Objective To examine prospectively the association between muscular strength and mortality from all causes, cardiovascular disease, and cancer in men.Design Prospective cohort study.Setting Aerobics ...centre longitudinal study.Participants 8762 men aged 20-80.Main outcome measures All cause mortality up to 31 December 2003; muscular strength, quantified by combining one repetition maximal measures for leg and bench presses and further categorised as age specific thirds of the combined strength variable; and cardiorespiratory fitness assessed by a maximal exercise test on a treadmill.Results During an average follow-up of 18.9 years, 503 deaths occurred (145 cardiovascular disease, 199 cancer). Age adjusted death rates per 10 000 person years across incremental thirds of muscular strength were 38.9, 25.9, and 26.6 for all causes; 12.1, 7.6, and 6.6 for cardiovascular disease; and 6.1, 4.9, and 4.2 for cancer (all P<0.01 for linear trend). After adjusting for age, physical activity, smoking, alcohol intake, body mass index, baseline medical conditions, and family history of cardiovascular disease, hazard ratios across incremental thirds of muscular strength for all cause mortality were 1.0 (referent), 0.72 (95% confidence interval 0.58 to 0.90), and 0.77 (0.62 to 0.96); for death from cardiovascular disease were 1.0 (referent), 0.74 (0.50 to 1.10), and 0.71 (0.47 to 1.07); and for death from cancer were 1.0 (referent), 0.72 (0.51 to 1.00), and 0.68 (0.48 to 0.97). The pattern of the association between muscular strength and death from all causes and cancer persisted after further adjustment for cardiorespiratory fitness; however, the association between muscular strength and death from cardiovascular disease was attenuated after further adjustment for cardiorespiratory fitness.Conclusion Muscular strength is inversely and independently associated with death from all causes and cancer in men, even after adjusting for cardiorespiratory fitness and other potential confounders.
The redefinition of neuropathic pain as "pain arising as a direct consequence of a lesion or disease affecting the somatosensory system," which was suggested by the International Association for the ...Study of Pain (IASP) Special Interest Group on Neuropathic Pain (NeuPSIG) in 2008, has been widely accepted. In contrast, the proposed grading system of possible, probable, and definite neuropathic pain from 2008 has been used to a lesser extent. Here, we report a citation analysis of the original NeuPSIG grading paper of 2008, followed by an analysis of its use by an expert panel and recommendations for an improved grading system. As of February, 2015, 608 eligible articles in Scopus cited the paper, 414 of which cited the neuropathic pain definition. Of 220 clinical studies citing the paper, 56 had used the grading system. The percentage using the grading system increased from 5% in 2009 to 30% in 2014. Obstacles to a wider use of the grading system were identified, including (1) questions about the relative significance of confirmatory tests, (2) the role of screening tools, and (3) uncertainties about what is considered a neuroanatomically plausible pain distribution. Here, we present a revised grading system with an adjusted order, better reflecting clinical practice, improvements in the specifications, and a word of caution that even the "definite" level of neuropathic pain does not always indicate causality. In addition, we add a table illustrating the area of pain and sensory abnormalities in common neuropathic pain conditions and propose areas for further research.
To examine the combined associations and relative contributions of leisure-time physical activity (PA) and cardiorespiratory fitness (CRF) with all-cause mortality.
Prospective cohort study. Setting ...Aerobics centre longitudinal study.
31,818 men and 10 555 women who received a medical examination during 1978-2002. Assessment of risk factors Leisure-time PA assessed by self-reported questionnaire; CRF assessed by maximal treadmill test. Main outcome measures All-cause mortality until 31 December 2003.
There were 1492 (469 per 10,000) and 230 (218 per 10,000) deaths in men and women, respectively. PA and CRF were positively correlated in men (r = 0.49) and women (r = 0.47) controlling for age (p < 0.001 for both). PA was inversely associated with mortality in multivariable Cox regression analysis among men, but the association was eliminated after further adjustment for CRF. No significant association of PA with mortality was observed in women. CRF was inversely associated with mortality in men and women, and the associations remained significant after further adjustment for PA. In the PA and CRF combined analysis, compared with the reference group "not meeting the recommended PA (< 500 metabolic equivalent-minute/week) and unfit", the relative risks (95% CIs) of mortality were 0.62 (0.54 to 0.72) and 0.61 (0.44 to 0.86) in men and women "not meeting the recommended PA and fit", 0.96 (0.61 to 1.53) and 0.93 (0.33 to 2.58) in men and women "meeting the recommended PA and unfit" and 0.60 (0.51 to 0.70) and 0.56 (0.37 to 0.85) in men and women "meeting the recommended PA and fit", respectively.
CRF was more strongly associated with all-cause mortality than PA; therefore, improving CRF should be encouraged in unfit individuals to reduce risk of mortality and considered in the development of future PA guidelines.
