiratory fitness (CRF) by the FRIEND equation showed similar results with directly measured CRF. As a result, the FRIEND equation can predict CRF more accurately than the ACSM.
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Affiliation(s)
- Won Young Jang
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Catholic University of Korea St. Vincent Hospital, The Catholic University of Korea College of Medicine, Suwon 16247, Korea;
| | - Dong Oh Kang
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Yoonjee Park
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Jieun Lee
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Woohyeun Kim
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Jah Yeon Choi
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Seung-Young Roh
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Yuna Jang
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Se-Hyun Park
- Sport Science Center, Korea University Guro Hospital, Seoul 08308, Korea;
| | - Woo-Sub Kim
- Department of rehabilitation, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea;
| | - Jin Oh Na
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Cheol Ung Choi
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Seung-Woon Rha
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Chang Gyu Park
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Hong Seog Seo
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
| | - Eung Ju Kim
- Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (D.O.K.); (J.L.); (W.K.); (J.Y.C.); (S.-Y.R.); (Y.J.); (J.O.N.); (C.U.C.); (S.-W.R.); (C.G.P.); (H.S.S.)
- Correspondence: ; Tel.: +82-2-2626-3022
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Fardman A, Banschick GD, Rabia R, Percik R, Segev S, Klempfner R, Grossman E, Maor E. Cardiorespiratory Fitness Is an Independent Predictor of Cardiovascular Morbidity and Mortality and Improves Accuracy of Prediction Models. Can J Cardiol 2020; 37:241-250. [PMID: 32428619 DOI: 10.1016/j.cjca.2020.05.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Although cardiorespiratory fitness (CRF) is a strong independent predictor of adverse cardiovascular outcomes, it is not considered as a risk enhancer by current guidelines. METHODS We evaluated asymptomatic self-referred adults aged 40 to 79 years of age, free of cardiovascular disease at baseline, who were screened annually and completed baseline exercise stress test. Baseline CRF was dichotomized into 2 groups: low (metabolic equivalents < 8) and high. The primary endpoint was the composite of death, nonfatal acute coronary syndrome, and stroke after excluding subjects diagnosed with metastatic cancer during follow-up. RESULTS Study population included 15,445 subjects with median age of 49 years (interquartile range: 44-55). During median follow-up of 8 years 1362 (9%) subjects developed the study endpoint. Kaplan-Meier survival analysis showed that both fitness and atherosclerotic cardiovascular disease (ASCVD) were associated with developing of the study endpoint (P < 0.001 for both). Cox regression model with adjustment for ASCVD risk consistently showed that lower fitness was associated with a significant 23% higher risk to develop the study endpoint (P = 0.001). Continuous net reclassification improvement analysis showed an overall improvement of 11.4% (95% confidence interval, 8%-14.6%; P value < 0.001) in the accuracy of classification when fitness was added to the ASCVD model. CONCLUSIONS Low CRF is a strong independent predictor of the cardiovascular morbidity and mortality in asymptomatic adults. Addition of fitness to the pooled cohort ASCVD risk significantly improves the accuracy of the model.
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Affiliation(s)
- Alexander Fardman
- Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Razi Rabia
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ruth Percik
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Institute of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Shlomo Segev
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Institute for Medical Screening, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Robert Klempfner
- Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Institute for Medical Screening, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Ehud Grossman
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Elad Maor
- Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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Perez-Bey A, Ruiz JR, Ortega FB, Martinez-Gomez D, Mota J, Veiga OL, Lavie CJ, Castro-Piñero J. Bidirectional associations between fitness and fatness in youth: A longitudinal study. Scand J Med Sci Sports 2020; 30:1483-1496. [PMID: 32297361 DOI: 10.1111/sms.13684] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/26/2020] [Accepted: 03/31/2020] [Indexed: 01/08/2023]
Abstract
The aim was to examine the bidirectional association between cardiorespiratory fitness (CRF) and fatness in a 2-year longitudinal study conducted in young people. A total of 1082 children (512 females) and 727 adolescents (342 females) with complete data at baseline and follow-up were included. CRF was determined by the 20-m shuttle run test. Height and weight were measured, and body mass index and fat mass index (kg/m2 ) were calculated. Triceps and subscapular skinfolds were assessed to compute body fat percentage. Bidirectionality was tested by including CRF and each fatness index as exposures and outcomes, alternatively, in different regression models. CRF was prospectively associated with fatness index levels (ß from -0.186 to -0.528; P < .001), remaining significant in children after adjusting for baseline fatness indices. Fatness indices were prospectively associated with CRF (ß from -0.207 to -0.479; P < .001), with no substantial changes observed in children and female adolescents when baseline CRF was considered. Changes in CRF were prospectively associated with several fatness indices, regardless of body fatness at baseline (ß from -0.062 to -0.220; P < .05). Body fatness changes were associated with future CRF levels, independently of baseline CRF, especially in children of both sexes and male adolescents (ß from -0.079 to -0.260; P < .05). Overall, a bidirectional association was observed between CRF and fatness in children and adolescents. The attainment of optimal CRF and fatness levels in early ages should be promoted since it could result in favorable future fatness and CRF levels, respectively, which are two key determinants of health status.
