Low Cardiorespiratory Fitness Research Articles

Análise da relação entre broncoespasmo induzido por exercício, aptidão cardiorrespiratória e nível de atividade física de adolescentes

ABSTRACT This study aims to verify the association between exercise-induced bronchospasm (EIB), cardiorespiratory fitness, and physical activity levels in adolescents. To do so, we evaluated 202 healthy adolescents aged from 13 to 18 years, out of which 94 (46.5%) were females and 108 (53.5%) males. Participants performed a bronchial challenge test in a treadmill (Master Super ATL, Inbramed®) to evaluate bronchial hyper-responsiveness; a spirometric test (Microquark, Cosmed®) to evaluate lung function; answered the Baecke’s Questionnaire of Habitual Physical Activity; and performed the progressive aerobic cardiovascular endurance run test. Data were analyzed using Spearman’s correlation, chi-square test, and odds ratio. The significance level adopted was p<0.05. No statistically significant correlations were found between the decrease of the forced expiratory volume in the first second (FEV1), cardiorespiratory fitness, and physical activity levels. Likewise, the chi-squared test revealed no significant differences between classifications of cardiorespiratory fitness (low or adequate) and EIB (presence or absence) (χ2=0.155; p=0.694). Finally, odds ratio showed no increased chances of the presence of EIB in participants who presented low cardiorespiratory fitness (OR=1.130; CI: 0.616-2.073). We concluded that cardiorespiratory fitness and physical activity levels are not associated with the decrease of FEV1 and that there is no relation between the presence of EIB and the classification of cardiorespiratory fitness of adolescents.

Obesity and Brain Health: The Impact of Metabolic Syndrome and Cardiorespiratory Fitness on Cognitive Performances in Middle-Aged Obese Women.

Mid-life obesity has been reported to be a significant risk factor for later-life dementia and Alzheimer's disease. Metabolic syndrome (MetS) has been suggested to have an adverse effect while cardiorespiratory fitness (CRF) has been suggested to have a protective effect on cognitive function of older adults. However, studies investigating such effects in middle-aged obese women are limited. To compare cognitive performances between obese and normal weight middle-aged women and examine the effects of MetS and CRF on cognitive performances when combined with obesity. Cross-sectional study with the data of 87 middle-aged women (58 obese and 29 normal weight, with age and education matched). The non-invasive screening method for metabolic syndrome (NIM-MetS) was used to detect MetS. CRF was determined by using maximal oxygen consumption (VO2 max) and was classified as high or low (VO2 max higher or lower than 50th percentile) based on the American College of Sports Medicine's guidelines. Neurocognitive tests including Montreal Cognitive Assessment (MoCA), digit span (DS), trail making test (TMT), hand reaction time (HRT), logical memory (LM), and semantic verbal fluency test (SVFT) were administered to all participants. The obese group demonstrated significantly lower score in MoCA, DS, TMT, HRT, and LM than the normal weight group (p < 0.05). The obese with MetS subgroup (n = 28) showed significantly lower score in LM than the obese non-MetS subgroup (n = 30) (p = 0.002). Normal weight with high CRF participants (NW-high CRF; n = 28) demonstrated significantly higher score in MoCA and HRT than obese with high CRF participants (OB-high CRF; n = 24) (p < 0.05), and demonstrated better score in MoCA, DS, TMT, HRT, and LM than obese with low CRF participants (OB-low CRF; n = 24) (p < 0.05). OB-high CRF showed significantly greater score in DS, TMT and LM than OB-low CRF (p < 0.05). Obesity shows negative impact on several cognitive functions, which memory appears to be further affected when combined with MetS in middle-aged women, whereas CRF is suggested to have benefit on certain aspects of cognitive domains. Maintaining a healthy body weight and improving CRF are beneficial for cognitive function of middle-aged women.

Association between Estimated Cardiorespiratory Fitness and Depression among Middle-income Country Adults: Evidence from National Health Survey.

