Abstract
Background
Obesity (OB) is a serious epidemic in the United States.
Methods
We examined OB patterns and time trends across socio-economic and geographic parameters and projected the future ...situation. Large national databases were used. Overweight (OW), OB and severe obesity (SOB) were defined using body mass index cut-points/percentiles; central obesity (CO), waist circumference cut-point in adults and waist:height ratio cutoff in youth. Various meta-regression analysis models were fit for projection analyses.
Results
OB prevalence had consistently risen since 1999 and considerable differences existed across groups and regions. Among adults, men’s OB (33.7%) and OW (71.6%) levelled off in 2009–2012, resuming the increase to 38.0 and 74.7% in 2015–2016, respectively. Women showed an uninterrupted increase in OB/OW prevalence since 1999, reaching 41.5% (OB) and 68.9% (OW) in 2015–2016. SOB levelled off in 2013–2016 (men: 5.5–5.6%; women: 9.7–9.5%), after annual increases of 0.2% between 1999 and 2012. Non-Hispanic Blacks had the highest prevalence in women’s OB/SOB and men’s SOB. OB prevalence in boys rose continuously to 20.6% and SOB to 7.5% in 2015–2016, but not in girls. By 2030, most Americans will be OB/OW and nearly 50% of adults OB, whereas ∼33% of children aged 6–11 and ∼50% of adolescents aged 12–19 will be OB/OW. Since 1999, CO has risen steadily, and by 2030 is projected to reach 55.6% in men, 80.0% in women, 47.6% among girls and 38.9% among boys. Regional differences exist in adult OB prevalence (2011–2016) and across ethnicities; South (32.0%) and Midwest (31.4%) had the highest rates.
Conclusions
US obesity prevalence has been rising, despite a temporary pause in 2009–2012. Wide disparities across groups and geographical regions persist. Effective, sustainable, culturally-tailored interventions are needed.
The importance of cardiorespiratory fitness (CRF) is now well established and it is increasingly being recognized as an essential variable which should be assessed in health screenings. The key ...findings that have established the clinical significance of CRF are reviewed in this report, along with an overview of the current relevance of exercise as a form of medicine that can provide a number of positive health outcomes, including increasing CRF. Current assessment options for assessing CRF are also reviewed, including the direct measurement via cardiopulmonary exercise testing which now can be interpreted with age and sex-specific reference values. Future directions for the use of CRF and related measures are presented.
Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates ...attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes. The purpose of this statement is to review current knowledge related to the association between CRF and health outcomes, increase awareness of the added value of CRF to improve risk prediction, and suggest future directions in research. Although the statement is not intended to be a comprehensive review, critical references that address important advances in the field are highlighted. The underlying premise of this statement is that the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk. These opportunities must be realized to optimize the prevention and treatment of cardiovascular disease and hence meet the American Heart Association's 2020 goals.
The importance of cardiorespiratory fitness (CRF) is well established. This report provides newly developed standards for CRF reference values derived from cardiopulmonary exercise testing (CPX) ...using cycle ergometry in the United States. Ten laboratories in the United States experienced in CPX administration with established quality control procedures contributed to the "Fitness Registry and the Importance of Exercise: A National Database" (FRIEND) Registry from April 2014 through May 2016. Data from 4494 maximal (respiratory exchange ratio, ≥1.1) cycle ergometer tests from men and women (20-79 years) from 27 states, without cardiovascular disease, were used to develop these references values. Percentiles of maximum oxygen consumption (VO
) for men and women were determined for each decade from age 20 years through age 79 years. Comparisons of VO
were made to reference data established with CPX data from treadmill data in the FRIEND Registry and previously published reports. As expected, there were significant differences between sex and age groups for VO
(P<.01). For cycle tests within the FRIEND Registry, the 50th percentile VO
of men and women aged 20 to 29 years declined from 41.9 and 31.0 mLO
/kg/min to 19.5 and 14.8 mLO
/kg/min for ages 70 to 79 years, respectively. The rate of decline in this cohort was approximately 10% per decade. The FRIEND Registry reference data will be useful in providing more accurate interpretations for the US population of CPX-measured VO
from exercise tests using cycle ergometry compared with previous approaches based on estimations of standard differences from treadmill testing reference values.