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Affiliation(s)
- Alejandro Perez-Bey
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Cádiz, Spain
| | - Jonatan R Ruiz
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Francisco B Ortega
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - David Martinez-Gomez
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Jorge Mota
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports at Porto University, Porto, Portugal
| | - Oscar L Veiga
- Department of Physical Education, Sports and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Madrid, Spain
| | - Carl J Lavie
- Department of Cardiovascular Medicine, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana
| | - José Castro-Piñero
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Cádiz, Spain
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Affiliation(s)
- Meagan M Wasfy
- 1 Cardiovascular Performance Program Massachusetts General Hospital Boston MA
| | - Aaron L Baggish
- 1 Cardiovascular Performance Program Massachusetts General Hospital Boston MA
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Peterman JE, Arena R, Myers J, Marzolini S, Ross R, Lavie CJ, Wisløff U, Stensvold D, Kaminsky LA. Development of Global Reference Standards for Directly Measured Cardiorespiratory Fitness: A Report From the Fitness Registry and Importance of Exercise National Database (FRIEND). Mayo Clin Proc 2020; 95:255-264. [PMID: 31883698 DOI: 10.1016/j.mayocp.2019.06.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/06/2019] [Accepted: 06/12/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To begin the process of developing global reference standards for adults from directly measured cardiorespiratory fitness (CRF). METHODS Percentiles of maximal oxygen consumption (VO2max) for men and women were determined for each decade from 20 through 79 years of age using International data from the Fitness Registry and Importance of Exercise: A National Database (FRIEND-I) along with previously published data from seven studies. FRIEND-I data from January 1, 2014, through January 1, 2019, included 11,678 maximal treadmill tests from three countries, whereas the previously published reports included 32,329 maximal treadmill tests from six countries. RESULTS FRIEND-I data revealed significant differences between sex and age groups for VO2max (P<0.01). For the 20- to 29-years of age group, the 50th percentile VO2max in men and women were 49.5 mLO2⋅kg-1⋅min-1 and 40.6 mLO2⋅kg-1⋅min-1, respectively. VO2max declined an average of 9% per decade with the 50th percentile for the 70- to 79-years of age group having a VO2max of 30.8 mLO2⋅kg-1⋅min-1 in men and 25.0 mLO2⋅kg-1⋅min-1 in women. These results were similar in magnitude and direction to the previously published literature. Within both the FRIEND-I and previously published data there were CRF differences between countries. CONCLUSION This report begins to establish global reference standards for CRF. Continued development of FRIEND-I will increase global representation providing an improved ability to identify and stratify CRF risk categories.
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Affiliation(s)
- James E Peterman
- Fisher Institute of Health and Well-Being, Ball State University, Muncie, IN
| | - Ross Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Science, University of Illinois, Chicago, IL
| | - Jonathan Myers
- Division of Cardiology, Veterans Affairs Palo Alto Healthcare System and Stanford University, CA
| | - Susan Marzolini
- KITE, Toronto Rehab-University Health Network, Ontario, Canada
| | - Robert Ross
- School of Medicine, Department of Endocrinology and Metabolism, Faculty of Health Sciences, Queens University, Kingston, Ontario, Canada
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dorthe Stensvold
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Leonard A Kaminsky
- Fisher Institute of Health and Well-Being, Ball State University, Muncie, IN.
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35
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Affiliation(s)
- Qiwei Fan
- From the Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China (Q.F., J.J.)
| | - Jie Jia
- From the Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China (Q.F., J.J.)
- School of Life and Environmental Sciences, University of Sydney, Australia (J.J.)
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36
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Evensen LH, Isaksen T, Braekkan SK, Hansen JB. Cardiorespiratory fitness and future risk of venous thromboembolism. J Thromb Haemost 2019; 17:2160-2168. [PMID: 31448518 DOI: 10.1111/jth.14619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 08/20/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) is a strong predictor of future arterial cardiovascular disease and premature mortality. However, there are limited data on the association between CRF and the risk of incident venous thromboembolism (VTE). OBJECTIVES To investigate whether estimated CRF (eCRF) was associated with the risk of incident VTE in a cohort recruited from the general population. METHODS Participants (n = 10 393) from the sixth survey of the Tromsø Study (2007-08) were included, and incident VTEs were recorded up to 31 December 2016. CRF was estimated in sex-specific algorithms based on age, waist circumference, resting heart rate, and self-reported physical activity. Hazard ratios (HRs) with 95% confidence intervals (CIs) of VTE according to categories of eCRF were estimated in Cox regression models adjusted for sex with age as timescale. The impact of weight status was evaluated in analyses stratified by weight category. RESULTS There were 176 incident VTEs during follow-up. Compared with individuals with eCRF < 85% of age-predicted, those with eCRF of 85% to 100% and >100% of age-predicted had 46% (HR 0.54; 95% CI 0.39-0.77) and 67% (HR 0.33; 95% CI 0.20-0.54) lower VTE risk, respectively. Compared with overweight/obese individuals with eCRF < 85% of age-predicted, overweight/obese individuals with eCRF ≥ 85% had 50% (HR 0.50, 95% CI 0.35-0.74) lower risk, and normal weight individuals with eCRF ≥ 85% had 55% (HR 0.45, 95% CI 0.30-0.68) lower risk. CONCLUSIONS Higher eCRF was associated with lower risk of incident VTE. The association was independent of weight categories, suggesting that higher eCRF may modify the association between obesity and VTE.
