Fitness Categories Research Articles

MUSCULOSKELETAL FITNESS AND ALL-CAUSE MORTALITY

The beneficial effects of cardiorespiratory fitness (CRF) on mortality are well known. However, the relation of musculoskeletal fitness (MSF), specifically muscular strength and endurance, to mortality risk has not been as thoroughly examined. PURPOSE To determine if a relation exists between MSF and mortality after controlling for age, sex, BMI, health status, current smoking status, cholesterol, SBP, and treadmill measured CRF. METHODS Individuals in the Aerobics Center Longitudinal Study who completed at least one medical examination and a MSF assessment at the Cooper Clinic in Dallas, TX between 1981 and 1989 were potential subjects. 7605 men and 1500 women, 20–82 years of age, with a total follow-up of 106,046 person-years met these criteria. The MSF assessment included a 1-minute sit-up test, a 1-repetition maximal leg press and a 1-repetition maximal bench press. All-cause mortality rates were calculated for low, moderate, and high MSF strata. Mortality surveillance through 1996 primarily using the National Death Index confirmed 194 deaths in this study group (2.1%). RESULTS The age- and sex-adjusted mortality rate of the lowest MSF category was almost twice that of those in the moderate MSF category (23.9 vs. 13.5 per 10,000 person-years, respectively). Individuals in the highest MSF category had a mortality rate of 15.4 per 10,000 person-years. The moderate and high MSF groups had relative risks of 0.64 (95%CI 0.44–0.93) and 0.80 (95%CI 0.49–1.31), respectively after adjustment for age, sex, BMI, health status, current smoking status, cholesterol, SBP, and CRF when compared with the low MSF group. CONCLUSION Mortality rates across low, moderate, and high musculoskeletal fitness categories suggest a threshold effect between low musculoskeletal fitness and moderate/high musculoskeletal fitness and all-cause mortality in the presence of other health factors. Supported in part by NIH grant AG06945

Subjective and quantitative assessment of patient fitness for cadaveric kidney transplantation: the "equity penalty".

Patient fitness at the time of organ allocation has an impact on graft survival equivalent to the effect of human leukocyte antigen (HLA) matching. The variation between institutions in assessment of fitness is not known, nor is the potential impact on mean graft survival of incorporating patient fitness into local adult cadaveric-kidney transplant-allocation algorithms. Data from the Collaborative Transplant Study (CTS, 1985-2000) were reviewed. Quantitative criteria (QC) of patient fitness based on national transplant society guidelines were compared with subjective categorization (SC) of each patient on the current local transplant waiting list (n=109) determined by their supervising nephrologist. Five-year cadaveric graft survival was 70%, 61%, and 53% for good-, moderate-, and poor-risk patients in the CTS data set (n=102, 612), equivalent to half lives of 12.7, 9.8, and 8.7 years, respectively, with similar results from the local program. The distribution of local waiting-list patients into fitness categories A (good), B (moderate), C (poor), and D (unacceptable) was 51%:31%:13%:5% by SC and 25%:40%:27%:8% by QC. At one hospital, 61% (n=51) of patients were classified category A by SC, and falling to 16% by QC (P<.0001). Compared with preferential category A recipient allocation, an unrestricted allocation policy was estimated to sacrifice 1.5 years of overall program-mean graft survival. Use of QC may reduce the variation in subjective patient assessment seen between institutions. Any proposed changes in organ allocation methods should address the "equity versus efficiency" balance in an open fashion and predict the impact on the overall graft survival for the program by quantifying the "equity penalty."

Study finds higher cardiovascular fitness associated with greater hearing acuity

Initial signs of auditory aging start long before age 65.Johnson and Hawkins reported evidence of nerve degen-eration in the cochlea secondary to hair cell degenerationby 5early adolescence. Numerous studies have reporteddeterioration of hearing levels with middle age and then anotable acceleration above 70 years.

Relative associations of fitness and fatness to fibrinogen, white blood cell count, uric acid and metabolic syndrome.

