Leisure-time Energy Expenditure Research Articles

Abstract P223: Reduced Nonconscious Reactivity to Threat in Amygdala Mediates Physical Activity and Energy Expenditure in Integrated Behavior Therapy for Adults With Obesity and Comorbid Depression

Introduction: Neural mechanisms underlying behavior therapy in obesity are poorly understood, particularly in patients with comorbid depression. Putative targets include neural circuits for conscious and nonconscious emotion regulation. Hypothesis: Changes in a priori neural circuits for emotion regulation from baseline (0) to 2 mo (mediators, M) mediate changes in BMI, physical activity, and eating behaviors from 0 to 6 or 12 mo (outcomes, Y). Methods: In a trial of integrated behavior therapy, adults with obesity and depression were randomized to intervention (n=59) or usual care (n=49). The yearlong intervention included 6 in-person problem solving therapy (PST) sessions for depression by 2 mo, 3 additional PST sessions for depression and 11 home videos on lifestyle changes for weight loss by 6 mo, and 6 maintenance calls by 12 mo. Participants completed validated conscious and nonconscious facial emotion viewing tasks in fMRI at 0 and 2 mo (time point corresponding to initial PST for depression in the intervention) and weight and height (baseline only) measurements, 7-day physical activity recalls, and 24-hour dietary recalls at 0, 6, and 12 mo. Analyses tested mediation as showing both a significant treatment effect (X) of the intervention vs. usual care on the mediator (X->M, path a ) and a significant correlation of the mediator with the outcome either as a main effect or an interaction effect by treatment group (M->Y, path b ). Results: Compared with usual care, the intervention led to significantly reduced nonconscious reactivity to threat-related facial emotions (fear, anger) at 2 mo for the left (-0.89, 95% CI -1.64 to -0.14; P =.02) and right amygdala (-0.84, 95% CI -1.54 to -0.13; P =.02) ( path a ). These reductions correlated significantly with increased leisure-time physical activity (MET minutes/wk) at 12 mo: main effect -686.0 (95% CI -1127.9 to -244.1; P =.003) and interaction effect 664.7 (95% CI 73.1 to 1256.4; P =.03) for the left amygdala and main effect -692.9 (95% CI -1365.3 to -20.6; P= .04) for the right amygdala. Similarly, the reductions correlated significantly with increased energy expenditure (kcal/kg/d) at 12 mo: main effect -1.72 (95% CI -2.49 to -0.95; P <.001) and interaction effect 1.89 (95% CI 0.84 to 2.95; P <.001) for the left amygdala; and main effect -1.82 (95% CI -3.08 to -0.56; P =.006) and interaction effect 1.94 (95% CI 0.50 to 3.38; P =.01) for the right amygdala ( path b ). Nonconscious reactivity to threat in bilateral amygdala did not correlate significantly with changes in BMI or eating behaviors. Conclusions: Reduced nonconscious reactivity to threat in bilateral amygdala in response to initial PST for depression significantly mediated improvements in leisure-time physical activity and energy expenditure. Results advance the understanding of neural mechanisms underlying behavior therapy in obesity and inform intervention optimization to enhance efficacy.

Leisure-Time Physical Activity and Metabolic Syndrome in Older Adults.

Background: Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular disease, atherosclerosis and diabetes mellitus type 2 which may be reduced by practicing regular physical activity. Objective: To assess the leisure-time physical activity (LTPA) of older adults with MetS and without MetS. Methods: Cross-sectional study of older adults (55–80 years old) from Balearic Islands (Spain) with MetS (n = 333; 55% men) and without MetS (n = 144; 43.8% men). LTPA was assessed with the validated Spanish version of the Minnesota LTPA Questionnaire. Two criteria of physically active were used: >150 min/week of moderate physical activity or >75 min/week of vigorous physical activity or a combination of both, and total leisure-time energy expenditure of >300 MET·min/day. Sociodemographic and lifestyle characteristics, anthropometric variables, MetS components, and adherence to the Mediterranean diet (MD) were also measured. Results: MetS subjects showed lower energy expenditure in LTPA, lower adherence to the MD, higher obesity and waist circumference, and were less active than non-MetS peers. LTPA increased as participants got older and there was higher LTPA intensity as educational level increased. Adherence to MD was as high as LTPA was. Conclusions: MetS is associated with physical inactivity and unhealthy diet. To increase LTPA recommendations and raise awareness in the population about the health benefits of PA and high adherence to MD is highly recommended.