Objective:This study assessed the relationship between cardiorespiratory fitness (CRF) and depression in adults.Methods:A total of 52,611 individuals aged between 18-59 years old were evaluated for symptoms of depression and CRF. The presence of depressive symptoms was self-report through the Patient Health Questionnaire (PHQ-9), and the CRF was predicted from a non-exercise equation. The association between CRF and the presence of depression was determined by crude and multivariable-adjusted logistic regressions.Results:The associations were identified between symptoms of depression and CRF in both unadjusted and adjusted models. After adjusting for age categories, sex, body mass index categories, educational level, marital status, smoking, and alcohol use, the individuals with moderate CRF had 18% lower odds of depression (OR: 0.82, CI 95%: 0.71 – 0.95) compared to individuals with low CRF.Conclusion:Depressive symptoms are inversely related to CRF levels in adults.

Physical Fitness as a Prognostic Marker for Infectious Events in Kidney Transplant Recipients

Introduction: Infectious events are one of the leading causes of death in kidney transplant recipients (KTRs). KTRs have reduced cardiorespiratory fitness (CRF), a predictor for infections in other populations. The aim of this study was to investigate whether CRF and muscle strength are prognostic markers for infectious events in KTRs. Methods: In this retrospective cohort study, 155 KTRs underwent an incremental, maximal cardiopulmonary exercise test (CPET) 3 months after transplantation. CRF was analyzed with peak oxygen consumption (VO₂ peak) while muscle strength with isometric handgrip (HG) test. Laboratory blood samples and drug therapy were collected. The median follow-up period was 54 (interquartile range 38–62) months. Cox regression analyses were performed to evaluate predictors of infectious events adjusting for potential confounders. Results: During this study, severe infectious events occurred in 41 subjects (26.5%). 15.5% (n = 24) of patients had a severely reduced CRF, defined as a VO₂ peak below the 5th percentile of the reference values reported for a matched healthy population. The hazard ratio for infectious events in this subgroup was 2.389 (95% CI = 1.188–4.801, p = 0.014), independently of gender, age, BMI, time on dialysis, hemoglobin concentration, eGFR, diabetes, and immunosuppressive regimen. On the contrary, no significant association of HG strength and infections was found. Conclusion: Therefore, low CRF may be considered as a modifiable predictor of severe infectious events in KTRs. A CPET should thus be recommended for cardiovascular screening, evaluation of CRF, and tailored exercise prescription to reduce the risk of infections and potentially improve long-term outcomes of transplantation.

The influence of menopause and cardiorespiratory fitness on lipoprotein particles in midlife women.

Lipoprotein particles may provide better information about cardiovascular risk than standard cholesterol measures for women. Whether lipoprotein subclasses change with menopausal stage is unclear. Given the high prevalence of low cardiorespiratory fitness in midlife women and benefit of cardiovascular disease risk, it is also important to understand the effect of fitness on lipoprotein profiles. This study evaluated the influence of menopausal status and fitness on lipoprotein particles in healthy midlife women. Lipoprotein particles were measured in high- (n = 25) and low- (n = 13) fit perimenopausal and late postmenopausal women, and in high-fit premenopausal (n = 10), perimenopausal (n = 12), and late postmenopausal women (n = 13). There were larger low-density lipoprotein particles (LDL-P; 21.7 ± 0.06 vs. 21.3 ± 0.1 nm, p = 0.002), more large LDL-P (623.1 ± 32.8 vs. 500.2 ± 52.6 nmol/L, p = 0.045), and fewer small LDL-P (145.5 ± 31.4 vs. 311.5 ± 44.7 nmol/L, p = 0.001) in the high-fit group vs. the low-fit group. High-density lipoprotein particles (HDL-P) were larger (10.1 ± 0.1 vs. 9.7 ± 0.1 nm, p = 0.002) in the high-fit group, with more large (14.8 ± 0.7 vs. 11.0 ± 0.9 μmol/L,p = 0.002), medium (12.9 ± 0.8 vs. 8.4 ± 0.9 μmol/L, p = 0.002) HDL-P, and fewer small HDL-P (10.2 ± 1.1 vs. 15.4 ± 1.6 μmol/L, p = 0.009) compared with the low-fit group. High-fit postmenopausal women had more large LDL-P (662.9 ± 47.5 nmol/L) compared with premenopausal women (479.1 ± 52.6 nmol/L, p = 0.035), and more HDL-P (40.2 ± 1.1 µmol/L) compared with premenopausal (34.9 ± 1.5 μmol/L, p = 0.023) and perimenopausal women (35.4 ± 1.3 μmol/L, p = 0.033). High fitness positively influences lipoprotein particles in healthy perimenopausal and late postmenopausal women. In healthy fit women, menopause may not have a large influence on lipoprotein particles. Novelty: In highly fit women, menopause may not have a negative influence on lipoprotein particle subclasses. High fitness is associated with a less atherogenic lipoprotein profile in perimenopausal and late postmenopausal women.