To examine the relation between fitness and fibrinogen, white blood cell count, uric acid and metabolic syndrome across levels of adiposity in apparently healthy, nonsmoking men. Cross-sectional study of 4057 men from the Aerobics Center Longitudinal Study examining the age-adjusted resting levels and risk of having a clinically significant elevation of fibrinogen, white blood cell count, uric acid and metabolic syndrome score across nine fitness-body fatness combinations. Fitness categories (low fitness, moderately fit or high fitness) were based on a maximal treadmill test. Body mass index (BMI) <25.0 was classified as normal weight, BMI > or = 25.0 but <30.0 as overweight and BMI > or = 30.0 as obese. Fitness (inversely) and BMI (directly) were independently related to the age-adjusted values of all four variables (P for trend P<0.0001 for each). For all four variables, the greatest age-adjusted risk of having a clinically relevant value was found in the low fitness-obese category and the lowest age-adjusted risk was found in the high fitness-normal weight group. Fibrinogen, white blood cells, uric acid and metabolic syndrome score are independently related to both fitness (inversely) and fatness (directly). Within levels of fatness, risk for significant elevations in fibrinogen, white blood cells, uric acid and metabolic syndrome score is lower for the higher fitness groups.

Determinants of exercise blood pressure response in normotensive and hypertensive women: role of cardiorespiratory fitness.

Exaggerated blood pressure (BP) response during physical exertion is associated with increased risk for cardiovascular events. Furthermore, it may be the predisposing factor for myocardial infarction triggered by physical exertion. The authors have shown that systolic BP achieved after 6 minutes of exercise is the strongest predictor of left ventricular hypertrophy. Furthermore, a 37 mm Hg increase in systolic BP above resting BP at 6 minutes of exercise was the threshold for left ventricular hypertrophy. The purpose of this study was to determine predictors of exercise BP response in normotensive and hypertensive women. An exercise tolerance test (Bruce) was performed by 1411 normotensive (resting BP < 140/90 mm Hg) and hypertensive (resting BP > or = 140/90 mm Hg) women. These women were faculty, students, and staff at the University of Maryland, College Park, Maryland, and the George Washington University Medical Center, as well as patients undergoing a routine exercise tolerance test at West Coast Cardiology, Pinellas Park, Florida. Two fitness categories (low-fit and high-fit) were established on the basis of treadmill time to exhaustion adjusted for age. Significant associations were observed among the 6-minute exercise BP and age, body mass index, resting systolic and diastolic BP, heart rate, and exercise time to exhaustion. In a stepwise multiple-regression analysis, the determinants of BP after 6 minutes of exercise were resting systolic BP and treadmill time to exhaustion (R2 = 0.36) for normotensive women and treadmill time to exhaustion and resting systolic BP (R2 = 0.30) for hypertensive women. When fitness categories were contrasted, low-fit women in both the normotensive and hypertensive categories had higher BP and rate-pressure product after 6 minutes of exercise than the high-fit women (P <.05). Resting systolic BP and cardiorespiratory fitness are determinants of a submaximal exercise BP response for both hypertensive and normotensive women. Low cardiorespiratory fitness is associated with a higher BP response during submaximal exercise, suggesting that increased fitness may attenuate this abnormal rise in BP. Thus, low- to moderate-intensity physical activities for most days of the week should be encouraged for all women to increase cardiorespiratory fitness. This is likely to attenuate an abnormal rise in systolic BP that may occur during routine daily activities and protect against the associated health consequences.

Fitness Counseling for the College Woman: These Are Not Her Mother's Norms!

