Low Levels Of Aerobic Fitness Research Articles

Aerobic Capacity Determines Habitual Walking Acceleration, Not Electromyography-Indicated Relative Effort

Objective: Habitual walking is important for health and can be measured with accelerometry, but accelerometry does not measure physiological effort relative to capacity. We compared accelerometer-measured absolute intensity and electromyography (EMG)-measured relative muscle activity between people with low versus excellent aerobic fitness levels during their habitual walking. Methods: Forty volunteers (19 women; age 49.3 ± 17.1 years, body mass index 24.0 ± 2.6 kg/m2; peak oxygen uptake 40.3 ± 12.5 ml/kg/min) wore EMG-shorts and a hip-worn accelerometer simultaneously for 11.6 ± 2.2 hr on 1.7 ± 1.1 days. Continuous gait bouts of at least 5-min duration were identified based on acceleration mean amplitude deviation (MAD, in milli gravitational acceleration, mg) and mean EMG amplitude, with EMG normalized to maximal isometric knee extension and flexion (EMG, in percentage of maximal voluntary contraction EMG). Peak oxygen uptake was measured on a treadmill and maximal strength in isometric leg press (leg press max). MAD and EMG were compared between age- and sex-specific fitness groups (low-average, good, and excellent) and in linear models. Results: During habitual walking bouts (4.1 ± 4.1 bouts/day, 0.9 ± 1.0 min/bout), the low-average fit participants had an approximately 28% lower MAD (245 ± 64.3 mg) compared with both good fit and excellent fit participants (313 ± 68.1 mg, p < .05), but EMG was the same (13.1% ± 8.42% maximal voluntary contraction EMG, p = .10). Absolute, relative to body mass, and relative to skeletal muscle mass peak oxygen uptake (but not leg press max) was positively associated with MAD independent of age and sex (p < .01), but there were no associations with EMG. Conclusions: People with low-average aerobic capacity habitually walk with a lower accelerometer-measured absolute intensity, but the physiological stimulus for lower-extremity muscles is similar to those with excellent aerobic capacity. This should be considered when measuring and prescribing walking for health.

Poor physical fitness is associated with impaired memory, executive function, and depression in institutionalized older adults: a cross-sectional study

Objective:To analyze the association between physical fitness, cognitive function, and depressive symptoms among older adults in long-term care facilities (LTCFs).Methods:Seventy-six institutionalized male and female elderly individuals (65 years and older) living in LTCFs participated of this study. Physical fitness (aerobic capacity and strength), cognitive functions (global cognition, short-term and working and semantic memories, and executive function), and depressive symptoms were assessed. Linear regression and contingency analyses were performed. Significance was accepted at p-values ≤ 0.05.Results:Aerobic capacity predicted 32% of variance in global cognition (p < 0.01) and 25% of variance in semantic fluency/executive function (p < 0.01). Low levels of upper limb strength, lower limb strength, and aerobic capacity were associated with semantic fluency/executive function (OR = 1.38, p = 0.01, OR = 1.26, p = 0.03, and OR = 1.07, p = 0.01, respectively) and depressive symptoms (OR = 1.06, p < 0.01).Conclusion:Poor physical fitness is associated with cognition and depressive symptoms in institutionalized older adults. Low levels of strength and aerobic fitness increase the odds of presenting with impaired semantic fluency and executive function, possibly denoting an increased risk of developing dementia.