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Affiliation(s)
- Line H Evensen
- K. G. Jebsen - Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trond Isaksen
- K. G. Jebsen - Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Sigrid K Braekkan
- K. G. Jebsen - Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - John-Bjarne Hansen
- K. G. Jebsen - Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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Abstract
More than 30% of U.S. adults are obese or overweight. A program of regular physical activity is recommended as part of an effective lifestyle intervention for weight loss and weight management. However, more than 40% of adults do not engage in sufficient physical activity to realize these beneficial effects on body weight. Physicians may encounter many barriers to counseling physical activity, such as lack of knowledge or self-efficacy for counseling patients about physical activity. Obese individuals may be reluctant to exercise because of weight stigma, physique anxiety, and other factors; therefore, referral to a weight management specialist or clinical exercise physiologist can be helpful in facilitating exercise and assisting in achieving a clinically meaningful weight loss. Exercise has many benefits on physical and mental health and well-being that go well beyond weight loss, and it is for these reasons that exercise is particularly important for overweight and obese individuals.
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Affiliation(s)
- Carol Ewing Garber
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
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Silva DR, Werneck AO, Collings PJ, Fernandes RA, Barbosa DS, Ronque ERV, Sardinha LB, Cyrino ES. Physical activity maintenance and metabolic risk in adolescents. J Public Health (Oxf) 2019; 40:493-500. [PMID: 28927241 DOI: 10.1093/pubmed/fdx077] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 06/14/2017] [Indexed: 11/13/2022] Open
Abstract
Aim Examine the association between child and adolescent physical activity maintenance categories and metabolic profile in adolescence. Methods This cross-sectional study was conducted with 1152 adolescents (57.4% female) aged 10-16 years from Londrina, Brazil. Physical activity was self-reported in childhood (7-10 years old, retrospective data) and adolescence through questionnaires. Cardiorespiratory fitness (20 m shuttle-run test), body fat (skinfolds), waist circumference, blood pressure (automatic instrument) and blood variables (fasting glucose, HDL-cholesterol and triglycerides) were measured at adolescence. Results Frequency of physical activity in childhood and adolescence was 50.3 and 17.2%, respectively, and only 25.7% of boys and 10.9% of girls were active at both ages. Adolescents who were physically active in childhood alone were less likely [OR = 0.71 (95% CI: 0.52-0.97)] to present low cardiorespiratory fitness in adolescence compared to those who were non-active in childhood. Regardless of controlled, actives in childhood and adolescence were less likely to present low cardiorespiratory fitness [OR = 0.50 (95% CI: 0.34-0.73)], high blood pressure [OR = 0.52 (95% CI: 0.32-0.85)] and high metabolic risk score [OR = 0.44 (95% CI: 0.22-0.90)] compared to the non-actives at both ages. Conclusions Actives through childhood to adolescence are less likely to present low cardiorespiratory fitness, high blood pressure and high metabolic risk.
