Longitudinal Examination of Age-Predicted Symptom-Limited Exercise Maximum Heart Rate

Na Zhu,^*,1 Jose Suarez,^*,1 Steve Sidney,² Barbara Sternfeld,² Pamela J. Schreiner,¹ Mercedes R. Carnethon,³ Cora E. Lewis,⁴ Richard S. Crow,¹ Claude Bouchard,⁶ William Haskell,⁵ and David R. Jacobs, Jr^1,7

Abstract

Purpose

To estimate the association of age with maximal heart rate (MHR).

Methods

Data were obtained in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants were black and white men and women aged 18-30 in 1985-86 (year 0). A symptom-limited maximal graded exercise test was completed at years 0, 7, and 20 by 4969, 2583, and 2870 participants, respectively. After exclusion 9622 eligible tests remained.

Results

In all 9622 tests, estimated MHR (eMHR, beats/minute) had a quadratic relation to age in the age range 18 to 50 years, eMHR=179+0.29*age-0.011*age². The age-MHR association was approximately linear in the restricted age ranges of consecutive tests. In 2215 people who completed both year 0 and 7 tests (age range 18 to 37), eMHR=189–0.35*age; and in 1574 people who completed both year 7 and 20 tests (age range 25 to 50), eMHR=199–0.63*age. In the lowest baseline BMI quartile, the rate of decline was 0.20 beats/minute/year between years 0-7 and 0.51 beats/minute/year between years 7-20; while in the highest baseline BMI quartile there was a linear rate of decline of approximately 0.7 beats/minute/year over the full age of 18 to 50 years.

Conclusion

Clinicians making exercise prescriptions should be aware that the loss of symptom-limited MHR is much slower at young adulthood and more pronounced in later adulthood. In particular, MHR loss is very slow in those with lowest BMI below age 40.

Keywords: prediction equations, graded exercise test, mixed models, epidemiologic study

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891874/

Treatment of obesity: need to focus on high risk abdominally obese patients

Jean-Pierre Després, professor,^a Isabelle Lemieux, PhD student,^b and Denis Prud'homme, professor

Summary points

• A simple measurement such as waist circumference can indicate accumulation of abdominal fat
• Viscerally obese men are characterised by an atherogenic plasma lipoprotein profile
• A triad of non-traditional markers for coronary heart disease found in viscerally obese middle aged men (hyperinsulinaemia, raised apolipoprotein B concentration, and small LDL particles) increases the risk of coronary heart disease 20-fold
• Four out of five middle aged men with a waist measurement 90 cm and triglyceride concentrations 2 mmol/l are characterised by this triad
• Even in the absence of hypercholesterolaemia, hyperglycaemia, or hypertension, obese patients could be at high risk of coronary heart disease if they have this “hypertriglyceridaemic waist” phenotype

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119905/

The Crucial Role of Recess in School

COUNCIL ON SCHOOL HEALTH

AAP—American Academy of Pediatrics


Recess is at the heart of a vigorous debate over the role of schools in
promoting the optimal development of the whole child. A growing trend
toward reallocating time in school to accentuate the more academic
subjects has put this important facet of a child’s school day at risk.
Recess serves as a necessary break from the rigors of concentrated,
academic challenges in the classroom. But equally important is the
fact that safe and well-supervised recess offers cognitive, social,
emotional, and physical benefits that may not be fully appreciated
when a decision is made to diminish it. Recess is unique from, and
a complement to, physical education—not a substitute for it. The
American Academy of Pediatrics believes that recess is a crucial
and necessary component of a child’s development and, as such, it
should not be withheld for punitive or academic reasons. Pediatrics
2013;131:183–188


http://pediatrics.aappublications.org/content/131/1/183.full.pdf+html?sid=5027c478-1779-471b-842c-c5dcc4362413

Television viewing time and reduced life expectancy: a life table analysis

1. J Lennert Veerman1, 
2. Genevieve N Healy2,3, 
3. Linda J Cobiac1, 
4. Theo Vos1,
5. Elisabeth A H Winkler2, 
6. Neville Owen2,3, 
7. David W Dunstan

Abstract

Background Prolonged television (TV) viewing time is unfavourably associated with mortality outcomes, particularly for cardiovascular disease, but the impact on life expectancy has not been quantified. The authors estimate the extent to which TV viewing time reduces life expectancy in Australia, 2008.

