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Pan S, Chen S, Fretts AM, Ali T. Associations of pedometer-measured ambulatory activity with incidence of atherosclerotic cardiovascular diseases: Strong heart family study. Prev Med 2023; 177:107781. [PMID: 37984645 PMCID: PMC10872869 DOI: 10.1016/j.ypmed.2023.107781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE Coronary heart disease has several risk factors that require a multifactorial community intervention approach in prevention efforts. Prevalence of coronary heart disease and its risk factors have been disproportionately high among American Indians. The objective of this study is to evaluate the impact of ambulatory activity levels on the development of coronary heart disease in this population. METHODS Using pedometer data and other lifestyle and clinical factors from 2492 participants in the Strong Heart Family Study, we examined the associations of average daily step counts with incident coronary heart disease during an 18 to 20 year follow-up. RESULTS After adjusting for potential confounders, participants with daily step counts in the 4th quartile (>7282 steps per day) had significantly lower odds of developing coronary heart disease compared to those in the 1st quartile (<3010 steps per day) (p = 0.035). CONCLUSIONS Higher daily step count (over 7282 steps per day) is significantly associated with lower incidence of coronary heart disease among American Indian participants of the Strong Heart Family Study in a 20-year follow-up period.
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Affiliation(s)
- Steven Pan
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Tauqeer Ali
- Department of Biostatistics and Epidemiology, Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Wilmut K, Purcell C. Why Are Older Adults More at Risk as Pedestrians? A Systematic Review. HUMAN FACTORS 2022; 64:1269-1291. [PMID: 33555944 PMCID: PMC9643822 DOI: 10.1177/0018720821989511] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore factors that could explain why older adults are more at risk at the roadside. BACKGROUND The physical and psychological health benefits of walking have been well-established, leading to the widespread promotion of walking amongst older adults. However, walking can result in an increased risk of injury as a pedestrian at the roadside, which is a greater risk for older adults who are overrepresented in pedestrian casualty figures. METHOD Relevant databases were searched up to January 2020. All peer-reviewed journals that presented data on healthy older adults and some aspect of road crossing or roadside behavior were included. A total of 142 papers were assessed and 60 met the inclusion criteria. RESULTS Identified papers could be grouped into three areas: crossing at a designated crossing place; crossing with no designated crossing place; perceptions or behaviors. CONCLUSION Multiple individual (attitudes, perceived behavioral control, walking time, time-to-arrival judgments, waiting endurance, cognitive ability), task (vehicle size, vehicle speed, traffic volume), and environmental (road layout, time of day, weather) constraints influence road crossing in older adulthood. APPLICATION Accessibility of designated crossing areas needs to be addressed by ensuring sufficient time to cross and nonrestrictive waiting times. Signalized crossings need to be simplified and visibility increased. Where there is no designated crossing place, a reduction in speed limit alongside the provision of pedestrian islands to provide "pause" places are needed. Educational-based programs may also help ensure safety of older adults where there is no designated crossing place.
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DHULI KRISTJANA, NAUREEN ZAKIRA, MEDORI MARIACHIARA, FIORETTI FRANCESCO, CARUSO PAOLA, PERRONE MARCOALFONSO, NODARI SAVINA, MANGANOTTI PAOLO, XHUFI SUELA, BUSHATI MARSIDA, BOZO DHURATA, CONNELLY STEPHENTHADDEUS, HERBST KARENL, BERTELLI MATTEO. Physical activity for health. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E150-E159. [PMID: 36479484 PMCID: PMC9710390 DOI: 10.15167/2421-4248/jpmh2022.63.2s3.2756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Physical activity plays a substantial role in maintaining people's good health and mental wellbeing, but that is not all: not only it positively affects the individuals' mental and physical health, but a lack of physical exercise exerts a negative impact also on the overall economy of a nation. In addition, physical inactivity not only increases the risk of non-communicable diseases (NCD), but also contributes significantly to the increased morbidity and mortality in patients suffering from these diseases. On the contrary, physical activity reduces the risk of NCDs - such as cardiovascular diseases, type 2 diabetes, and cancer - in a dose-dependent manner; regular exercise is also associated with many health benefits and delayed mortality. However, understanding the role of physical activity in modern society and creating an awareness in the general population is one of the most important tasks of health and recreation promoters. Correspondingly, there is a dire need to enhance our knowledge, perception, and awareness of physical activity and its impacts on an individual's health, ultimately contributing to developing a healthy society. The current review will focus on the health benefits of the two most widely studied modifiable lifestyle risk factors, physical activity and diet, focusing particularly on the Mediterranean diet.
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Affiliation(s)
- KRISTJANA DHULI
- MAGI’S LAB, Rovereto (TN), Italy
- Correspondence: Kristjana Dhuli, MAGI’S LAB, Rovereto (TN), 38068, Italy. E-mail:
| | | | | | - FRANCESCO FIORETTI
- Department of Cardiology, University of Brescia and ASST “Spedali Civili” Hospital, Brescia, Italy
| | - PAOLA CARUSO
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Trieste, Italy
| | | | - SAVINA NODARI
- Department of Cardiology, University of Brescia and ASST “Spedali Civili” Hospital, Brescia, Italy
| | - PAOLO MANGANOTTI
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Trieste, Italy
| | | | | | | | - STEPHEN THADDEUS CONNELLY
- San Francisco Veterans Affairs Health Care System, Department of Oral & Maxillofacial Surgery, University of California, San Francisco, CA, USA7
| | - KAREN L. HERBST
- Total Lipedema Care, Beverly Hills California and Tucson Arizona, USA
| | - MATTEO BERTELLI
- MAGI’S LAB, Rovereto (TN), Italy
- MAGI EUREGIO, Bolzano, Italy
- MAGISNAT, Peachtree Corners (GA), USA
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Wafi A, Aqeel A, Zogel B, Shami A, Alharthi A, Alameer A, Kulaybi A, Sumayli A, Abutalib Y, Alessa A, Alhazmi AH. Adherence to Physical Activity Recommendations in the Adult Population of Jazan Region. Cureus 2022; 14:e23481. [PMID: 35494978 PMCID: PMC9038591 DOI: 10.7759/cureus.23481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/05/2022] Open
Abstract
Background Physical activity (PA) is an important determinant of health because of its role in preventing multiple chronic diseases. A better understanding of the relationship between PA and factors that promote or hinder PA is necessary for adherence to PA recommendations. This study aimed to estimate the proportion of adults of the Jazan region of Saudi Arabia adhering to PA recommendations and to examine the effects of socio-economic factors on meeting these recommendations. Method The official short form of the International Physical Activity Questionnaire (IPAQ) was used to assess PA. Participants aged 17-74 years (n = 709) were categorized into active or inactive categories. Independent associations between PA categories and socio-economic factors were explored using binary logistic regression. Results The proportion of the adults of the Jazan region who were inactive, i.e., not adhering to the PA recommendations, was 58.3%. Those with body mass index >30 kg /m2 (OR = 0.51; 95%CI: 0.32-0.84) were less likely to be more active than those with normal weight. Participants who rated their health as very good (OR = 0.68; 95% CI: 0.49-0.96) and good (OR = 0.39; 95% CI: 0.22-0.70) were less likely to be more active than those who rated their health as excellent. Conclusions More than half of the adult population of the Jazan region did not adhere to the PA levels necessary to promote health and prevent chronic diseases. Such a high prevalence of low PA is a major health problem. Thus, efforts are warranted to promote PA in the Jazan region, particularly among obese female adults. High self-perceived health was an important correlate of PA among the adult population of Jazan. Because of the wide range of physical activity levels among population subgroups, a social-ecological approach for physical activity promotion may be warranted.
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Chauhan S, Srivastava S, Kumar P, Patel R. Decomposing urban-rural differences in multimorbidity among older adults in India: a study based on LASI data. BMC Public Health 2022; 22:502. [PMID: 35291975 PMCID: PMC8922782 DOI: 10.1186/s12889-022-12878-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity; however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity. METHODS The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release cross-sectional data of the Longitudinal Ageing Study in India (LASI). Descriptive, bivariate, and multivariate decomposition analysis techniques were used. RESULTS Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p < 0.001). The multivariate decomposition analysis revealed that about 51% of the overall differences (urban-rural) in the prevalence of multimorbidity among older adults was due to compositional characteristics (endowments). In contrast, the remaining 49% was due to the difference in the effect of characteristics (Coefficient). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively. Work status and education were found to reduce the urban-rural gap in the prevalence of multimorbidity among older adults by 8% and 6%, respectively. CONCLUSIONS There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.