Physical activity in mild multiple sclerosis: contribution of perceived fatigue, energy cost, and speed of walking

Purpose: To clarify the relationship between leisure-time physical activity, perceived fatigue, and energy expenditure while walking in people with multiple sclerosis.Methods: Sixty-six people afflicted with multiple sclerosis (MS) (32 women) with a mild neurological disability, participated in this study. Energy expenditure was separately measured at rest, during comfortable walking and during fast walking via a portable metabolic device using breath-by-breath technology (COSMED K5, COSMED Srl, Rome, Italy). The Godin leisure-time exercise questionnaire assessed leisure-time physical activity. The Modified Fatigue Impact Scale determined the level of perceived fatigue.Results: Seventeen people with MS were classified as physically active; 49 were insufficiently active. Scores recorded on the Godin Leisure-Time Exercise Questionnaire were 47.8 (SD = 18.4), 7.0 (SD = 8.2), respectively. Insufficiently physically active people with MS walked slower at both normal and fast walking conditions. However, no differences between groups were observed in energy expenditure measures in both walking speeds. O2 cost was 0.20 (SD = 0.13) and 0.21 (SD = 0.06) in the active and insufficiently active group, respectively. The insufficiently active group reported more perceived fatigue compared with the active patients; 33.3 (SD = 18.6) vs. 15.0 (SD = 19.0), p value = 0.002. Perceived fatigue was a significant variable maintaining a 10.4% variance related to leisure-time physical activity.Conclusions: Leisure-time physical activity was inversely associated with perceived fatigue and walking speed in persons with mild MS. Rehabilitation professionals should be aware of these relationships when planning rehabilitation strategies.Implication for rehabilitationThis study found that perceived fatigue is a barrier to physical activity participation even in people with mild multiple sclerosis and minimal disability.Insufficiently active people with multiple sclerosis expend the same amount of energy while walking as active multiple sclerosis individuals, though walking slower.The relationship between perceived fatigue and physical activity participation requires further exploration in the multiple sclerosis population.

Prevention of heart failure in older adults may require higher levels of physical activity than needed for other cardiovascular events

Little is known if the levels of physical activity required for the prevention of incident heart failure (HF) and other cardiovascular events vary in community-dwelling older adults. We studied 5503 Cardiovascular Health Study (CHS) participants, age ≥ 65 years, free of baseline HF. Weekly metabolic equivalent task-minutes (MET-minutes), estimated using baseline total leisure-time energy expenditure, were used to categorize participants into four physical activity groups: inactive (0 MET-minutes; n=489; reference), low (1-499; n=1458), medium (500-999; n=1086) and high (≥ 1000; n=2470). Participants had a mean (± SD) age of 73 (± 6) years, 58% were women, and 15% African American. During 13 years of follow-up, centrally-adjudicated incident HF occurred in 26%, 23%, 20%, and 19% of participants with no, low, medium and high physical activity, respectively (trend p<0.001). Compared with inactive older adults, age-sex-race-adjusted hazard ratios (95% confidence intervals) for incident HF associated with low, medium and high physical activity were 0.87 (0.71-1.06; p=0.170), 0.68 (0.54-0.85; p=0.001) and 0.60 (0.49-0.74; p<0.001), respectively (trend p<0.001). Only high physical activity had significant independent association with lower risk of incident HF (HR, 0.79; 95% CI, 0.64-0.97; p=0.026). All levels of physical activity had significant independent association with lower risk of incident acute myocardial infarction (AMI), stroke and cardiovascular mortality. In community-dwelling older adults, high level of physical activity was associated with lower risk of incident HF, but all levels of physical activity were associated with lower risk of incident AMI, stroke, and cardiovascular mortality.

Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance

BackgroundA randomized control trial was performed to test whether a lifestyle intervention program, carried out in a primary healthcare setting using existing resources, can reduce the incidence of type 2 diabetes in Japanese with impaired glucose tolerance (IGT). The results of 3 years' intervention are summarized.MethodsThrough health checkups in communities and workplaces, 304 middle-aged IGT subjects with a mean body mass index (BMI) of 24.5 kg/m2 were recruited and randomized to the intervention group or control group. The lifestyle intervention was carried out for 3 years by public health nurses using the curriculum and educational materials provided by the study group.ResultsAfter 1 year, the intervention had significantly improved body weight (-1.5 ± 0.7 vs. -0.7 ± 2.5 kg in the control; p = 0.023) and daily non-exercise leisure time energy expenditure (25 ± 113 vs. -3 ± 98 kcal; p = 0.045). Insulin sensitivity assessed by the Matsuda index was improved by the intervention during the 3 years. The 3-year cumulative incidence tended to be lower in the intervention group (14.8% vs.8.2%, log-rank test: p = 0.097). In a sub-analysis for the subjects with a BMI > 22.5 kg/m2, a significant reduction in the cumulative incidence was found (p = 0.027).ConclusionsThe present lifestyle intervention program using existing healthcare resources is beneficial in preventing diabetes in Japanese with IGT. This has important implications for primary healthcare-based diabetes prevention.Trial registration numberUMIN000003136

The Association Between Meeting Physical Activity Guidelines and Chronic Diseases Among Canadian Adults

Physical activity is associated with a reduced risk of chronic disease. This study describes the relationship between meeting the guidelines for physical activity described in Canada's Physical Activity Guide and heart disease, type 2 diabetes, hypertension, obesity, and low levels of general health. Leisure-time energy expenditure (LTEE) was calculated from leisure-time physical activities reported by adults who participated in the 2007 Canadian Community Health Survey. Respondents were classified as meeting the guidelines for physical activity or not, and were stratified by sex into quartiles of LTEE. Logistic regression was used to determine the odds for all conditions associated with not meeting the guidelines and by quartile of LTEE, adjusting for covariates. The odds of type 2 diabetes, obesity, and fair/poor health were significantly higher among those not meeting the guidelines for both sexes and for high blood pressure among women. Significantly higher odds were seen between the lowest and highest quartiles of LTEE for type 2 diabetes and high blood pressure and across all quartiles for obesity and fair/poor health for both sexes. Canadian adults meeting the physical activity guidelines have lower odds of chronic diseases and fair/poor health than those not meeting the guidelines.

The Economic Costs Associated with Physical Inactivity and Obesity in Ontario

Background: Physical inactivity and obesity are highly prevalent in every Canadian province and territory. Purpose: To estimate the economic costs of physical inactivity and obesity for the province of Ontario in 2009. Methods: A prevalence-based economic burden analysis was undertaken. The relative risks of diseases associated with physical inactivity and obesity were determined from a meta-analysis of existing prospective studies and applied to the health care costs of these diseases in Ontario. The prevalences of physical inactivity and obesity were obtained from the 2009 Canadian Community Health Survey (CCHS) for the province of Ontario. Estimates of the economic burden were derived from both direct and indirect expenditure categories. Direct medical costs included hospital care expenditures, drug expenditures, physician care expenditures, expenditures for care in other institutions, and additional direct health expenditures; whereas indirect costs included the value of years of life lost due to premature death and the value of days lost due to short-term and long-term disability. Results: The prevalences of physical inactivity (<1.5 kcal.kg-1.day-1 of leisure time energy expenditure) and obesity (body mass index ?30 kg/m2) among Ontario adults for 2009 were 49.3% and 25.4%, respectively. The economic burden of physical inactivity was $3.4 billion ($1.02 billion in direct costs and $2.34 billion in indirect costs) while the burden associated with obesity was $4.5 billion ($1.60 billion in direct costs and $2.87 billion in indirect costs). Conclusions: These estimates reinforce the public health importance of curbing the current epidemics of physical inactivity and obesity in Ontario