OXYGEN UPTAKE AND INDICATORS OF OBESITY: META-ANALYSIS INCLUDING 17,604 ADOLESCENTS

ABSTRACT Introduction: Low aerobic fitness levels are associated with excess body adiposity in adolescents. However, studies that have analyzed this association in adolescents have used different methods and measures to evaluate aerobic fitness, making it difficult to compare the results. Objective: To conduct a systematic review with meta-analysis of studies that have analyzed the association between aerobic fitness and anthropometric body adiposity indicators in adolescents aged 10-19 years. Methods: A systematic search was performed in May 2016, updated in March 2017, in the following electronic databases: LILACS (BIREME), Embase, MEDLINE (PubMed), Web of Science (Web of Knowledge), Scopus, and SPORTDiscus. Results: Twenty-three studies were selected. The meta-analysis indicated that as the aerobic fitness levels increased, the BMI, waist circumference and body fat percentage values of the adolescents decreased. Conclusion: There is a negative association between aerobic fitness (evaluated by measuring maximum oxygen uptake in the 20-meter Shuttle Run test) and the body fat percentage, BMI and waist circumference of adolescents and a negative association between aerobic fitness (assessed by measuring the number of laps in the 20-meter Shuttle Run test) and body fat percentage. However, caution is required in the interpretation of data due to the heterogeneity of the studies analyzed. Level of Evidence II; Systematic review of studies with level II of evidence.

Objectively measured preoperative physical activity is associated with time to functional recovery after hepato-pancreato-biliary cancer surgery: a pilot study

BackgroundSurgical resection is currently the cornerstone of hepato-pancreato-biliary (HPB) cancer treatment. A low preoperative aerobic fitness level has been identified as a modifiable risk factor associated with complications after major abdominal surgery. A person’s aerobic fitness is influenced by performing moderate to vigorous physical activity (MVPA). This study aims to determine the activity monitor measured levels of MVPA performed among patients on the waiting list for HPB cancer surgery and their association with postoperative outcomes.MethodsA prospective, observational multi-center cohort pilot study was conducted. Patients enlisted for resection surgery on suspicion of HPB (pre)malignancy were enrolled. Performed MVPA was measured by an Actigraph wGT3X-BT. Additionally, aerobic fitness was measured via the Incremental Shuttle Walk Test, and (post)operative variables were collected from the electronic patient files. The association between MVPA and the pre- and postoperative variables was determined by univariate and multivariable (logistic) robust regression.ResultsA total of 38 participants, median age 66.0 (IQR 58.25–74.75) years, were enrolled. The median daily MVPA was 10.7 (IQR 6.9–18.0) min; only 8 participants met the Dutch MVPA guidelines. Participant’s age and aerobic fitness were associated with MVPA by multivariable statistical analysis. Time to functional recovery was 8 (IQR 5–12) days and was associated with MVPA and type of surgery (major/minor) in multivariable analysis.ConclusionSeventy-six percent of patients enlisted for resection of HPB (pre)malignancy performed insufficient MVPA. A higher level of MVPA was associated with a shorter time to functional recovery.

Influence of aerobic fitness on the correspondence between heart rate variability and ventilatory threshold

The aims of this study were to verify the correspondence between heart rate variability (HRV) and ventilatory thresholds during a progressive exercise test and the relationship with low and high aerobic fitness levels. Twenty male volunteers (29.5±6.2 years; 75.9±13.0 kg; 175.0±7.4 cm) were recruited. The subjects were allocated to two groups according to their VO2max &lt;48.8 ml•kg−1•min−1 (low cardiorespiratory fitness group) (n=10) and &gt;48.81 ml•kg−1•min−1 (high cardiorespiratory fitness group) (n=10). A progressive test was performed, consisting of 3-min stages beginning at 25 watts and increasing by 25 watts every 3-min. The HRV threshold (HRVT) and ventilatory threshold (VT) analyses were performed through visual inspection. The comparisons with RMSSD values in percentage of maximum workload resulted in a higher effect size (ES) than the SDNN values. The VO2 in the high cardiorespiratory fitness group at VT (+32%), HRVTRMSSD (+27%), and HRVTSDNN (+31%) was signifi cantly higher compared to the group with low cardiorespiratory fitness. Higher values were observed for relative load (W•kg-1) at VT and HRVTSDNN in the high cardiorespiratory fitness group in comparison with the low cardiorespiratory fitness group (P&lt;0.05), but no difference for VT and HRVTRMSSD. Signifi cant correlations between at VT and HRVTSDNN (r=0.77) were found only in the low cardiorespiratory fitness group. Cardiorespiratory fitness should be regarded as a factor for HRVT evaluation. The HRVTSDNN was closer to the VT in the low cardiorespiratory fitness group than the HRVTRMSSD, however, the use of vagal modulation assessed using the HRV parameter was more sensitive to observe possible differences regarding cardiorespiratory fitness.