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Affiliation(s)
- Shekhar Chauhan
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Research Scholar, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- Consultant- Research & Data Analysis, Population Council India Office, Zone 5A, India Habitat Centre, Lodi Road, 110003, New Delhi, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
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OUP accepted manuscript. Eur J Prev Cardiol 2022; 29:1412-1424. [DOI: 10.1093/eurjpc/zwac033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/24/2022] [Accepted: 02/10/2022] [Indexed: 11/13/2022]
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Santhanaraj KK, M.M. R, D. D. A survey of assistive robots and systems for elderly care. JOURNAL OF ENABLING TECHNOLOGIES 2021. [DOI: 10.1108/jet-10-2020-0043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The rousing phenomenon of the ageing population is becoming a vital issue and demanding fulminant actions. Population ageing is a resultant of the enhanced health-care system, groovy antibiotics, medications and economic well-being. Old age leads to copious amounts of ailments. Aged people, owing to their reduced mobility and enervating disabilities, tend to rely upon caretakers and/or nursing personnel. With the increasing vogue of nuclear families in the society, the elderly are at the risk of being unveiled to emotional, physical and fiscal insecurities in the years to come. Caring for those seniors will be an enormous undertaking.
Design/methodology/approach
There is a dire need for an intelligent assistive system to meet out the requirements of continuous holistic care and monitoring. Assistive robots and systems used for elderly care are studied. The design motivation for the robots, elderly–robot interaction capabilities and technology incorporated in the systems are examined meticulously.
Findings
From the survey, it is suggested that the subsystems of an assistive robot revamped for better human–machine interactions will be a potential alternative to the human counterpart. Affirmable advancements in the robot design and interaction methodologies that would increase the holistic care and assistance for aged people are analyzed and listed.
Originality/value
This paper reviews the available assistive technologies and suggests a synergistic model that can be adopted for the caring of the elderly.
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Ono H, Akahoshi K, Kai M. The Trends of Medical Care Expenditure with Adjustment of Lifestyle Habits and Medication; 10-Year Retrospective Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9546. [PMID: 33419363 PMCID: PMC7767014 DOI: 10.3390/ijerph17249546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023]
Abstract
In Japan, the prevention of lifestyle-related diseases is the most important issue for the optimization of medical expenditure. This study aimed to analyze the impact of lifestyle and medication status on medical expenditure. Health checkup data and medical expenditure records of a retrospective cohort of 1463 people aged between 40 and 65 years old who underwent specific health checks at least three times between 2008 and 2017 were analyzed. Regression analysis was performed with medical expenditure as the dependent variable and age, gender, waist ratio, medication status, and lifestyle habits as independent variables using a Tobit model. Focusing on the factors that increase medical expenditure, the regression coefficients of age, medication status, weight gain of 10 kg or more since the age of 20, and walking more than 1 h per day were 0.048 (95% CI 0.04 to 0.06), 1.020 (95% CI 0.88 to 1.16), 0.210 (95% CI 0.06 to 0.36), and -0.208 (95% CI -0.35 to -0.07), respectively. The estimate of 5-year cumulative medical expenditure showed that those with walking habits without medication had the lowest medical expenditure. The result of this study suggests that walking more than 1 h a day may lower health expenditure in the general population.
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Affiliation(s)
- Haruko Ono
- Department of Community Health Nursing, Oita University of Nursing and Health Science, Oita 870-1201, Japan;
| | - Kotomi Akahoshi
- Department of Community Health Nursing, Oita University of Nursing and Health Science, Oita 870-1201, Japan;
| | - Michiaki Kai
- Department of Environmental Health Science, Oita University of Nursing and Health Science, Oita 870-1201, Japan;
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Howell NA, Tu JV, Moineddin R, Chu A, Booth GL. Association Between Neighborhood Walkability and Predicted 10-Year Cardiovascular Disease Risk: The CANHEART (Cardiovascular Health in Ambulatory Care Research Team) Cohort. J Am Heart Assoc 2019; 8:e013146. [PMID: 31665997 PMCID: PMC6898849 DOI: 10.1161/jaha.119.013146] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background Individuals living in unwalkable neighborhoods appear to be less physically active and more likely to develop obesity, diabetes mellitus, and hypertension. It is unclear whether neighborhood walkability is a risk factor for future cardiovascular disease. Methods and Results We studied residents living in major urban centers in Ontario, Canada on January 1, 2008, using linked electronic medical record and administrative health data from the CANHEART (Cardiovascular Health in Ambulatory Care Research Team) cohort. Walkability was assessed using a validated index based on population and residential density, street connectivity, and the number of walkable destinations in each neighborhood, divided into quintiles (Q). The primary outcome was a predicted 10‐year cardiovascular disease risk of ≥7.5% (recommended threshold for statin use) assessed by the American College of Cardiology/American Heart Association Pooled Cohort Equation. Adjusted associations were estimated using logistic regression models. Secondary outcomes included measured systolic blood pressure, total and high‐density lipoprotein cholesterol levels, prior diabetes mellitus diagnosis, and current smoking status. In total, 44 448 individuals were included in our analyses. Fully adjusted analyses found a nonlinear relationship between walkability and predicted 10‐year cardiovascular disease risk (least [Q1] versus most [Q5] walkable neighborhood: odds ratio =1.09, 95% CI: 0.98, 1.22), with the greatest difference between Q3 and Q5 (odds ratio=1.33, 95% CI: 1.23, 1.45). Dose–response associations were observed for systolic blood pressure, high‐density lipoprotein cholesterol, and diabetes mellitus risk, while an inverse association was observed with smoking status. Conclusions In our setting, adults living in less walkable neighborhoods had a higher predicted 10‐year cardiovascular disease risk than those living in highly walkable areas.
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Affiliation(s)
- Nicholas A Howell
- Centre for Urban Health Solutions Li Ka Shing Knowledge Institute St. Michael's Hospital Toronto Ontario Canada.,Institute of Health Policy, Management, and Evaluation Dalla Lana School of Public Health University of Toronto Ontario Canada.,Faculty of Medicine University of Toronto Ontario Canada.,ICES Toronto Ontario Canada
| | - Jack V Tu
- Institute of Health Policy, Management, and Evaluation Dalla Lana School of Public Health University of Toronto Ontario Canada.,Department of Medicine University of Toronto Ontario Canada.,ICES Toronto Ontario Canada.,Schulich Heart Centre Sunnybrook Health Sciences Centre Toronto Ontario Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine Faculty of Medicine University of Toronto Ontario Canada.,ICES Toronto Ontario Canada
| | - Anna Chu
- Faculty of Medicine University of Toronto Ontario Canada.,ICES Toronto Ontario Canada
| | - Gillian L Booth
- Centre for Urban Health Solutions Li Ka Shing Knowledge Institute St. Michael's Hospital Toronto Ontario Canada.,Institute of Health Policy, Management, and Evaluation Dalla Lana School of Public Health University of Toronto Ontario Canada.,Department of Medicine University of Toronto Ontario Canada.,ICES Toronto Ontario Canada
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Sung KD, Pekas EJ, Scott SD, Son WM, Park SY. The effects of a 12-week jump rope exercise program on abdominal adiposity, vasoactive substances, inflammation, and vascular function in adolescent girls with prehypertension. Eur J Appl Physiol 2018; 119:577-585. [PMID: 30554386 DOI: 10.1007/s00421-018-4051-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/06/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Childhood obesity is strongly associated with cardiovascular disease (CVD) development. It is necessary to combat unfavorable outcomes of obesity at a young age by utilizing effective interventions, such as exercise. PURPOSE We sought to examine the effects of a jump rope exercise program on CVD risk factors, including body composition, vasoactive substances, inflammation, and vascular function in prehypertensive adolescent girls. METHODS Forty girls (age 14-16) were recruited and randomly assigned to a jump rope exercise group (EX, n = 20) or control group (CON, n = 20). Body composition, nitrate and nitrite levels, endothelin-1 (ET-1), C-reactive protein (CRP), systolic blood pressure and diastolic blood pressure (SBP, DBP), and arterial stiffness were measured before and after 12 weeks. RESULTS There were significant group by time interactions following the 12-week program for body composition (from 33.8 ± 3.6 to 30.2 ± 3.1%), central adiposity (from 86.4 ± 4 to 83.3 ± 5 cm), SBP (from 126 ± 3.3 to 120 ± 2.1 mmHg), and brachial-to-ankle pulse wave velocity (from 8.2 ± 1.0 to 7.4 ± 0.2 m/s). Nitrate/nitrite levels increased (from 54.5 ± 5.1 to 57.2 ± 5.2 µmol) along a reduction in CRP levels (from 0.5 ± 0.4 to 0.2 ± 0.1 mg/L). There were no significant changes in ET-1 (P = 0.22). CONCLUSIONS These findings indicate that jump rope exercise may be an effective intervention to improve these CVD risk factors in prehypertensive adolescent girls. Jumping rope is an easily accessible exercise modality that may have important health implications for CVD prevention in younger populations.
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Affiliation(s)
- Ki-Dong Sung
- Department of Physical Education, Pusan National University, Busan, South Korea
| | - Elizabeth J Pekas
- School of Health and Kinesiology, University of Nebraska at Omaha, 6001 Dodge St., Omaha, NE, 68182, USA
| | - Steven D Scott
- School of Health and Kinesiology, University of Nebraska at Omaha, 6001 Dodge St., Omaha, NE, 68182, USA
| | - Won-Mok Son
- Department of Physical Education, Pusan National University, Busan, South Korea
| | - Song-Young Park
- Department of Physical Education, Pusan National University, Busan, South Korea. .,School of Health and Kinesiology, University of Nebraska at Omaha, 6001 Dodge St., Omaha, NE, 68182, USA.
