Associations of Cardiorespiratory Fitness and Fatness With Cardiovascular Risk Factors Among Adolescents: The NHANES 1999–2002

2010 ◽  
Vol 7 (6) ◽  
pp. 746-753 ◽  
Author(s):  
Soyang Kwon ◽  
Trudy L. Burns ◽  
Kathleen Janz

Background:This study aimed to examine combined and independent effects of cardiorespiratory fitness and fatness on cardiovascular risk factors among U.S. adolescents.Methods:Data from adolescents age 12 to 19 years participating in the NHANES 1999 to 2002 were used. Fitness level was determined by submaximal treadmill test and was dichotomized as ‘not fit’ or ‘fit’ according to the FITNESSGRAM. Fatness level was categorized as ‘not fat’ or ‘fat’ based on the CDC BMI growth charts. Gender-specific multivariable linear regression analyses were conducted to compare age-, race/ethnicity-, fatness-, and waist circumference-adjusted means of blood pressure, lipids, lipoproteins, C-peptide, insulin, and C-reactive protein (CRP) levels.Results:A total of 3202 adolescents (1629 boys) were included for data analysis. Among boys, total cholesterol, tri-glycerides, insulin, and CRP mean levels were significantly higher (P < .05) in the ‘not fit’ group than in the ‘fit’ group, after adjustment for fatness level and waist circumference. Among girls, the fatness level- and waist circumference-adjusted means of total cholesterol (P < .01) and LDL-C (P < .09) were higher in the ‘not fit’ than ‘fit’ groups.Conclusion:Cardiorespiratory fitness, independent of fatness, may have beneficial effects on lipid profiles among girls, and on lipid profiles, insulin metabolism, and inflammation levels among boys.

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Hong Seok LEE ◽  
Zhiwei Zhang ◽  
Karen Xu ◽  
Yong-Moon Park

Background: Cardiorespiratory fitness is a distinct health characteristic that relates to the ability to perform physical activity. Higher cardiorespiratory fitness was reported to have reverse relationship with overall mortality and morbidity rates due to various chronic disease. The assessment of cardiorespiratory fitness was measured by maximal oxygen uptake (VO2max; mL/kg/minute) on a submaximal treadmill test. This study was aimed to examine cardiorespiratory fitness among U.S. adults 20-49 years of age, to describe the distribution of cardiorespiratory fitness and cardiovascular risk factors depends on different ethnicity for without physical limitations or indications of cardiovascular disease. Method: Data from the 1999-2004, National Health and Nutrition Examination Survey were used to describe the distribution of cardiorespiratory fitness for adults 20-49 years of age. 8324 out of 31126 subjects have valid values of cardiopulmonary fitness in the dataset with 5391 in low category of cardiorespiratory fitness (VO 2 max < 27), 2606 in medium category (37.1 > VO 2 max ≥27) and 327 in high category (37.1 ≥ VO 2 max). The risk factors for cardiopulmonary fitness was assessed by using logistic regression after adjusting all cardiovascular risk factors. All data were analyzed using SAS Ver. 9.4. Result: Overall, there is no significant association of cardiorespiratory fitness with ethnicity ( P =0.08). 65.9% of study population was male in all races. Among, non-Hispanic whites, those with 25 m 2 /kg > BMI had better cardiorespiratory fitness (more than 37.1 mL/kg/minute) than those with BMI ≥ 35 [Odds ratio (OR): 0.496, Confidence Interval (CI): 0.258-0.957]. A similar pattern was observed for Mexican Americans. Non-Hispanic black with 25 m 2 /kg > BMI had better cardiorespiratory fitness than ones with BMI ≥ 35 m 2 /kg [OR:0.137, CI:0.059-0.318], 35 m 2 /kg > BMI≥30 m 2 /kg [OR:0.269, CI:0.124-0.583], 30 m 2 /kg > BMI≥25 m 2 /kg [OR: 0.241,0.123-0.318]. Non-Hispanic white with higher diastolic blood pressure over 90 mmHg had tendency to have lower cardiorespiratory fitness. Among metabolic panel, only Mexican American with LDL<100 mg/dl has higher cardiorespiratory fitness [OR:0.559, CI:0.319-0.981]. Discussion: Our findings on cardiorespiratory fitness level among non-Hispanic blacks, non-Hispanic whites and Mexican Americans are similar to previously reported studies, however, non-Hispanic black had different risk factors related to cardiorespiratory fitness, especially significant benefit from lower BMI less than 25 m 2 /kg since other ethnicities with BMI less than 25 m 2 /kg had benefit only compared to BMI> 35 m 2 /kg. These results can be used to improve cardiorespiratory fitness level for future population based on ethnicities. The different risk factors in fitness status can also be used to develop health policies and targeted educational campaigns.


