We previously reported that CRP is inversely associated with fitness independent of body composition. IL-6 is the primary stimulant of CRP production by the liver, and it has been postulated that plasma IL-6 concentrations might be responsible for the CRP-fitness inverse association. PURPOSE To examine whether the association of CRP and fitness is independent of plasma IL-6. METHODS Cross-sectional study of 66 men in the Aerobics Center Longitudinal Study. Fitness was assessed by maximal treadmill exercise test and participants were classified into tertiles of fitness based on time on the treadmill. CRP and IL-6 were measured following a 12-hour fast prior to the fitness test. Due to the skewed distributions, CRP and IL-6 data are presented as medians (25th, 75th percentiles) or adjusted geometric means (95\% CI). †adjusted for age & smoking; ‡further adjustment for IL-6. For both mean CRP1 & CRP2: Low < Mod & High (p < 0.05), a=Spearman Correlation, b=regression model with log CRP as dependent variable and time on treadmill as the independent with adjustment for age, smoking, and IL-6 as noted above. Confirming previous results, we found a strong inverse association between CRP and fitness. We found no association between fitness level and IL-6. The unique finding of this report is that the fitness-CRP relation was not significantly altered by the adjustment for IL-6. Therefore, it is possible that an alternate mechanism is responsible for the relation between fitness and CRP. CONCLUSION The inverse association between fitness and CRP could not be explained by plasma IL-6 concentrations in this cohort of 66 men. Supported in part by NIH research grants AG06945 and HL71900.Table: No Caption Available
Nonalcoholic steatohepatitis (NASH) is characterized by ectopic fat deposition in the liver and is associated with hepatic in.ammation, hepatocyte dysfunction, and with Nonalcoholic steatohepatitis (NASH) is characterized by ectopic fat deposition in the liver and is associated with hepatic inflammation, hepatocyte dysfunction, and with cirrhosis in 20% of afficted individuals. The underlying causes of NASH are largely unknown, however, increases in population levels of obesity and physical inactivity may be links in the etiological chain. PURPOSE To determine the prevalence of NASH across levels of cardiorespiratory fitness and body mass index (BMI) in men. METHODS Participants were 154 nonsmoking men from the Aerobics Center Longitudinal Study who were free of known CHD, cancer, and metabolic disease; and were not on statin therapy. We measured liver and spleen fat by computed tomography and defined NASH as having plasma alanine aminotransferase (ALT)>35 U/L with a liver/spleen (L/S) attenuation ratio ≤1.0. Fitness was defined as thirds of maximal METs achieved during a graded treadmill exercise test. BMI was categorized as normal weight (NW;18.5–24.9 kg/m2), overweight (OW;25 −29.9 kg/m2) & obese (OB:=30 kg/m2). RESULTS The prevalence of NASH was higher across categories of BMI:NW (0%), OW (4.8%), & OB (15.8%, Trend χ2df=2 =8.045, p < 0.018); and declined across the lowest (12%), middle (8%) and highest (0%) third of fitness (Trend χ2df=2 =6.47, P=0.039). Using multivariable logistic regression, age (p=0.03), alcohol use (p=0.06) and BMI (p=0.02) were directly associated with higher risk of having NASH while higher levels of fitness (p=0.05) were inversely associated with lower risk of having NASH. CONCLUSION Higher levels of fitness and lower levels of BMI are associated with a lower prevalence of NASH.TableSupported by NIH grant HL62508- 04 & AG06945
Cardiovascular disease (CVD) is the leading cause of adult death in Western societies. The pathological processes associated with its development are initiated early in life; for example, elevated blood pressure (BP) can be seen in childhood, and has been shown to track into adulthood. There is a well-established relationship between physical activity (PA) and BP in adults, but few studies have investigated this in children, using an objective measure of PA. PURPOSE: To establish whether there is an association between objectively measured PA and BP in children. METHODS: Children aged 11 to 12 were recruited from a large birth cohort- the Avon Longitudinal Study of Parents and Children, and asked to wear a uniaxial accelerometer for seven days. Accelerometer counts per minute (cpm) and minutes per day spent in moderate to vigorous physical activity (MVPA) were derived, and children included if they had data for at least 10 hours on at least three days. The means of two BP readings taken using an automatic BP monitor were calculated. Data on a number of possible confounders were also available. RESULTS: Analyses were based on 5505 children. Associations between PA and BP after minimal and full adjustment for possible confounders are shown below:TableaAdjusted for age, gender (N=5505) bAdjusted for age, gender, BP measurement factors, social factors, maternal factors, current size, birthweight, gestation, puberty (N=2675). When cpm and MVPA were entered into models simultaneously, associations with cpm remained similar, while those with MVPA were reduced. CONCLUSIONS: Increases in PA at age 11 were associated with small reductions in BP, and the amount was more important than the intensity of activity.