Validation of an Historical Physical Activity Recall Tool in Postpartum Women

Physical activity (PA) is an important component of a healthy pregnancy and postpartum period. Since prospective PA monitoring throughout gestation is difficult, a valid PA recall tool would be of significant benefit to researchers. The purpose of this study was to evaluate the ability of women to recall their physical activity performed during pregnancy and postpartum, 6 years later. Thirty women participated in an historical PA recall study. Pregnancy PA was monitored carefully via assisted physical activity diary (PAD) 6 years before the current investigation. A Modifiable Activity Questionnaire (MAQ) was used to assess current and past pregnancy PA. The MAQ was administered for each time period in the order of most distant past to most current. Leisure time energy expenditure values (kcal/kg/day) calculated from the PAD and the MAQ were compared. MAQ energy expenditure values showed good positive relationships with PAD measures at 20 weeks gestation (r = .57; P < .01), 32 weeks gestation (r = .85; P < .01), and 12 weeks postpartum (r = .86; P < .01). Correlations found were similar to those from previous PA recall and MAQ validation studies using nonpregnant populations. The MAQ is an appropriate tool to assess pregnancy and postpartum PA in women 6 years postpartum.

The effects of physical activity, education, and body mass index on the aging brain

Normal human aging is accompanied by progressive brain tissue loss and cognitive decline; however, several factors are thought to influence brain aging. We applied tensor-based morphometry to high-resolution brain MRI scans to determine whether educational level or physical activity was associated with brain tissue volumes in the elderly, particularly in regions susceptible to age-related atrophy. We mapped the 3D profile of brain volume differences in 226 healthy elderly subjects (130F/96M; 77.9 ± 3.6 SD years) from the Cardiovascular Health Study-Cognition Study. Statistical maps revealed the 3D profile of brain regions whose volumes were associated with educational level and physical activity (based on leisure-time energy expenditure). After controlling for age, sex, and physical activity, higher educational levels were associated with ~2-3% greater tissue volumes, on average, in the temporal lobe gray matter. After controlling for age, sex, and education, greater physical activity was associated with ~2-2.5% greater average tissue volumes in the white matter of the corona radiata extending into the parietal-occipital junction. Body mass index (BMI) was highly correlated with both education and physical activity, so we examined BMI as a contributing factor by including physical activity, education, and BMI in the same model; only BMI effects remained significant. This is one of the largest MRI studies of factors influencing structural brain aging, and BMI may be a key factor explaining the observed relationship between education, physical activity, and brain structure. Independent contributions to brain structure could not be teased apart as all these factors were highly correlated with one another.