Abstract Cardiorespiratory fitness (CRF) has been one of the most widely examined physiological variables, particularly as it relates to functional capacity and human performance. Over the past three ...decades, CRF has emerged as a strong, independent predictor of all-cause and disease-specific mortality. The evidence supporting the prognostic use of CRF is so powerful that the American Heart Association recently advocated for the routine assessment of CRF as a clinical vital sign. Interestingly, the continuity of evidence of the inverse relationship between CRF and mortality over the past decade exists despite a wide variation of methods used to assess CRF in these studies, ranging from the gold-standard method of directly measured maximal oxygen uptake (VO2max ) during cardiopulmonary exercise testing to estimation from exercise tests and non-exercise prediction equations. This review highlights new knowledge and the primary advances since 2009, with specific reference to the impact variations in CRF have on all-cause and disease-specific mortality.
To develop reference values by age and sex for LM measures using GE-Healthcare DXA systems.
A de-identified sample was obtained from Ball State University's Clinical Exercise Physiology Laboratory ...and University of Wisconsin-Milwaukee's Physical Activity & Health Research Laboratory. DXA scans of 2,076 women and 1,251 men were completed using a GE Lunar Prodigy or iDXA. Percentiles (%ile) were calculated for all variables of interest (LM, LMI, %LM, and ALMI) and a factorial ANOVA was used to assess differences for each variable between 10-year age groups and sex, as well as the interaction between age and sex.
Men had higher mean total LM, %LM, LMI, and ALMI than women (p<0.01), across all age groups. All LM variables decreased significantly over the 5 decades in men, however in women only total LM, %LM, and ALMI decreased from the youngest to oldest age groups (p<0.01).
These reference values provide for a more accurate interpretation of GE-Healthcare DXA-derived LM measurements offering clinicians and researchers with an initial resource to aid in the early detection and assessment of LM deficits.
The cardiovascular disease (CVD) pandemic has placed considerable strain on healthcare systems, quality of life, and physical function, while remaining the leading cause of death globally. Decades of ...scientific investigations have fortified the protective effects of cardiorespiratory fitness (CRF), exercise training, and physical activity (PA) against the development of CVD. This review will summarize recent efforts that have made significant strides in; 1) the application of novel analytic techniques to increase the predictive utility of CRF; 2) understanding the protective effects of long-term compliance to PA recommendations through large cohort studies with multiple points of assessment; 3) and understanding the potential harms associated with extreme volumes of PA.
Consumer-based physical activity (PA) monitors are popular for individual tracking of PA variables. However, current research has not examined how these monitors track energy expenditure (EE) and ...steps in distinct activities. This study examined the accuracy of the Fitbits One, Zip, and Flex and Jawbone UP24 for estimating EE and steps for specific activities and activity categories.
Thirty subjects completed a structured protocol consisting of three sedentary, four household, and four ambulatory/exercise activities. All subjects began by lying on a bed for 10 min; 10 other activities were performed for 5 min each. Indirect calorimetry (COSMED) and researcher-counted steps were criterion measures for EE and step counts, respectively. The Omron HJ-720IT pedometer was used as a comparison of step count accuracy. EE and steps were compared with criterion measures using the Friedman repeated-measures nonparametric test and mean absolute percent error (MAPE).
All PA monitors predicted EE within 8% of COSMED for sedentary activity but overestimated EE by 16%-40% during ambulatory activity. All monitors except the Fitbit Flex (within 8% of criterion) underestimated EE by 27%-34% during household activity. EE predictions were accompanied with MAPE >10%. For household activity, the Fitbit Flex estimated steps within 10% of researcher-counted steps; all other monitors underestimated steps by 35%-64%. All monitors estimated steps within 4% of researcher-counted steps and displayed MAPE <10% during ambulatory activity. The Omron underestimated household steps by 74% but was within 1% for ambulatory steps. All monitors severely underestimated EE and steps during cycling.
Consumer-based PA monitors should be used cautiously for estimating EE, although they provide accurate measures of steps for structured ambulatory activity, similar to validated pedometers.
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