Association Between Cardiorespiratory Fitness and Healthcare Costs in Adults Using the Criterion Referenced Fitness Thresholds: The Korea Institute of Sport Science Fitness Standards Study

PURPOSE: This study aimed to determine the association between cardiorespiratory fitness (CRF) and healthcare utilization and healthcare costs in Korean adults using criterion-referenced health fitness thresholds.METHODS: The sample was drawn from the Korea Institute of Sport Science Fitness Standards Study (2014–2015) participants (n=1,780) aged 19–64 years. Participants completed a treadmill exercise test in which the peak oxygen uptake was estimated from the treadmill time. CRF thresholds were identified using receiver operating characteristic curve analysis using CRF z-scores as the test and metabolic syndrome as the criterion. The participants were categorized into low-, middle-, and high-risk groups. Healthcare utilization and healthcare costs, derived from the Korea National Health Insurance Data Sharing Service, were compared using multiple linear regression with control for body mass index (BMI), income, healthcare utilization, and healthcare costs in the previous year.RESULTS: In this study, two CRF thresholds were established: one for high sensitivity, the other for high specificity. CRF thresholds at the low-risk group were 35.2–42.6 mL/kg/min for men and 26.8–34.3 mL/kg/min for women. The total healthcare costs per participant per year for the middle- and high-risk groups were 173,016 Won and 324,840 Won, respectively, higher than those in the low-risk group after the adjustment for BMI, income, healthcare utilization, and costs in the previous year (p=.006, p&lt;.001). The high-risk group had 2.890 visits, 3.177 visit days, and 27.215 prescription days, all of which were significantly higher than those of the low-risk group (p=.003, p=.003, p=.002).CONCLUSIONS: A low CRF is associated with higher healthcare utilization and costs. Improving CRF may result in lower healthcare utilization and costs.

Benchmarking Depressive Symptoms in Cardiac Rehabilitation.

Depression affects cardiac health and is important to track within cardiac rehabilitation (CR). Using two depression screeners within one sample, we calculated prevalence of baseline depressive symptomology, improvements during CR, and predictors of both. Data were drawn from the University of Vermont Medical Center CR program prospectively collected database. A total of 1781 patients who attended between January 2011 and July 2019 were included. Two depression screeners (Geriatric Depression Scale-Short Form [GDS-SF] and Patient Health Questionnaire-9 [PHQ-9]) were compared on proportion of the sample categorized with ≥ mild or moderate levels of depressive symptoms (PHQ-9 ≥5, ≥10; GDS-SF ≥6, ≥10). Changes in depressive symptoms by screener were examined within patients who had completed ≥9 sessions of CR. Patient characteristics associated with depressive symptoms at entry, and changes in symptoms were identified. Within those who completed ≥9 sessions of CR with exit scores on both screeners (n = 1201), entrance prevalence of ≥ mild and ≥ moderate depressive symptoms differed by screener (32% and 9% PHQ-9; 12% and 3% GDS-SF; both P< .001). Patients who were younger, female, with lower cardiorespiratory fitness (CRF) scores were more likely to have ≥ mild depressive symptoms at entry. Most patients with ≥ mild symptoms decreased severity by ≥1 category by exit (PHQ-9 = 73%; GDS-SF = 77%). Nonsurgical diagnosis and lower CRF were associated with less improvement in symptoms on the PHQ-9 (both P< .05). Our results provide initial benchmarks of depressive symptoms in CR. They identify younger patients, women, patients with lower CRF, and those with nonsurgical diagnosis as higher risk groups for having depressive symptoms or lack of improvement in symptoms.