Exercise therapy - the public health message Blair, S. N.; Sallis, R. E.; Hutber, A. ...
Scandinavian journal of medicine & science in sports,
August 2012, Letnik:
22, Številka:
4
Journal Article
Recenzirano
Non‐communicable chronic diseases (NCDs), such as cardiovascular disease, diabetes, and cancer, are currently responsible for 65% of all deaths worldwide and are projected to cause over 75% of all ...deaths by 2030. A substantial accumulation of epidemiological and experimental evidence has established a causal relationship between NCDs and well‐known yet preventable risk factors (e.g., physical inactivity and obesity). Given that physical activity has both direct and indirect effects on the mortality and morbidity of NCDs via other risk factors (e.g., obesity, diabetes, and hypertension), it is now undeniable that sedentary lifestyles are one of the most significant public health problems of the 21st century.
In 2007, the American College of Sports Medicine (ACSM) and American Medical Association (AMA) launched the Exercise is Medicine® (EIM) initiative in recognition of the fundamental importance of physical activity to health and well‐being. EIM is on the forefront of a global movement to reduce sedentary lifestyles, foster implementation of exercise counseling into clinical practice, and disseminate exercise therapy on a global scale. If the devastating human losses and financial burden of inactivity‐induced chronic disease are to be ameliorated, the wide‐ranging cost‐effective health benefits and financial feasibility of physical activity interventions must be appreciated and promoted.
Objective
Chronic inflammation is linked to many chronic conditions. One of the strongest modulators of chronic inflammation is diet. The Dietary Inflammatory Index (DII) measures dietary ...inflammatory potential and has been validated previously, but not among African Americans (AAs).
Design
Cross-sectional analysis using baseline data from the Healthy Eating and Active Living in the Spirit (HEALS) intervention study.
Setting
Baseline data collection occurred between 2009 and 2012 in or near Columbia, SC.
Participants
African-American churchgoers.
Measurements
Baseline data collection included c-reactive protein (CRP) and interleukin-6 from blood draws, anthropometric measures, and numerous questionnaires. The questionnaires included a food frequency questionnaire which was used for DII calculation. The main analyses were performed using quantile regression.
Results
Subjects in the highest DII quartile (i.e., more pro-inflammatory) were younger, more likely to be married, and had less education and greater BMI. Individuals in DII quartile 4 had statistically significantly greater CRP at the 75th and 90th percentiles of CRP versus those in quartile 1 (i.e., more anti-inflammatory).
Conclusion
Construct validation provides support for using the DII in research among AA populations. Future research should explore avenues to promote more anti-inflammatory diets, with use of the DII, among AA populations to reduce risk of chronic disease.
The purpose of this review was to address three specific questions. 1) Do higher levels of physical activity attenuate the increased health risk normally observed in overweight or obese individuals? ...2) Do obese but active individuals actually have a lower morbidity and mortality risk than normal weight persons who are sedentary? 3) Which is a more important predictor of mortality, overweight or inactivity?
We initially identified more than 700 articles that included information on the exposure variables of body habitus (body mass index, body composition, or body fat pattern) and physical activity habits, and on outcomes such as morbidity or mortality. To be included in the review, we required that an article include an analysis of one of our outcomes by strata of the two exposure variables. We excluded review articles and reports of cross-sectional analyses. We used an evidence-based approach to evaluate the quality of the published data.
We summarized results from 24 articles that met all inclusion criteria. Data were available for the outcomes of all-cause mortality, cardiovascular disease mortality, coronary heart disease (CHD), hypertension, type 2 diabetes mellitus, and cancer. Summary results for all outcomes except cancer were generally consistent in showing that active or fit women and men appeared to be protected against the hazards of overweight or obesity. This apparent protective effect was often stronger in obese individuals than in those of normal weight or who were overweight. There were too few data on cancer to permit any conclusions.
There are no randomized clinical trials on the topics addressed in this review. All studies reviewed were prospective observational studies, so all conclusions are based on Evidence Category, C. The conclusions for the three questions addressed in the review are: 1) regular physical activity clearly attenuates many of the health risks associated with overweight or obesity; 2) physical activity appears to not only attenuate the health risks of overweight and obesity, but active obese individuals actually have lower morbidity and mortality than normal weight individuals who are sedentary, and 3) inactivity and low cardiorespiratory fitness are as important as overweight and obesity as mortality predictors. Research needs include extending current observations to more diverse populations, including more studies in women, the elderly, and minority groups, assessment methods need to be improved, and randomized clinical trials addressing the questions discussed in this review should be undertaken. Owing to size, complexity, and cost, these trials will need to be designed with valid noninvasive measures of subclinical disease processes as outcomes.
This study examined the association between cardiorespiratory fitness and C-reactive protein (CRP), with adjustment for weight and within weight categories.