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Abstract
Previous studies have shown that walking is associated with increased longevity and a reduced risk of cardiovascular and age-related diseases. Whether walking benefits individuals with diabetes who are at high risk of coronary heart disease (CHD) remains to be determined. The objective of this study is to examine the association between walking and risk of CHD among elderly men with and without diabetes. Walking data was assessed in 2732 men aged 71 to 93 years participating in the Honolulu Heart Program from 1991-1993. Study participants were initially without disabilities and free of prevalent CHD. Men were then followed for incident CHD for up to 7 years. For men with diabetes who walked <0.25 miles/day, the age-adjusted incidence of CHD was significantly higher than in men without diabetes (27.1 vs. 12.7/1000 person years, p = 0.026). In contrast when distance walked was >1.5 miles/day, incidence of CHD was similar in men with and without diabetes (12.2 vs. 9.1/1000 person-years, p = 0.46). While risk of CHD declined significantly with increasing walking distance in men with diabetes after age and risk factor adjustment (p = 0.043, p = 0.025), associations in those without diabetes were weaker (p = 0.070, p = 0.10). These findings suggest that among elderly men with diabetes who are capable of physical activity, walking reduces CHD risk to levels similar to when diabetes is absent. Walking is an easy, safe and accessible form of physical activity that may have marked health benefits for elderly men with diabetes.
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Li S, Barywani S, Fu M. Relationship between Physical Inactivity and Long-term Outcome in Patients Aged≥80 Years with Acute Coronary Syndrome. Curr Med Sci 2018; 38:64-69. [PMID: 30074153 DOI: 10.1007/s11596-018-1847-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 01/05/2018] [Indexed: 11/30/2022]
Abstract
Physical inactivity is very common in octogenarians. However, association between physical inactivity and mortality in octogenarians with acute coronary syndrome (ACS) remains unclear. In this study, we aimed to investigate association between physical inactivity and allcause mortality in octogenarian patients with ACS. In this study, we included a total of 353 hospitalized patients, aged >80 years, with ACS during the period of 5-year follow-up. The association between physical inactivity and all-cause mortality was analyzed by multivariable Cox aggression. Of the enrolled patients, 132 (37.4%) were defined as physically inactive, and 221 (62.6%) as physically active. Patients with physical inactivity tended to have lower survival rate (21.2% vs. 56.5%, P<0.001) and higher mortality rate (78.8% vs. 43.5%, PcO.OOl), and had a worse long-term outcome than those with physical activity (chi-square=27.52, and log rank PcO.OOl). The physical inactivity was still an independent predictor for long-term allcause mortality independent of confounders including age, prior heart failure, stroke, ejection fraction, beta-blocker, clopidogrel and percutaneous coronary intervention (HR: 2.35, 95% CI: 1.26-4.37, P=0.007). Our study demonstrates that physical inactivity is independently related to increased all-cause mortality in octogenarians with ACS.
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Affiliation(s)
- Shijun Li
- Section of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, 100853, China.
- Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Ostra Hospital, Gothenburg, Sweden.
| | - Salim Barywani
- Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Ostra Hospital, Gothenburg, Sweden
| | - Michael Fu
- Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Ostra Hospital, Gothenburg, Sweden
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Bénéfices de l’activité physique en endurance chez les seniors âgés de 70 ans ou plus : une revue systématique. Presse Med 2017; 46:794-807. [DOI: 10.1016/j.lpm.2017.05.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 05/07/2017] [Accepted: 05/23/2017] [Indexed: 01/13/2023] Open
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Sugiyama T, Cerin E, Mridha M, Koohsari MJ, Owen N. Prospective Associations of Local Destinations and Routes With Middle-to-Older Aged Adults’ Walking. THE GERONTOLOGIST 2017; 58:121-129. [DOI: 10.1093/geront/gnx088] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Takemi Sugiyama
- Australian Catholic University, Melbourne
- Swinburne University of Technology, Melbourne, Australia
| | | | | | | | - Neville Owen
- Swinburne University of Technology, Melbourne, Australia
- Baker Heart & Diabetes Institute, Melbourne, Australia
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Forman DE, Arena R, Boxer R, Dolansky MA, Eng JJ, Fleg JL, Haykowsky M, Jahangir A, Kaminsky LA, Kitzman DW, Lewis EF, Myers J, Reeves GR, Shen WK. Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association. Circulation 2017; 135:e894-e918. [PMID: 28336790 PMCID: PMC7252210 DOI: 10.1161/cir.0000000000000483] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has long been applied by cardiologists as a measure of function that depended primarily on cardiac physiology, multiple other factors also contribute, usually with increasing bearing as age advances. Comorbidity, inflammation, mitochondrial metabolism, cognition, balance, and sleep are among the constellation of factors that bear on cardiorespiratory function and that become intricately entwined with cardiovascular health in old age. This statement reviews the essential physiology underlying functional capacity on systemic, organ, and cellular levels, as well as critical clinical skills to measure multiple realms of function (eg, aerobic, strength, balance, and even cognition) that are particularly relevant for older patients. Clinical therapeutic perspectives and patient perspectives are enumerated to clarify challenges and opportunities across the caregiving spectrum, including patients who are hospitalized, those managed in routine office settings, and those in skilled nursing facilities. Overall, this scientific statement provides practical recommendations and vital conceptual insights.
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Sakaki S, Takahashi T, Matsumoto J, Kubo K, Matsumoto T, Hishinuma R, Terabe Y, Ando H. Characteristics of physical activity in patients with critical limb ischemia. J Phys Ther Sci 2016; 28:3454-3457. [PMID: 28174472 PMCID: PMC5276781 DOI: 10.1589/jpts.28.3454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/07/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to evaluate the amount of physical activity of the patients with critical limb ischemia consecutively in order to clarify the characteristics of physical activity of critical limb ischemia. [Subjects and Methods] Twelve patients who were eligible for the 2 months of consecutive evaluation of the amount of physical activity were enrolled in the study (men: 11; woman: 1; mean age: 64.4 [range: 44-80]). A pedometer with an accelerometer was used for the measurement of the number of steps walked as an index of the amount of physical activity. Participants were asked to lead a regular life and no instruction was given as to the number of steps. [Results] The average number of daily steps walked was 2,323 steps (range: 404-6,505). There was no clear tendency in the number of amputation site-specific steps walked. There was also no correlation between the number of steps walked and age as well as the maximum strength of the knee-extension muscle, skin perfusion pressure of the sole and the dorsum, and QOL scores. [Conclusion] The number of steps walked of the patients with critical limb ischemia was remarkably low and no significant association with health-related QOL.
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Affiliation(s)
- Satoko Sakaki
- Department of Rehabilitation, Kasukabe Chuo General Hospital, Japan
| | | | | | - Kasuya Kubo
- Department of Rehabilitation, Kasukabe Chuo General Hospital, Japan
| | - Takuya Matsumoto
- Department of Rehabilitation, Kasukabe Chuo General Hospital, Japan
| | - Ryo Hishinuma
- Department of Rehabilitation, Kasukabe Chuo General Hospital, Japan
| | - Yuuta Terabe
- Department of Cosmetic and Plastic Surgery, Saitamana Medical University International Medical Center, Japan
| | - Hiroshi Ando
- Department of Cardiology, Kasukabe Chuo General Hospital, Japan
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17
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An HS, Jones GC, Kang SK, Welk GJ, Lee JM. How valid are wearable physical activity trackers for measuring steps? Eur J Sport Sci 2016; 17:360-368. [PMID: 27912681 DOI: 10.1080/17461391.2016.1255261] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Goyal P, Delgado D, Hummel SL, Dharmarajan K. Impact of Exercise Programs on Hospital Readmission Following Hospitalization for Heart Failure: A Systematic Review. CURRENT CARDIOVASCULAR RISK REPORTS 2016; 10. [PMID: 28713480 DOI: 10.1007/s12170-016-0514-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Given persistently high 30-day readmission rates among patients hospitalized for heart failure, there is an ongoing need to identify new interventions to reduce readmissions. Although exercise programs can improve outcomes among ambulatory heart failure patients, it is not clear whether this benefit extends to reducing readmissions following heart failure hospitalization. We therefore conducted a systematic review of the literature to identify randomized controlled trials examining the impact of exercise programs on hospital readmissions among patients recently hospitalized for heart failure. We searched Ovid MEDLINE, EMBASE, and the Wiley Cochrane Library for studies that fulfilled pre-defined criteria, including that the exercise program pre-specify activity type and exercise frequency, duration, and intensity. Exercise interventions could occur at any location including within the hospital, at an outpatient facility, or at home. Among 1213 unique publications identified, only one study fulfilled inclusion criteria. This study was a single-site randomized controlled trial that consisted of a 12-week exercise program in a cohort of 105 patients with a principal diagnosis of HF at a metropolitan hospital in Australia. This study revealed a reduction in 12-month all-cause and cardiovascular-related hospitalization rates. However, inferences were limited by its single-site study design, small sample size, premature termination, and high risk for selection, performance, and detection bias. As no studies have built upon the findings of this study, it remains unknown whether exercise programs can improve readmission rates among patients recently hospitalized for heart failure, a significant gap in the literature.