Carbohydrate Intake and Overweight and Obesity among Healthy Adults

Background Little is known about the dietary habits of people with optimal body weight in communities with high overweight and obesity prevalence. Objective To evaluate carbohydrate intake in relation to overweight and obesity in healthy, free-living adults. Design We used a cross-sectional analysis. Subjects/setting The Canadian Community Health Survey Cycle 2.2 is a cross-sectional survey of Canadians conducted in 2004-2005. There were 4,451 participants aged 18 years and older with anthropometric and dietary data and no comorbid conditions in this analysis. Main outcome measures Outcome variables were body mass index (BMI; calculated as kg/m 2) and overweight or obesity status (dichotomous) defined as BMI ≥25 compared with BMI <25 based on measured height and weight. Diet was evaluated by 24-hour dietary recall based on the Automated Multi-Pass Method. Statistical analyses performed Weighted regression models with bootstrapping and cubic splines were used. Outcome variables were BMI and overweight or obesity, and predictors were daily nutrient intake. Adjustment for total energy intake, age, leisure time energy expenditure, sex, smoking, education, and income adequacy was performed. Results Risk of overweight and obesity was decreased in all quartiles of carbohydrate intake compared to the lowest intake category (multivariate odds ratio quartile 2=0.63; 95% confidence interval: 0.49 to 0.90; odds ratio quartile 3=0.58; 95% confidence interval: 0.41 to 0.82; odds ratio quartile 4=0.60; 95% confidence interval: 0.42 to 0.85). Spline analyses revealed lowest risk among those consuming 290 to 310 g/day carbohydrates. Conclusions Consuming a low-carbohydrate (approximately <47% energy) diet is associated with greater likelihood of being overweight or obese among healthy, free-living adults. Lowest risk may be obtained by consuming 47% to 64% energy from carbohydrates.

Relationships between leisure-time energy expenditure and individual coping strategies for shift-work

A total of 13 to 14% of European and North American workers are involved in shift work. The present aim is to explore the relationships between coping strategies adopted by shift workers and their leisure-time energy expenditure. Twenty-four female and 71 male shift workers (mean ± SD age: 37 ± 9 years) completed an adapted version of the Standard Shift-work Index (SSI), together with a leisure-time physical activity questionnaire. Predictors of age, time spent in shift work, gender, marital status and the various shift-work coping indices were explored with step-wise multiple regression. Leisure-time energy expenditure over a 14-d period was entered as the outcome variable. Gender (β = 7168.9 kJ/week, p = 0.023) and time spent in shift work (β = 26.36 kJ/week, p = 0.051) were found to be predictors of energy expenditure, with the most experienced, male shift workers expending the most energy during leisure-time. Overall ‘disengagement’ coping scores from the SSI were positively related to leisure-time energy expenditure (β = 956.27 kJ/week, p = 0.054). In males, disengagement of sleep problems (β = −1078.1 kJ/week, p = 0.086) was found to be negatively correlated to energy expenditure, whereas disengagement of domestic-related problems was found to be positively related to energy expenditure (β = 1961.92 kJ/week, p = 0.001). These relations were not found in female shift workers (p = 0.762). These data suggest that experienced male shift workers participate in the most leisure-time physical activity. These people ‘disengage’ more from their domestic-related problems, but less from their sleep-related problems. It is recommended that physical activity interventions for shift workers should be designed with careful consideration of individual domestic responsibilities and perceived disruption to sleep.

Estudio poblacional de actividad física en tiempo libre

Objective To estimate the frequency of persons who are physically active in their leisure time and the quantity and intensity of their activities in relation to age, sex, body mass index and socioeconomic status in the adult population of Navarre (Spain). Methods We performed a cross-sectional study in an age and sex stratified random sample of the population aged 35–84 years old (1,893 men and 2,275 women). The response rate was 73.4%. The Minnesota Leisure-Time Physical Activity Questionnaire, previously validated for the Spanish population, was used. Two definitions of “physically active” were employed: a) total leisure-time energy expenditure of > 300 metabolic equivalentes (METs)/day, and b) physical exercise in activities expending ⩾ 4 METs for at least 25 min/day for women and 30 min/day for men. Results When both definitions were applied, approximately half the population aged 35–84 years old were active in their leisure time. The prevalence of physically active persons (> 300 METs/day) decreased after the age of 65 in women and no differences were found according to body mass index, educational level or occupation-based social class. In men, being active in their leisure time was related to age 65–74 years and medium or low social class. Conclusions The population subgroups most susceptible to interventions aimed at promoting leisure-time physical activity in Navarre consisted of women over the age of 65 and men of high social class.

