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Zou Q, Su C, Du W, Ouyang Y, Wang H, Zhang B, Luo S, Tan T, Chen Y, Zhong X, Zhang H. The Mediation and Moderation Effect Association among Physical Activity, Body-Fat Percentage, Blood Pressure, and Serum Lipids among Chinese Adults: Findings from the China Health and Nutrition Surveys in 2015. Nutrients 2023; 15:3113. [PMID: 37513531 PMCID: PMC10383535 DOI: 10.3390/nu15143113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Physical activity (PA) is of benefit and particularly important for cardiovascular disease risk factors as being sedentary becomes a lifestyle habit. Research into Chinese complex association among physical activity, body-fat percentage (BF%), blood pressure, and serum lipids is limited. The present study is based on an observational study among adults (>18 years old) residing in fifteen provinces in China. Data of 10,148 adult participants in the 2015 China Health and Nutrition Survey (CHNS) were analyzed. The simple mediation effect models with covariates were utilized to assess the association among PA and blood pressure or serum lipids, and BF% was played as a mediator. The serial multiple-mediator models with covariates were constructed to the further analysis of the relationship between PA and blood pressure, and BF% was the mediator 1 and blood lipids were the mediator 2. Based on the above hypothesis, the moderated mediation models with covariates were used to analyze the association among PA, BF%, and blood pressure; in addition, BF% was used as the mediator and blood lipids played as the moderator. In the simple mediation models, the model with a dependent variable was high-density lipoprotein cholesterol (HDL-C) or low-density lipoprotein cholesterol (LDL-C); BF% was played as the partly mediation effect and the proportion of contribution was 0.23 and 0.25, respectively. In the serial multiple-mediator models, blood lipids, as the second mediator, played the mediation effect; however, the effect was smaller than the BF%. In the moderated mediation model, blood lipids had the moderation effect as the moderator variable. HDL-C played a moderating role in the latter pathway of the "PA→BF%→SBP/DBP" mediation model, and LDL-C/TC played a moderating role in the direct effect of the "PA→BF%→DBP". In conclusion, BF% played a mediating role in the relationship between PA and blood pressure. HDL-C, LDL-C, and TC were more likely to act as moderating variables in the mediation model "PA→BF%→SBP/DBP". PA could directly and indirectly benefit to control the CVD risk factors simultaneously.
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Affiliation(s)
- Qinpei Zou
- Chongqing Center for Disease Control and Prevention, Chongqing 400042, China
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
- Department of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Wenwen Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yifei Ouyang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Shuquan Luo
- Chongqing Center for Disease Control and Prevention, Chongqing 400042, China
| | - Tao Tan
- Chongqing Health Statistics Information Center, Chongqing 401120, China
| | - Yaokai Chen
- Department of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - Xiaoni Zhong
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
| | - Huadong Zhang
- Chongqing Center for Disease Control and Prevention, Chongqing 400042, China
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Park JH, Lim NK, Park HY. Association of leisure-time physical activity and resistance training with risk of incident hypertension: The Ansan and Ansung study of the Korean Genome and Epidemiology Study (KoGES). Front Cardiovasc Med 2023; 10:1068852. [PMID: 36776249 PMCID: PMC9912934 DOI: 10.3389/fcvm.2023.1068852] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/05/2023] [Indexed: 02/14/2023] Open
Abstract
Hypertension is the most common preventable risk factor for the onset of cardiovascular disease and mortality. We aimed to investigate the association between incident hypertension and 4-year leisure-time physical activity (PA) levels and resistance training (RT). In this community-based Korean cohort, 5,075 participants without hypertension were included. To evaluate cumulative PA, the average PA time (the total time of moderate-intensity leisure-time PA) at baseline, 2-year follow-up, and 4-year follow-up were calculated. Based on participation in RT and compliance to PA guidelines (≥150 min/week of PA time), the participants were divided into the following four groups: Low-PA, Low-PA+RT, High-PA, and High-PA+RT. A multivariate Cox proportional hazards regression model was used to evaluate the 12-year incidence of hypertension in relation to leisure-time PA levels and RT regularity. During a mean 7.86 ± 4.20-year follow-up, 2,544 participants (1,366 women) were diagnosed with hypertension. Compared with Low-PA, High-PA, and High-PA+RT decreased the risk for hypertension by 30 and 39%, respectively. Participation in RT without compliance to PA guidelines did not affect the incidence of hypertension. The additive effect of RT on hypertension in the High-PA group was further examined. Although sex-based comparisons indicated that men had a significantly longer training period for RT than women, an additional reduction in the risk for hypertension in relation to the addition of RT was observed only in women (35%). PA may confer protective effects against hypertension, whereas the addition of RT to high levels of PA can further reduce the risk for hypertension in women.