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Affiliation(s)
- Parag Goyal
- Chief Fellow, Division of Cardiology, Weill Cornell Medicine, 525 East 68 Street, New York, NY 10021, USA, , ,
| | - Diana Delgado
- Weill Cornell Medicine, 1300 York Avenue, New York, NY, USA
| | - Scott L Hummel
- University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, USA
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19
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Allen NA. Social Cognitive Theory in Diabetes Exercise Research: An Integrative Literature Review. DIABETES EDUCATOR 2016; 30:805-19. [PMID: 15510532 DOI: 10.1177/014572170403000516] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This integrative review critically examined the literature on diabetes research using Social Cognitive Theory (SCT) to determine its predictive ability in explaining exercise behavior and to identify key interventions that enhance exercise initiation and maintenance. METHODS Literature published between 1985 and 2002 was searched using the following keywords: SCT, self-efficacy, diabetes mellitus, non-insulin-dependent diabetes mellitus, insulin-dependent diabetes mellitus, physical activity, and exercise. The databases searched were CINAHL, Medline, and PsychInfo. Of the 38 articles retrieved from databases, 13 were reviewed. RESULTS A statistically significant relationship between self-efficacy and exercise behavior was found in correlational studies. Results from the predictive study support the predictability of self-efficacy for exercise behavior. Mixed results were found for the predictive ability of outcome expectancies for exercise behavior. Self-efficacy was predictive of exercise initiation and maintenance over time. The evidence for successful interventions to increase self-efficacy and exercise behavior over time was inconclusive. CONCLUSIONS To better understand exercise behavior and to develop effective exercise interventions, a microanalytic, theory-driven approach to studying exercise behavior is needed. Several suggestions are offered to strengthen exercise self-efficacy.
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Affiliation(s)
- Nancy A Allen
- Graduate School of Nursing, University of Massachusetts, Worcester, USA
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20
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Gohlke H, Winter M, Karoff M, Held K. CARRISMA: a new tool to improve risk stratification and guidance of patients in cardiovascular risk management in primary prevention. ACTA ACUST UNITED AC 2016; 14:141-8. [PMID: 17301640 DOI: 10.1097/01.hjr.0000244581.30421.69] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIMS Risk stratification is important for decisions about the intensity of treatment in primary prevention. Risk factors and lifestyle factors are responsible for over 80% of cardiovascular morbidity and mortality. However, body mass index (BMI), physical activity and smoking (cigarettes/day) are not or not quantitatively represented in the risk stratification system. METHODS AND RESULTS CARdiovascular RISk MAnagement (CARRISMA) is a software program considering the prognostic impact of BMI, physical activity and cigarettes per day adjusted for age and sex based on multivariate regression analyses from the literature on top of one of the three major scores to improve risk stratification. The 10-year European Society of Cardiology Systematic COronary Risk Evaluation (SCORE) cardiovascular mortality risk for an intermediate risk region, e.g. increases from 3 to 6% by considering smoking of 30 cigarettes per day instead of just 'smoking' and by taking into account a BMI of 34. Whereas the 10-year ESC cardiovascular mortality risk of a 55-year-old active individual decreases from 5 to 3%, by considering a physical activity equivalent of 2100 kcal/week, the Framingham or PROspective CArdiovascular Münster (PROCAM) risks change accordingly. CONCLUSION CARRISMA facilitates the application of knowledge of the current literature in the individual patient in a user-friendly manner allowing a more detailed and yet time-efficient risk stratification and risk management in primary prevention, particularly in the intermediate risk range.
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Affiliation(s)
- Helmut Gohlke
- Klinische Kardiologie II, Herz-Zentrum, Bad Krozingen, Germany.
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21
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22
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Ashley A, Lloyd A, Lamb S, Bartlett H. Is health-related quality of life a suitable outcome measure for evaluating health promotion programmes? ACTA ACUST UNITED AC 2016. [DOI: 10.1177/136140960100600305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study describes results from a double blind randomised controlled trial which examined the efficacy of a primary care-based exercise promotion programme (the Health Walks Scheme). Quality of life data from the SF-36 questionnaire are presented from 260 previously sedentary participants randomly selected from a large GP practice (data are available for 72% at the 12-month follow-up). After 12 months, only 61% of participants in the health walks group were still classified as sedentary, compared with 73% in the control group who were simply given advice regarding exercise (p=0.05). There were no significant changes in the dimensions of the SF-36 questionnaire at 12 months. Those people who actually completed a health walk showed larger improvements in dimensions of the SF-36 (although these were also not significant). The appropriateness of quality of life outcome measures in health promotion trials is discussed in the light of the findings.
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Affiliation(s)
- Andrew Ashley
- Oxford Centre of Health Care Research & Development, Oxford Brookes University
| | - Andrew Lloyd
- Oxford Centre of Health Care Research & Development, Oxford Brookes University
| | - Sarah Lamb
- School of Health and Social Sciences, Coventry University
| | - Helen Bartlett
- Oxford Centre of Health Care Research & Development, Oxford Brookes University
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23
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Koolhaas CM, Dhana K, Golubic R, Schoufour JD, Hofman A, van Rooij FJA, Franco OH. Physical Activity Types and Coronary Heart Disease Risk in Middle-Aged and Elderly Persons: The Rotterdam Study. Am J Epidemiol 2016; 183:729-38. [PMID: 27022033 DOI: 10.1093/aje/kwv244] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/04/2015] [Indexed: 12/22/2022] Open
Abstract
Physical activity is associated with decreased risk of coronary heart disease (CHD). The specific physical activity types that provide beneficial effects in an older population remain unclear. We assessed the association of total physical activity, walking, cycling, domestic work, sports, and gardening with CHD by using Cox proportional hazard models among 5,901 participants aged >55 (median age, 67) years from the prospective population-based Rotterdam Study, enrolled between 1997 and 2001. Activities were categorized into tertiles, and the lowest tertiles were used as reference. In the multivariable model, we adjusted for age, sex, smoking, alcohol consumption, education, diet, and other physical activity types. During 15 years of follow-up (median, 10.3 (interquartile range, 8.0-11.8) years), 642 participants (10.9%) experienced a CHD event. In the multivariable model, the respective hazard ratios for the medium and high categories compared with the low category were 0.79 (95% confidence interval CI): 0.66, 0.96) and 0.71 (95% CI: 0.58, 0.87) for total physical activity, 0.76 (95% CI: 0.63, 0.92) and 0.70 (95% CI: 0.57, 0.88) for cycling, and 0.81 (95% CI: 0.66, 0.98) and 0.71 (95% CI: 0.56, 0.90) for domestic work. Walking, sports, and gardening were not associated with CHD. In conclusion, in this long-term follow-up study of older adults, domestic work and cycling were associated with reduced CHD risk. Physical activity should be promoted in this population with the aim to prevent CHD.
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24
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Zhao W, Ukawa S, Kawamura T, Wakai K, Ando M, Tsushita K, Tamakoshi A. Health Benefits of Daily Walking on Mortality Among Younger-Elderly Men With or Without Major Critical Diseases in the New Integrated Suburban Seniority Investigation Project: A Prospective Cohort Study. J Epidemiol 2015; 25:609-16. [PMID: 26155815 PMCID: PMC4626390 DOI: 10.2188/jea.je20140190] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Regular physical activity contributes to the prevention of cancer, cardiovascular disease, and other chronic diseases. However, the frequency of physical activity often declines with age, particularly among the elderly. Thus, we investigated the effects of daily walking on mortality among younger-elderly men (65–74 years) with or without major critical diseases (heart disease, cerebrovascular disease, or cancer). Methods We assessed 1239 community-dwelling men aged 64/65 years from the New Integrated Suburban Seniority Investigation Project. We estimated hazard ratios (HRs) of all-cause mortality and 95% confidence intervals (CIs) according to daily walking duration and adjusted for potential confounders, including survey year, marital status, work status, education, smoking and drinking status, BMI, regular exercise, regular sports, sleeping time, medical status, disease history, and functional capacity. Results For men without critical diseases, mortality risk declined linearly with increased walking time after adjustment for confounders (Ptrend = 0.018). Walking ≥2 hours/day was significantly associated with lower all-cause mortality (HR 0.49; 95% CI, 0.27–0.90). For men with critical diseases, walking 1–2 hours/day showed a protective effect on mortality compared with walking <0.5 hours/day after adjustment for confounders (HR 0.29; 95% CI, 0.06–1.20). Walking ≥2 hours/day showed no benefit on mortality in men with critical diseases, even after adjustment for confounders. Conclusions Different duration of daily walking was associated with decreased mortality for younger-elderly men with or without critical diseases, independent of sociodemographic and lifestyle factors, BMI, medical status, disease history, and functional capacity. Incorporating regular walking into daily lives of younger-elderly men may improve longevity and successful aging.