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Affiliation(s)
- Danilo R Silva
- Department of Physical Education, Federal University of Sergipe-São Cristóvão, Sergipe, Brazil.,Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE), State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - André O Werneck
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE), State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - Paul J Collings
- Bradford Institute for Health Research, Bradford NHS Foundation Trust, Bradford, UK
| | - Rômulo A Fernandes
- Scientific Research Group Related to Physical Activity (GICRAF), Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Décio S Barbosa
- Department of Pathology, Clinical and Toxicological Analysis, Center of Health Sciences, University Hospital, State University of Londrina-UEL, Londrina, Brazil
| | - Enio R V Ronque
- Department of Physical Education, Federal University of Sergipe-São Cristóvão, Sergipe, Brazil
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - Edilson S Cyrino
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE), State University of Londrina (UEL), Londrina, Paraná, Brazil
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Kandola A, Ashdown-Franks G, Stubbs B, Osborn DPJ, Hayes JF. The association between cardiorespiratory fitness and the incidence of common mental health disorders: A systematic review and meta-analysis. J Affect Disord 2019; 257:748-757. [PMID: 31398589 PMCID: PMC6997883 DOI: 10.1016/j.jad.2019.07.088] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Physical activity is associated with a lower incidence of common mental health disorder, but less is known about the impact of cardiorespiratory fitness (CRF). METHODS In this review, we systematically evaluated the relationship between CRF and the incidence of common mental health disorders in prospective cohort studies. We systematically searched six major electronic databases from inception to 23rd of May 2019. We assessed study quality using the Newcastle-Ottawa scale. RESULTS We were able to pool the hazard ratios (HRs) and 95% confidence intervals (CIs) of four studies including at least 27,733,154 person-years of data. We found that low CRF (HR = 1.47, [95% CI 1.23 - 1.76] p < 0.001 I2 = 85.1) and medium CRF (HR = 1.23, [95% CI 1.09 - 1.38] p < 0.001 I2 = 87.20) CRF are associated with a 47% and 23% greater risk of a common mental health disorders respectively, compared with high CRF. We found evidence to suggest a dose-response relationship between CRF and the risk of common mental health disorders. LIMITATIONS We were only able to identify a small number of eligible studies from our search and heterogeneity was substantial in the subsequent meta-analysis. CONCLUSIONS Our findings indicate that there is a longitudinal association between CRF levels and the risk of a common mental health disorder. CRF levels could be useful for identifying and preventing common mental health disorders at a population-level.
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Affiliation(s)
- A Kandola
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7BN, UK.
| | - G Ashdown-Franks
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK; Department of Exercise Sciences, University of Toronto, 27 King's College Circle, Toronto, Ontario, ON M5S, Canada
| | - B Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK; Physiotherapy Department, South London and Maudsley National Health Services Foundation Trust, London, SE5 8AZ, UK
| | - D P J Osborn
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7BN, UK
| | - J F Hayes
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7BN, UK
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Jalene S, Pharr J, Shan G, Poston B. Estimated Cardiorespiratory Fitness Is Associated With Reported Depression in College Students. Front Physiol 2019; 10:1191. [PMID: 31620016 PMCID: PMC6759774 DOI: 10.3389/fphys.2019.01191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 09/03/2019] [Indexed: 01/05/2023] Open
Abstract
Depression is a serious but treatable health issue that affects college students at an alarming rate. Improved cardiorespiratory fitness (CRF) decreases depression risk and severity but this relationship has not been fully evaluated in the college student population. Non-exercise estimated CRF (eCRF) could be used to identify students at risk for or suffering from depression. This study investigated the associations of depression and eCRF in college students. Participants (N = 437) completed a survey which included demographic and student-status questions, eCRF variables, and a validated depression instrument. Descriptive, chi-square, t-test, regression, and odds ratio analyses were employed. Depression was associated with low-fitness (X 2 = 4.660, P = 0.031) and eCRF below age-predicted CRF (t = 3.28, P < 0.001). Predictors of increased depression included low-fitness, sexual orientation, current depression treatment, and GPA (R 2 = 0.145-0.159; Adj R 2 = 0.135-0.149). Odd ratio analyses determined that low-fitness increased the risk of reporting depression (β = 2.39, P = 0.017, 95% CI = 1.17-4.872) which remained significant when adjusted (β = 2.478, P = 0.017, 95% CI = 1.175-5.229). Adjusted odds ratio analyses also indicated increased risk of reporting depression for those in a sexual minority (β = 2.582, P = 0.001, 95% CI = 1.44,4.629) and undergoing current depression treatment (β = 2.393, P < 0.001, 95% CI = 2.393-13.043). High levels of fitness did not reduce the odds of reporting depression compared to age predicted CRF. A simple eCRF algorithm can be used to identify college student depression.
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Affiliation(s)
- Sharon Jalene
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Jennifer Pharr
- Department of Environmental and Occupational Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Guogen Shan
- Department of Environmental and Occupational Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Brach Poston
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, Las Vegas, NV, United States
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Winett RA, Ogletree AM. Evidence-Based, High-Intensity Exercise and Physical Activity for Compressing Morbidity in Older Adults: A Narrative Review. Innov Aging 2019; 3:igz020. [PMID: 31380470 PMCID: PMC6658199 DOI: 10.1093/geroni/igz020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Indexed: 12/12/2022] Open
Abstract
Recent research in exercise science has important applications for middle-aged and older adults and points to how the programming of individual and multicomponent interventions including theory-based health behavior change strategies may be improved to compress morbidity by delaying or reducing the disabling process. High-intensity interval training and sprint interval training until recently were seen as only applicable to athletes. But recent lab-based research has adapted these interventions for even older adults and demonstrated their safety with beneficial outcomes on cardiometabolic risk factors comparable to or surpassing the usual lower- to moderate-intensity endurance training, and their potential translatability by showing the efficacy of much lower duration and frequency of training, even by systematic stair climbing. Moreover, people report positive affect while engaged in such training. For a century, resistance training was conceived as weightlifting with heavy weights required. Recent research has shown that using a higher degree of effort with lighter to moderate resistance in simple, time efficient protocols result in gains in strength and muscle mass similar to heavy resistance, as well as improvement of cardiometabolic risk factors, strength, body composition, and cognitive, affective, and functional abilities. More effort-based resistance training with moderate resistance may make resistance training more appealing and accessible to older adults. A key potential translational finding is that with correct technique and a high degree of effort, training with inexpensive, portable elastic bands, useable virtually anywhere, can provide appreciable benefits. More emphasis should be placed on long-term, translational interventions, resources, and programs that integrate interval and resistance trainings. This work may improve public health programs for middle-aged and older adults and reflects an emerging evidence base.