Influence of aerobic fitness on the correspondence between heart rate variability and ventilatory threshold

The aims of this study were to verify the correspondence between heart rate variability (HRV) and ventilatory thresholds during a progressive exercise test and the relationship with low and high aerobic fitness levels. Twenty male volunteers (29.5±6.2 years; 75.9±13.0 kg; 175.0±7.4 cm) were recruited. The subjects were allocated to two groups according to their VO2max &lt;48.8 ml•kg−1•min−1 (low cardiorespiratory fitness group) (n=10) and &gt;48.81 ml•kg−1•min−1 (high cardiorespiratory fitness group) (n=10). A progressive test was performed, consisting of 3-min stages beginning at 25 watts and increasing by 25 watts every 3-min. The HRV threshold (HRVT) and ventilatory threshold (VT) analyses were performed through visual inspection. The comparisons with RMSSD values in percentage of maximum workload resulted in a higher effect size (ES) than the SDNN values. The VO2 in the high cardiorespiratory fitness group at VT (+32%), HRVTRMSSD (+27%), and HRVTSDNN (+31%) was signifi cantly higher compared to the group with low cardiorespiratory fitness. Higher values were observed for relative load (W•kg-1) at VT and HRVTSDNN in the high cardiorespiratory fitness group in comparison with the low cardiorespiratory fitness group (P&lt;0.05), but no difference for VT and HRVTRMSSD. Signifi cant correlations between at VT and HRVTSDNN (r=0.77) were found only in the low cardiorespiratory fitness group. Cardiorespiratory fitness should be regarded as a factor for HRVT evaluation. The HRVTSDNN was closer to the VT in the low cardiorespiratory fitness group than the HRVTRMSSD, however, the use of vagal modulation assessed using the HRV parameter was more sensitive to observe possible differences regarding cardiorespiratory fitness.

Physical fitness of medical residents: Is the health of surgical residents at risk?

Postgraduate medical residency programs are laborious and timeintensive, and can be physically, intellectually and emotionally demanding. These working conditions may lead to the neglect of personal health and well-being. The objective of this study was to compare the anthropometric and fitness characteristics of surgical and nonsurgical medical residents. We hypothesized that there is a difference in physical health between these 2 groups. Medical residents completed a demographic information questionnaire and were assessed by trained staff for height, weight, body fat percentage, muscular strength and endurance, and peak oxygen consumption (V̇ᴏ2peak). The average number of working hours per week was also documented. Forty-five residents (21 surgical and 24 nonsurgical; 31 men and 14 women) participated in the study. Surgical residents worked more hours per week on average than nonsurgical residents (p = 0.02) and had a higher body mass index (BMI) (p = 0.04) and lower V̇ᴏ2peak (p = 0.01). Surgical residents worked more hours than nonsurgical residents, which may have contributed to their higher BMI and lower aerobic fitness levels. Despite a heavy workload, it is important for all medical residents to find strategies to promote a healthy lifestyle for both themselves and their patients to ensure long-term well-being.