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Affiliation(s)
- Wenjing Zhao
- Department of Public Health, Hokkaido University Graduate School of Medicine
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25
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Steinbacher P, Feichtinger RG, Kedenko L, Kedenko I, Reinhardt S, Schönauer AL, Leitner I, Sänger AM, Stoiber W, Kofler B, Förster H, Paulweber B, Ring-Dimitriou S. The single nucleotide polymorphism Gly482Ser in the PGC-1α gene impairs exercise-induced slow-twitch muscle fibre transformation in humans. PLoS One 2015; 10:e0123881. [PMID: 25886402 PMCID: PMC4401702 DOI: 10.1371/journal.pone.0123881] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/23/2015] [Indexed: 12/13/2022] Open
Abstract
PGC-1α (peroxisome proliferator-activated receptor γ co-activator 1α) is an important regulator of mitochondrial biogenesis and a master regulator of enzymes involved in oxidative phosphorylation. Recent evidence demonstrated that the Gly482Ser single nucleotide polymorphism (SNP) in the PGC-1α gene affects insulin sensitivity, blood lipid metabolism and binding to myocyte enhancer factor 2 (MEF2). Individuals carrying this SNP were shown to have a reduced cardiorespiratory fitness and a higher risk to develop type 2 diabetes. Here, we investigated the responses of untrained men with the Gly482Ser SNP to a 10 week programme of endurance training (cycling, 3 x 60 min/week, heart rate at 70-90% VO2peak). Quantitative data from analysis of biopsies from vastus lateralis muscle revealed that the SNP group, in contrast to the control group, lacked a training-induced increase in content of slow contracting oxidative fibres. Capillary supply, mitochondrial density, mitochondrial enzyme activities and intramyocellular lipid content increased similarly in both groups. These results indicate that the impaired binding of MEF2 to PGC-1α in humans with this SNP impedes exercise-induced fast-to-slow muscle fibre transformation.
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Affiliation(s)
- Peter Steinbacher
- Department of Cell Biology, Paris Lodron-University of Salzburg, Salzburg, Austria
- * E-mail:
| | - René G. Feichtinger
- Research Program for Receptor Biochemistry and Tumor Metabolism, Department of Pedicatrics, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Lyudmyla Kedenko
- First Department of Internal Medicine, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Igor Kedenko
- First Department of Internal Medicine, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Sandra Reinhardt
- Department of Cell Biology, Paris Lodron-University of Salzburg, Salzburg, Austria
| | - Anna-Lena Schönauer
- Department of Cell Biology, Paris Lodron-University of Salzburg, Salzburg, Austria
| | - Isabella Leitner
- Department of Cell Biology, Paris Lodron-University of Salzburg, Salzburg, Austria
| | - Alexandra M. Sänger
- Department of Cell Biology, Paris Lodron-University of Salzburg, Salzburg, Austria
| | - Walter Stoiber
- Department of Cell Biology, Paris Lodron-University of Salzburg, Salzburg, Austria
| | - Barbara Kofler
- Research Program for Receptor Biochemistry and Tumor Metabolism, Department of Pedicatrics, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Holger Förster
- Medical Office in Pediatrics and Sports Medicine, Salzburg, Austria
| | - Bernhard Paulweber
- First Department of Internal Medicine, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Susanne Ring-Dimitriou
- Department of Sport Science and Kinesiology, Paris Lodron-University of Salzburg, Hallein, Austria
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Ohta Y, Kawano Y, Minami J, Iwashima Y, Hayashi S, Yoshihara F, Nakamura S. Effects of daily walking on office, home and 24-h blood pressure in hypertensive patients. Clin Exp Hypertens 2015; 37:433-7. [PMID: 25815710 DOI: 10.3109/10641963.2015.1013115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Aerobic exercise has been recommended in the management of hypertension. However, few studies have examined the effect of walking on ambulatory blood pressure (BP), and no studies have employed home BP monitoring. We investigated the effects of daily walking on office, home, and 24-h ambulatory BP in hypertensive patients. Sixty-five treated or untreated patients with essential hypertension (39 women and 26 men, 60 ± 9 years) were examined in a randomized cross-over design. The patients were asked to take a daily walk of 30-60 min to achieve 10 000 steps/d for 4 weeks, and to maintain usual activities for another 4 weeks. The number of steps taken and home BP were recorded everyday. Measurement of office and ambulatory BP, and sampling of blood and urine were performed at the end of each period. The average number of steps were 5349 ± 2267/d and 10 049 ± 3403/d in the control and walking period, respectively. Body weight and urinary sodium excretion did not change. Office, home, and 24-h BP in the walking period were lower compared to the control period by 2.6 ± 9.4/1.3 ± 4.9 mmHg (p < 0.05), 1.6 ± 6.8/1.5 ± 3.7 mmHg (p < 0.01), and 2.4 ± 7.6/1.8 ± 5.3 mmHg (p < 0.01), respectively. Average 24-h heart rate and serum triglyceride also decreased significantly. The changes in 24-h BP with walking significantly correlated with the average 24-h BP in the control period. In conclusion, daily walking lowered office, home, and 24-h BP, and improved 24-h heart rate and lipid metabolism in hypertensive patients. However, the small changes in BP may limit the value of walking as a non-pharmacologic therapy for hypertension.
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Affiliation(s)
- Yuko Ohta
- Division of Internal Medicine, Japan Seafarers Relief Association, Moji Ekisaikai Hospital , Kitakyushu, Fukuoka , Japan
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27
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Preventive Cardiology: The Effects of Exercise. Coron Artery Dis 2015. [DOI: 10.1007/978-1-4471-2828-1_28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Madsen SM, Thorup AC, Overgaard K, Bjerre M, Jeppesen PB. Functional and structural vascular adaptations following 8 weeks of low volume high intensity interval training in lower leg of type 2 diabetes patients and individuals at high risk of metabolic syndrome. Arch Physiol Biochem 2015; 121:178-86. [PMID: 26471849 DOI: 10.3109/13813455.2015.1087033] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED We wished to investigate the effects of 8 weeks of low volume high intensity interval training (HIIT) on endothelial function of popliteal artery and circulating cell adhesion molecules in type 2 diabetes (T2D) patients and matched controls (CON). METHODS Over 8 weeks, non-active T2D patients and CONs cycled three times per week (10 × 60 sec HIIT). Pre- and post-HIIT measurements of endothelial function were conducted by applying flow-mediated dilation (FMD) along with taking venous blood samples. RESULTS Baseline diameter of popliteal artery increased significantly from an average of 5.53 mm to 5.97 mm (∼8%) in the CON-group (p = 0.006) and 5.32 mm to 5.61 mm (∼6%) in the T2D-group (p = 0.009). Peak diameter increased significantly from 5.82 mm to 6.36 mm (∼9%) in the CON-group (p = 0.001) and 5.57 mm to 5.93 mm (∼7%) in the T2D-group (p = 0.004). FMD% increased significantly from 5.12% to 6.58% in the CON-group (p = 0.004) and 4.84% to 5.66% in the T2D-group: (p = 0.045). The shear rate reduced significantly in both groups (CON-group: p = 0.04; T2D-group: p = 0.002). Circulating cell adhesion molecules remained unchanged (p > 0.05). CONCLUSION HIIT induced an improvement of endothelium-dependent FMD and significant outwards artery modelling. No changes in circulating cell adhesion molecules were observed.
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Affiliation(s)
- Søren Møller Madsen
- a Department of Endocrinology and Internal Medicine , Aarhus Sygehus THG, Aarhus University Hospital , Aarhus C , Denmark
| | - Anne Cathrine Thorup
- a Department of Endocrinology and Internal Medicine , Aarhus Sygehus THG, Aarhus University Hospital , Aarhus C , Denmark
| | - Kristian Overgaard
- b Section of Sport Science, Department of Public Health, Aarhus University , Aarhus , Denmark , and
| | - Mette Bjerre
- c The Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University , Denmark
| | - Per Bendix Jeppesen
- a Department of Endocrinology and Internal Medicine , Aarhus Sygehus THG, Aarhus University Hospital , Aarhus C , Denmark
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Li Y, Hanssen H, Cordes M, Rossmeissl A, Endes S, Schmidt-Trucksäss A. Aerobic, resistance and combined exercise training on arterial stiffness in normotensive and hypertensive adults: A review. Eur J Sport Sci 2014; 15:443-57. [PMID: 25251989 DOI: 10.1080/17461391.2014.955129] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Exercise training has different effects on arterial stiffness according to training modalities. The optimal exercise modality for improvement of arterial function in normotensive and hypertensive individuals has not been well established. In this review, we aim to evaluate the effects of aerobic, resistance and combined aerobic and resistance training on arterial stiffness in individuals with and without hypertension. We systematically searched the Pubmed and Web of Science database from 1985 until December 2013 for relevant randomised controlled trials (RCTs). The data were extracted by one investigator and checked by a second investigator. The training effects on arterial stiffness were estimated using weighted mean differences of the relative changes (%) with 95% confidence intervals (CIs). We finally reviewed the results from 17 RCTs. The available evidence indicates that aerobic exercise tends to have a beneficial effect on arterial stiffness in normotensive and hypertensive patients, but does not affect arterial stiffness in patients with isolated systolic hypertension. Resistance exercise has differing effects on arterial stiffness depending on type and intensity. Vigorous resistance training is associated with an increase in arterial stiffness. There seem to be no unfavourable effects on arterial stiffness if the training is of low intensity, in a slow eccentric manner or with lower limb in healthy individuals. Combined training has neutral or even a beneficial effect on arterial stiffness. In conclusion, our review shows that exercise training has varying effects on arterial stiffness depending on the exercise modalities.