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Affiliation(s)
| | - Aaron M Ogletree
- Health Research and Evaluation, American Institutes for Research, Washington, District of Columbia
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GARNVIK LARSE, MALMO VEGARD, JANSZKY IMRE, WISLØFF ULRIK, LOENNECHEN JANP, NES BJARNEM. Estimated Cardiorespiratory Fitness and Risk of Atrial Fibrillation: The Nord-Trøndelag Health Study. Med Sci Sports Exerc 2019; 51:2491-2497. [DOI: 10.1249/mss.0000000000002074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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An Overview of Non-exercise Estimated Cardiorespiratory Fitness: Estimation Equations, Cross-Validation and Application. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s42978-019-0003-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mcleod JC, Stokes T, Phillips SM. Resistance Exercise Training as a Primary Countermeasure to Age-Related Chronic Disease. Front Physiol 2019; 10:645. [PMID: 31244666 PMCID: PMC6563593 DOI: 10.3389/fphys.2019.00645] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/07/2019] [Indexed: 12/20/2022] Open
Abstract
Age is a primary risk factor for a number of chronic diseases including mobility disability, cardiovascular disease (CVD), type 2 diabetes (T2D), and cancer. Most physical activity guidelines emphasize the performance of 150 min of moderate-to-vigorous or 75 min of vigorous aerobic exercise training (AET) weekly for reduction of chronic disease risk. Nonetheless, there is an emerging body of evidence showing that resistance exercise training (RET) appears to be as effective as AET in reducing risk of several chronic diseases. It may also be that RET is more effective than AET in some regards; the converse is likely also true. We posit that the perceived divergent exercise mode-dependent health benefits of AET and RET are likely small in most cases. In this short review, our aim is to examine evidence of associations between the performance of RET and chronic health disease risk (mobility disability, T2D, CVD, cancer). We also postulate on how RET may be influencing chronic disease risk and how it is a critical component for healthy aging. Accumulating evidence points to RET as a potent and robust preventive strategy against a number of chronic diseases traditionally associated with the performance of AET, but evidence favors RET as a potent countermeasure against declines in mobility. On the basis of this review we propose that the promotion of RET should assume a more prominent position in exercise guidelines particularly for older persons.
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Affiliation(s)
- Jonathan C Mcleod
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Tanner Stokes
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Shigdel R, Stubbs B, Sui X, Ernstsen L. Cross-sectional and longitudinal association of non-exercise estimated cardiorespiratory fitness with depression and anxiety in the general population: The HUNT study. J Affect Disord 2019; 252:122-129. [PMID: 30981055 DOI: 10.1016/j.jad.2019.04.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/19/2019] [Accepted: 04/06/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cardiorespiratory fitness may help to prevent depression and anxiety. A paucity of literature has considered the relationship between cardiorespiratory fitness (CRF) and the incidence of depression and anxiety. The objective of this study was to investigate cross-sectional and longitudinal associations of estimated cardiorespiratory fitness (CRF) with depression and anxiety. METHODS This study included middle-aged and older participants from the second (HUNT 2, 1995-1997) and third (HUNT3, 2006-2008) survery of the Nord-Trøndelag Health Study (HUNT). Baseline non-exercise estimated CRF (eCRF) was determined using standardized algorithms. Depression and anxiety were measured using the Hospital Anxiety and Depression Scale. Logistic regression models were used to evaluate the cross-sectional and longitudinal associations between eCRF and depression and anxiety. RESULTS In cross-sectional adjusted analysis including those who participated in HUNT2 (n = 26,615 mean age 55.7 years), those with medium and high level of eCRF had 21% (OR, 0.79; 95% CI, 0.71-0.89) and 26% (OR, 0.74; 95% CI, 0.66-0.83) lower odds of depression compared to those with low eCRF level, respectively. Longitudinal analysis including those who participated in both HUNT2 and HUNT3 (n = 14,020 mean age 52.2 years) found that medium and level of eCRF was associated with 22% (OR, 0.78; 95% CI, 0.64-0.96) and 19% (OR, 0.81; 95% CI, 0.66-0.99) lower odds of depression compared to those with low eCRF level, respectively. CRF was not associated with anxiety, either cross-sectionally or longitudinally. CONCLUSION Our data suggest that a medium and high level of eCRF during late middle age is cross-sectionally and prospectively associated with lower odds of depression. However, our data do not support that eCRF is associated with anxiety. Further studies are warranted to conclude a causal relationship between eCRF and depression.