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Affiliation(s)
- Jae Ho Park
- Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Nam-Kyoo Lim
- Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hyun-Young Park
- Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea,*Correspondence: Hyun-Young Park,
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Zhou L, Feng W, Xiang N, Cheng Y, Ya X, Wang M, Wang X, Liu Y. Association between physical activity dimensions and the risk of hypertension among middle and older adults: A cross-sectional study in China. Front Public Health 2022; 10:995755. [PMID: 36217539 PMCID: PMC9547049 DOI: 10.3389/fpubh.2022.995755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/09/2022] [Indexed: 01/26/2023] Open
Abstract
Background It is known that insufficient physical activity is associated with the risk of hypertension, but the relationship to different physical activity dimensions within hypertension risk remains to be elucidated. Objective The objective of this study is to identify the association between physical activity intensity, frequency, duration, and volume with hypertension risk. Meanwhile, a dose-response experiment is conducted to determine the relationship between physical activity level and hypertension risk. Methods Data came from the 2018 China Health and Retirement Longitudinal Study (CHARLS, 2018), which included 14266 participants over the age of 45. Binary logistic regression models were established to assess the associations between different dimensions of physical activity and the risk of hypertension. Restricted cubic spline analysis was used to examine possible non-linear associations between physical activity volume and hypertension risk. Results For frequency, lower hypertension risk was associated with performing vigorous physical activity 6-7d/w (OR 0.82, 95%CI 0.73-0.93) and moderate physical activity 6-7d/w (OR 0.89, 95%CI 0.80-0.99). No significant association between any light physical activity frequency and hypertension was observed before and after being adjusted. For the duration, lower hypertension risk was observed in performing vigorous physical activity ≥240 min/d (OR 0.85, 95%CI 0.75-0.97) and moderate physical activity ≥240 min/d (OR 0.83, 95%CI 0.71-0.97). For volume, the risks of hypertension in the participants who reported TPA in the 3th and 4th of quantiles were reduced by 18% (OR 0.82, 95%CI 0.72-0.95) and 22% (OR 0.78, 95%CI 0.68-0.91). A non-linear dose-response association between total physical activity and the risk of hypertension was shown among all of the participants (P non-linearity < 0.05). Conclusion Higher frequency and longer duration of vigorous physical activity or moderate physical activity were significantly associated with a lower risk of hypertension. Higher physical activity levels were associated with a lower risk of hypertension and there was an inverse non-linear dose-response relationship between weekly total physical activity and the risk of hypertension. These findings provide further proof that hypertension could be prevented through increased physical activity.
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Affiliation(s)
- Linlin Zhou
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Wei Feng
- Department of Physical Education, Suzhou University, Suzhou, China
| | - Na Xiang
- Caoxian People's Hospital, Heze, China
| | - Yue Cheng
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Xudong Ya
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Mingxia Wang
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Xingqi Wang
- School of Life Science, Biomedical R&D Center, Jiangsu Normal University, Xuzhou, China,*Correspondence: Xingqi Wang
| | - Yujia Liu
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China,Yujia Liu
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Abstract
PURPOSE OF REVIEW We reviewed most current medical literature in order to describe the epidemiology, clinical manifestation, outcome, and management of hypertension in athletes. RECENT FINDINGS An estimated quarter of the world's population is suffering from hypertension and this prevalence is also reflected in athletes and in individuals involved in leisure time sport activities. Several studies found an inverse relationship between physical activity and blood pressure. Therefore, physical exercise is recommended to prevent, manage, and treat hypertension. On the other hand, the prevalence of hypertension may vary by sport and in some cases may even be higher in athletes competing in certain disciplines than in the general population. Hypertension is the most common medical condition in athletes and may raise concerns about its management and the individual's eligibility for competitive sports. A thorough clinical evaluation should be performed to correctly diagnose or rule out hypertension in athletes, describe the individual's risk profile, rule out secondary causes, and detect possible hypertension-mediated organ damage caused by hypertension at an early stage. Based on most recent clinical research and international consensus documents, we propose a diagnostic algorithm as well the non-pharmacological and pharmacological management of hypertension in athletes. Although elevated blood pressure levels are less common in the active population, athletes are not protected from hypertension. A thorough diagnostic approach may help to identify individual at risk for adverse cardiovascular events and to address the optimal treatment as well as sport recommendations.