Lower Cardiorespiratory Fitness Is Associated With Right Ventricular Geometry and Function - The Sedentary's Heart: SHIP.

BackgroundLower cardiorespiratory fitness (CRF) is associated with an increased risk for cardiovascular disease. However, very little information is available about the association between lower CRF and right ventricular (RV) remodeling. We investigated the relationship between CRF and RV structure and function in a large, aging, and largely sedentary adult population–based cohort.Methods and ResultsWe used cross‐sectional data of 2844 subjects (1486 women; median age, 51 years; interquartile range, 40–62 years) from the population‐based cohort SHIP (Study of Health in Pomerania) with echocardiography, of which 941 also had cardiac magnetic resonance imaging. We analyzed the associations of peak oxygen uptake with RV parameters determined by both imaging techniques using multivariable‐adjusted linear regression models. In echocardiography, a 1 L/min lower peak oxygen uptake was associated with a 1.18 mm (95% CI, 0.66–1.71; P<0.001) smaller RV end‐diastolic diameter and a 1.41 mm (95% CI, 0.90–1.92; P<0.001) narrower RV end‐diastolic outflow tract diameter. Similarly, using cardiac magnetic resonance imaging measurements, a 1 L/min lower peak oxygen uptake was associated with a 23.5 mL (95% CI, 18.7–28.4; P<0.001) smaller RV end‐diastolic volume, a 13.0 mL (95% CI, 9.81–16.2; P<0.001) lower RV end‐systolic volume, and a 10.7 mL/beat (95% CI, 8.10–13.3; P<0.001) lower RV stroke volume.ConclusionsOur results indicate a significant association between CRF and RV remodeling. Lower CRF was associated with smaller RV chamber and lower RV systolic function, stroke volume, and cardiac output.

Cardiorespiratory fitness, white blood cell count, and mortality in men and women

BackgroundWe examined the associations of cardiorespiratory fitness (CRF) and white blood cell count (WBC) with mortality outcomes. MethodsA total of 52,056 apparently healthy adults completed a comprehensive health examination, including a maximal treadmill test and blood chemistry analyses. CRF was categorized as high, moderate, or low by age and sex; WBC was categorized as sex-specific quartiles. ResultsDuring 17.8 ± 9.5 years (mean ± SD) of follow-up, a total of 4088 deaths occurred. When regressed jointly, significantly decreased all-cause mortality across CRF categories was observed within each quartile of WBC in men. Within WBC Quartile 1, all-cause mortality hazard ratios (HRs) with a 95% confidence interval (95%CI) were 1.0 (referent), 1.29 (95%CI: 1.06‒1.57), and 2.03 (95%CI: 1.42‒2.92) for high, moderate, and low CRF categories, respectively (p for trend < 0.001). Similar trends were observed in the remaining 3 quartiles. With the exception of cardiovascular disease (CVD) mortality within Quartile 1 (p for trend = 0.743), there were also similar trends across CRF categories within WBC quartiles in men for both CVD and cancer mortality (p for trend < 0.01 for all). For women, there were no significant trends across CRF categories for mortality outcomes within Quartiles 1–3. However, we observed significantly decreased all-cause mortality across CRF categories within WBC Quartile 4 (HR = 1.05 (95%CI: 0.76‒1.44), HR = 1.63 (95%CI:1.20‒2.21), and HR = 1.87 (95%CI:1.29‒2.69) for high, moderate, and low CRF, respectively (p for trend = 0.002)). Similar trends in women were observed for CVD and cancer mortality within WBC Quartile 4 only. ConclusionThere are strong joint associations between CRF, WBC, and all-cause, CVD, and cancer mortality in men; these associations are less consistent in women.

The association of breathing pattern with exercise tolerance and perceived fatigue in women with systemic lupus erythematosus: an exploratory case-control study.