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Affiliation(s)
- Rajesh Shigdel
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, King`s College London, De Crespigny Park, London, United Kingdom
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Linda Ernstsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Werneck AO, Silva DR, Agostinete RR, Fernandes RA, Valente-Dos-Santos J, Coelho-E-Silva MJ, Ronque ERV. TRACKING OF CARDIORESPIRATORY FITNESS FROM CHILDHOOD TO EARLY ADOLESCENCE: MODERATION EFFECT OF SOMATIC MATURATION. ACTA ACUST UNITED AC 2019; 37:338-344. [PMID: 31090851 PMCID: PMC6868555 DOI: 10.1590/1984-0462/;2019;37;3;00015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/15/2018] [Indexed: 08/17/2023]
Abstract
Objective: To evaluate cardiorespiratory fitness’ tracking from childhood to
adolescence, as well as to test the moderation role of somatic
maturation. Methods: Our sample was composed by 375 children (197 boys), with a baseline age
between 7 and 10 years old. The children were followed-up over three years.
Body mass and stature were measured as anthropometric indicators and were
used to estimate maturity status through Moore’s method. Cardiorespiratory
fitness was evaluated through 9-minute running test. Body adiposity was
estimated through the subcutaneous skinfold method, with measures of triceps
and subscapular skinfolds and used as a covariate. Sample was categorized
into tertiles. Thereafter, the Kappa (k) coefficient and
Lin’s concordance correlation coefficient (LCCC) tests were adopted to
verify stability. Dummy variable in regression was used to test moderation
effects. All analyses were conducted in Stata 14.0, adopting p<0.05. Results: Cardiorespiratory fitness presented a moderate to low tracking from
childhood to adolescence (k=0.294; LCCC=0.458). Moreover, maturity status
significantly moderated the association between cardiorespiratory fitness at
childhood and adolescence (regardless of cohort and body adiposity) among
boys (β=0.644; p=0.003) and role sample (β=0.184; p=0.020), but not girls
(-0.217; p=0.413). Conclusions: Tracking of cardiorespiratory fitness from childhood to adolescence is
moderate to low in both sexes. Moreover, maturity status moderated the
relationship between cardiorespiratory fitness at baseline and in
adolescence. A lower age at peak height velocity was associated to a greater
cardiorespiratory fitness.
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Elevated liver enzymes and cardiovascular mortality: a systematic review and dose-response meta-analysis of more than one million participants. Eur J Gastroenterol Hepatol 2019; 31:555-562. [PMID: 30614883 DOI: 10.1097/meg.0000000000001353] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Gamma glutamyl transferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) are commonly used liver function markers. We performed a dose-response meta-analysis to investigate the association between liver enzymes and cardiovascular disease (CVD) mortality in prospective cohort studies. We conducted a systematic search up to April 2018 in Medline/PubMed, Scopus, Cochrane, and Embase databases. Combined hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using a random-effects model as described by DerSimonian and Laird. Dose-response analysis was also carried out. Twenty-three studies with 1 067 922 participants reported association between GGT and CVD mortality and were included in our analysis. Pooled results showed a significant association between GGT and risk of CVD mortality (HR: 1.62; 95% CI: 1.47-1.78, P=0.001, P-heterogeneity=0.001) and it was HR: 0.87; 95% CI: 0.73-1.07; P=0.221, P-heterogeneity=0.028, for ALT. There was a direct association between baseline levels of ALP and AST/ALT ratio with CVD mortality (HR: 1.45; 95% CI: 1.11-1.89; P=0.005, P-heterogeneity=0.026, and HR: 2.20; 95% CI: 1.60-3.04; P=0.001, P-heterogeneity=0.540, respectively). Pooled results did not show any significant association between AST and the risk of CVD mortality (HR: 1.20; 95% CI: 0.83-1.73; P=0.313, P-heterogeneity=0.024). Moreover, there was a significant nonlinear association between GGT and ALP levels and the risk of CVD mortality (P=0.008 and 0.016, respectively). Our dose-response meta-analysis revealed a direct relationship between GGT and ALP levels and the risk of CVD mortality. High levels of GGT, ALP and AST/ALT were associated with an increased CVD mortality rate.