Methods The authors constructed a life table model that incorporates a previously reported mortality risk associated with TV time. Data were from the Australian Bureau of Statistics and the Australian Diabetes, Obesity and Lifestyle Study, a national population-based observational survey that started in 1999–2000. The authors modelled impacts of changes in population average TV viewing time on life expectancy at birth.

Results The amount of TV viewed in Australia in 2008 reduced life expectancy at birth by 1.8 years (95% uncertainty interval (UI): 8.4 days to 3.7 years) for men and 1.5 years (95% UI: 6.8 days to 3.1 years) for women. Compared with persons who watch no TV, those who spend a lifetime average of 6 h/day watching TV can expect to live 4.8 years (95% UI: 11 days to 10.4 years) less. On average, every single hour of TV viewed after the age of 25 reduces the viewer's life expectancy by 21.8 (95% UI: 0.3–44.7) min. This study is limited by the low precision with which the relationship between TV viewing time and mortality is currently known.

Conclusions TV viewing time may be associated with a loss of life that is comparable to other major chronic disease risk factors such as physical inactivity and obesity.

http://bjsm.bmj.com/content/46/13/927.full

Body mass index, fitness and physical activity from childhood through adolescence

1. Katja Pahkala1,2, 
2. Miika Hernelahti2, 
3. Olli J Heinonen2, 
4. Päivi Raittinen3, 
5. Maarit Hakanen1,
6. Hanna Lagström4, 
7. Jorma S A Viikari5, 
8. Tapani Rönnemaa5, 
9. Olli T Raitakari1,6, 
10. Olli Simell1,

Abstract

Background Obesity, sedentary lifestyle and poor cardiorespiratory fitness in childhood may increase the risk of health problems later in life.

Purpose The authors studied the association of early childhood weight status with cardiorespiratory fitness and leisure-time physical activity (LTPA) in adolescence. The stability and associations of LTPA and fitness from childhood through adolescence were also studied.

Methods Body mass index (BMI) was assessed annually since birth in a prospective, longitudinal study. The mean BMI between ages 2 and 7 years indicated weight status at preschool age. Fitness was studied with a shuttle run test at age 9 and with a maximal cycle ergometer test at age 17. The same questionnaire was used to assess LTPA at age 9, 13 and 17. Complete data on preschool BMI, LTPA at ages 13 and 17 and fitness at age 17 years was provided by 351 children, while fitness and LTPA data were available for 74 children at ages 9 and 17.

Results Preschool BMI was inversely associated with fitness in adolescence independently of adolescent LTPA (p=0.0001). Children who had a high preschool BMI but whose weight status was reduced in adolescence had similar fitness in adolescence as the children with a persistently low BMI. Regardless of the fitness level in childhood, the children whose LTPA increased between age 9 and 17 had a similar adolescent fitness level as persistently active subjects.

Conclusions It is important to maintain a healthy body weight and a physically active lifestyle from very childhood through adolescence to improve fitness during adolescence.

http://bjsm.bmj.com/content/47/2/71.full

Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults

DONNELLY, JOSEPH E. Ed.D (Chair); BLAIR, STEVEN N. PED; JAKICIC, JOHN M. Ph.D.; MANORE, MELINDA M. Ph.D., R.D.; RANKIN, JANET W. Ph.D.; SMITH, BRYAN K. Ph.D