Use of electronic motion sensors may eliminate some of the problems associated with self-reported physical activity. To date research findings have been equivocal. Some research suggests the Tritrac® accelerometer(TT) provides an objective indicator of free-living activity in sedentary individuals, yet other research indicates that the TT lacks validity for certain types of activity. The purpose of this field study was to examine the relationship between energy expenditure (EE; Kcal) as estimated by the TT and the 7-Day Physical Activity Recall Questionnaire (PAQ) under extended free-living conditions. Seventeen volunteers (7 male, 10 female), mean± SD age of 46.5 ± 7.0, wore the TT in a standardized manner for seven consecutive days. Occupational and leisure time activity over the 7-day period was measured with the PAQ. Average VO2max (28.06±4.82) as measured by a maximal treadmill test and average self-reported hours per week of vigorous activities (0.74±1.12) characterize the population as relatively sedentary. Paired t-tests showed a significant difference (p=.001) in average daily EE between the TT (2240.95±439.23) and PAQ(2467.78±456.96). A significant correlation (r=.86, p=.001) was found between the TT and the PAQ for total EE. These data support findings which indicate the Tritrac® may be used to estimate caloric expenditure with sedentary populations; however, additional research is needed to confirm the relationships found in this study using more active samples in free living conditions.
The United States is experiencing an epidemic of obesity among both adults and children. Approximately 35 percent of women and 31 percent of men age 20 and older are considered obese, as are about one-quarter of children and adolescents. While government health goals for the year 2000 call for no more than 20 percent of adults and 15 percent of adolescents to be obese, the prevalence of this often disabling disease is increasing rather than decreasing. Obesity, of course, is not increasing because people are consciously trying to gain weight. In fact, tens of millions of people in this country are dieting at any one time; they and many others are struggling to manage their weight to improve their appearance, feel better, and be healthier. Many programs and services exist to help individuals achieve weight control. But the limited studies paint a grim picture: those who complete weight-loss programs lose approximately 10 percent of their body weight, only to regain two-thirds of it back within 1 year and almost all of it back within 5 years. These figures point to the fact that obesity is one of the most pervasive public health problems in this country, a complex, multifactorial disease of appetite regulation and energy metabolism involving genetics, physiology, biochemistry, and the neurosciences, as well as environmental, psychosocial, and cultural factors. Unfortunately, the lay public and health-care providers, as well as insurance companies, often view it simply as a problem of willful misconduct--eating too much and exercising too little. Obesity is a remarkable disease in terms of the effort required by an individual for its management and the extent of discrimination its victims suffer. While people often wish to lose weight for the sake of their appearance, public health concerns about obesity relate to this disease's link to numerous chronic diseases that can lead to premature illness and death. The scientific evidence summarized in Chapter 2 suggests strongly that obese individuals who lose even relatively small amounts of weight are likely to decrease their blood pressure (and thereby the risk of hypertension), reduce abnormally high levels of blood glucose (associated with diabetes), bring blood concentrations of cholesterol and triglycerides (associated with cardiovascular disease) down to more desirable levels, reduce sleep apnea, decrease their risk of osteoarthritis of the weight-bearing joints and depression, and increase self-esteem. In many cases, the obese person who loses weight finds that an accompanying comorbidity is improved, its progression is slowed, or the symptoms disappear. Healthy weights are generally associated with a body mass index (BMI; a measure of whether weight is appropriate for height, measured