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Affiliation(s)
- Victor Schweiger
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Christine Attenhofer-Jost
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
- Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
| | - Stefano Caselli
- Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
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Longitudinal association between physical activity and blood pressure, risk of hypertension among Chinese adults: China Health and Nutrition Survey 1991-2015. Eur J Clin Nutr 2021; 75:274-282. [PMID: 32404900 DOI: 10.1038/s41430-020-0653-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/17/2020] [Accepted: 04/29/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To examine the effects of physical activity (PA) in adults with or without prehypertension at baseline on systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension risk by gender. METHODS A total of 5986 men and 6525 women (≥18 years old) without hypertension-related disease at baseline who attended surveys from China Health and Nutrition Survey (1991-2015) at least twice were selected. In terms of the nested data structure, three-level random intercept growth model and three-level logistic regression were used to estimate the relationship between the PA and SBP/DBP or hypertension risk. RESULTS The incidence of hypertension increased from 10.86% in 1991 to 20.34% in 2015, and the median of PA dropped from 408 MET·h/week in 1991 to 104 MET·h/week in 2015. After adjusting confounders, PA in the third and fourth quartiles decreased SBP (by 0.98 and 0.96 mm Hg, p < 0.05) and DBP (by 0.30 and 0.38 mm Hg, p < 0.05), and it reduced the odds of hypertension by 12 and 15% (p < 0.05), compared with PA in the lowest quartile. For normotensive women in the third quartile of PA and prehypertensive women in the fourth quartile of PA, the risk of hypertension was reduced 15 and 22%, compared with women in the lowest quartile of PA. CONCLUSIONS Physical activity should be improved to the relatively high level to be effective in controlling blood pressure. Normotensive women had an association between physical activity and SBP, DBP, and the risk of hypertension.
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Aune D, Sen A, Kobeissi E, Hamer M, Norat T, Riboli E. Physical activity and the risk of abdominal aortic aneurysm: a systematic review and meta-analysis of prospective studies. Sci Rep 2020; 10:22287. [PMID: 33339835 PMCID: PMC7749100 DOI: 10.1038/s41598-020-76306-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 10/26/2020] [Indexed: 12/31/2022] Open
Abstract
The association between physical activity and risk of abdominal aortic aneurysm has been inconsistent with some studies reporting a reduced risk while others have found no association. We conducted a systematic review and meta-analysis of prospective studies to quantify the association. PubMed and Embase databases were searched up to 3 October 2020. Prospective studies were included if they reported adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) of abdominal aortic aneurysm associated with physical activity. Summary RRs (95% CIs) were estimated using a random effects model. Nine prospective studies (2073 cases, 409,732 participants) were included. The summary RR for high vs. low physical activity was 0.70 (95% CI: 0.56-0.87, I2 = 58%) and per 20 metabolic equivalent task (MET)-hours/week increase of activity was 0.84 (95% CI: 0.74-0.95, I2 = 59%, n = 6). Although the test for nonlinearity was not significant (p = 0.09) the association appeared to be stronger when increasing the physical activity level from 0 to around 20-25 MET-hours/week than at higher levels. The current meta-analysis suggest that higher physical activity may reduce the risk of abdominal aortic aneurysm, however, further studies are needed to clarify the dose-response relationship between different subtypes and intensities of activity and abdominal aortic aneurysm risk.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.
- Department of Nutrition, Bjørknes University College, Oslo, Norway.
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
| | - Abhijit Sen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elsa Kobeissi
- Big Data Institute, University of Oxford, Oxford, UK
| | - Mark Hamer
- Institute Sport Exercise & Health, Division Surgery & Interventional Science, University College London, London, UK
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK
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Franco RJDS. Physical Activity in the Present Can Be the Recipe to Avoid the Ills of Obesity and Hypertension in the Future. Arq Bras Cardiol 2020; 115:50-51. [PMID: 32785493 PMCID: PMC8384312 DOI: 10.36660/abc.20200483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Roberto Jorge da Silva Franco
- Universidade Estadual Paulista Júlio de Mesquita FilhoFaculdade de MedicinaBotucatuSPBrasilUniversidade Estadual Paulista Júlio de Mesquita Filho Câmpus de Botucatu Faculdade de Medicina, Botucatu, SP – Brasil
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Thapliyal V, Singh K, Joshi A. Prevalence and Associated Factors of Hypertension among Adults in Rural Uttarakhand: A Community Based Cross Sectional Study. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2018. [DOI: 10.12944/crnfsj.6.2.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
India is in a state of transition epidemiological, economic, and demographic and nutrition transition. And all these transitions are leading to non communicable diseases like obesity, hypertension and insulin resistance. The study was aimed to estimate the Prevalence of hypertension and its associated risk factors among adults of rural Uttrakhand.
It is a cross sectional community based study. Survey was conducted in rural areas of Uttrakhand, to make a sample size of 300 adults (18-45yr), using WHO STEPS questionnaire. Waist Circumference, Blood pressure, Body Mass Index of the participants was calculated. P value < 0.05 was considered significant.
In the sample population based on systolic BP, 61.3% were non-hypertensive, 29.7% were pre-hypertensive and 9% were hypertensive. Based on diastolic BP, 43.3% were non-hypertensive, 32.7% were pre-hypertensive and 24% were hypertensive. Subjects with hypertension and pre-hypertension have higher BMI and waist circumference.
A high prevalence rate of pre-hypertension and hypertension was depicted in rural areas of Uttrakhand region.4.8% of the female participants had systolic high blood pressure compared to the 11.9% of the male participants. On the other hand, 21.8% of the female participants had diastolic high blood pressure compared to the over 25% of the male participants.