SECULAR CHANGES IN AEROBIC FITNESS LEVELS IN BRAZILIAN CHILDREN

ABSTRACT Introduction: Aerobic fitness is a component of physical fitness related to health and has great importance in the prevention of cardiovascular diseases. Objective: To verify the secular changes in aerobic fitness levels and to identify factors over a decade related to low levels of aerobic fitness in Brazilian children. Methods: This secular change study was carried out from 1999 to 2010 with 11,083 children aged from six to nine years, of both sexes, living in all regions of Brazil. The aerobic fitness was assessed by the 9-minute run test. The independent variables were sex, age, geographic region, area of residence, and nutritional status. The “t” test was used for independent samples and analysis of variance, chi-square test, and Poisson regression were used to estimate prevalence ratio (PR) and confidence intervals of 95% (CI 95%). Results: No significant changes in the distance covered in the 9-minute run test and in the prevalence of low levels of aerobic fitness were observed from 1999 to 2010. The population subgroups most likely to have low aerobic fitness levels were students aged seven years, those in the Midwestern, Southeast, and South of Brazil, those living in rural areas and those with overweight and obesity. Conclusions: Over a decade, low levels of aerobic fitness were present in four fifths of Brazilian children and this picture did not change. Low levels of aerobic fitness affected more children above six years old, living in the economically most favored regions of Brazil, in rural areas and with overweight.

Lower aerobic fitness levels among adolescents of a city in southern Brazil

Study design: Cross sectional study. Objective: To analyze the association between lower levels of aerobic fitness and sociodemographic factors, lifestyle and excess body fatness in students. Methods: Study with 84 adolescents aged 14 to 19 years from southern Santa Catarina. Aerobic fitness was assessed by the modified Canadian Aerobic Fitness test-mCAFT. Sociodemographic variables, sexual maturation and lifestyle were assessed self-administered questionnaire. Excess body fatness assessed the sum of skin folds triceps and subscapular. Results: The prevalence of lower level of aerobic fitness was 83.3%. The female gender (OR: 5,99; IC95%: 1,40-25,52) and adolescents little physically active (OR: 5,62; IC95%: 1,21-26,38) had low levels aerobic fitness. Conclusion: The factors had associated with low levels of aerobic fitness were females and physical inactivity

Factors associated with low levels of aerobic fitness among adolescents

ObjectiveTo evaluate the prevalence of low aerobic fitness levels and to analyze the association with sociodemographic factors, lifestyle and excess body fatness among adolescents of southern Brazil. MethodsThe study included 879 adolescents aged 14–19 years the city of São José/SC, Brazil. The aerobic fitness was assessed by Canadian modified test of aerobic fitness. Sociodemographic variables (skin color, age, sex, study turn, economic level), sexual maturation and lifestyle (eating habits, screen time, physical activity, consumption of alcohol and tobacco) were assessed by a self-administered questionnaire. Excess body fatness was evaluated by sum of skinfolds triceps and subscapular. We used logistic regression to estimate odds ratios and 95% confidence intervals. ResultsPrevalence of low aerobic fitness level was 87.5%. The girls who spent two hours or more in front screen, consumed less than one glass of milk by day, did not smoke and had an excess of body fatness had a higher chance of having lower levels of aerobic fitness. White boys with low physical activity had had a higher chance of having lower levels of aerobic fitness. ConclusionsEight out of ten adolescents were with low fitness levels aerobic. Modifiable lifestyle factors were associated with low levels of aerobic fitness. Interventions that emphasize behavior change are needed.

Aerobic fitness in adolescents in southern Brazil: Association with sociodemographic aspects, lifestyle and nutritional status

ObjectiveThe purpose was to investigate the factors related to aerobic fitness levels of adolescents in southern Brazil. MethodsThe sample consisted of 1081 students (545 males and 536 females), with mean age of 12.8 (± 1.2) years. This is a cross-sectional epidemiological study. Aerobic fitness was assessed by the 9-min running test. The independent variables analyzed were: age, socioeconomic status, school system (public/private), sedentary behavior, physical activity level, nutritional status and body adiposity. Analyses were stratified by sex. We used the Student “t” test for independent samples and logistic regression to estimate odds ratio (OR) and confidence intervals of 95% (95% CI). ResultsThe prevalence of low aerobic fitness levels was 92.5%. Boys aged 13–14 years were 2.44 times more likely to have low aerobic fitness levels; poorer boys were 4.31 times more likely to have low aerobic fitness levels. Girls aged 13–14 years were 5.35 times more likely to have low aerobic fitness levels; poorer girls were 10.70 times more likely to have low aerobic fitness levels; girls with sedentary behavior were approximately 4 times more likely to have low aerobic fitness levels. ConclusionThus, it was concluded that almost all adolescents show low aerobic fitness levels, which makes necessary effective interventions in the school environment with the promotion of sports and regular practice of physical activity.