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Affiliation(s)
- Yanlei Li
- a Division Sports and Exercise Medicine, Department of Sport, Exercise and Health , University of Basel , Basel , Switzerland
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Supporting South Asian Taxi Drivers to Exercise through Pedometers (SSTEP) to decrease cardiovascular disease risk. J Urban Health 2014; 91:463-76. [PMID: 24500026 PMCID: PMC4074328 DOI: 10.1007/s11524-013-9858-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There is considerable evidence demonstrating the positive impact of pedometers and walking programs for increasing physical activity and reducing risk for cardiovascular disease among diverse populations. However, no interventions have been targeted towards South Asian taxi drivers, a population that may be at high risk for developing cardiovascular disease. Supporting South Asian Taxi Drivers to Exercise through Pedometers (SSTEP) was a 12-week pilot study among South Asian taxi drivers to increase their daily step counts. SSTEP assessed the feasibility, acceptability, and potential impact of an exercise intervention employing pedometers, a step diary, written materials, and telephone follow-up to initiate or increase physical activity in this at-risk occupational group. Seventy-four drivers were recruited to participate at sites frequented by South Asian taxi drivers. Participant inclusion criteria were: (1) age 18 or over; (2) birthplace in India, Pakistan, or Bangladesh; (3) fluent in English, Hindi, Urdu, Punjabi, or Bengali; and (4) intention to remain in New York City for the 3-month study period. Comprehensive intake and exit questionnaires were administered to participants in their preferred languages. Intake and exit health screenings, including blood pressure, cholesterol, and glucose were completed. Daily step counts were obtained 4 days after recruitment, and at the 4-, 8-, and 12-week mark via phone calls. To measure the impact of the intervention, step counts, blood pressure, cholesterol, and body mass index were compared at intake and exit. Participants in SSTEP were sedentary at baseline. The SSTEP intervention resulted in a small increase in step counts among participants overall, and in a significant increase (>2,000 steps) among a subset ("Bigsteppers"). Drivers with higher baseline glucose values had significantly greater improvements in their step counts. Focused lifestyle interventions for drivers at high risk for cardiovascular disease may be particularly impactful.
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Carmeli E, Imam B. Health promotion and disease prevention strategies in older adults with intellectual and developmental disabilities. Front Public Health 2014; 2:31. [PMID: 24783190 PMCID: PMC3995041 DOI: 10.3389/fpubh.2014.00031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 03/28/2014] [Indexed: 02/04/2023] Open
Abstract
The rapid growth in the number of individuals living with intellectual and developmental disabilities (IDD) along with their increased longevity present challenges to those concerned about health and well-being of this unique population. While much is known about health promotion and disease prevention in the general geriatric population, far less is known about those in older adults with IDD. Effective and efficient health promotion and disease prevention strategies need to be developed and implemented for improving the health and quality of life of older adults living with IDD. This is considered to be challenging given the continued shrinkage in the overall health care and welfare system services due to the cut in the governmental budget in some of the western countries. The ideal health promotion and disease prevention strategies for older adults with IDD should be tailored to the individuals' health risks, address primary and secondary disease prevention, and prevent avoidable impairments that cause premature institutionalization. Domains of intervention should include cognitive, mental and physical health, accommodations, workplace considerations, assistive technology, recreational activities, and nutrition.
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Affiliation(s)
- Eli Carmeli
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa , Haifa , Israel
| | - Bita Imam
- Rehabilitation Research Lab, GF Strong Rehab Centre, University of British Columbia , Vancouver, BC , Canada
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Jefferis BJ, Whincup PH, Lennon LT, Papacosta O, Goya Wannamethee S. Physical activity in older men: longitudinal associations with inflammatory and hemostatic biomarkers, N-terminal pro-brain natriuretic peptide, and onset of coronary heart disease and mortality. J Am Geriatr Soc 2014; 62:599-606. [PMID: 24635212 PMCID: PMC4283726 DOI: 10.1111/jgs.12748] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine associations between habitual physical activity (PA) and changes in PA and onset of coronary heart disease (CHD) and the pathways linking PA to CHD. DESIGN British Regional Heart Study population-based cohort; men completed questionnaires in 1996 and 1998 to 2000, attended rescreen in 1998 to 2000, and were followed up to June 2010. SETTING Community. PARTICIPANTS Of 4,252 men recruited from primary care centers (77% of those invited and eligible) who were rescreened in 1998 to 2000, 3,320 were ambulatory and free from CHD, stroke, and heart failure and participated in the current study. MEASUREMENTS Usual PA (regular walking and cycling, recreational activity and sport). Outcome was first fatal or nonfatal myocardial infarction. RESULTS In 3,320 ambulatory men, 303 first and 184 fatal CHD events occurred during a median of 11 years of follow-up; 9% reported no usual PA, 23% occasional PA, and 68% light or more-intense PA. PA was inversely associated with novel risk markers C-reactive protein, D-dimer, von Willebrand Factor and N-terminal pro-brain natriuretic peptide (NT-proBNP). Compared with no usual PA, hazard ratios (HRs) for CHD events, adjusted for age and region, were 0.52 (95% confidence interval (CI) = 0.34-0.79) for occasional PA, 0.47 (95% CI = 0.30-0.74) for light PA, 0.51 (95% CI = 0.32-0.82) for moderate PA, and 0.44 (95% CI = 0.29-0.65) for moderately vigorous or vigorous PA (P for linear trend = .004). Adjustment for established and novel risk markers somewhat attenuated HRs and abolished linear trends. Compared with men who remained inactive, men who maintained at least light PA had an HR for CHD events of 0.73 (95% CI = 0.53-1.02) and men whose PA level increased had an HR of 0.86 (95% CI = 0.55-1.35). CONCLUSION Even light PA was associated with significantly lower risk of CHD events in healthy older men, partly through inflammatory and hemostatic mechanisms and cardiac function (NT-proBNP).
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Affiliation(s)
- Barbara J Jefferis
- Department of Primary Care and Population Health, University College London, London, UK; Population Health Domain Physical Activity Research Group, University College London, London, UK
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Gill JM, Celis-Morales CA, Ghouri N. Physical activity, ethnicity and cardio-metabolic health: Does one size fit all? Atherosclerosis 2014; 232:319-33. [DOI: 10.1016/j.atherosclerosis.2013.11.039] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 11/07/2013] [Accepted: 11/08/2013] [Indexed: 12/24/2022]
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Fiuza-Luces C, Garatachea N, Berger NA, Lucia A. Exercise is the real polypill. Physiology (Bethesda) 2014; 28:330-58. [PMID: 23997192 DOI: 10.1152/physiol.00019.2013] [Citation(s) in RCA: 312] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The concept of a "polypill" is receiving growing attention to prevent cardiovascular disease. Yet similar if not overall higher benefits are achievable with regular exercise, a drug-free intervention for which our genome has been haped over evolution. Compared with drugs, exercise is available at low cost and relatively free of adverse effects. We summarize epidemiological evidence on the preventive/therapeutic benefits of exercise and on the main biological mediators involved.
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Fleg JL, Forman DE, Berra K, Bittner V, Blumenthal JA, Chen MA, Cheng S, Kitzman DW, Maurer MS, Rich MW, Shen WK, Williams MA, Zieman SJ. Secondary prevention of atherosclerotic cardiovascular disease in older adults: a scientific statement from the American Heart Association. Circulation 2013; 128:2422-46. [PMID: 24166575 PMCID: PMC4171129 DOI: 10.1161/01.cir.0000436752.99896.22] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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36
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Petry NM, Andrade LF, Barry D, Byrne S. A randomized study of reinforcing ambulatory exercise in older adults. Psychol Aging 2013; 28:1164-73. [PMID: 24128075 DOI: 10.1037/a0032563] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Many older adults do not meet physical activity recommendations and suffer from health-related complications. Reinforcement interventions can have pronounced effects on promoting behavior change; this study evaluated the efficacy of a reinforcement intervention to enhance walking in older adults. Forty-five sedentary adults with mild to moderate hypertension were randomized to 12-week interventions consisting of pedometers and guidelines to walk 10,000 steps/day or that same intervention with chances to win $1-$100 prizes for meeting recommendations. Patients walked an average of about 4,000 steps/day at baseline. Throughout the intervention, participants in the reinforcement intervention met walking goals on 82.5% ± 25.8% of days versus 55.3% ± 37.1% of days in the control condition, p < .01. Even though steps walked increased significantly in both groups relative to baseline, participants in the reinforcement condition walked an average of about 2,000 more steps/day than participants in the control condition, p < .02. Beneficial effects of the reinforcement condition relative to the control condition persisted at a 24-week follow-up evaluation, p < .02, although steps/day were lower than during the intervention period in both groups. Participants in the reinforcement intervention also evidenced greater reductions in blood pressure and weight over time and improvements in fitness indices, ps < .05. This reinforcement-based intervention substantially increased walking and improved clinical parameters, suggesting that larger-scale evaluations of reinforcement-based interventions for enhancing active lifestyles in older adults are warranted. Ultimately, economic analyses may reveal reinforcement interventions to be cost-effective, especially in high-risk populations of older adults.