Author(s):  
Kym Joanne Price ◽  
Brett Ashley Gordon ◽  
Stephen Richard Bird ◽  
Amanda Clare Benson

Long-term maintenance of changes in cardiovascular risk factors and physical capacity once patients leave the supervised program environment have not previously been reported. This study investigated the changes in physical capacity outcomes and cardiovascular risk factors in an Australian cardiac rehabilitation setting, and the maintenance of changes in these outcomes in the 12 months following cardiac rehabilitation attendance. Improvements in mean (95% CI) cardiorespiratory fitness (16.4% (13.2–19.6%), p < 0.001) and handgrip strength (8.0% (5.4–10.6%), p < 0.001) were observed over the course of the cardiac rehabilitation program, and these improvements were maintained in the 12 months following completion. Waist circumference (p = 0.003) and high-density lipoprotein cholesterol (p < 0.001) were the only traditional cardiovascular risk factors to improve during the cardiac rehabilitation program. Vigorous-intensity aerobic exercise was associated with significantly greater improvements in cardiorespiratory fitness, Framingham risk score, and waist circumference in comparison to moderate-intensity exercise. An increase in the intensity of the exercise prescribed during cardiac rehabilitation in Australia is recommended to induce larger improvements in physical capacity outcomes and cardiovascular risk. A standardized exercise test at the beginning of the rehabilitation program is recommended to facilitate appropriate prescription of exercise intensity.


2007 ◽  
Vol 97 (2) ◽  
pp. 399-404 ◽  
Author(s):  
Leila Azadbakht ◽  
Parvin Mirmiran ◽  
Ahmad Esmaillzadeh ◽  
Fereidoun Azizi

The objective of the present study was to determine the effects of a long-term moderate-fat diet (30 % energy from fat)v.a low-fat one (20 % energy from fat) on metabolic risks. The study was a randomised, prospective 14-month trial on overweight and obese patients (eighty-nine overweight and obese men and women). The intervention was a moderate-fat diet (30 % energy) or a low-fat diet (20 % energy). The main outcome measurements were change in body weight, waist circumference, LDL-cholesterol, HDL-cholesterol, total cholesterol, TAG, and systolic and diastolic blood pressure. Forty-five subjects on the moderate-fat diet and forty-four subjects on the low-fat one were studied. Characteristics of all randomised participants were similar in both groups. After 7 months, the moderate- and low-fat diets had similar effects on cardiovascular risks. The moderate-fat diet was more successful after 14 months in reducing weight ( − 5·0 (sd2·5) kg in the moderate-fat groupv.− 1·2 (sd1·1) kg in the low-fat one;P < 0·0001), waist circumference ( − 5·5 (sd2·4) cm in the moderate-fat groupv.− 2·3 (sd1·3) cm in the low-fat one;P < 0·0001), and other cardiovascular risk factors as well (LDL, TAG, total cholesterol and systolic blood pressure). In conclusion, a moderate-fat energy-restricted diet in the long term might have more beneficial effects on weight maintenance and cardiovascular risk factors compared with a low-fat diet. Better dietary adherence with the moderate-fat diet may be the reason for its successful effects.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
H Bergum ◽  
I Sandven ◽  
TO Klemsdal

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Norwegian health department Background The evidence of the long-term effects of multiple lifestyle intervention on cardiovascular risk is uncertain. We aimed to summarize the evidence from randomized clinical trials examining the efficacy of lifestyle intervention on major cardiovascular risk factors in subjects at high cardiovascular risk. Methods  Eligible trials investigated the impact of lifestyle intervention versus usual care with minimum 24 months follow-up, reporting more than one major cardiovascular risk factor. A literature search updated April 15, 2020 identified 12 eligible studies. The results from individual trials were combined using fixed and random effect models, using the standardized mean difference (SMD) to estimate effect sizes. Small-study effect was evaluated, and heterogeneity between studies examined by subgroup and meta-regression analyses considering patient- and study-level variables. Results  Small-study effect was not identified. Lifestyle intervention reduced systolic blood pressure modestly with an estimated SMD of -0.13, 95% confidence interval (CI): -0.21 to -0.04, with moderate heterogeneity (I² = 59%), corresponding to a mean difference of approximately 2 mmHg (MD = -1.86, 95% CI: -3.14 to -0.57, p = 0.0046). This effect disappeared in the subgroup of trials judged at low risk of bias (SMD = 0.02, 95% CI: -0.08 to 0.11). For the outcome total cholesterol SMD was -0.06, 95% CI: -0.13 to 0.00, with no heterogeneity (I² = 0%), indicating no effect of the intervention. Conclusion  Lifestyle intervention resulted in only a modest effect on systolic blood pressure and no effect on total cholesterol after 24 months. Further lifestyle trials should consider the challenge of maintaining larger long-term benefits to ensure impact on cardiovascular outcomes.