Physical Activity Recommendations

Most adults do not meet the American College of Sports Medicine and Centers for Disease Control and Prevention (ACSM/CDC) physical activity recommendations. Even fewer meet the more extreme Institute of Medicine (IOM) physical activity recommendations. Compliance with either recommendation has been conventionally assessed by combining frequencies and durations of self-reported activities. Leisure-time energy expenditure is a cumulative measure of activity that offers an alternative method of defining compliance. To calculate the leisure-time energy expenditure of adults complying with the ACSM/CDC or the IOM physical activity recommendations determined by conventional measures and to reexamine compliance with the IOM recommendation using energy expenditure criteria. National, cross-sectional data from the 2000 Behavioral Risk Factor Surveillance System determined the mode, frequency, and duration of up to two leisure-time activities performed by adults. Four mutually exclusive activity groups (Non-, Low-, ACSM/CDC-, and IOM-Active) were defined on the basis of frequencies and durations of reported activities. Leisure-time energy expenditure (kcal x kg(-1) x wk(-1)) was calculated per respondent. The energy expenditure threshold for meeting the IOM recommendation was calculated as 21 kcal x kg(-1) x wk(-1). Of the 162,669 respondents included in the analyses, 29.9% were Nonactive, whereas 42.3%, 23.3%, and 4.5% were Low-, ACSM/CDC-, and IOM-Active, respectively. Median leisure-time energy expenditure values were 9.0, 27.4, and 63.0 kcal x kg(-1) x wk(-1) for Low-, ACSM/CDC-, and IOM-Active groups, respectively. When using energy expenditure criteria, compliance with the IOM recommendation rose to 27.7% of respondents. Compliance with the IOM physical activity recommendation dramatically increased when assessed by energy expenditure compared with conventional criteria, thereby highlighting the potential bias of conventional methods. A significant proportion of adults meet the intent but not the letter of the IOM activity recommendation.

Physical Activity, APOE Genotype, and Dementia Risk: Findings from the Cardiovascular Health Cognition Study

Physical activity may help preserve cognitive function and decrease dementia risk, but epidemiologic findings are inconsistent. The authors conducted a prospective study to determine the association between physical activity and risk of dementia, Alzheimer's disease, and vascular dementia. The US study population comprised 3,375 men and women aged 65 years or older, free of dementia at baseline, who participated in the Cardiovascular Health Cognition Study in 1992-2000. Leisure-time energy expenditure and an activity index reflecting number of different physical activities were calculated. Analyses were based on Cox proportional hazards models. There were 480 incident cases of dementia over an average of 5.4 years of follow-up. After multivariate adjustment, participants in the highest quartile of physical energy expenditure had a relative risk of dementia of 0.85 (95% confidence interval: 0.61, 1.19) compared with those in the lowest quartile, and participants engaging in >or=4 activities had a relative risk of dementia of 0.51 (95% confidence interval: 0.33, 0.79) compared with those engaging in 0-1 activity. These associations were more marked in apolipoprotein E genotype (APOE) epsilon4 allele noncarriers but were absent in carriers. A similar pattern was observed for Alzheimer's disease and vascular dementia. Mechanisms to explain the observed relations deserve further study.

Seasonal variation in adult leisure-time physical activity.

