Regular Leisure-time Physical Activity Research Articles

Physical activity reduces genetic susceptibility to increased central systolic pressure augmentation: a study of female twins

ObjectivesWe sought to examine associations between the augmentation index (AI) and metabolic, adiposity, and lifestyle factors, independent of genetic influences, and to determine whether gene-environment interactions modulate these relationships. BackgroundReported associations between AI, an index of systemic arterial stiffness, and metabolic, adiposity, and lifestyle factors remain contradictory. The modulating effect of genetic risk is unknown. MethodsWe studied 684 female twins (age 18 to 71 years); AI was derived from the pressure waveform measured at the radial artery by applanation tonometry. Percentage of total body fat (TBF) and percentage of central abdominal fat (CAF) were assessed by dual-energy X-ray absorptiometry. ResultsIn univariate analysis, age-adjusted AI was significantly associated with fasting triglyceride levels (r = 0.1, p = 0.03), apolipoprotein-B/A1 (r = 0.1, p = 0.04), percentage of TBF (r = 0.11, p = 0.006), and percentage of CAF (r = 0.11, p = 0.004). In co-twin case-control (monozygotic twin) analysis, a 3.1% absolute within-pair difference in percentage of CAF accounted for a 6% within-pair difference in AI, independent of genetic effects. Smokers and subjects with alcohol intakes >15 U/week had higher AI than nonsmokers (p = 0.01) and nondrinkers (p = 0.02), respectively. Forty percent of the variance in AI was explained by age, central mean arterial pressure, heart rate, height, percentage of CAF, and smoking. In gene-environment interaction analysis, subjects at high genetic risk of increased AI participating in regular leisure-time physical activity had AI values similar to low genetic risk subjects. ConclusionsCentral abdominal adiposity is a significant determinant of AI in female twins, independent of hemodynamic, lifestyle, and, importantly, genetic effects. Smoking is associated with increased AI, even after controlling for abdominal obesity and other AI determinants. Physical activity reduces genetic predisposition to increased AI.

The association between physical activity and the development of acute coronary syndromes in treated and untreated hypertensive subjects.

The objective of this study was to evaluate the effect of physical activity on the risk of coronary events in different groups of hypertensive patients. During 2000-2001, 848 patients hospitalized for a first event of coronary heart disease and 1078 hospitalized controls without any suspicion of coronary heart disease, paired by sex and age, were randomly selected from all Greek regions. A total of 418 (49%) of the patients and 303 (28%) of the controls were classified as hypertensives, while 88 (21%) of the hypertensive patients and 88 (29%) of the hypertensive controls, reported regular leisure-time physical activity. Compared to physical inactivity, the analysis showed that light to moderate physical activity was associated with a reduction by 12% of the coronary risk in controlled hypertensive subjects (p=0.03), by 9% (p=0.04) in hypertensives who were untreated or unaware of their condition, and by 5% (p=0.087) in uncontrolled hypertensives. The practice of regular physical activity seems to be associated with lower coronary risk in various groups of hypertensives. However, these data cannot prove causality, and prospective studies will be necessary to confirm or refute the authors findings.

Changes in the Prevalence of Overweight and Obesity and Their Risk Factors in Spain, 1987–1997

Background. The aim of this study was to examine the relationship of the changes in the prevalence of overweight and obesity with the changes in some of their risk factors in Spain from 1987 to 1997.Methods. Data were obtained from three interview-based health surveys, covering representative samples of the noninstitutionalized Spanish population aged 16 years and over and undertaken in 1987 (n = 17,434), 1995 (n = 4,736), and 1997 (n = 4,678). To compensate for the different sample sizes, the 1995 and 1997 surveys were combined. Risk factors for obesity and overweight considered in this study were age, educational level, physical activity at work, physical activity during leisure time, tobacco use, alcohol consumption, and civil status. Data analysis was performed with logistic regression.Results. The prevalence of overweight and obesity (body mass index ≥ 25 kg/m2) rose from 35.6% in 1987 to 40.9% in 1995/1997 among women and from 47.1 to 56.2% among men. In the period 1987–1995/1997, the proportion of persons with secondary or university education increased by 11.3% in women and 10.8% in men. Similarly, the prevalence of intense or regular leisure-time physical activity increased by 5.7 and 6.2% in women and men, respectively. The remaining risk factors for overweight and obesity registered no substantial change in prevalence over the study period. The prevalence of overweight and obesity expected in 1995/1997, had educational level and leisure-time physical activity been the same as in 1987, is higher than the observed figures; for educational level, expected figures are 7.3 and 1.4% higher than those observed among women and men, respectively, while for leisure-time physical activity corresponding values are 2.8 and 1.6%.Conclusions. The rise in the prevalence of overweight and obesity in Spain from 1987 to 1997 may have been attenuated by an increase in leisure-time physical activity and by an improvement in educational level, particularly among women. The contribution to overweight and obesity trends attributable to physical activity at work or to tobacco and alcohol consumption appears to be small or null.