Association Between Aerobic Fitness And High Blood Pressure in Adolescents in Brazil: Evidence for Criterion-Referenced Cut-Points.

Criterion-referenced cut-points for health-related fitness measures are lacking. This study aimed to determine the associations between aerobic fitness and high blood pressure levels (HBP) to determine the cut-points that best predict HBP among adolescents. This cross-sectional school-based study with sample of 875 adolescents aged 14-19 years was conducted in southern Brazil. Aerobic fitness was assessed using the modified Canadian Aerobic Fitness Test (mCAFT). Systolic and diastolic blood pressure were measured by the oscillometric method with a digital sphygmomanometer. Analyses controlled for sociodemographic variables, physical activity, body mass and biological maturation. Receiver Operating Characteristic (ROC) curves demonstrated that mCAFT measures could discriminate HBP in both sexes (female: AUC = 0.70; male: AUC = 0.63). The cut-points with the best discriminatory power for HBP were 32 mL·kg-1·min-1 for females and 40 mL·kg-1·min-1 for males. Females (OR = 8.4; 95% CI: 2.1, 33.7) and males (OR: 2.5; CI 95%: 1.2, 5.2) with low aerobic fitness levels were more likely to have HBP. mCAFT measures are inversely associated with BP and cut-points from ROC analyses have good discriminatory power for HBP.

Prevalência e fatores associados a baixos níveis de aptidão aeróbia em adolescentes

ObjectiveTo evaluate the prevalence of low aerobic fitness levels and to analyze the association with sociodemographic factors, lifestyle and excess body fatness among adolescents of southern Brazil. MethodsThe study included 879 adolescents aged 14 to 19 years the city of São José/SC, Brazil. The aerobic fitness was assessed by Canadian modified test of aerobic fitness. Sociodemographic variables (skin color, age, sex, study turn, economic level), sexual maturation and lifestyle (eating habits, screen time, physical activity, consumption of alcohol and tobacco) were assessed by a self‐administered questionnaire. Excess body fatness was evaluated by sum of skinfolds triceps and subscapular. We used logistic regression to estimate odds ratios and 95% confidence intervals. ResultsPrevalence of low aerobic fitness level was 87.5%. The girls who spent two hours or more in front screen, consumed less than one glass of milk by day, did not smoke and had an excess of body fatness had a higher chance of having lower levels of aerobic fitness. White boys with low physical activity had had a higher chance of having lower levels of aerobic fitness. ConclusionsEight out of ten adolescents were with low fitness levels aerobic. Modifiable lifestyle factors were associated with low levels of aerobic fitness. Interventions that emphasize behavior change are needed.