Abstract

Overweight and obesity affects more than 66% of the adult population and is associated with a variety of chronic diseases. Weight reduction reduces health risks associated with chronic diseases and is therefore encouraged by major health agencies. Guidelines of the National Heart, Lung, and Blood Institute (NHLBI) encourage a 10% reduction in weight, although considerable literature indicates reduction in health risk with 3% to 5% reduction in weight. Physical activity (PA) is recommended as a component of weight management for prevention of weight gain, for weight loss, and for prevention of weight regain after weight loss. In 2001, the American College of Sports Medicine (ACSM) published a Position Stand that recommended a minimum of 150 min·wk^-1 of moderate-intensity PA for overweight and obese adults to improve health; however, 200-300 min·wk^-1 was recommended for long-term weight loss. More recent evidence has supported this recommendation and has indicated more PA may be necessary to prevent weight regain after weight loss. To this end, we have reexamined the evidence from 1999 to determine whether there is a level at which PA is effective for prevention of weight gain, for weight loss, and prevention of weight regain. Evidence supports moderate-intensity PA between 150 and 250 min·wk^-1 to be effective to prevent weight gain. Moderate-intensity PA between 150 and 250 min·wk^-1 will provide only modest weight loss. Greater amounts of PA (>250 min·wk^-1) have been associated with clinically significant weight loss. Moderate-intensity PA between 150 and 250 min·wk^-1 will improve weight loss in studies that use moderate diet restriction but not severe diet restriction. Cross-sectional and prospective studies indicate that after weight loss, weight maintenance is improved with PA >250 min·wk^-1. However, no evidence from well-designed randomized controlled trials exists to judge the effectiveness of PA for prevention of weight regain after weight loss. Resistance training does not enhance weight loss but may increase fat-free mass and increase loss of fat mass and is associated with reductions in health risk. Existing evidence indicates that endurance PA or resistance training without weight loss improves health risk. There is inadequate evidence to determine whether PA prevents or attenuates detrimental changes in chronic disease risk during weight gain.

http://journals.lww.com/acsm-msse/Fulltext/2009/02000/Appropriate_Physical_Activity_Intervention.26.aspx

Progression Models in Resistance Training for Healthy Adults

Nicholas A. Ratamess, Ph.D.; Brent A. Alvar,
Ph.D.; Tammy K. Evetoch, Ph.D., FACSM; Terry J. Housh, Ph.D.,
FACSM (Chair); W. Ben Kibler, M.D., FACSM; William J. Kraemer,
Ph.D., FACSM; and N. Travis Triplett, Ph.D.

Abstract

In order to stimulate further adaptation toward specific training goals, progressive resistance training (RT) protocols are necessary. The optimal characteristics of strength-specific programs include the use of concentric (CON), eccentric (ECC), and isometric muscle actions and the performance of bilateral and unilateral single- and multiple-joint exercises. In addition, it is recommended that strength programs sequence exercises to optimize the preservation of exercise intensity (large before small muscle group exercises, multiple-joint exercises before single-joint exercises, and higher-intensity before lower-intensity exercises). For novice (untrained individuals with no RT experience or who have not trained for several years) training, it is recommended that loads correspond to a repetition range of an 8-12 repetition maximum (RM). For intermediate (individuals with approximately 6 months of consistent RT experience) to advanced (individuals with years of RT experience) training, it is recommended that individuals use a wider loading range from 1 to 12 RM in a periodized fashion with eventual emphasis on heavy loading (1-6 RM) using 3- to 5-min rest periods between sets performed at a moderate contraction velocity (1-2 s CON; 1-2 s ECC). When training at a specific RM load, it is recommended that 2-10% increase in load be applied when the individual can perform the current workload for one to two repetitions over the desired number. The recommendation for training frequency is 2-3 d·wk^-1 for novice training, 3-4 d·wk^-1 for intermediate training, and 4-5 d·wk^-1 for advanced training. Similar program designs are recommended for hypertrophy training with respect to exercise selection and frequency. For loading, it is recommended that loads corresponding to 1-12 RM be used in periodized fashion with emphasis on the 6-12 RM zone using 1- to 2-min rest periods between sets at a moderate velocity. Higher volume, multiple-set programs are recommended for maximizing hypertrophy. Progression in power training entails two general loading strategies: 1) strength training and 2) use of light loads (0-60% of 1 RM for lower body exercises; 30-60% of 1 RM for upper body exercises) performed at a fast contraction velocity with 3-5 min of rest between sets for multiple sets per exercise (three to five sets). It is also recommended that emphasis be placed on multiple-joint exercises especially those involving the total body. For local muscular endurance training, it is recommended that light to moderate loads (40-60% of 1 RM) be performed for high repetitions (>15) using short rest periods (<90 s). In the interpretation of this position stand as with prior ones, recommendations should be applied in context and should be contingent upon an individual's target goals, physical capacity, and training status.

http://journals.lww.com/acsm-msse/Fulltext/2009/03000/Progression_Models_in_Resistance_Training_for.26.aspx