Most university recreation centers offer some form of fitness assessment service to both their undergraduate and graduate student populations. These assessments typically include evaluation of each of the major fitness components — cardiovascular endurance, muscular strength and endurance, flexibility, and body composition. Following assessment of these components, the student is informed of his/her fitness classification and receives a recommended exercise program based on the results. In many instances, the norms used for the fitness classification of these students are those provided by the American College of Sports Medicine (ACSM), which are based on two separate age-related categories, the under 20 and 20–29 year divisions. Since the average undergraduate and graduate student is between 17–25 years of age, the ACSM norms do not provide a single normative distribution. In addition, currently used fitness classifications utilize category headings such as poor and fair which may be disheartening, especially for de-conditioned female students who are already leery about beginning an exercise program. Therefore, the purpose of this research was two-fold: 1) to determine a single normative distribution for 17–25 year-old college female on a variety of commonly used fitness tests; and 2) to develop more user-friendly categories for reporting fitness performance. The intent was to establish more accurate normative data and create a more positive climate during the post-test consultation in a college or university fitness setting. The test battery used combined protocols for each of the major components of fitness including the YMCA sub-maximal ergometer test, 1-RM bench and leg press, curl ups, push ups, trunk flexion, shoulder elevation, and a 3-site body composition test. Testing was performed on 377 female undergraduate and graduate students between the ages of 17 and 25. Normative data including means and standard deviations were determined. In addition, five fitness categories (performance, fitness, healthy, potential risk, and at risk) were established for each of the tests administered. Category descriptors were designed to help foster a supportive atmosphere during the post-test consultation. The integration of these findings into a college-based fitness assessment program may help to create a more reassuring climate and thus positively impact exercise program adherence rates of female college students.

A health-related fitness and functional performance test battery for middle-aged and older adults: Feasibility and health-related content validity

Malmberg JJ, Miilunpalo SI, Vuori IM, Pasanen ME, Oja P, Haapanen-Niemi NA. A health-related fitness and functional performance test battery for middle-aged and older adults: feasibility and health-related content validity. Arch Phys Med Rehabil 2002;83:666-77. Objective: To evaluate the feasibility and health-related content validity of 6 health-related fitness (HRF) and 3 functional performance (FP) tests among middle-aged and older persons. Design: Cross-sectional methodologic study. Setting: Field laboratories in 3 communities of northeast Finland. Participants: A regionally representative, community-based cohort of 55- to 79-year-old men (n=501) and women (n=632). Interventions: Not applicable. Main Outcome Measures: Health-related test exclusion rates (%) by age groups and odds ratios (ORs) of subjective health outcomes by fitness categories (least 20%, next 40%, most fit 40%). Results: The health-related test exclusion rates increased with age, mainly because of musculoskeletal health limitations among the women and cardiovascular and musculoskeletal health limitations among the men. With the exception of dynamic back extension, 1-leg squat, 1-leg standing balance, and the 1-km walk among the women 75 years and older, 85% or more of the subjects qualified for the HRF tests and 95% or more for the FP tests. Strong and graded associations were found for cardiorespiratory and musculoskeletal fitness and the FP test levels with perceived health and functional ability status among both the men and the women (OR range, 2-31). The motor fitness test level was primarily associated with functional ability status. Conclusions: All the HRF and FP tests showed health-related content validity, and 4 of 6 of the HRF tests and all of the FP tests proved to be safe, with minor health-related test exclusions for middle-aged and older adults. The findings may help to target physical activity intervention toward persons at high risk for declining health and functional ability. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Rethinking the Meaning and Management of Intersexuality

Given that ample research has established that surgery to `correct' the appearance of intersexed genitals is socially motivated, this article is concerned how actual medical practices obfuscate social interests, and what the results of that obfuscation can be. By applying Eric Parens' distinctive means of categorizing medical procedures as either `enhancements' or `treatments' this article argues that the current means of managing intersexuality fit neither category. The article then proceeds to question the logic of dominant medical practice concerned with intersexuality and proposes new ways to think about intersexuality and provide care for intersexed children. Case studies form exemplars that demonstrate the consequences of the medical and cultural illogic at work in early childhood diagnosis and clinical management.