The aims of the study were to (1) to characterize the breathing pattern and work of breathing during peak exercise in patients with SLE; (2) to examine the extent to which the breathing pattern and work of breathing impact the exercise capacity and fatigue. Forty-one women participated in the study (SLE: n = 23, median = 35, range = 21-57years, control: n = 18, median = 38, range = 22-45years). Each subject performed a treadmill cardiopulmonary exercise test (a modified Bruce treadmill protocol) ending with volitional exhaustion. Breathing mechanic was characterized by measures of expired minute volume (VE), tidal volume (Vt), respiratory rate (f), work of breathing, and cardiorespiratory fitness was quantified by measures of peak oxygen consumption (VO2) and time to exhaustion. Data presented as median and interquartile range (IQR). Women with SLE had lower Vt {1221 [488.8] mL/min vs. 1716 [453.1] mL; p = .006}, VE {58.9 [18.9] L/min vs 70 [28.1] L/min, p = 0.04} and increased breathing frequency {51.5 [10.8] vs 43.6 [37.8] bpm, p = 0.01} compared to the control group. The time to exhaustion and peak VO2 during the CPET were significantly reduced in those with SLE compared to controls {13.3 [10.2] vs 16.1 [2.2] min; p = 0.004}, {20 [6.1] mL/kg/min vs 26.6 [7] mL/kg/min p < 0.001}, respectively. Differences remained when the analyses were controlled for the observed differences in peak VO2. When the regression model adjusted for the peak VO2, it had been shown that Vt, WOB and f were explained variances in the fatigue severity by 64% [p < 0.001]. The decline in VE and Vt coupled with a decreased peak VO2, and work of breathing may have contributed to low cardiorespiratory fitness and fatigue in patients with systemic lupus erythematosus.

The Importance of Cardiorespiratory vs. Muscular Fitness in Reducing the Odds of Hypertension in War Veterans: A Population-Based Study.

Purpose: The purpose of the study was to examine separate and combined associations between cardiorespiratory fitness (CRF) and musculoskeletal fitness (MF) with hypertension. Methods: In this cross-sectional study, participants were 764 men and women aged 45–75 years, who were part of the Homeland War between 1990 to 1995 (33.5% women). CRF included the 2-min step test, while MF was consisted of push-ups in 30 s, chair-stands in 30 s and sit-ups in 30 s. The prevalence of hypertension was defined according to new American College of Cardiology and American Hearts Association Blood Pressure Guidelines for systolic and diastolic blood pressure of ≥130 mmHg and/or ≥80 mmHg. Results: In models adjusted for sex, age, fatness and fasting blood glucose, we found a graded inverse association between CRF and MF with hypertension. Less cardiorespiratory and muscular fit individuals were more likely to have hypertension. When CRF and MF were combined, individuals with high MF and low CRF, low MF and high CRF and low MF and CRF were 1.77, 2.15 and 7.09 more likely to have of hypertension. Conclusion: Both CRF and MF are associated with the prevalence of hypertension, while the magnitude of the associations between MF and hypertension was more pronounced.

Combinations of BMI and cardiorespiratory fitness categories: trends between 1995 and 2020 and associations with CVD incidence and mortality and all-cause mortality in 471 216 adults.

To describe time trends in combinations of cardiorespiratory fitness (CRF) and body mass index (BMI) status, and to analyse their associations with cardiovascular disease (CVD) incidence and mortality and all-cause mortality. Prospective cohort study with data from occupational health screenings in Swedish employees, including n = 471 216 (aged 18-74 years) between 1995 and 2020, and n = 169 989 in risk analyses. Cardiorespiratory fitness was estimated from a submaximal cycle test. High CRF was defined as top quartile, and low CRF as bottom quartile. Body mass index was used to define normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obesity (≥30 kg/m2). Outcome data (CVD incidence and mortality, all-cause mortality) were obtained from national registers. From 1995 to 2020, the combination of obesity + low CRF increased from 2.1% to 5.3% (relative increase 154%) whereas the combination of normal weight + high CRF decreased from 13.2% to 9.3% (-30%) (both P < 0.001). Negative changes were more pronounced in men, younger ages, and non-university educated. At the end of the period, prevalence of obesity + low CRF were higher in men vs. women (3.1% vs. 2.2%), older vs. younger (3.7% vs. 1.7%), and in non-university vs. university educated (5.0% vs. 0.3%), all P-value <0.001. Having a high CRF attenuated the risk of all three outcomes in all BMI categories, especially in individuals with obesity (hazard ratio 3.90 vs. 6.67 for CVD mortality). Both a low BMI and a high CRF prolonged age of onset for all three outcomes. The combination of obesity with low CRF has increased markedly since the mid-90s, with clear implications for increased CVD morbidity and mortality, and all-cause mortality.