2017 ◽  
Vol 3 (1) ◽  
pp. 7-14
Author(s):  
Okon Ekwere Essien ◽  
Iya Eze Bassey ◽  
Rebecca Mtaku Gali ◽  
Alphonsus Ekpe Udoh ◽  
Uwem Okon Akpan ◽  
...  

Purpose Cardiovascular disease risk factors have been associated with androgen-deprivation therapy (ADT) in white and Hispanic populations. It is therefore relevant to determine if there exists a relationship between these parameters in the African population. Patients and Methods The design of the study was cross sectional. Prostate-specific antigen concentration, waist circumference, body mass index (BMI), lipid profile, glucose level, and insulin level were determined in 153 patients with prostate cancer and 80 controls. The patients with prostate cancer were divided into subgroups of treatment-naïve patients and those receiving ADT. Results Mean total cholesterol ( P = .010), LDL cholesterol ( P = .021), BMI ( P = .001), and waist circumference ( P = .029) values were significantly higher in patients treated with ADT when compared with treatment-naïve patients. In patients treated with ADT for up to 1 year, only mean BMI was significantly higher than in treatment-naïve patients, whereas those treated with ADT for more than 1 year had significantly higher mean BMI, waist circumference, total cholesterol, and LDL cholesterol values when compared with treatment-naïve patients. There were no significant differences in insulin or glucose levels. Those undergoing hormone manipulation after orchiectomy had fewer cardiovascular risk factors compared with those undergoing hormone manipulation alone. Conclusion This study shows that ADT results in elevated total cholesterol, LDL cholesterol, BMI, and waist circumference values, all of which are risk factors of cardiovascular disease. Screening for cardiovascular risk factors should be included in treatment plans for patients with prostate cancer.


2016 ◽  
Vol 115 (9) ◽  
pp. 1586-1597 ◽  
Author(s):  
Michelle Alessandra Castro ◽  
Valéria Troncoso Baltar ◽  
Dirce Maria Marchioni ◽  
Regina Mara Fisberg

AbstractThe association between dietary patterns and metabolic cardiovascular risk factors has long been addressed but there is a lack of evidence towards the effects of the overall diet on the complex net of biological inter-relationships between risk factors. This study aimed to derive dietary patterns and examine their associations with metabolic cardiovascular risk factors following a theoretic model for the relationship between them. Participants included 417 adults of both sexes, enrolled to the cross-sectional population-based study performed in Brazil. Body weight, waist circumference, high-sensitivity C-reactive protein, blood pressure, total cholesterol:HDL-cholesterol ratio, TAG:HDL-cholesterol ratio, fasting plasma glucose and serum leptin were evaluated. Food consumption was assessed by two non-consecutive 24-h dietary recalls adjusted for the within-person variation of intake. A total of three dietary patterns were derived by exploratory structural equation modelling: ‘Traditional’, ‘Prudent’ and ‘Modern’. The ‘Traditional’ pattern had a negative and direct effect on obesity indicators (serum LEP, body weight and waist circumference) and negative indirect effects on total cholesterol:HDL-cholesterol ratio, TAG:HDL-cholesterol ratio and fasting plasma glucose. The ‘Prudent’ pattern had a negative and direct effect on systolic blood pressure. No association was observed for the ‘Modern’ pattern and metabolic risk factors. In conclusion, the ‘Traditional’ and ‘Prudent’ dietary patterns were negatively associated with metabolic cardiovascular risk factors among Brazilian adults. Their apparent protective effects against obesity and high blood pressure may be important non-pharmacological strategies for the prevention and control of obesity-related metabolic disorders and CVD.


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