THE ASSOCIATION OF FITNESS AND C-REACTIVE PROTEIN

The inflammatory marker C-reactive protein (CRP) has been identified as an independent risk factor for cardiovascular disease (CVD) and diabetes. It is well known that moderate to high levels of fitness are protective against the development of CVD and diabetes. However the mechanisms whereby increased fitness confers protection against CVD and the development of diabetes remains incompletely understood. Reduced baseline inflammatory status may be one possible mechanism where-by higher levels of fitness provides protection. However, there is limited data examining this hypothesis. Purpose: To examine the association of CRP and fitness. Methods: Cross-sectional study of 241 men in the Aerobics Center Longitudinal Study. Participants had no history of current tobacco use or CVD. Fitness was assessed by maximal treadmill exercise test (Balke protocol) and participants were classified into low, moderate and high fitness categories based on age and treadmill time. CRP was measured following a 12-hour fast prior to fitness test. Due to the skewed distribution, CRP data are presented as geometric means (± SE) and medians (25th, 75th percentiles). Results: *adjusted for age and body mass index (kg/m2), b = Spearmen Correlation For mean CRP: Low < Mod (p = 0.02), Low & Mod < High (p < 0.0001 for both) For adjusted mean CRP: Low & Mod < High (p = 0.001 & 0.0009 respectively) Conclusion: Higher levels of fitness are associated with lower levels of CRP in this group of healthy, non-smoking men. This relation is independent of age and BMI. Lower levels of C-reactive protein may be one mechanism whereby higher levels of fitness provide protection against the development of CVD and diabetes. Supported in part by U.S.P.H.S research grant AG06945 from the N.I.A.Table: No Caption Available.

Usefulness of cardiorespiratory fitness as a predictor of all-cause and cardiovascular disease mortality in men with systemic hypertension

There is an inverse gradient of mortality across levels of cardiorespiratory fitness in healthy adults; however, the association of fitness to mortality in persons with comorbidities such as hypertension is not fully understood. This study quantifies the relation of cardiorespiratory fitness to all-cause mortality and cardiovascular disease (CVD) mortality in hypertensive men. In this observational cohort study, we calculated death rates for low, moderate, and high fitness categories in normotensive (n = 15,726) and hypertensive (n = 3,184) men, and in men without a history of hypertension but with elevated blood pressure (BP) (systolic BP ≥140 or diastolic BP ≥90 mm Hg) at baseline (n = 3,257). The participants were 22,167 men (average age 42.6 ± 9.2 years [mean ± SD]) who underwent a medical examination that included a maximal exercise test during 1970 to 1993, with mortality follow-up to December 31, 1994. We identified 628 deaths (188 from CVD) during 224,173 man-years of observation. There was an inverse linear trend across fitness groups for all-cause and CVD mortality. The relative risk (95% confidence interval [CI]), using the low fitness group as reference, for all-cause mortality in hypertensive men was 0.45 (95% CI 0.31 to 0.65) and 0.42 (95% CI 0.27 to 0.66) for moderate and high fitness groups, respectively, and in men with elevated BP, 0.49 (95% CI 0.34 to 0.70) and 0.44 (95% CI 0.29 to 0.68) for moderate and high fitness groups, respectively. The pattern of results was similar for CVD mortality. There was an inverse linear relation between fitness and death rate for all-cause mortality in both the uncontrolled and controlled hypertensive groups. This study provides evidence that moderate to high levels of cardiorespiratory fitness provide protection against all-cause and CVD mortality in hypertensive men and men without a history of hypertension but with elevated BP at examination.

Is physical activity or physical fitness more important in defining health benefits?