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Vogel T, Lang PO, Schmitt E, Kaltenbach G, Geny B. Bénéfices pour la santé de la pratique d’une activité physique chez le sujet âgé. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s12612-013-0360-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Physical activity is inversely associated with multimorbidity in elderly men: results from the KORA-Age Augsburg Study. Prev Med 2013; 57:17-9. [PMID: 23485795 DOI: 10.1016/j.ypmed.2013.02.014] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 02/11/2013] [Accepted: 02/15/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Physical activity is suggested to play a key role in the prevention of several chronic diseases. However, data on the association between physical activity and multimorbidity are lacking. METHODS Using data from 1007 men and women aged 65-94 years who participated in the population-based KORA (Cooperative Health Research in the Region of Augsburg)-Age project conducted in Augsburg/Germany and two adjacent counties in 2008/09, 13 chronic conditions were identified, and physical activity scores were calculated based on the self-reported physical activity scale for the elderly (PASE). Multivariable sex-specific logistic regression was applied to determine the association of the continuous physical activity score with multimorbidity (≥ 2 out of 13 diseases). RESULTS Physical activity (mean PASE score±SD) was higher in men (125.1 ± 59.2) than in women (112.2 ± 49.2). Among men, the odds ratio (OR) for multimorbidity was 0.73 (95% CI: 0.60-0.90) for a 1 standard deviation increase of the PASE score. No significant results could be observed for women (OR: 1.05; 95% CI: 0.83-1.33). CONCLUSION We demonstrated an inverse association between physical activity and multimorbidity among men. Further prospective studies have to confirm the temporality of effects.
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Abstract
The reality of regression of atherosclerotic plaques was established as long ago as 1987 by aggressive cholesterol reduction even before the era of statin therapy. Nevertheless, the most important aspect of patient benefit to prevent cardiovascular (CV) disease events is stabilization of these plaques so they will not rupture. Lowering of low-density lipoproteins is critical to this goal and can be considered the gold standard of preventive CV medicine. The major goal for the high-risk patient and the diabetic patient is lowering these harmful lipoproteins to less than 70 mg/dL. No discussion of CV disease prevention is complete without considering tobacco abuse and its elimination. Even secondhand smoke has been established as harmful. Control of hypertension is another major aspect of CV disease prevention, and a blood pressure less than 120/80 mm Hg is ideal. With obesity a major problem in the developed world, its role in the metabolic syndrome is of major significance as is the high prevalence of this so-called syndrome versus collection of specific risk factors in a population with poor health habits. Control of diabetes mellitus has established benefit from the standpoint of CV disease prevention except that some problems have been reported with extremely tight blood sugar control. Exercise was long considered good but now there are evidence-based reasons to recommend it as essential in CV disease prevention. There are many unforeseen frontiers in CV disease prevention but, for now, everything points to elevation of high-density lipoproteins as the next focus of this prevention.
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Affiliation(s)
- Thomas F Whayne
- Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, Kentucky
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41
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Lammers G, van Duijnhoven NTL, Hoenderop JG, Horstman AM, de Haan A, Janssen TWJ, de Graaf MJJ, Pardoel EM, Verwiel ETP, Thijssen DHJ, Hopman MTE. The identification of genetic pathways involved in vascular adaptations after physical deconditioningversusexercise training in humans. Exp Physiol 2012; 98:710-21. [DOI: 10.1113/expphysiol.2012.068726] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Morris C, Bourne PA, Eldemire-Shearer D, McGrowder DA. Social determinants of physical exercise in older men in Jamaica. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2012; 2:87-96. [PMID: 22624120 PMCID: PMC3354440 DOI: 10.4297/najms.2010.287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background: Background: Physical activity interventions have been demonstrated to improve health-related quality of life and to be of special benefit to older adults with specific chronic conditions including arthritis, hypertension, diabetes mellitus, and heart disease. Aim: This study examined the extent and social determinants of physical exercise in elderly men in Jamaica. Materials and Methods: A sample of 2,000 men 55 years of age and older was extracted from a total of 33,674 males in the parish of St. Catherine. A 132-item questionnaire was used to collect the data. A stratified random sampling technique was used to draw the sample. Descriptive statistics were used to provide background information on the sub-sample, and logistic regressions were utilized to model physical exercise. Results: Of the respondents, 55.4% indicated good health status, 51.0% lived in rural areas; 10.4% had moderate to high functional dependence and 67.3% reported that they did some form of physical exercise. Of those who indicated involvement in physical exercise (n = 1,345), 77.2% jogged, ran, and/or walked; 13.3% did aerobics; 4.7% swam; 2.0% cycled and 0.6% did push-ups or sit-ups. The variables that predicted being engaged in physical exercise were education; age of respondents; current good health status; household head; health plan; employment status, and social support. Conclusion: Most of the elderly men were engaged in some form of physical activity and had good health. Age and good health status were the most influential social determinants of physical exercise. However, effective interventions to promote physical activity in older men in Caribbean countries such as Jamaica deserve wide implementation.
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Affiliation(s)
- Chloe Morris
- Department of Community Health and Psychiatry, Faculty of Medical Sciences, The University of the West Indies, Mona Campus, Kingston 7, Jamaica
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Wang JS, Lin CW, Yang YTC, Ho YJ. Walking pattern classification and walking distance estimation algorithms using gait phase information. IEEE Trans Biomed Eng 2012; 59:2884-92. [PMID: 22893370 DOI: 10.1109/tbme.2012.2212245] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This paper presents a walking pattern classification and a walking distance estimation algorithm using gait phase information. A gait phase information retrieval algorithm was developed to analyze the duration of the phases in a gait cycle (i.e., stance, push-off, swing, and heel-strike phases). Based on the gait phase information, a decision tree based on the relations between gait phases was constructed for classifying three different walking patterns (level walking, walking upstairs, and walking downstairs). Gait phase information was also used for developing a walking distance estimation algorithm. The walking distance estimation algorithm consists of the processes of step count and step length estimation. The proposed walking pattern classification and walking distance estimation algorithm have been validated by a series of experiments. The accuracy of the proposed walking pattern classification was 98.87%, 95.45%, and 95.00% for level walking, walking upstairs, and walking downstairs, respectively. The accuracy of the proposed walking distance estimation algorithm was 96.42% over a walking distance.
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Affiliation(s)
- Jeen-Shing Wang
- Department of Electrical Engineering, National Cheng Kung University, Tainan 701, Taiwan.
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44
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Whayne TF, Maulik N. Nutrition and the healthy heart with an exercise boost. Can J Physiol Pharmacol 2012; 90:967-76. [DOI: 10.1139/y2012-074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In this era of potent medications and major cardiovascular (CV) procedures, the value of nutrition can be forgotten. A healthy diet is essential, regardless of CV risk. Caloric balance is inherent to a good diet. Despite patients who say they eat little, ideal weight can be maintained if calories are burned. Composition is another component of a healthy diet. The Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets provide proof of CV benefit from their specific content. Metabolic syndrome (MS) is associated with poor diet and obesity. A healthy diet with good nutrition benefits the MS patient and associated conditions such as obesity and diabetes. Exercise, in conjunction with a healthy diet and good nutrition, helps maintain optimal weight and provides CV benefit such as decreased inflammation and increased vasodilatation. Whether vitamins or other nutritional supplements are important in a healthy diet is unproven. Nevertheless, the most promising data of added benefit to a healthy diet is with vitamin D. Some dietary supplements also have promise. Alcohol, in moderation, especially red wine, has nutritional and heart protective benefits. Antioxidants, endogenous or exogenous, have received increased interest and appear to play a favorable nutritional role. CV health starts with good nutrition.