Prevalence of Healthy Lifestyle Characteristics--Michigan, 1998 and 2000

Most persons with chronic diseases such as cardiovascular disease, cancer, diabetes, and chronic lung disease share multiple common risk factors and lifestyle behaviors. Tobacco use, poor diet, and physical inactivity have been identified as the leading contributors to overall mortality in the United States, accounting for one third of all deaths; Michigan has a particularly high burden of chronic disease-related mortality. To characterize the prevalence of four healthy lifestyle characteristics (HLCs) (i.e., healthy weight, adequate fruit and vegetable consumption, regular leisure-time physical activity [LTPA], and not smoking) in Michigan residents, data were analyzed from Michigan's Behavioral Risk Factor Surveillance System (BRFSS) for 1998 and 2000. This report summarizes the results of the analysis, which indicate that the proportion of Michigan residents who engaged in all four healthy lifestyle practices was extremely low, and that the prevalence was influenced by sex, education and self-reported health status. The comprehensive assessment of HLCs may be a useful adjunct to chronic disease surveillance.

Relationship of leisure-time physical activity and occupational activity to the prevalence of obesity.

To assess the interaction between leisure-time physical activity (LTPA) and occupational activity (OA) on the prevalence of obesity. Secondary data analysis of a population based cross-sectional US national sample (NHANES III). A total of 4889 disease-free, currently employed adults over age 20 y. Subjects body mass index (BMI) was categorized as (1) obese (BMI> or =30 kg/m(2)), or (2) non-obese (BMI<30 kg/m(2)). LTPA was divided into four categories: (1) no LTPA; (2) irregular LTPA; (3) regular moderate intensity LTPA; and (4) regular vigorous intensity LTPA. OA was grouped as (1) high OA and (2) low OA. Age, gender, race-ethnicity, smoking status, urbanization classification, alcohol consumption and income were statistically controlled. In all, 16.8% (s.e. 0.7) of the total subject population were obese (15.1% (s.e. 1.1) of men and 19.1% (s.e. 1.1) of women). Logistic regression revealed that compared to those who engage in no LTPA and have low levels of OA, the likelihood of being obese is 42% (95% CI 0.35, 0.96) lower for those who engage in no LTPA and have high OA, 48% (95% CI 0.32, 0.83) lower for those who have irregular LTPA and have high levels of OA, and about 50% lower for all those who have regular LTPA through moderate or vigorous activity levels regardless of OA level. When considering disease free adults above 20 y of age employed in high and low activity occupations, a high level of occupational activity is associated with a decreased likelihood of being obese.

Physical activity and incidence of postmenopausal breast cancer.

Whether physical activity reduces the risk of postmenopausal breast cancer is uncertain; few studies have addressed this issue. We examined the association of leisure physical activity with breast cancer incidence among 37,105 postmenopausal participants in the Iowa Women's Health Study. Women reporting the highest level of physical activity at baseline compared with women with the lowest level of activity had an age-adjusted relative risk of breast cancer of 0.92 (95% confidence interval = 0.80-1.05). Women reporting any regular leisure-time physical activity had a relative risk of 0.97 (95% confidence interval = 0.87-1.08) compared with those reporting no such regular physical activity. Adjustment for potential confounders did not appreciably alter the findings. There is little evidence from this study that physical activity later in life is associated to any appreciable extent with breast cancer incidence.

Correlates of leisure-time physical activity in an elderly population in Singapore.

This study assessed correlates of leisure-time physical activity among the elderly in Singapore. A cross-sectional household survey was conducted in 1998 with 2494 subjects 60 years and older. Regular leisure-time physical activity was practiced by 47.0% of men and 38.5% of women. It was significantly correlated with family support, proportion of family members exercising, awareness of benefits of exercise, and healthy dietary habits. Other significant but negative correlates were smoking and barriers to exercise, such as lack of time and poor health. Exercise programs for the elderly should aim at helping them overcome barriers to exercise, informing them of the benefits of exercise, and involving their families.

Leisure-time physical activity but not work-related physical activity is associated with decreased plasma viscosity. Results from a large population sample.