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Affiliation(s)
| | - Karuna Singh
- Amity Institute of Food Technology, Amity University, Noida
| | - Anil Joshi
- Himalayan Environmental Studies and Conservation Organization (HESCO)
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Menai M, Brouard B, Vegreville M, Chieh A, Schmidt N, Oppert JM, Lelong H, Loprinzi PD. Cross-Sectional and longitudinal associations of objectively-measured physical activity on blood pressure: evaluation in 37 countries. Health Promot Perspect 2017; 7:190-196. [PMID: 29085795 PMCID: PMC5647353 DOI: 10.15171/hpp.2017.34] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 08/12/2017] [Indexed: 11/24/2022] Open
Abstract
Background: We examined the cross-sectional and longitudinal associations of objectively-measured physical activity (step counts) and blood pressure (BP) among adults spanning 37 countries. Methods: Across 37 countries, we used data from a pool of 9238 adult owners of Withings’ Pulse activity trackers, which measures steps taken each day, and Wireless Blood Pressure Monitor, which measures BP. Analyses were adjusted on age, sex, number of days where the tracker was worn, and number of BP measurements. Data was collected from 2009 to 2013. Results: Subjects had a mean ± standard deviation (SD) age of 51.6 ± 11.3 years and a body mass index (BMI) of 28.7±5.5 kg/m2. A 1-month increase of more than 3000 steps per day was associated with a decrease of systolic BP (SBP) and diastolic BP (DBP) among the obese (1.57mm Hg and 1.29 mm Hg respectively, both P<0.001) and the overweight population (0.79 mm Hg and 0.84 mm Hg respectively, both P≤0.001), but not in the normal weight population (P=0.60 and P=0.36 respectively). Conclusion: One-month increases in daily step counts was associated with a decrease of SBP and DBP in a large obese and overweight free living population.
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Affiliation(s)
| | | | | | - Angela Chieh
- Nokia Digital Health, Issy-les-Moulineaux, France
| | | | - Jean-Michel Oppert
- Department of Nutrition Pitié-Salpêtrière Hospital (AP-HP), Institute of Cardiometabolism and Nutrition (ICAN), Université Pierre et Marie Curie-Paris, Paris, France
| | - Hélène Lelong
- Paris-Descartes University, Faculty of Medicine; Hôtel-Dieu Hospital; AP-HP; Diagnosis and Therapeutic Center, Paris, France
| | - Paul D Loprinzi
- Department of Health, Exercise Science and Recreation Management, Physical Activity Epidemiology Laboratory, University of Mississippi, Mississippi, USA
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Aune D, Sen A, Vatten LJ. Hypertension and the risk of endometrial cancer: a systematic review and meta-analysis of case-control and cohort studies. Sci Rep 2017; 7:44808. [PMID: 28387226 PMCID: PMC5384280 DOI: 10.1038/srep44808] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 02/15/2017] [Indexed: 12/12/2022] Open
Abstract
A history of hypertension has been associated with increased risk of endometrial cancer in several studies, but the results have not been consistent. We conducted a systematic review and meta-analysis of case-control and cohort studies to clarify the association between hypertension and endometrial cancer risk. PubMed and Embase databases were searched up to 27th of February 2016. Prospective and case-control studies which reported adjusted relative risk estimates and 95% confidence intervals of endometrial cancer associated with a hypertension diagnosis were included. Summary relative risks were estimated using a random effects model. Nineteen case-control studies and 6 cohort studies were included. The summary RR was 1.61 (95% CI: 1.41–1.85, I2 = 86%) for all studies, 1.73 (95% CI: 1.45–2.06, I2 = 89%) for case-control studies and 1.32 (95% CI: 1.12–1.56, I2 = 47%) for cohort studies. The association between hypertension and endometrial cancer was weaker, but still significant, among studies with adjustment for smoking, BMI, oral contraceptive use, and parity, compared to studies without such adjustment. This meta-analysis suggest an increased risk of endometrial cancer among patients with hypertension, however, further studies with more comprehensive adjustments for confounders are warranted to clarify the association.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, Imperial College, London, UK.,Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Bjørknes University College, Oslo, Norway
| | - Abhijit Sen
- Department of Epidemiology and Biostatistics, Imperial College, London, UK
| | - Lars J Vatten
- Department of Epidemiology and Biostatistics, Imperial College, London, UK
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Vencato MM, Karageorghis CI, Priest DL, Nevill AM. Concurrent validity and cross-validation of the Brunel Lifestyle Physical Activity Questionnaire. J Sci Med Sport 2017; 20:766-770. [PMID: 28189462 DOI: 10.1016/j.jsams.2016.12.077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 12/02/2016] [Accepted: 12/06/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Given the profoundly negative impact of inactivity on public health, it is important to have valid and reliable measures of lifestyle physical activity (LPA). The Brunel Lifestyle Physical Activity Questionnaire (BLPAQ) was designed to measure planned physical activity (PPA) and unplanned physical activity (UPA). The objective of the present study was to assess the criterion-related validity of the BLPAQ. DESIGN A correlational design was employed. METHODS A sample of British leisure centre users (N=356; age range 18-69 y: mean age 26.5±10.4 y) completed the BLPAQ and two reference measures: the Baecke Questionnaire of Habitual Physical Activity (BQHPA) and the Godin's Leisure-Time Exercise Questionnaire (GLTEQ). MANOVA was used to test for gender differences in LPA. Each measure was also cross-validated using a split-sample approach and the limits of agreement (LoA) method. RESULTS With the exception of the Moderate and Vigorous dimensions of the GLTEQ in the case of UPA, the remaining scores of the reference instruments were correlated with both PPA and UPA factors (p<0.05). A significant difference in levels of UPA was found between women and men (p=0.039). Furthermore, multiple linear regression analyses demonstrated that the BLPAQ subscales could be predicted by the criterion measures. The LoA analyses demonstrated satisfactory agreement between BLPAQ subscales and those of the BQHPA and GLTEQ. CONCLUSIONS The BLPAQ is a criterion- and cross-validated measure of PPA and UPA that can be used to assess the efficacy of LPA interventions by researchers and practitioners.