Prevalence of Colorectal Polyps Based on Cardiorespiratory Fitness, Muscle Strength, Health Behavior, and Abdominal Obesity in Asymptomatic Elderly.

Colorectal polyps are precursor lesions of colorectal cancer and are known to be associated with obesity, low physical activity, and unhealthy behavior. This cross-sectional study analyzed the prevalence of colorectal polyps based on cardiorespiratory fitness (CRF), muscle strength, and health behavior in older adults. Participants were asymptomatic and included 1024 men and 472 women aged 65–80 years who visited the health care center. Colonoscopy was performed under conscious sedation, and cardiorespiratory fitness was measured as the maximum oxygen uptake using gas analysis. Muscle strength was determined using isokinetic equipment, and physical activity, alcohol consumption, and smoking status were investigated using questionnaires. Waist circumference was measured at the thickest part of the middle of the abdomen. Logistic regression analysis was used to calculate the prevalence of colorectal polyps using odds ratios (ORs) based on the variables. The incidence of colorectal polyps was 65.2% in men and 48.5% in women. The ORs of colorectal polyps for obesity were 1.151 (95% confidence interval [CI], 1.010–2.291) and 1.178 (95% CI, 1.015–2.612) in men and women, respectively. The OR for colorectal polyps in male current smokers was 1.884. The ORs for low CRF were 1.985 and 1.841 in men and women, respectively, compared with high CRF. The prevalence of polyps increased with low muscle strength (men’s OR 1.343 women’s OR 1.440) and physical activity in both men (OR 1.693) and women (OR 1.861). In conclusion, lower CRF and muscle strength were associated with an increased prevalence of colorectal polyps in men and women. In both sexes, high waist circumference and low physical activity increased the prevalence of colorectal polyps.

Cardiorespiratory fitness and lifestyle on severe COVID-19 risk in 279,455 adults: a case control study

BackgroundThe impact of cardiorespiratory fitness (CRF) and other lifestyle-related factors on severe COVID-19 risk is understudied. The present study aims to investigate lifestyle-related and socioeconomic factors as possible predictors of COVID-19, with special focus on CRF, and to further study whether these factors may attenuate obesity- and hypertension-related risks, as well as mediate associations between socioeconomic factors and severe COVID-19 risk.MethodsOut of initially 407,131 participants who participated in nationwide occupational health service screening between 1992 and 2020, n = 857 cases (70% men, mean age 49.9 years) of severe COVID-19 were identified. CRF was estimated using a sub-maximum cycle test, and other lifestyle variables were self-reported. Analyses were performed including both unmatched, n = 278,598, and sex-and age-matched, n = 3426, controls. Severe COVID-19 included hospitalization, intensive care or death due to COVID-19.ResultsPatients with more severe COVID-19 had significantly lower CRF, higher BMI, a greater presence of comorbidities and were more often daily smokers. In matched analyses, there was a graded decrease in odds for severe COVID-19 with each ml in CRF (OR = 0.98, 95% CI 0.970 to 0.998), and a two-fold increase in odds between the lowest and highest (< 32 vs. ≥ 46 ml·min−1·kg−1) CRF group. Higher BMI (per unit increase, OR = 1.09, 1.06 to 1.12), larger waist circumference (per cm, OR = 1.04, 1.02 to 1.06), daily smoking (OR = 0.60, 0.41 to 0.89) and high overall stress (OR = 1.36, 1.001 to 1.84) also remained significantly associated with severe COVID-19 risk. Obesity- and blood pressure-related risks were attenuated by adjustment for CRF and lifestyle variables. Mediation through CRF, BMI and smoking accounted for 9% to 54% of the associations between low education, low income and blue collar/low skilled occupations and severe COVID-19 risk. The results were consistent using either matched or unmatched controls.ConclusionsBoth lifestyle-related and socioeconomic factors were associated with risk of severe COVID-19. However, higher CRF attenuated the risk associated with obesity and high blood pressure, and mediated the risk associated with various socioeconomic factors. This emphasises the importance of interventions to maintain or increase CRF in the general population to strengthen the resilience to severe COVID-19, especially in high-risk individuals.