To determine the effect of season on self-reported leisure-time physical activity (LTPA) behaviors of Michigan adults. Data were obtained from the 1996 Michigan Behavioral Risk Factor Survey conducted throughout the year. Survey respondents were considered active if they reported participating in at least one LTPA during the past month. Complete information regarding type, frequency, and duration of up to two LTPA was available on 2843 adults (1635 women and 1208 men). Four seasons were defined as winter (January-March; N = 677), spring (April-June; N = 759), summer (July-September; N = 760), and fall (October-December; N = 647). Total weekly leisure-time energy expenditure was quantified (kcal x kg-1 x wk-1) from MET intensities, duration, and frequency of activity sessions per week. Seasonal differences were identified using ANOVA. Average (+/-SEM) weekly leisure time energy expenditure was significantly greater (P < 0.001) during spring (17.5 +/- 0.8 kcal x kg-1 x wk-1) and summer (17.5 +/- 0.7 kcal.kg-1.wk-1) compared with winter (14.8 +/- 0.7 kcal x kg-1 x wk-1) and fall (15.0 +/- 0.7 kcal x kg-1 x wk-1). Duration of the first activity was significantly greater (P < 0.05) in summer (58.6 +/- 1.6 min) compared with winter (53.4 +/- 1.8 min). However, intensity (4.6 +/- 0.1 METs) and frequency (3.1 +/- 0.1 sessions per week) of the first activity did not differ among seasons. A second activity was performed by 1319 (46.4%) of active individuals and was more common in the spring (46.8%) and summer (54.5%) compared with fall (42.6%) and winter (39.4%) (chi2 = 31.0; P < 0.01). When both active and inactive subjects are considered, the Healthy People 2010 recommendation for moderate physical activity was met only during spring and summer. Weekly leisure-time energy expenditure averaged approximately 15-20% higher during spring and summer. Much of this difference was due to active respondents participating in a second activity during these seasons.

Leisure-time energy expenditure in asthmatics and non-asthmatics

An association between obesity and asthma has been documented previously, but the nature of this relationship remains unknown. This study aimed to determine if asthma is associated with a sedentary lifestyle which may explain this association.The energy expenditure (EE) on leisure activities was examined in 16813 subjects, of at least 12 years of age, who participated in the Canadian National Population Health Survey 1994–95. Energy expenditure was calculated by multiplying the duration of leisure-time physical activity by its estimated metabolic energy cost. Asthma was considered to be present if an affirmative response was given to the question, ‘Do you have asthma diagnosed by a health professional?’The average EE (± standard error) in males was 2·47 (± 0·11)kcalkg−1day−1for asthmatics and 1·98 (± 0·03)kcalkg−1day−1for non-asthmatics. The corresponding average EEs in females were 1·77 (± 0·08) and 1·54 (± 0·02)kcalkg−1day−1for asthmatics and non-asthmatics, respectively. The mean EE values decreased with increasing age. A significant interaction between asthma and age was noted with respect to EE; asthmatics tended to have higher mean EE values than non-asthmatics among younger subjects, and lower mean EE values in older subjects. This effect was more pronounced in females than in males.It was concluded that asthmatics were not consistently inactive compared with non-asthmatics. Leisure-time physical activity cannot explain the positive association between obesity and asthma.

Leisure time physical activity: Are there black/white differences?

Background. Behavioral risk factor surveillance survey data collected during 1984 and 1985 in South Carolina were analyzed. Methods. This article is based on telephone interviews conducted with 2,005 individuals (431 black, 1574 white), mean age, 45.1 years, selected by random-digit dialing. Information on the type, frequency, and duration of leisure time physical activity was used to estimate leisure time energy expenditure (kcal/week) averaged over the previous month. The median level of leisure time energy expenditure differed significantly (all P < 0.001) by gender (men = 741, women = 421), age (six categories; youngest, 18–29 years = 780; oldest, 70 + = 301), annual household income (four categories; lowest, ⩽$10,000 = 300; highest, >$35,000 = 870), body mass index (kg/m 2, ⩽24.1 = 601, ⩾30.1 = 180), and race (black = 301, white = 601). Results. Leisure time energy expenditure generally decreased with increasing age and body mass index and increased with increasing levels of education and income among all race/gender groups. Logistic regression analyses revealed that after adjustment for gender (if applicable), age, income, and body mass index, the variable race made a statistically significant contribution to the model, in the total sample ( P < .03) and for women P < .001), but not for men. Conclusions. Our results suggest that blacks living in the South, particularly black women, have lower levels of leisure time physical activity compared with their white counterparts after control for several important confounders.