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Affiliation(s)
- Thomas F. Whayne
- Gill Heart Institute, University of Kentucky, 326 Wethington Building, 900 South Limestone Street, Lexington, KY 40536-0200, USA
| | - Nilanjana Maulik
- Molecular Cardiology and Angiogenesis Laboratory, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-1110, USA
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Abstract
Regular physical activity during leisure time has been shown to be associated with better health outcomes. The American Heart Association, the Centers for Disease Control and Prevention and the American College of Sports Medicine all recommend regular physical activity of moderate intensity for the prevention and complementary treatment of several diseases. The therapeutic role of exercise in maintaining good health and treating diseases is not new. The benefits of physical activity date back to Susruta, a 600 BC physician in India, who prescribed exercise to patients. Hippocrates (460–377 BC) wrote “in order to remain healthy, the entire day should be devoted exclusively to ways and means of increasing one’s strength and staying healthy, and the best way to do so is through physical exercise.” Plato (427–347 BC) referred to medicine as a sister art to physical exercise while the noted ancient Greek physician Galen (129–217 AD) penned several essays on aerobic fitness and strengthening muscles. This article briefly reviews the beneficial effects of physical activity on cardiovascular diseases.
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Vanhees L, Rauch B, Piepoli M, van Buuren F, Takken T, Börjesson M, Bjarnason-Wehrens B, Doherty P, Dugmore D, Halle M. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III). Eur J Prev Cardiol 2012; 19:1333-56. [DOI: 10.1177/2047487312437063] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - B Rauch
- Centre for Ambulatory Cardiac and Angiologic Rehabilitation, Ludwigshafen, Germany
| | - M Piepoli
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - T Takken
- University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Börjesson
- Sahlgrenska University Hospital/Ostra, Goteborg, Sweden
| | | | | | - D Dugmore
- Wellness International Medical Centre, Stockport, UK
| | - M Halle
- University Hospital ‘Klinikum rechts der Isar’, Technische Universitaet Muenchen, Munich, Germany
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Rankin AJ, Rankin AC, Macintyre P, Hillis WS. Walk or run? is high-intensity exercise more effective than moderate-intensity exercise at reducing cardiovascular risk? Scott Med J 2011; 57:99-102. [DOI: 10.1258/smj.2011.011284] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The benefits of exercise in the prevention of cardiovascular disease are irrefutable. However, the optimum ‘dose’ of exercise in order to derive the maximum cardiovascular benefit is not certain. Current national and international guidelines advocate the benefits of moderate-intensity exercise. The relative benefits of vigorous versus moderate-intensity exercise have been studied in large epidemiological studies, addressing coronary heart disease and mortality, as well as smaller randomized clinical trials which assessed effects on cardiovascular risk factors. There is evidence that exercise intensity, rather than duration or frequency, is the most important variable in determining cardioprotection. Applying this evidence into practice must take into account the impact of baseline fitness, compliance and the independent risk associated with a sedentary lifestyle. This review aims to evaluate the role of exercise intensity in the reduction of cardiovascular risk, and answer the question: should you be advising your patients to walk or run?
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Affiliation(s)
- A J Rankin
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - A C Rankin
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - P Macintyre
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - W S Hillis
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
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Park J, Ishikawa-Takata K, Tanaka S, Mekata Y, Tabata I. Effects of walking speed and step frequency on estimation of physical activity using accelerometers. J Physiol Anthropol 2011; 30:119-27. [PMID: 21636955 DOI: 10.2114/jpa2.30.119] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
This study evaluated the accuracy of assessing step counts and energy costs under walking conditions altered by step frequency changes at given speeds using uni- (LC) and tri-axial accelerometers (AM, ASP). Healthy young men and women (n=18) volunteered as subjects. Nine tests were designed to manipulate three step frequencies, low (-15% of normal), normal, and high (+15%), at each walking speed (55, 75, and 95 m/min). A facemask connected to a Douglas bag was attached to subjects, who wore accelerometers around their waist. LC underestimated the step counts at normal or high step frequency at 55 m/min and AM also at all step frequencies at 55 m/min, whereas ASP did not in all trials. LC underestimated metabolic equivalents (METs) at low or normal step frequency at all walking speeds. AM underestimated METs at low step frequency at all walking speeds and at high step frequency of 95 m/min. ASP gave underestimates only at low step frequency of 95 m/min. The degree of the percentage error of METs for AM and ASP was affected by step frequency. Significant interaction between step frequency and speed was found that for LC. These results suggest that LC and AM can cause errors in step-count functions at a low walking speed. Furthermore, LC may show low accuracy of the METs measurement during walking altered according to step frequency and speed, whereas AM and ASP, which are tri-axial accelerometers, are more accurate but the degree of the percentage error is affected by step frequency.
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Affiliation(s)
- Jonghoon Park
- Health Promotion and Exercise Program, National Institute of Health and Nutrition, Tokyo, Japan.
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Hill K, Dolmage TE, Woon L, Coutts D, Goldstein R, Brooks D. Defining the relationship between average daily energy expenditure and field-based walking tests and aerobic reserve in COPD. Chest 2011; 141:406-412. [PMID: 21835907 DOI: 10.1378/chest.11-0298] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The aims of this study were to determine which tests of exercise capacity relate to average daily energy expenditure (DEE) and to quantify aerobic reserve during daily life in people with COPD. METHODS A cross-sectional study was undertaken in 26 people with COPD (16 men; FEV(1), 50% ± 16%). Six-min walk distance (6MWD) and incremental shuttle walk distance (ISWD) measures were collected, and peak oxygen uptake (VO(2) peak) was measured during a symptom-limited ramp cycle ergometry test. The SenseWear Armband was worn during the waking hours for 4.4 ± 1.1 days to measure DEE. The intensity at which activities of daily living were undertaken was expressed as a percentage of VO(2) peak. RESULTS DEE was associated with 6MWD (r = 0.40, P = .046) and ISWD (r = 0.52, P = .007) but not VO(2) peak (mL/kg per min) (r = 0.07, P = .74). Stronger associations were observed between DEE and the body weight-walking distance product for the 6MWD (r = 0.73, P < .001) and ISWD (r = 0.75, P < .001). The average intensity of daily activity was equivalent to 58% ± 11% of VO(2) peak, leaving an average aerobic reserve of 42%. CONCLUSIONS Both 6MWD and ISWD, but not VO(2) peak, were related to DEE. Because activities of daily living were performed at a high percentage of VO(2) peak, it may be more realistic to optimize habitual DEE in COPD by increasing the frequency or duration rather than the intensity of physical activity.
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Affiliation(s)
- Kylie Hill
- Department of Respiratory Medicine, Toronto, ON, Canada; Departments of Physical Therapy and Medicine, University of Toronto, Toronto, ON, Canada; School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia; Lung Institute of Western Australia and Centre for Asthma, Allergy and Respiratory Research, University of Western Australia, Crawley, WA, Australia
| | - Thomas E Dolmage
- Department of Respiratory Medicine, Toronto, ON, Canada; Respiratory Diagnostic and Evaluations Services, West Park Healthcare Centre, Toronto, ON, Canada
| | - Lynda Woon
- Department of Respiratory Medicine, Toronto, ON, Canada
| | - Debbie Coutts
- Department of Respiratory Medicine, Credit Valley Hospital, Mississauga, ON, Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, Toronto, ON, Canada; Departments of Physical Therapy and Medicine, University of Toronto, Toronto, ON, Canada
| | - Dina Brooks
- Department of Respiratory Medicine, Toronto, ON, Canada; Departments of Physical Therapy and Medicine, University of Toronto, Toronto, ON, Canada.
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Sattelmair J, Pertman J, Ding EL, Kohl HW, Haskell W, Lee IM. Dose response between physical activity and risk of coronary heart disease: a meta-analysis. Circulation 2011; 124:789-95. [PMID: 21810663 DOI: 10.1161/circulationaha.110.010710] [Citation(s) in RCA: 652] [Impact Index Per Article: 50.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND No reviews have quantified the specific amounts of physical activity required for lower risks of coronary heart disease when assessing the dose-response relation. Instead, previous reviews have used qualitative estimates such as low, moderate, and high physical activity. METHODS AND RESULTS We performed an aggregate data meta-analysis of epidemiological studies investigating physical activity and primary prevention of CHD. We included prospective cohort studies published in English since 1995. After reviewing 3194 abstracts, we included 33 studies. We used random-effects generalized least squares spline models for trend estimation to derive pooled dose-response estimates. Among the 33 studies, 9 allowed quantitative estimates of leisure-time physical activity. Individuals who engaged in the equivalent of 150 min/wk of moderate-intensity leisure-time physical activity (minimum amount, 2008 U.S. federal guidelines) had a 14% lower coronary heart disease risk (relative risk, 0.86; 95% confidence interval, 0.77 to 0.96) compared with those reporting no leisure-time physical activity. Those engaging in the equivalent of 300 min/wk of moderate-intensity leisure-time physical activity (2008 U.S. federal guidelines for additional benefits) had a 20% (relative risk, 0.80; 95% confidence interval, 0.74 to 0.88) lower risk. At higher levels of physical activity, relative risks were modestly lower. People who were physically active at levels lower than the minimum recommended amount also had significantly lower risk of coronary heart disease. There was a significant interaction by sex (P=0.03); the association was stronger among women than men. CONCLUSIONS These findings provide quantitative data supporting US physical activity guidelines that stipulate that "some physical activity is better than none" and "additional benefits occur with more physical activity."
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Affiliation(s)
- Jacob Sattelmair
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
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