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Affiliation(s)
| | | | - David-Lee Priest
- Department of Life Sciences, Brunel University London, UK; School of Higher Education, City College Norwich, UK
| | - Alan M Nevill
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, UK
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Lin GM, Li YH, Lee CJ, Shiang JC, Lin KH, Chen KW, Chen YJ, Wu CF, Lin BS, Yu YS, Lin F, Su FY, Wang CH. Rationale and design of the cardiorespiratory fitness and hospitalization events in armed forces study in Eastern Taiwan. World J Cardiol 2016; 8:464-471. [PMID: 27621774 PMCID: PMC4997527 DOI: 10.4330/wjc.v8.i8.464] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 06/18/2016] [Accepted: 07/11/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the association between cardiorespiratory fitness and hospitalization events in a cohort of large voluntary arm forces in Taiwan. METHODS The cardiorespiratory fitness and hospitalization events in armed forces (CHIEF) is a retrospective cohort consisting of more than 4000 professional military members aged 18-50 years in Eastern Taiwan. All participants received history taking, physical examination, chest radiography, 12-lead electrocardiography, blood tests for cell counts and fasting glucose, lipid profiles, uric acid, renal function and liver function in the Hualien Armed Forces General Hospital during 2014. In addition, participants were required to undergo two indoor resistant exercise tests including 2-min push-up and 2-min sit-up, both scored by infrared sensing, and one outdoor endurance 3000-m none weight-bearing running test, the main indicator of cardiorespiratory fitness in the Military Physical Training and Testing Center in Eastern Taiwan in 2014. RESULTS Hospitalization events for cardiovascular disease, acute kidney injury, rhabdomyolysis, severe infectious disease, acute psychiatric illness, diabetes, orthopedic surgery and mortality will be identified in the National Insurance Research Database for 10 years. CONCLUSION CHIEF will be among the largest Eastern Asian armed forces cohort, in which physical status was strictly evaluated to follow up the hospitalization events for severe illness.
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Affiliation(s)
- Gen-Min Lin
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Yi-Hwei Li
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Chung-Jen Lee
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Jeng-Chuan Shiang
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Ko-Huan Lin
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Kai-Wen Chen
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Yu-Jung Chen
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Ching-Fen Wu
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Been-Sheng Lin
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Yun-Shun Yu
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Felicia Lin
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Fung-Ying Su
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
| | - Chih-Hung Wang
- Gen-Min Lin, Yi-Hwei Li, Fung-Ying Su, Department of Public Health, Tzu-Chi University, Hualien 970, Taiwan
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Roka R, Michimi A, Macy G. Associations Between Hypertension and Body Mass Index and Waist Circumference in U.S. Adults: A Comparative Analysis by Gender. High Blood Press Cardiovasc Prev 2015; 22:265-73. [PMID: 26014837 DOI: 10.1007/s40292-015-0106-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 05/16/2015] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION The body mass index (BMI) and waist circumference (WC) are a risk of hypertension, but their potentially multiplicative effect on hypertension is underexplored. AIM To examine modifying effects of BMI and WC on hypertension using a nationally representative U.S. adult sample stratified by gender. METHODS Data were derived from the 2009-2010 NHANES. Overweight and obesity were based on BMI of 25.0-29.9 and ≥30 kg/m(2), respectively. High-risk WC was based on ≥102.0 and ≥88.0 cm for males and females, respectively. Hypertension was determined by systolic/diastolic blood pressure of ≥140/≥90 mmHg, or taking prescribed medications. Logistic regression was used to examine the association between hypertension and BMI and WC by gender. Interaction terms were added to examine if BMI modified the effect of WC on hypertension. RESULTS Both BMI and WC were significant predictors of hypertension in overall population. Gender-specific models indicated that BMI played an important role in hypertension risk among males, but WC in females. The interaction effects were present among males implying that the association of WC with hypertension was stronger if subjects were overweight or obese. This effect, however, was not present in females. CONCLUSION BMI and WC may influence hypertension differently among males and females.