Low aerobic fitness in Brazilian adolescents

INTRODUCTION: aerobic fitness is considered one of the most important components of health-related physical fitness, with low levels related to increased risk of premature death from all causes, especially cardiovascular diseases.OBJECTIVE: to identify the characteristics of adolescents at higher risk of low levels of aerobic fitness.METHODS: the study included 696 adolescents 15-17 years of age enrolled in public high schools of Florianópolis, southern Brazil. This cross-sectional epidemiological study was conducted in Florianópolis, Santa Catarina, Brazil. Aerobic fitness was measured using the modified Canadian Aerobic Fitness Test mCAFT. Sociodemographic gender, age, school grade, paternal and maternal schooling, socioeconomic status, and anthropometric variables body weight, height, triceps and subscapular skinfold thickness, sexual maturation, physical activity, sedentary behavior, and eating habits were collected.RESULTS: it was found that 31.5% of adolescents had low aerobic fitness levels, being higher in boys 49.2% compared to girls 20.6%. Moreover, girls with sedentary behavior, overweight and high body fat percentage were the groups most likely to have inadequate aerobic fitness. In males, the groups most likely to have inadequate aerobic fitness were those whose parents studied more than eight years, those with low levels of physical activity, and those with inadequate nutrition and excessive body fat.CONCLUSION: low aerobic fitness levels were present in one third of adolescents and was more prevalent in boys. Lifestyle changes, including replacement of sedentary behaviors by physical and sport activities , may assist in improving the aerobic fitness of Brazilian adolescents.

Fatores associados aos baixos níveis de força lombar em adolescentes do Sul do Brasil

ObjectiveTo determine the prevalence and factors associated with low levels of lumbar strength in adolescents. MethodThis was a cross‐sectional study involving 601 adolescents, aged 14 to 17 years, enrolled in public schools in the western region of Santa Catarina State – Southern Brazil. Lumbar strength was analyzed by the lumbar extension test developed by the Canadian Society of Exercise Physiology, which proposes different cutoffs for boys and girls. Independent variables were sex, age, socioeconomic status, dietary habits, alcohol consumption, physical activity, and aerobic fitness. For data analysis, univariate and multivariate logistic regression were used, with significance level of 5%. ResultsThe prevalence of low levels of lumbar strength was 27.3%. The population subgroups most likely to present low levels of lumbar strength were females (OR: 1.54, 95% CI: 1.06 to 2.23), adolescents with low levels of aerobic fitness (OR: 2.10, 95% CI: 1.41 to 3.11) and the overweight (OR: 2.28, 95% CI: 1.35 to 3.81). ConclusionAlmost one‐third of the studied students have low levels of lumbar strength. Interventions in the school population should be taken with special attention to female adolescents, those with low levels of aerobic fitness, and those with overweight, as these population subgroups were most likely to demostrate low levels of lumbar strength.

Factors associated with low levels of lumbar strength in adolescents in Southern Brazil

OBJECTIVE: To determine the prevalence and factors associated with low levels of lumbar strength in adolescents.METHOD: This was a cross-sectional study involving 601 adolescents, aged 14 to 17 years, enrolled in public schools in the western region of Santa Catarina State - Southern Brazil. Lumbar strength was analyzed by the lumbar extension test developed by the Canadian Society of Exercise Physiology, which proposes different cutoffs for boys and girls. Independent variables were sex, age, socioeconomic status, dietary habits, alcohol consumption, physical activity, and aerobic fitness. For data analysis, univariate and multivariate logistic regression were used, with significance level of 5%.RESULTS: The prevalence of low levels of lumbar strength was 27.3%. The population subgroups most likely to present low levels of lumbar strength were females (OR: 1.54, 95% CI : 1.06 to 2.23), adolescents with low levels of aerobic fitness (OR: 2.10, 95% CI: 1.41 to 3.11) and the overweight (OR: 2.28, 95% CI: 1.35 to 3.81).CONCLUSION: Almost one-third of the studied students have low levels of lumbar strength. Interventions in the school population should be taken with special attention to female adolescents, those with low levels of aerobic fitness, and those with overweight, as these population subgroups were most likely to demostrate low levels of lumbar strength.