We addressed three questions: 1) Is there a dose-response relation between physical activity and health? 2) Is there a dose-response relation between cardiorespiratory fitness and health? 3) If both activity and fitness have a dose-response relation to health, is it possible to determine which exposure is more important? We identified articles by PubMed search (restricted from 1/1/90 to 8/25/00) using keywords related to physical activity, physical fitness, and health. An author scanned titles and abstracts of 9831 identified articles. We included for thorough review articles that included three or more categories of activity or fitness and a health outcome and excluded articles on clinical trials, review papers, comments, letters, case reports, and nonhuman studies. We used an evidence-based approach to evaluate the quality of the published data. We summarized results from 67 articles meeting final selection criteria. There is good consensus across studies with most showing an inverse dose-response gradient across both activity and fitness categories for morbidity from coronary heart disease (CHD), stroke, cardiovascular disease (CVD), or cancer; and for CVD, cancer, or all-cause mortality. All studies reviewed were prospective observational investigations; thus, conclusions are based on Evidence Category C. 1) There is a consistent gradient across activity groups indicating greater longevity and reduced risk of CHD, CVD, stroke, and colon cancer in more active individuals. 2) Studies are compelling in the consistency and steepness of the gradient across fitness groups. Most show a curvilinear gradient, with a steep slope at low levels of fitness and an asymptote in the upper part of the fitness distribution. 3) It is not possible to conclude whether activity or fitness is more important for health. Future studies should define more precisely the shape of the dose-response gradient across activity or fitness groups, evaluate the role of musculoskeletal fitness, and investigate additional health outcomes.

PHYSICAL ACTIVITY OR CARDIORESPIRATORY FITNESS

We evaluated the association of cardiorespiratory fitness and physical activity to mortality in 7,855 women and 25,218 men examined during 1970–1994. All participants were apparently healthy and completed a maximal exercise test on a treadmill. Participants were followed to date of death or to 12/31/94 for survivors. There were 102 deaths in women and 743 deaths in men. We assigned participants to 3 categories of activity (Sedentary, Active = up to 19.9 MET hours/week, and Highly active = ≥ 20 MET hours/week), and fitness (Low = least fit 20%, Moderate = next 40%, and High = most fit 40%). There was a significant inverse trend for mortality across both activity and fitness categories, which remained after adjustment for BMI, smoking habit, alcohol intake, hypertension, and parental history of early death. When both activity and fitness were entered into the same model, the inverse trend across activity categories disappeared. The inverse trend remained across fitness categories (RR (95% confidence interval))-Women (Low = 1.0, Moderate = 0.44 (0.28–0.71), and High = 0.33 (0.17–0.65)) and Men (Low = 1.0, Moderate = 0.53 (0.44–0.64), and High = 0.42 (0.32–0.56). We conclude that cardiorespiratory fitness is stronger than physical activity as a predictor of mortality in women and men. Supported by NIA 06945

THE ASSOCIATION OF FITNESS AND BMI ON WHITE BLOOD CELL COUNT

Elevations in white blood cell (WBC) count have been identified as an independent risk factor for all-cause and cardiovascular disease (CVD) mortality. It is well known that moderate to high levels of fitness are protective against all-cause and CVD mortality. The association of fitness with WBC count has not been examined. Since body mass index (BMI) is correlated with both fitness and WBC count, it was the goal of this study to examine the relationship between fitness and WBC count across BMI categories. A cross-sectional analysis was performed using 8480 participants of the Aerobics Center Longitudinal Study with no history of tobacco use, CVD or cancer. Participants performed a maximal exercise test (Balke protocol) and were classified into fitness groups based on age, sex, and treadmill time: 1) low fitness (least fit 20%) 2) moderate fitness (next fit 40%), and 3) high fitness (most fit 40%). WBC counts were measured following a 12-hour fast. Data are presented as averaged WBC counts ± standard deviation. P for trend was analyzed with the multiple regression model: WBC = BMI + treadmill time. Fitness was inversely related to WBC count in all BMI categories for men and women. Additionally the P values for trend across fitness categories and BMI categories were statistically significant (P < 0.0001). Thus reduced WBC counts may be a mechanism whereby increased fitness provides protection against all-cause and CVD mortality.Table

Foregrounding the Environment

It goes without saying that there has been recently a proliferation of ecotheological publishing; indeed ‘the river of theological writing in this area has now turned into a flood’. Beyond the fact that there is a general concern for the environment, generalizations about this deluge are not easy to make. There are typologies that offer helpful categories, albeit categories of approximate fit; however these classi-fications vary according to different departure points. But what can be claimed is that most ecotheology does not pay sustained attention to the central Christian doctrine of soteriology.