High fitness levels offset the increased risk of chronic obstructive pulmonary disease due to low socioeconomic status: A cohort study

ObjectiveEvidence suggests that higher cardiorespiratory fitness (CRF) levels can offset the increased risk of adverse outcomes due to other risk factors. The impact of high CRF levels on the increased risk of chronic obstructive pulmonary disease (COPD) due to low socioeconomic status (SES) is unknown. We aimed to assess the combined effects of SES and CRF on the future risk of COPD. MethodsWe employed a prospective cohort of 2312 Finnish men aged 42–61 years at study entry. Socioeconomic status was self-reported and CRF was objectively assessed using respiratory gas exchange analyzers. Both exposures were categorized as low and high based on median cutoffs. Multivariable-adjusted hazard ratios (HRs) with confidence intervals (CIs) were estimated. ResultsDuring 26.0 years median follow-up, 120 COPD cases occurred. Low SES was associated with increased COPD risk and high CRF was associated with reduced COPD risk. Compared with high SES-low CRF, low SES-low CRF was associated with an increased COPD risk 2.36 (95% CI: 1.44–3.87), with no evidence of an association for low SES-high CRF and COPD risk 1.46 (95% CI:0.82–2.60). ConclusionIn middle-aged Finnish men, SES and CRF are each independently associated with COPD risk. However, high CRF levels offset the increased COPD risk related to low SES.

Serum metabolites associated with increased insulin resistance and low cardiorespiratory fitness in overweight adolescents

Background and aimsObesity affects metabolism, increasing the risk of developing non-communicable diseases in adolescence, due to excess adipose tissue and low cardiorespiratory fitness (CRF). The metabolomics approach allows the elucidation of metabolites, which may have the concentrations altered by several factors, such as body composition (BC). We aimed to analyze the metabolomic profile of normal-weight and overweight adolescents and associate the metabolites with clinical markers related to BC, insulin resistance (IR), and CRF. Methods and resultsThe sample was composed of 57 adolescents and divided into two groups: the normal-weight group (NWG, n = 24) and the overweight group (OWG, n = 33). They underwent blood collection and anthropometric, BC, and CRF assessment. Blood serum samples were analyzed by 1H-NMR spectroscopy (600 MHz). The OWG presented higher values of body weight (BW), body mass index (BMI), waist circumference (WC), fasting glucose, insulin, IR, cholesterol, and percentage of fat mass (%FM) and lower levels of peak oxygen consumption (VO2 peak) compared with the NWG. The OWG presented lower concentrations of 3-hydroxyisovalerate, glutamate, and methionine as well as higher concentrations of aspartate, asparagine, creatine, glycerol, myo-inositol, proline, pyruvate, tyrosine, and valerate compared with the NWG. The concentrations of glutamate, myo-inositol, creatine, methionine, and valerate correlated with %FM; pyruvate and valerate positively correlated with IR; and glutamate, tyrosine, and valerate negatively correlated with CRF. ConclusionChanges in the BC lead to changes in the metabolomic profile of adolescents, and the altered metabolites are associated with increased IR and low CRF. These results indicate new targets for health monitoring and prevention of cardiovascular and metabolic diseases in adolescents.

Health-related physical fitness in patients with complaints of hand, wrist, forearm and elbow: an exploratory study

ObjectivesLittle is known about the physical fitness of patients with complaints of hand, wrist, forearm and/or elbow and its possible determinants. Aims were to assess health-related physical fitness (HRPF) in...

Investigating impact of cardiorespiratory fitness in reducing brain tissue loss caused by ageing.