Factors associated with low levels of lumbar strength in adolescents in Southern Brazil

OBJECTIVETo determine the prevalence and factors associated with low levels of lumbar strength in adolescents. METHODThis was a cross-sectional study involving 601 adolescents, aged 14 to 17 years, enrolled in public schools in the western region of Santa Catarina State – Southern Brazil. Lumbar strength was analyzed by the lumbar extension test developed by the Canadian Society of Exercise Physiology, which proposes different cutoffs for boys and girls. Independent variables were sex, age, socioeconomic status, dietary habits, alcohol consumption, physical activity, and aerobic fitness. For data analysis, univariate and multivariate logistic regression were used, with significance level of 5%. RESULTSThe prevalence of low levels of lumbar strength was 27.3%. The population subgroups most likely to present low levels of lumbar strength were females (OR: 1.54, 95% CI: 1.06 to 2.23), adolescents with low levels of aerobic fitness (OR: 2.10, 95% CI: 1.41 to 3.11) and the overweight (OR: 2.28, 95% CI: 1.35 to 3.81). CONCLUSIONAlmost one-third of the studied students have low levels of lumbar strength. Interventions in the school population should be taken with special attention to female adolescents, those with low levels of aerobic fitness, and those with overweight, as these population subgroups were most likely to demostrate low levels of lumbar strength.

Aerobic fitness and limiting factors of maximal performance in chronic low back pain patients (884.26)

Objective: To determine the level of cardiorespiratory fitness in patients with chronic low back pain and to establish factors limiting the maximal effort during the ergometry Methods: Patients performed a maximal exercise test to measure V ̇O2max. Clinical endpoints of the tests were determined and grouped as maximal effort and symptom‐limited effort.Results: 101 patients aged 29.8 achieved a V ̇O2max value of 30 ml.kg‐1.min‐1. When compared to normative categories, men and women were situated in the fair category. Quadriceps/leg fatigue was the most frequent limiting factor. Symptom limited effort endpoints were reported by 54.4% of the subjects. An association between the clinical endpoint and the accomplished V ̇O2 value was established. Maximal effort is associated with a V ̇O2max value while symptom‐limited effort is associated with a V ̇O2peak value.Conclusions: Clinical limiting factors of maximal exertion interfere the achievement of maximal oxygen uptake in patients with chronic low back pain. Further, there exists an association among the clinical endpoints of the tests and the V ̇O2 value achieved. Chronic low back pain patients have a lower level of aerobic fitness than healthy controls.

Long-distance running: running for a long life?

Physical exercise has been said to be healthy for the heart even in patients with various forms of cardiac disease [1–5]. A recent study published online in the European Heart Journal suggested that already being fit during the transition from the teenage years into adulthood may protect against heart disease decades later [6]. Men who had lower aerobic fitness levels when they were examined before entering mandatory military service at age 18 were more likely to have a myocardial infarction during a median follow-up of 34 years. Genetics likely play a large part in the aerobic fitness of teens but it could also be that men who are in good shape in their teens have adopted the sort of lifestyle that will keep them healthy later in life [7, 8]. What about the effects of extreme exercise, such as long-distance running [9], in particular marathons [10], or even longer distances than that, on health and physical well-being? Running races longer than a marathon (42 km, 26.2 miles) have grown in popularity. In North America, 15,500 people finished such races in 1998 and more than 63,500 individuals in 2012, according to UltraRunning magazine. To that purpose, researchers from Stanford University School of Medicine and the University of California (USA) decided to investigate the health effects of extreme exercise. They assessed the physical health in a large population of ultramarathon runners to establish a baseline for the Ultrarunners Longitudinal Tracking (ULTRA) Study [11]. The results are based on an online survey of 1212 runners who had completed at least one race of at least 31 miles, of whom some had even performed 100-mile races. The findings were reported on Wednesday 8 January 2014 in the journal PLOS One [12]. The participants in the study were 18 to 81 years old, with an average of 42 years: mostly men (68 %) of Caucasian race. Their average running distance for the previous year was 3347 miles, being equal to an average of 64 miles a week. In general, the study found that most of these runners are very healthy people, but most also do get injured in their activity. Important specific findings of the study were: 1) the ultramarathon runners had fewer carcinomas (4.5 %), heart disease (0.7 %) and diabetes (0.7 %) than the overall population-reported diseases, 2) the most prevalent findings were allergies and hay fever (25 %) and exercise-induced asthma (13 %), which are significantly higher than in the overall population occurring in only 7 to 8 % of people. The investigators attributed these phenomena to the amount of time runners spent outdoors; the asthma might result from the drying of the airways during exercise and the allergies from the increased exposure to airborne allergens, 3) a total of 77 % of the runners experienced exercise-related injuries and 64 % of the runners reported that an injury cost them training days, but those injuries rarely cost them time from daily activities. Runners lost an average of 2.2 days a year of work or school because of injury or illness versus 3.7 days for less active employed American citizens, 4) older and seasoned runners fared better than starting runners; younger and less experienced long-distance runners were more inclined to be injured, 5) people who ran more than 50 miles got more easily injured—stresses and strains and bruised toes; most of the injuries were to the legs, in particular knees and feet; 3.7 % of them were stress fractures, 6) finally, the study found that 5 % of ultrarunners were hospitalised after a competitive event in the past year due to dehydration, electrolyte disturbance or heat exhaustion. The authors stated that this information is valuable in understanding potential benefits and risks from levels of exercise beyond the moderate amounts known to have health benefits. Assessing these runners over time will also help reveal how much exercise is optimal, how much recreational activity is appropriate and beneficial. The next step, a questionnaire to be sent early this year, will look at whether the runners have particular knowledge or adaptations to prevent injuries. The authors also hope to evaluate the psychological factors that motivate the ultramarathon runners. To summarise, ultramarathon runners are generally healthier and take less sick time than the rest of the population. However, they tend to suffer from more knee pain, stress fractures, allergies and asthma than the general population. It therefore remains important for anyone planning to run marathons of any length to have a medical check-up first to make sure their heart and lungs are healthy enough for endurance exercise [13]. Lastly, one should always remember the old proverb: exercise may increase the expectancy of life, but the extra years gained are spent exercising.