Regular leisure-time physical activity (LTPA) is inversely associated with coronary heart disease (CHD). This has been mainly explained by its impact on traditional CHD risk factors, but more recently it was also shown to lower fibrinogen, which largely determines plasma viscosity. No data on the effect of work activity (WA) on plasma viscosity have been published. We studied the relationship between self-reported LTPA or WA and plasma viscosity as well as other CHD risk factors in 3522 men and women age 25 to 64 years. Physical activity was assessed by questionnaire. LTPA was inversely associated with plasma viscosity in both sexes. The unadjusted mean differences in plasma viscosity in men between no activity and the highest activity were 0.024 mPa.s (95% confidence interval [CI], 0.016 to 0.032 mPa.s, P < .001) during winter and 0.024 mPa.s (95% CI, 0.016 to 0.031 mPa.s, P < .001) during summer. After adjustment for age, cholesterol, smoking, blood pressure, body mass index, and years of education, mean differences decreased but still remained substantial and statistically significant (0.010 mPa.s; 95% CI, 0.003 to 0.018 mPa.s [P = .009] for winter activity; and 0.010 mPa.s; 95% CI, 0.002 to 0.017 mPa.s [P = .011] for summer activity). Similar results were found in women. WA showed no appreciable association with plasma viscosity after controlling for the covariates. LTPA is inversely associated with plasma viscosity, independent of other risk factors, whereas WA shows no material effect in men and women. Decreased plasma viscosity may represent one mechanism through which LTPA confers a decrease of CHD risk.

Regular leisure time physical activity predicts high activity of tissue plasminogen activator: The Northern Sweden MONICA Study.

Leisure time physical activity protects against the development of cardiovascular disease, partly by lowering blood pressure, cholesterol and body weight. Little is known about the effects of regular exercise on fibrinolytic variables in the population. In a population sample of 733 men and 774 women aged 25-64 years physical activity during leisure time was related to fibrinolytic variables. The activity of tissue plasminogen activator (tPA) increased linearly with greater physical activity, the difference between sedentary and most active subjects being 28.9% in men and 11.6% in women. The tPA mass concentrations decreased by 27.4% and 28.0% in men and women respectively, as did also plasminogen activator inhibitor (PAl-1) activity; 38.5% and 30.6%. Tests for trend were significant (P < 0.001) for all but tPA activity in women. Adjusting for age, body mass index and waist:hip ratio only slightly decreased three relationships. When taking triglyceride into account, tPA activity and PAl-1 activity (in men) were no longer significantly related to physical activity level but lower tPA mass concentrations and PA1-1 activity (in women) were still found in those who exercised regularly. Further adjustment for insulin levels abolished all differences, except for PA1-1 activity in women. Greater leisure time physical activity is associated with an increased fibrinolytic activity. This may contribute to less cardiovascular disease in subjects who exercise regularly.

F83. Regular leisure time physical activity and reduced incidence in coronary heart disease: Which mechanisms are involved? Potential role of plasma viscosity

F83. Regular leisure time physical activity and reduced incidence in coronary heart disease: Which mechanisms are involved? Potential role of plasma viscosity

The association between alcohol use and health behaviors related to the risk of cardiovascular disease: the South Carolina Cardiovascular Disease Prevention Project.

This study examines the relationship between alcohol use and health behaviors related to the risk of cardiovascular disease (CVD). In particular, we examined the relationship between alcohol use and leisure time physical activity, participation in community physical activity programs and behaviors used for weight loss. Numerous studies have found a "protective" effect of moderate alcohol consumption on the risk of CVD. However, most of these studies have not adequately controlled for potential confounding by health behaviors associated with alcohol use. We used descriptive and logistic regression analyses to examine cross-sectional survey data from 2,072 participants in the South Carolina Cardiovascular Disease Prevention Project. After controlling for age, race, education and preexisting CVD, moderate and heavy drinkers who do not smoke were more likely than nondrinkers to report engaging in regular leisure time physical activity. The relationship between other health behaviors and alcohol consumption was less clear. Among men, moderate and heavy drinkers were no more likely than nondrinkers to participate in community physical activity programs; among women, moderate and heavy drinkers were more likely than nondrinkers to report this activity. Moderate drinkers were more likely than nondrinkers to report that they were attempting to lose weight, however this difference was not statistically significant. These data suggest that at least some of the apparent protective effect of moderate alcohol consumption found in other studies may be due to differences between nondrinkers and drinkers with respect to physical activity and other health practices.

Social Network, Social Support and Regular Leisure-time Physical Activity in Elderly Men

We examined the associations among different aspects of social network and social support and regular leisure-time physical activity. The study sample (N = 621) comprised a random half of all male residents in Malmo, Sweden, born in 1914. The response rate was 80.5%. Eight conceptually differentiated aspects of social networks and social support were measured. All social network indices and two of the four social support indices were associated with regular physical activity (OR 1.9–3.5 and 1.7–2.1, respectively). After adjustment for medical disorders, risk factors and risk behavior in multivariate analysis only minor reductions of the associations were noted. Men who reported being socially anchored, having many social contacts, feeling satisfied with their social participation, and having good material and informational support, more often took part in regular physical activity. Results from this study indicate that the health effect of social network and social support, at least in some part, could be mediated through physical activity. These new psychosocial determinants make it easier to characterize groups of people in need of regular physical activity, a finding of potential importance in the field of health promotion.