Mitigating the loss of brain tissue due to age is a major problem for an ageing population. Improving cardiorespiratory fitness has been suggested as a possible strategy, but the influenceon brain morphology has not been fully characterized. To investigate the dependent shifts in brain tissue distribution as a function of cardiorespiratory fitness, we used a 3D transport-based morphometry approach. In this study of 172 inactive older adults aged 58–81 (66.5 ± 5.7) years, cardiorespiratory fitness was determined by V peak (ml/kg/min) during graded exercise and brain morphology was assessed through structural magnetic resonance imaging. After correcting for covariates including age (in the fitness model), gender and level of education, we compared dependent tissue shifts with age to those due to . We found a significant association between cardiorespiratory fitness and brain tissue distribution (white matter, r = 0.30, P = 0.003; grey matter, r = 0.40, P < 0.001) facilitated by direct visualization of the brain tissue shifts due to cardiorespiratory fitness through inverse transformation—a key capability of 3D transport-based morphometry. A strong statistical correlation was found between brain tissue changes related to ageing and those associated with lower cardiorespiratory fitness (white matter, r = 0.62, P < 0.001; grey matter, r = 0.74, P < 0.001). In both cases, frontotemporal regions shifted the most while basal ganglia shifted the least. Our results highlight the importance of cardiorespiratory fitness in maintaining brain health later in life. Furthermore, this work demonstrates 3D transport-based morphometry as a novel neuroinformatic technology that may aid assessment of therapeutic approaches for brain ageing and neurodegenerative diseases.

Anthropometric characteristics, quality of life and functional capacity in adults living with HIV in Puerto Rico

Survival and longevity rates in people living with HIV (HIV+) have increased with the availability and use of antiretroviral therapy (ART). However, despite the above HIV+ adults treated with ART have a higher risk of developing dyslipidemia and high waist circumference. In addition, they have lower cardiorespiratory fitness, loss of muscle mass, reduced balance, and reduced functional capacity, which affects their quality of life. To explore the impact of balance perception, treadmill time, grip strength, body mass index (BMI), and waist-to-height ratio (WHtR) on quality of life in Latino Hispanic people living with HIV. This study recruited twenty-five participants from a community-based center, La Perla de Gran Precio, in San Juan, Puerto Rico, with the medical diagnosis of HIV. Descriptive measures were obtained for all variables of interest, and correlation and regression analyses were used to assess the associations between functional capacity, quality of life, and anthropometric measures. Result: Men had greater left- and right-hand grip strength than women (86.9±18.8, 56.9±26.8 kg; p=0.003 and 87.6±15.1 vs. 61.4±26.6 kg; p =0.004). Two anthropometric variables showed a trend toward a moderate positive correlation with quality of life: WHtR (r= -0.38, p =0.12) and BMI (r= -0.38, p = p-0.14). Although gender differences in upper body strength are expected, handgrip strength is within the gender-specific average range of the general population. The integration of anthropometric characteristics and upper body strength when prescribing exercise must be considered since these factors influence functional capacity and quality of life among HIV+ adults.

Relationship between Resting Metabolic rate and Body Composition Factors in Obese and Normal Weight Gymnast Children

Background: Inconsistent results have been reported about the relationship between low RMR and obesity. The purpose of this study was to investigate the relationship between resting metabolic rate and body composition factors in obese and normal weight gymnastics children. Materials and Methods: 20 obese and 21 normal-weight boys, aged 8-12 years, participated in this study. In the first session, data regarding the participants’ anthropometrical (weight, height, waist to hip ratio (WHR)) and body composition (body fat percentage (BF%), body fat weight (BFW), and lean body weight (LBW)) measurements were recorded. In the next session, at first, subjects rested for 15 min and then performed a modified Bulk exhausting test. The subjects were connected to the mouthpiece of gas analyzer throughout the rest and exhausting test and VO2max, RER, and RMR were conducted in both groups. Results: Significant difference was observed for a mean of VO2max, weight, BF%, BFW, LBW, and WHR between the two groups (P=0/001). The mean of RMR per kg body weight was significantly lower in the obese group than in the normal-weight group (P 0.05). There was a significant linear relationship between RMR with weight, WHR, BFW, LBW, and VO2max in the obese group (P≤0/05). Conclusion: Based on the results of the present study it can be concluded that the difference between the weight of obese and normal-weight beginner gymnast children is partly due to low RMR; and the lower RMR in obese children might be due to their low cardiorespiratory fitness.