Physical activity, aerobic fitness and parental socio-economic position among adolescents: the German Health Interview and Examination Survey for Children and Adolescents 2003–2006 (KiGGS)

BackgroundThe positive association between parental socio-economic position (PSEP) and health among adolescents may be partly explained by physical activity behaviour. We investigated the associations between physical activity, aerobic fitness and PSEP in a population based sample of German adolescents.Methods5,251 participants, aged 11–17 years, in the German Health Interview and Examination Survey for Children and Adolescents 2003–2006 (KiGGS) underwent a sub-maximal cycle ergometer test and completed a questionnaire obtaining information on physical activity and media use. The associations between physical activity, media use, aerobic fitness and PSEP were analysed with multivariate logistic regression models for boys and girls separately. Odds ratios (ORs) of PSEP (education, occupation and income) on the outcomes were calculated adjusted for age, region, and other influencing factors.ResultsParental education was more strongly associated with the outcome variables than parental occupation and income. After adjusting for age and region, a higher parental education level was associated with better aerobic fitness – with an OR of 1.5 (95% CI 1.2-1.9) for girls whose parents had secondary education and 1.9 (1.4-2.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 1.3 (1.0-1.6) and 1.6 (1.2-2.1), respectively. Higher parental education level was associated with lower media use: an OR of 2.1 (1.5-3.0) for girls whose parents had secondary education and 2.7 (1.8-4.1) for girls whose parents had primary education compared to girls whose parents had tertiary education. The corresponding ORs for boys were 1.5 (1.2-1.9) and 1.9 (1.5-2.5), respectively. Higher parental education level was associated with a higher physical activity level only among girls: an OR of 1.3 (1.0-1.6) for girls whose parents had secondary education and 1.2 (0.9-1.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 0.9 (0.8-1.2) and 0.8 (0.6-1.0), respectively.ConclusionsAdolescents of parents with low SEP showed a lower level of aerobic fitness and higher levels of media use than adolescents of parents with higher SEP. Health-promotion interventions need to reach adolescents of parents with low PSEP and stimulate physical activity.