HDL, HDL2, and HDL3 subfractions, and the risk of acute myocardial infarction. A prospective population study in eastern Finnish men.

We investigated the association of cholesterol concentrations in serum high density lipoprotein (HDL) and its subfractions HDL2 and HDL3 with the risk of acute myocardial infarction in 1,799 randomly selected men 42, 48, 54, or 60 years old. Baseline examinations in the Kuopio Ischaemic Heart Disease Risk Factor Study were done during 1984-1987. In Cox multivariate survival models adjusted for age and examination year, serum HDL cholesterol of less than 1.09 mmol/l (42 mg/dl) was associated with a 3.3-fold risk of acute myocardial infarction (95% confidence intervals [CI], 1.7-6.4), serum HDL2, cholesterol of less than 0.65 mmol/l (25 mg/dl) was associated with a 4.0-fold risk of acute myocardial infarction (95% CI, 1.9-8.3), and serum HDL3 cholesterol of less than 0.40 mmol/l (15 mg/dl) was associated with a 2.0-fold (95% CI, 1.1-4.0) risk of acute myocardial infarction. Adjustments for obesity, ischemic heart disease, other cardiovascular disease, maximal oxygen uptake, systolic blood pressure, antihypertensive medication, serum low density lipoprotein cholesterol, and triglyceride concentrations reduced the excess risks associated with serum HDL, HDL2, and HDL3 cholesterol in the lowest quartiles by 52%, 48%, and 41%, respectively. Additional adjustments for alcohol consumption, cigarettes smoked daily, smoking years, and leisure time energy expenditure reduced these excess risks associated with low HDL, HDL2, and HDL3 cholesterol levels by another 26%, 24% and 21%, respectively. Our data confirm that both total HDL and HDL2 levels have inverse associations with the risk of acute myocardial infarction and may thus be protective factors in ischemic heart disease, whereas the role of HDL3 remains equivocal.

Time Trends in Leisure-Time Physical Activity in the Upper Midwest 1957–1987

The assessment of leisure-time physical activity in four studies that used a similar questionnaire was carried out by the University of Minnesota between 1957-1960 and 1985-1987. Each study included adults living in the Upper Midwest. In men, age-adjusted leisure-time energy expenditure consistently increased over time, with the greatest increase occurring between 1957-1960 and 1974-1975. Much of this increase occurred in moderate and heavy intensity activity and was greater for white collar workers than for blue collar workers. The increase in the last period was similar for both classes of workers. Data were unavailable for women before 1980. Age-adjusted leisure-time physical activity in women also increased between 1980-1982 and 1985-1987. This increase was greater for blue collar than for white collar women. A major strength of these analyses is the last two surveys, which were specifically designed to assess time trends. Exact comparability of the earlier two surveys with the two latter surveys cannot be established; however, the use of the same detailed questionnaire across 30 years is unique. We conclude that leisure-time physical activity has been increasing for three decades, including substantial increases in vigorous activities.

Test-retest reliability of the Minnesota Leisure Time Physical Activity Questionnaire

The test-retest reliability of the Minnesota Leisure Time Physical Activity Questionnaire was assessed by two administrations of the questionnaire at a five-week interval in 140 adults from a general population sample and at a two-week interval in 150 male participants in the Multiple Risk Factor Intervention Trial (MRFIT). In both study populations, there was a slight, nonsignificant drop in reported leisure time energy expenditure between the test and the retest. The largest test-retest differences in estimated energy expenditure were found among those reporting greater levels of energy expenditure. Nevertheless, in both study populations Spearman rank correlation coefficients between the test and retest were high—0.79 to 0.88 for total activity and ranging 0.69–0.86 among the light, moderate, and heavy intensity subcategories. The high reliability of the Minnesota Leisure Time Physical Activity Questionnaire corroborates its utility in epidemiologic research.