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Werneck AO, Conde J, Coelho-e-Silva MJ, Pereira A, Costa DC, Martinho D, Duarte JP, Valente-dos-Santos J, Fernandes RA, Batista MB, Ohara D, Cyrino ES, Ronque ERV. Allometric scaling of aerobic fitness outputs in school-aged pubertal girls. BMC Pediatr 2019; 19:96. [PMID: 30961568 PMCID: PMC6452511 DOI: 10.1186/s12887-019-1462-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 03/19/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to determine the allometric exponents for concurrent size descriptors (stature, body mass and fat-free mass) and also to examine the contribution of chronological age and pubertal status combined with above mentioned size descriptors to explain inter-individual variability in the peak of oxygen uptake (VO2peak) among girls during circumpubertal years. METHODS The final sample included 51 girls (10.7-13.5 years). VO2peak was derived from an incremental progressive maximal protocol using a motorized treadmill. Anthropometry included body mass, stature and skinfolds. Measurements were performed by a single trained observer. Sexual maturation was assessed as self-reported stage of pubic hair (PH) development. Static allometric models were explored as an alternative to physiological output per unit of size descriptors. Allometry also considered chronological age and sexual maturation as dummy variable (PH2 vs. PH3 and PH3 vs. PH4). RESULTS Scaling coefficients for stature, body mass and fat-free mass were 1.463 (95%CI: 0.476 to 2.449), 0.516 (95%CI: 0.367 to 0.666) and 0.723 (95%CI: 0.494 to 0.951), respectively. The inclusion of sexual maturation increased explained variance for VO2peak (55% for PH2 vs. PH3 and 47% for PH3 vs. PH4). Body mass was identified as the most prominent body size descriptor in the PH2 vs. PH3 while fat-free mass was the most relevant predictor combined with PH3 vs. PH4. CONCLUSIONS Body mass and fat-free mass seemed to establish a non-linear relationship with VO2peak. Across puberty, inter-individual variability in VO2peak is explained by sexual maturation combined with whole body during early puberty and by sexual maturation and fat-free mass during late puberty. Additional studies need to confirm ontogenetic allometric models during years of maximal growth.
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Affiliation(s)
- André O. Werneck
- Study and Research Group in Physical Activity and Exercise (GEPAFE), State University of Londrina (UEL), Londrina, Paraná Brazil
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE), State University of Londrina (UEL), Londrina, Paraná Brazil
- Scientific Research Group Related to Physical Activity (GICRAF), Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, São Paulo State University, Presidente Prudente, São Paulo Brazil
| | - Jorge Conde
- School of Health and Technology, Polytechnic Institute of Coimbra, Coimbra, Portugal
| | - Manuel J. Coelho-e-Silva
- CIDAF (uid/dtp/04213/2019), University of Coimbra, Coimbra, Portugal
- Faculty of Sports Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Universidade de Coimbra, Estadio Universitario, Pavilhao III, 3040-156 Coimbra, Portugal
| | - Artur Pereira
- Faculty of Sports Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Daniela C. Costa
- CIDAF (uid/dtp/04213/2019), University of Coimbra, Coimbra, Portugal
- Faculty of Sports Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Portuguese Foundation for Science and Technology (SFRF/BD/136193/2018), Lisbon, Portugal
| | - Diogo Martinho
- CIDAF (uid/dtp/04213/2019), University of Coimbra, Coimbra, Portugal
- Faculty of Sports Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Portuguese Foundation for Science and Technology (SFRH/BD/121441/2016), Lisbon, Portugal
| | - João P. Duarte
- CIDAF (uid/dtp/04213/2019), University of Coimbra, Coimbra, Portugal
- Portuguese Foundation for Science and Technology (SFRH/BD/101083/2014), Lisbon, Portugal
| | - João Valente-dos-Santos
- CIDAF (uid/dtp/04213/2019), University of Coimbra, Coimbra, Portugal
- Portuguese Foundation for Science and Technology (SFRH/BPD/100470/2014), Lisbon, Portugal
- Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Faculty of Physical Education and Sport, Lusófona University of Humanities and Technologies, Lisbon, Portugal
| | - Rômulo A. Fernandes
- Scientific Research Group Related to Physical Activity (GICRAF), Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, São Paulo State University, Presidente Prudente, São Paulo Brazil
| | - Mariana B. Batista
- Study and Research Group in Physical Activity and Exercise (GEPAFE), State University of Londrina (UEL), Londrina, Paraná Brazil
- Federal University of Mato Grosso do Sul (UFMS), Pantanal Campus, Corumbá, Brazil
| | - David Ohara
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE), State University of Londrina (UEL), Londrina, Paraná Brazil
| | - Edilson S. Cyrino
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE), State University of Londrina (UEL), Londrina, Paraná Brazil
| | - Enio R. V. Ronque
- Study and Research Group in Physical Activity and Exercise (GEPAFE), State University of Londrina (UEL), Londrina, Paraná Brazil
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE), State University of Londrina (UEL), Londrina, Paraná Brazil