Physical Activity and 10.5 Year Mortality in the Multiple Risk Factor Intervention Trial (MRFIT)

The effect of habitual leisure time physical activity (LTPA) on the 10.5-year total and cause-specific mortality rates was studied in 12,138 middle-aged men at high risk for coronary heart disease (CHD) who participated in the MRFIT. The level of LTPA as determined by the Minnesota questionnaire was inversely related to rate of death from cardiovascular (CVD), coronary heart disease (CHD), and all-causes, but was unrelated to the cancer death rate. The least active men (LTPA tertile 1) had excess mortality rates of 22%, 27%, and 15% for CVD, CHD, all-causes, respectively, as compared to more active men in the middle third (tertile 2). Additional LTPA (tertile 3) was not associated with further attenuation of mortality rates. Proportional hazards regression analysis only slightly weakened risk differentials. This study supports previous observations that regular LTPA is associated with a reduced rate of CVD mortality, independent of other risk factor levels.

The effect of leisure time physical activity on the risk of pre-eclampsia and gestational hypertension.

To assess the relation between leisure time physical activity (LTPA) during the first 20 weeks of pregnancy and the risk of developing pre-eclampsia and gestational hypertension. Case-control study carried out over a 28 month period with retrospective data collection. Six hospitals in Quebec City and four hospitals in Montreal. 172 women with pre-eclampsia, 254 with gestational diabetes, 505 controls. All were primiparous, with no history of high blood pressure before pregnancy (unless due to oral contraceptive use), or during the first 20 weeks of gestation. Cases were defined using recognised criteria, and 97% of those eligible agreed to be interviewed. Controls delivered in same hospital immediately after cases and had no more than one reading of elevated blood pressure during pregnancy; 96% of those eligible agreed to be interviewed. Participants were interviewed in hospital a few days after delivery using a questionnaire. Information was collected on type, frequency and average duration of any LTPA performed regularly during the first 20 weeks of pregnancy, together with medical, obstetric and sociodemographic details. It was found that women who performed regular LTPA had a reduced risk of pre-eclampsia (adjusted RR 0.67, 95% CI 0.46-0.96) and gestational hypertension (aRR 0.75, 95% CI 0.54-1.05), and the relative risks decreased as the average time spent in LTPA increased (aRR for pre-eclampsia among women with low, moderate and high energy expenditure: 1.00, 0.77 and 0.57, p = 0.01). The same trend was present for gestational hypertension (1.00, 0.80 and 0.71, respectively, p = 0.08). Leisure time physical activity during the first half of pregnancy is likely to reduce the risk of pre-eclampsia and gestational hypertension.

Physical activity and fracture risk in a free-living elderly cohort.

A prospective study to determine if regular leisure-time physical activity (including recreational walking) is associated with fracture risk was conducted in a large cohort (N = 3110) of free-living elderly men and women in the retirement community of Dunedin, Florida. Sixty-three percent of the cohort was female, all were white, and the average age was 73.0 years +/- 5.3 (SD). Participants in regular physical activity at baseline had a reduced risk of fracture; the risk ratio (RR) of fracture for men and women, respectively, was RR = 0.41, 95% CI = 0.17 to 1.01 and RR = 0.76, 95% CI = 0.50 to 1.15. Walking at least one mile 3 times/week appeared to offer a protective effect for both sexes. After controlling for potentially confounding variables including body mass and selected health conditions, the RR for regular physical activity on fracture incidence in men and women remained essentially unchanged. We conclude that regular physical activity such as walking may protect against fracture in older persons.

Alcohol and exercise in myocardial infarction and sudden coronary death in men and women.

The relation of alcohol consumption and regular leisure time physical activity with nonfatal myocardial infarction and sudden coronary death in men and women of Auckland, New Zealand, was examined in a large population-based case-control analysis. Within each sex, alcohol drinkers had decreased relative risks of both myocardial infarction and sudden coronary death compared with nondrinkers. Similarly, physical activity was associated with decreased relative risks of myocardial infarction and sudden coronary death in both women and men, but only in those subjects who had been exercising for five or more years. After controlling for hypertension, cigarette smoking, and alcohol consumption, 43% (95 confidence interval (CI) = 26-60) of coronary events could be explained by lack of exposure to physical activity. This compares with the per cent of coronary events in the study population attributable to hypertension (22%; 95% CI = 17-27) or cigarette smoking (31%; 95% CI = 25-38). Although the estimation of the attributable risk for a continuous variable is affected by the cut-point used to define exposure, from a public health viewpoint, regular leisure time physical activity may be as important as the above-mentioned major coronary heart disease risk factors.