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Affiliation(s)
- Ranjana Roka
- Department of Public Health, College of Health and Human Services, Western Kentucky University, 1906 College Heights Blvd., Bowling Green, KY, 42101-1038, USA,
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14
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Wang Z, Hao G, Zhang L, Chen Z, Wang X, Guo M, Tian Y, Shao L, Zhu M. Central systolic blood pressure is associated with ethnicity and cardiovascular disease risk factors in Chinese middle-aged population. Eur J Prev Cardiol 2015; 23:228-36. [PMID: 25818763 DOI: 10.1177/2047487315579290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 03/07/2015] [Indexed: 01/22/2023]
Affiliation(s)
- Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, China
| | - Guang Hao
- Division of Prevention and Community Health, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, China
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, China
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, China
| | - Min Guo
- Division of Prevention and Community Health, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, China
| | - Ye Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, China
| | - Lan Shao
- Division of Prevention and Community Health, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, China
| | - Manlu Zhu
- Division of Prevention and Community Health, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, China
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Williams PT. Dose-response relationship of physical activity to premature and total all-cause and cardiovascular disease mortality in walkers. PLoS One 2013; 8:e78777. [PMID: 24312170 PMCID: PMC3843666 DOI: 10.1371/journal.pone.0078777] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 09/22/2013] [Indexed: 12/05/2022] Open
Abstract
Purpose To assess the dose-response relationships between cause-specific mortality and exercise energy expenditure in a prospective epidemiological cohort of walkers. Methods The sample consisted of the 8,436 male and 33,586 female participants of the National Walkers' Health Study. Walking energy expenditure was calculated in metabolic equivalents (METs, 1 MET = 3.5 ml O2/kg/min), which were used to divide the cohort into four exercise categories: category 1 (≤1.07 MET-hours/d), category 2 (1.07 to 1.8 MET-hours/d), category 3 (1.8 to 3.6 MET-hours/d), and category 4 (≥3.6 MET-hours/d). Competing risk regression analyses were use to calculate the risk of mortality for categories 2, 3 and 4 relative to category 1. Results 22.9% of the subjects were in category 1, 16.1% in category 2, 33.3% in category 3, and 27.7% in category 4. There were 2,448 deaths during the 9.6 average years of follow-up. Total mortality was 11.2% lower in category 2 (P = 0.04), 32.4% lower in category 3 (P<10−12) and 32.9% lower in category 4 (P = 10−11) than in category 1. For underlying causes of death, the respective risk reductions for categories 2, 3 and 4 were 23.6% (P = 0.008), 35.2% (P<10−5), and 34.9% (P = 0.0001) for cardiovascular disease mortality; 27.8% (P = 0.18), 20.6% (P = 0.07), and 31.4% (P = 0.009) for ischemic heart disease mortality; and 39.4% (P = 0.18), 63.8% (P = 0.005), and 90.6% (P = 0.002) for diabetes mortality when compared to category 1. For all related mortality (i.e., underlying and contributing causes of death combined), the respective risk reductions for categories 2, 3 and 4 were 18.7% (P = 0.22), 42.5% (P = 0.001), and 57.5% (P = 0.0001) for heart failure; 9.4% (P = 0.56), 44.3% (P = 0.0004), and 33.5% (P = 0.02) for hypertensive diseases; 11.5% (P = 0.38), 41.0% (P<10−4), and 35.5% (P = 0.001) for dysrhythmias: and 23.2% (P = 0.13), 45.8% (P = 0.0002), and 41.1% (P = 0.005) for cerebrovascular diseases when compared to category 1. Conclusions There are substantial health benefits to exceeding the current exercise guidelines.