We calculated median and adjusted ...geometric mean CRP levels, percentages of individuals with an elevated CRP (> or =2.00 mg/L), and odds ratios of elevated CRP across 5 levels of cardiorespiratory fitness for 722 men. CRP values were adjusted for age, body mass index, vitamin use, statin medication use, aspirin use, the presence of inflammatory disease, cardiovascular disease, and diabetes, and smoking habit. We found an inverse association of CRP across fitness levels (P for trend<0.001), with the highest adjusted CRP value in the lowest fitness quintile (1.64 1.27 to 2.11 mg/L) and the lowest adjusted CRP value in the highest fitness quintile (0.70 0.60 to 0.80 mg/L). Similar results were found for the prevalence of elevated CRP across fitness quintiles. We used logistic regression to model the adjusted odds for elevated CRP and found that compared with the referent first quintile, the second (odds ratio OR 0.43, 95% CI 0.22 to 0.85), third (OR 0.33, 95% CI 0.17 to 0.65), fourth (OR 0.23, 95% CI 0.12 to 0.47), and fifth (OR 0.17, 95% CI 0.08 to 0.37) quintiles of fitness had significantly lower odds of elevated CRP. Similar results were found when examining the CRP-fitness relation within categories of body fatness (normal weight, overweight, and obese) and waist girth (<102 or > or =102 cm).
Cardiorespiratory fitness levels were inversely associated with CRP values and the prevalence of elevated CRP values in this sample of men from the Aerobics Center Longitudinal Study.
Background: Cardiorespiratory fitness and body fatness are both related to health, but their interrelation to all-cause and cardiovascular disease (CVD) mortality is unknown. Objective: We examined ...the health benefits of leanness and the hazards of obesity while simultaneously considering cardiorespiratory fitness. Design: This was an observational cohort study. We followed 21925 men, aged 30-83 y, who had a body-composition assessment and a maximal treadmill exercise test. There were 428 deaths (144 from CVD, 143 from cancer, and 141 from other causes) in an average of 8 y of follow-up (176742 man-years). Results: After adjustment for age, examination year, cigarette smoking, alcohol intake, and parental history of ischemic heart disease, unfit (low cardiorespiratory fitness as determined by maximal exercise testing), lean men had double the risk of all-cause mortality of fit, lean men (relative risk: 2.07; 95% CI: 1.16, 3.69; P = 0.01). Unfit, lean men also had a higher risk of all-cause and CVD mortality than did men who were fit and obese. We observed similar results for fat and fat-free mass in relation to mortality. Unfit men had a higher risk of all-cause and CVD mortality than did fit men in all fat and fat-free mass categories. Similarly, unfit men with low waist girths (< 87 cm) had greater risk of all-cause mortality than did fit men with high waist girths (> or = 99 cm). Conclusions: The health benefits of leanness are limited to fit men, and being fit may reduce the hazards of obesity.
Small-scale farming may have large impacts on the selection and spread of antimicrobial resistance to humans. We conducted an observational study to evaluate antibiotic-resistant
populations from ...poultry and humans in rural northwestern Esmeraldas, Ecuador. Our study site is a remote region with historically low resistance levels of third-generation antibiotics such cefotaxime (CTX), a clinically relevant antibiotic, in both poultry and humans. Our study revealed 1) high CTX resistance (66.1%) in farmed broiler chickens, 2) an increase in CTX resistance over time in backyard chicken not fed antibiotics (2.3-17.9%), and 3) identical
sequences from human and chicken bacteria, suggesting a spillover event. These findings provide evidence that small-scale meat production operations have direct impacts on the spread and selection of clinically important antibiotics among underdeveloped settings.
To examine the association of sedentary behavior (SB) with metabolic syndrome (MetS) in adults, as well as to identify the impact of physical inactivity and economic condition on such association.
...This is a cross-sectional study.
This study was conducted in the city of Bauru, São Paulo State, Brazil (n = 970). Television (TV) viewing and physical activity (PA) were assessed by questionnaire. MetS was assessed via medical records. Descriptive statistics and binary logistic regression were used in data analyses.
Participants with moderate TV viewing were associated with MetS when compared with low TV viewing group, even after adjustments for age, sex, economic status, smoking, and PA (odds ratio OR = 1.49 95% confidence interval {CI}: 1.01–2.20). The fully adjusted model showed an association between high exposure to TV viewing with MetS (OR = 1.77 95%CI: 1.11–2.82). The combination of physical inactivity and high TV viewing boosted the likelihood of having MetS (OR = 1.89 95%CI: 1.08–3.29).
The results of the present study suggest that moderate and high TV viewing time is associated with the presence of MetS, mainly in insufficiently active adults and those living in lower economic condition.
•Television (TV) viewing was associated with metabolic syndrome (MetS) even after adjustments including physical activity.•The combination of physical inactivity and high TV viewing had double the likelihood of having MetS.•Combined low economic status and TV viewing revealed a significant association with the higher occurrence of MetS.
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