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Zotcheva E, Pintzka CWS, Salvesen Ø, Selbæk G, Håberg AK, Ernstsen L. Associations of Changes in Cardiorespiratory Fitness and Symptoms of Anxiety and Depression With Brain Volumes: The HUNT Study. Front Behav Neurosci 2019; 13:53. [PMID: 30971904 PMCID: PMC6443896 DOI: 10.3389/fnbeh.2019.00053] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 03/04/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: We investigated the independent and joint associations of changes in estimated cardiorespiratory fitness (eCRF) and symptoms of anxiety and depression with brain volumes in individuals from the general population. Method: 751 participants (52% women, aged 50-67 years) from the Nord-Trøndelag Health Study (HUNT) MRI cohort were included. eCRF obtained from a non-exercise algorithm and symptoms of anxiety and depression were assessed twice; at HUNT2 (1995-97) and HUNT3 (2006-08). Brain MRI was performed shortly after HUNT3. Brain parenchymal fraction (BPF), bilateral hippocampal and total cortical volume were extracted from brain MRI obtained at 1.5T, using FreeSurfer and Statistical Parametric Mapping. Results: Multiple regression revealed that participants whose eCRF increased had larger BPF (β = 0.09, 95% CI 0.02, 0.16) and larger hippocampal volume (β = 0.09, 95% CI 0.03, 0.16) compared to participants whose eCRF remained low. Participants whose eCRF remained high had larger BPF (β = 0.15, 95% CI 0.07, 0.22) and larger cortical volume (β = 0.05, 95% CI 0.01, 0.09). Participants whose anxiety symptoms worsened had smaller BPF (β = -0.09, 95% CI -0.15, -0.02) and cortical volume (β = -0.05, -0.08, -0.01) than participants whose anxiety symptoms remained low. Each ml/kg/min increase in eCRF was associated with larger cortical volume among individuals with worsening of anxiety symptoms (β = 0.13, 95% CI 0.001, 0.27), and larger BPF among individuals whose depressive symptoms improved (β = 0.28, 95% CI 0.02, 0.53). Conclusion: Promoting exercise intended to improve eCRF may be an important public health initiative aimed at maintaining brain health among middle-aged individuals with and without changing psychological symptoms.
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Affiliation(s)
- Ekaterina Zotcheva
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Carl W S Pintzka
- Norwegian National Advisory Unit on functional MRI, Department of Radiology and Nuclear Medicine, St. Olav's Hospital, Trondheim, Norway
| | - Øyvind Salvesen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway.,Center for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Asta K Håberg
- Norwegian National Advisory Unit on functional MRI, Department of Radiology and Nuclear Medicine, St. Olav's Hospital, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Linda Ernstsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Namgoong H, Lee D, Hwang MH, Lee S. The relationship between arterial stiffness and maximal oxygen consumption in healthy young adults. J Exerc Sci Fit 2019; 16:73-77. [PMID: 30662497 PMCID: PMC6323163 DOI: 10.1016/j.jesf.2018.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/19/2018] [Accepted: 07/30/2018] [Indexed: 11/28/2022] Open
Abstract
Objective Arterial stiffness is associated with an increased risk of cardiovascular diseases in various populations. There was little research on the relationship between arterial stiffness and maximal aerobic capacity (VO2max) in healthy young adults. The aim of this study was to investigate the relationship between VO2max and arterial stiffness in young adults. Methods The subjects were 13 men and 10 women with mean age of 22.9 ± 0.7, 23.6 ± 0.4 years, respectively. Height, weight, body mass index, body fat (%), waist to hip ratio, total/high density lipoprotein (HDL)/low density lipoprotein (LDL) cholesterol, triglycerides, fasting glucose, blood pressure, heart rate, glycated hemoglobin and blood lactate were measured. In addition, peripheral arterial stiffness was assessed by measuring brachial-ankle pulse wave velocity (baPWV) and VO2max was determined using graded exercise test. Results VO2max had no significant correlation with baPWV (r = 0.2, p = 0.2). Total cholesterol correlated significantly to variables such as HDL (r = 0.6, p = 0.0015) and LDL cholesterol (r = -0.6, p = 0.0018). VO2max had a significant association with triglyceride (r = -0.5, p = 0.0033). Conclusions This study suggests that there is no relationship between arterial stiffness and aerobic capacity in healthy young adults.
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Affiliation(s)
- Hyun Namgoong
- Department of Human Movement Science, Graduate School, Incheon National University, Incheon, South Korea
| | - Dongmin Lee
- Department of Human Movement Science, Graduate School, Incheon National University, Incheon, South Korea
| | - Moon-Hyon Hwang
- Division of Health and Exercise Science, Incheon National University, Incheon, South Korea.,Sport Science Institute, Incheon National University, Incheon, South Korea
| | - Sewon Lee
- Division of Sport Science, Incheon National University, Incheon, South Korea.,Sport Science Institute, Incheon National University, Incheon, South Korea
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