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Affiliation(s)
- Paul T. Williams
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California, United States of America
- * E-mail:
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Ooms L, Veenhof C, de Bakker DH. Effectiveness of Start to Run, a 6-week training program for novice runners, on increasing health-enhancing physical activity: a controlled study. BMC Public Health 2013; 13:697. [PMID: 23898920 PMCID: PMC3735486 DOI: 10.1186/1471-2458-13-697] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 07/26/2013] [Indexed: 01/08/2023] Open
Abstract
Background The use of the organized sports sector as a setting for health-promotion is a relatively new strategy. In the past few years, different countries have been investing resources in the organized sports sector for promoting health-enhancing physical activity. In the Netherlands, National Sports Federations were funded to develop and implement “easily accessible” sporting programs, aimed at the least active population groups. Start to Run, a 6-week training program for novice runners, developed by the Dutch Athletics Organization, is one of these programs. In this study, the effects of Start to Run on health-enhancing physical activity were investigated. Methods Physical activity levels of Start to Run participants were assessed by means of the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH) at baseline, immediately after completing the program and six months after baseline. A control group, matched for age and sex, was assessed at baseline and after six months. Compliance with the Dutch physical activity guidelines was the primary outcome measure. Secondary outcome measures were the total time spent in physical activity and the time spent in each physical activity intensity category and domain. Changes in physical activity within groups were tested with paired t-tests and McNemar tests. Changes between groups were examined with multiple linear and logistic regression analyses. Results In the Start to Run group, the percentage of people who met the Dutch Norm for Health-enhancing Physical Activity, Fit-norm and Combi-norm increased significantly, both in the short- and longer-term. In the control group, no significant changes in physical activity were observed. When comparing results between groups, significantly more Start to Run participants compared with control group participants were meeting the Fit-norm and Combi-norm after six months. The differences in physical activity between groups in favor of the Start to Run group could be explained by an increase in the time spent in vigorous-intensity activities and sports activities. Conclusions Start to Run positively influences levels of health-enhancing physical activity of participants, both in the short- and longer-term. Based on these results, the use of the organized sports sector as a setting to promote health-enhancing physical activity seems promising.
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Affiliation(s)
- Linda Ooms
- Netherlands Institute for Health Services Research (NIVEL), PO Box 1568, 3500 BN, Utrecht, The Netherlands.
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Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, Coke LA, Fleg JL, Forman DE, Gerber TC, Gulati M, Madan K, Rhodes J, Thompson PD, Williams MA. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation 2013; 128:873-934. [PMID: 23877260 DOI: 10.1161/cir.0b013e31829b5b44] [Citation(s) in RCA: 1307] [Impact Index Per Article: 108.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Bogner HR, de Vries HF, Kaye EM, Morales KH. Pilot trial of a licensed practical nurse intervention for hypertension and depression. Fam Med 2013; 45:323-329. [PMID: 23681683 PMCID: PMC4076921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Depression is a risk factor for hypertension, and risk of depression is increased substantially in patients with hypertension. Our objective was to examine whether an intervention carried out by Licensed Practical Nurses (LPNs) integrating depression treatment into care for hypertension improved blood pressure control and depressive symptoms. METHODS In all, 60 patients ages 41 to 92 years with hypertension and depressive symptoms at a large primary care practice in Philadelphia were randomly assigned to an integrated care intervention carried out by LPNs (n=30) or usual care (n=30). Intervention and control groups did not differ statistically on baseline measures. Outcomes assessed at baseline and 12 weeks included standard laboratory procedures to measure blood pressure control and the Patient Health Questionnaire (PHQ-9) to assess depression. RESULTS Patients in the integrated care intervention had lower diastolic blood pressure (intervention 74.2 mmHg versus usual care 82.0 mmHg) and fewer depressive symptoms (PHQ-9 mean scores, intervention 2.4 versus usual care 7.1) compared with patients in the usual care group at 12 weeks after adjustment for baseline values. Patients in the integrated care intervention also had lower systolic blood pressure (intervention 130.0 mmHg versus usual care 140.6 mmHg) compared with patients in the usual care group at 12 weeks although the results approached but did not reach conventional levels of statistical significance. CONCLUSION Training existing primary care practice office staff will facilitate implementation in real world practices with limited resources and competing demands.
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Affiliation(s)
- Hillary R Bogner
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA.
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dos Santos JC, Moreira TMM. [Risk factors and complications in patients with hypertension/diabetes in a regional health district of northeast Brazil]. Rev Esc Enferm USP 2012; 46:1125-1132. [PMID: 23223728 DOI: 10.1590/s0080-62342012000500013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 03/19/2012] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to identify the risk factors and associated complications present in clients with hypertension/diabetes, enrolled in the HIPERDIA of the Executive Regional Health Department VI in Fortaleza, CE. This analytical documental study included 2,691 people. Of this total, 73.6% were women; 44.6% were between 60-79 years of age (mean age of 60.8 years); 87.4% were Caucasian, Asian or Pardo; 63.7% had eight or fewer years of education; 79.7% were non-smokers; 56.6% were considered sedentary; 59.6% were overweight/obese; and 48.4% had a family history of cardiovascular disease. An association was observed between having a sedentary lifestyle and being overweight/obese among patients with diabetes, and those with both diabetes and hypertension; family history of cardiovascular disease in patients with hypertension and those with both diabetes and hypertension; stroke, coronary artery disease and chronic renal failure in patients with hypertension and those with both diabetes and hypertension; and infarction and stroke in patients with diabetes. A family history of cardiovascular disease was associated with coronary artery disease and infarction. A relevant presence of risk factors and complications was found, highlighting the need for health education among clients.