Physical activity, physical fitness, and Framingham 10-year risk score: the cross-cultural activity participation study.

Although physical activity and physical fitness are inversely and causally associated with coronary heart disease (CHD) morbidity and mortality, available equations for estimating CHD risk do not include scores for activity or fitness. Therefore, this study evaluated the association of physical fitness and moderate-intensity physical activity with the 10-year Framingham CHD risk estimate. Cross-sectional analyses were performed on data from 137 healthy middle-aged women (53.9 +/- 9.9 yr; 28.3 +/- 6.0 kg/m2). Health histories, body composition, blood pressure, and blood samples were obtained from a clinical examination. Levels of moderate (3-6 METS) intensity physical activity, expressed as MET-minutes/day of energy expenditure, were derived from multiple 24-hour physical activity records. Physical fitness was quantified as duration of a symptom-limited maximal treadmill exercise test. After adjustment for race, body mass index (BMI), and hormone replacement status, a graded reduction in the Framingham risk score was observed across low (5.8%), moderate (4.0%), and high (3.6%) fitness levels (P for trend = 0.009). Women in both the moderate and high fitness categories had a lower (P < 0.01) risk score compared with their low fit counterparts. Significant differences in risk were not seen among low (3.9%), moderate (4.9%), and high (4.4%) physical activity groups. The lack of association between the risk score by physical activity may have been due to the homogeneity of activity levels among participants. Our findings reinforce existing data that show enhanced levels of fitness are associated with lower risk for CHD.

Development and Initial Validation of the Effort Sense Rating Scale (ESRS): A Self-Perceived Index of Physical Fitness

Background. The Effort Sense Rating Scale is a non invasive, easy to administer, self-assessment device for deriving an index of physical fitness comprising only aerobic and anaerobic power components. The scale originates from the notion that people who have experienced varying degrees of effort doing "everyday" tasks can accurately estimate the exertion required in fairly common, physically demanding "situations" when provided with an appropriate perceptual frame-of-reference. Estimations elicited in this way can be scaled and used to categorize fitness level. This article reports an initial validity study. Further development of this technique is in progress.Sample. Forty volunteers from a university community, mainly students (17 women and 23 men), completed ESRS twice and then underwent submaximal aerobic (cycle ergometry: YMCA protocol) and anaerobic power (Wingate protocol) assessments.Results. Nonparametric correlation coefficients between the Effort Sense Rating Scale and the aerobic power were rs = 0.47 (P < 0.05) and anaerobic power rs = 0.62 (P < 0.05). Interpreted at the category level there was 77.5% agreement between ESRS indices and category levels for measured fitness components. Readministration of the Effort Sense Rating Scale after 14 days prior to physical assessments showed 100% consistency in choice of rating items with some changes in assigned values (rs = 0.86, P < 0.01).Conclusions. Modifications to the equivalence and selection of fitness elements and wording of the effort-demanding "scenarios," the discriminative level of the fitness categories, and broadening the size and composition of the validation sample are required to further enhance the veracity of the scale. Appropriately tuned, this perception-based approach to self-assessment of physical fitness can provide a low-cost, meaningful device for baseline setting and progress monitoring by people either entering or continuing with an exercise program for health-related fitness purposes.

Metabolic clustering, physical activity and fitness in nonsmoking, middle-aged men.