in kg/m2) of 19-25 in those 19-34 years of age and 21-27 in those 35 years of age and older. Beyond these ranges, health risks increase as BMI increases. Health risks also increase with excess abdominal/visceral fat (as estimated by a waist-hip ratio [WHR] > 1.0 for males and > 0.8 for females), high blood pressure (> 140/90), dyslipidemias (total cholesterol and triglyceride concentrations of > 200 and > 225 mg/dl, respectively), non-insulin-dependent diabetes mellitus, and a family history of premature death due to cardiovascular disease (e.g., parent, grandparent, sibling, uncle, or aunt dying before age 50). Weight loss usually improves the management of obesity-related comorbidities or decreases the risks of their development. The high prevalence of obesity in the United States together with its link to numerous chronic diseases leads to the conclusion that this disease is responsible for a substantial proportion of total health-care costs. We estimate that today's health-care costs of obesity exceed $70 billion per year.(ABSTRACT TRUNCATED AT 400 WORDS)
69 The purpose of this study was to validate the potential of two questions in assessing the current or the previous physical activity (PA) recommendations. These two interviewer-administered questions were validated against a 7-day PA diary and a CSA accelerometer. Participants were 28 Latina and 28 African-American women who participated in the Women On The Move Study M age=51.30 ± 9.68). CSA and diary data were summarized, using a FORTRAN algorithm, to assess if each participant: 1) accumulated 30 minutes of moderate-intensity PA on at least five days in the previous week; and 2) did 20 to 60 minutes of moderate to high intensity endurance exercise on at least three days in the previous week. Cutoffs employed to summarize the diary data were 3 and 4 METs while all counts above 1560 served to summarize the CSA data. Kappa coefficients of agreement for the 1990 recommendation question were as follow:.30 (p<.05) for the CSA accelerometer;.23 (p<.05) for diary patterns above 3 MET; and.42 (p<.05) for diary patterns above 4 MET. Kappa coefficients of agreement for the 1995 recommendation question were as follow:.19 (p=.07) for the CSA accelerometer;.33 (p<.05) for diary patterns above 3 MET; and.43 (p<.05) for diary patterns above 4 MET. In summary, it is observed that these two global recommendation questions correlate significantly with the validation standards. Of interest is to note that the CSA, although significant with the 1990 recommendation question, was not significantly correlated with the 1995 recommendation question. In contrast the diary data was significantly correlated with both questions. Because the newer recommendation emphasizes more unstructured activities, the CSA accelerometer alone may not adequately identify unstructured activities or non walking activities.
The health effects of physical activity or cardiorespiratory fitness on the progression of smoking-related carcinoma remain poorly documented. We investigated the association between cardiorespiratory fitness levels and smoking-related (lung, trachea, bronchus, oral cavity, larynx, esophagus, pancreas, bladder, and kidney), non-smoking-related, and total cancer mortality in 25,892 men, age 30 to 87 years, who had a medical evaluation, including a maximal exercise test and self-reported health habits assessed at baseline. There were 335 cancer deaths (133 from smoking-related cancer, 202 from non-smoking-related cancer) during an average of 10 years of follow-up (259,124 man-years). After adjustment for age, examination year, hypertension, diabetes mellitus, high cholesterol, alcohol intake, body mass index, and smoking habits, there was an inverse association between cardiorespiratory fitness levels and smoking-related (p < 0.001 for trend), non-smoking-related (p = 0.008 for trend), and total cancer mortality (p < 0.001 for trend) in men, respectively. Moderate and high levels of cardiorespiratory fitness are associated with lower risk of smoking-related and non-smoking-related cancer mortality. We conclude that cardiorespiratory fitness may provide protection against smoking-related and total cancer mortality in men. Supported by NIH grant AG06945
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