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Laurent P, Marenco P, Castagna O, Smulyan H, Blacher J, Safar ME. Differences in central systolic blood pressure and aortic stiffness between aerobically trained and sedentary individuals. ACTA ACUST UNITED AC 2011; 5:85-93. [DOI: 10.1016/j.jash.2011.01.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 01/09/2011] [Accepted: 01/10/2011] [Indexed: 10/18/2022]
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Chen YL, Liu YF, Huang CY, Lee SD, Chan YS, Chen CC, Harris B, Kuo CH. Normalization effect of sports training on blood pressure in hypertensives. J Sports Sci 2010; 28:361-7. [DOI: 10.1080/02640410903508862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
PURPOSE Test whether changes in vigorous exercise affect the risk for hypercholesterolemia. METHODS : Incident physician-diagnosed hypercholesterolemia was compared in recreational runners whose weekly distances run increased >0.5 km x d (4034 men, 1897 women), remained constant (+/-0.5 km x d; 4685 men, 1904 women), or decreased >0.5 km x d (15,678 men, 6224 women) during 7.8 yr of prospective follow-up. RESULTS Relative to those whose distance was maintained or reduced, the odds ratio (95% confidence interval) for hypercholesterolemia for those whose running increased was significantly less than 1 for men {0.82 (0.72-0.93), P = 0.0006}, women {0.71 (0.54-0.92), P = 0.01}, and men and women combined adjusted for sex {0.80 (0.72-0.89), P < 0.0001}. The significance of the odds ratios was somewhat diminished when adjusted for baseline and follow-up BMI in men {0.89 (0.79-1.01), P = 0.06}, women {0.71 (0.54-0.92), P = 0.08}, and the adjusted sexes combined {0.88 (0.79-0.98), P = 0.02}. When average distance run {i.e., (baseline + follow-up) / 2} was compared with incident hypercholesterolemia in the 6589 runners whose distance remained constant, each kilometer-per-day increment in average running distance was associated with an odds ratio significantly less than 1 in men {0.90 (0.86-0.93)}, women {0.91 (0.84-0.98)}, and the adjusted sexes combined {0.90 (0.87-0.93)}, which was also attributable in part to BMI in men {0.94 (0.90-0.97), P = 0.0005}, women {0.96 (0.89-1.04), P = 0.35}, and the adjusted sexes combined {0.94 (0.91-0.97), P = 0.0003}. CONCLUSIONS The odds for hypercholesterolemia 1) decrease in runners who increase their running mileage and 2) decline in association with the higher dose of vigorous activity even in the absence of any change in exercise. These effects are associated in part to the runners' BMI.
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Affiliation(s)
- Paul T Williams
- Ernest Orlando Lawrence Berkeley National Laboratory, Life Sciences Division, 1 Cyclotron Road, Berkeley, CA 94720, USA.
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Williams PT. Effects of running distance and performance on incident benign prostatic hyperplasia. Med Sci Sports Exerc 2008; 40:1733-9. [PMID: 18799982 DOI: 10.1249/mss.0b013e31817b8eba] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE Benign prostatic hyperplasia (BPH) is generally not considered a preventable condition. Our goal is to assess whether running (a vigorous physical activity) and 10-km race performance (an indicator of cardiorespiratory fitness) reduce BPH risk. METHODS Prospective cohort study of incident BPH in 28,612 nonsmoking, nonvegetarian, nondiabetic men. RESULTS The 1899 men (6.64%) reported physician-diagnosed incident BPH during (mean +/- SD) 7.74 +/- 1.84 yr of follow-up. Survival analyses showed significantly lower risk with both longer distance run (km x wk(-1); P < 0.0001) and faster 10-km performance (m x s(-1); P = 0.0004) independent of age, BMI, and meat, fish, fruit, and alcohol intake. When adjusted for age, the fastest men (> or =4.0 m x s(-1)) had 32% lower risk than the slowest men (<3 m x s(-1); P = 0.0006). The decline in incidence extended throughout the performance range, with even the fastest category (> or =4 m x s(-1)) having significantly lower risk than the penultimate fastest category (3.5-4.0 m x s(-1); P = 0.03). The decline in BPH risk with running distance was independent of performance. BPH incidence was more strongly related to the average of the baseline and the follow-up distance run than to concurrent changes in running distance between baseline and follow-up. Incident BPH was significantly lower in men who ran >16 than <16 km x wk(-1) (P = 0.05), >32 than 16-32 km x wk(-1) (P = 0.02), and >48 than 32-48 km x wk(-1) (P = 0.04). CONCLUSIONS Greater distances run per week may reduce BPH risk independent of BMI, 10-km performance, and diet. If the relationship is causal, then this health benefit accrues at greater exercise doses and intensities than the minimum guideline levels currently recommended.
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Affiliation(s)
- Paul T Williams
- Donner Laboratory, Life Sciences Division, Ernest Orlando Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
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