The relationship of both physical activity and predicted maximum oxygen consumption (VO2max) with the clustering of metabolic risk factors associated with the metabolic syndrome (MS) was examined within 711 employed middle-aged (46.9 +/- 7.8 yr) men. Metabolic markers included fasting glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure, and BMI, defined by highest risk quintiles or clinically relevant risk thresholds. The prevalence and age-adjusted odds ratios of all MS clusters were inversely graded across both higher physical activity index (PAI) and cardiorespiratory fitness (CRF) categories. The age-adjusted odds ratio for the clustering of clinically relevant metabolic markers was 0.60 (95% CI 0.22-1.22) for subjects in the occasional/light PAI, 0.32 (95% CI 0.12-0.82) for the moderate/moderately vigorous PAI, and 0.13 (95% CI 0.02-1.02) for the vigorous PAI when compared with subjects in the sedentary PAI (P < 0.05 for trend). The corresponding age-adjusted odds ratio was 0.28 (95% CI 0.14-0.57) for subjects in the moderate fitness category and 0.12 (95% CI 0.05-0.32) for the highest fitness category compared with those in the lowest fitness category (P < 0.001 for trend). Higher levels of physical activity or CRF were also associated with significantly lower age-adjusted odds ratios for the MS after exclusion of obesity in the MS definition. Overall, these cross-sectional results suggest that higher physical activity and predicted VO2max levels are associated with a decreased clustering of risk factors associated with the MS in middle-aged men of higher social class.

Sedentary habits, health, and function in older women and men.

To evaluate the relation of physical activity and cardiorespiratory fitness to morbidity, mortality, and functional limitations in older persons. We reviewed published reports related to the review's purpose. Sources were identified from recent major reports and position statements from scientific and public health organizations, our files, and reference lists of published papers. We included prospective epidemiological studies and clinical trials published in the peer-reviewed literature that included data from age groups of people 60 years and older. We evaluated study methods and included studies that used valid measures of exposures, clearly specified outcomes, and controlled for confounders. We extracted by detailed review data on sample characteristics, outcomes, and rates and relative risks. Extracted data were included in tables, figures, or the text and were synthesized by nonquantitative methods. Active and fit individuals were at much lower risk for morbidity, mortality, and loss of function when compared with sedentary and unfit persons. Data from the studies generally conformed to a steep inverse dose-response gradient across activity or fitness categories. Results were consistent, temporally appropriate, strong, and graded, and therefore support a causal hypothesis that a fit and active way of life improves health and function in older individuals.

The Impact of Brand Extensions on Parent Brand Memory Structures and Retrieval Processes

In this research, the author examines the impact of brand extensions on consumer memory for parent brand information. The author proposes that such exposure will strengthen parent brand memory structures and facilitate retrieval processes. The author hypothesizes that the impact of extensions will be moderated by parent brand dominance, extension fit, extension number, and product category crowdedness. Two experiments are conducted. The first demonstrates that (1) exposure to brand extensions facilitates the speed with which subjects can categorize parent brands correctly, (2) this result is moderated by parent brand dominance such that nondominant brands benefit more from such exposure, and (3) extension fit moderates this effect for nondominant but not for dominant parent brands. The second study demonstrates that (1) longitudinal exposure to brand extension advertising facilitates parent brand recall but that (2) both recall and recognition are facilitated to a lesser degree than that resulting from exposure to parent brand advertising.

Physical activity patterns associated with cardiorespiratory fitness and reduced mortality: the Aerobics Center Longitudinal Study.

This study examined cross sectionally the physical activity patterns associated with low, moderate, and high levels of cardiorespiratory fitness. Physical activity was assessed by questionnaire in a clinic population of 13,444 men and 3972 women 20 to 87 years of age. Estimated energy expenditure (kcal.wk-1) and volume (min.wk-1) of reported activities were calculated among individuals at low, moderate, and high fitness levels (assessed by maximal exercise tests). Average leisure time energy expenditures of 525 to 1650 kcal.wk-1 for men and 420 to 1260 kcal.wk-1 for women were associated with moderate to high levels of fitness. These levels of energy expenditure can be achieved with a brisk walk of approximately 30 minutes on most days of the week. In fact, men in the moderate and high fitness categories walked between 130 and 138 min.wk-1, and women in these categories walked between 148 and 167 min.wk-1. Most individuals should be able to achieve these physical activity goals and thus attain a cardiorespiratory fitness level sufficient to result in substantial health benefits.