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ABSTRACT: Leisure time physical activity has been extensively studied. However, the health benefits of non-leisure time physical activity, particular those undertaken at home on all-cause and cancer mortality are limited, particularly among the elderly.
We studied physical activity in relation to all-cause and cancer mortality in a cohort of 4,000 community-dwelling elderly aged 65 and older. Leisure time physical activity (sport/recreational activity and lawn work/yard care/gardening) and non-leisure time physical activity (housework, home repairs and caring for another person) were self-reported on the Physical Activity Scale for the Elderly. Subjects with heart diseases, stroke, cancer or diabetes at baseline were excluded (n = 1,133).
Among the 2,867 subjects with a mean age of 72 years at baseline, 452 died from all-cause and 185 died from cancer during the follow-up period (2001-2012). With the adjustment for age, education level and lifestyle factors, we found an inverse association between risk of all-cause mortality and heavy housework among men, with the adjusted hazard ratio (HR) of 0.72 (95%CI = 0.57-0.92). Further adjustment for BMI, frailty index, living arrangement, and leisure time activity did not change the result (HR = 0.71, 95%CI = 0.56-0.91). Among women, however, heavy housework was not associated with all-cause mortality. The risk of cancer mortality was significantly lower among men who participated in heavy housework (HR = 0.52, 95%CI = 0.35-0.78), whereas among women the risk was not significant. Men participated in light housework also were at lower risk of cancer mortality than were their counterparts, however, the association was not significant. Leisure time physical activity was not related to all-cause or cancer mortality in either men or women.
Heavy housework is associated with reduced mortality and cancer deaths over a 9-year period. The underlying mechanism needs further study.
PLoS ONE 01/2013; 8(5):e61529. · 4.09 Impact Factor
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ABSTRACT: This study examines the relative importance of fitness versus fatness in predicting mortality in elderly populations aged 70 years and over, and whether fitness may account for the 'paradoxical' relationship between better survival and increasing weight. Four thousand community-living Chinese men and women aged 65 years or over were recruited and stratified so that approximately 33% were in each of the age groups: 65-69, 70-74, and 75 or above. Medical history, height, weight, waist-hip ratio, body composition using DEXA, and walking speed were obtained. They were followed up for a mean of 7.0 years to ascertain death. Compared with the high fitness category, those in the moderate and low categories have a 43% and 68% increased risk of mortality at 7 years adjusting for multiple confounders. When mortality risk according to various fatness indicators was examined, only the lowest quartile of BMI, BFI, and FLMR conferred statistically significant increased risk. Fitness categories were significantly associated with all fatness indicators. The finding of fewer people in the high fitness category among the highest quartiles of other fatness indicators suggests that fitness is not the underlying mechanism for the obesity paradox. Within each quartile of fatness indicator, there was a significant trend towards reduced mortality with increasing fitness. In conclusion, the study confirms the beneficial effects of cardiorespiratory fitness on mortality but does not explain the 'obesity paradox'. The findings underscore the importance of maintaining physical fitness through exercise and re-confirm the importance of weight maintenance in reducing mortality risk.
Age 03/2012; · 6.28 Impact Factor
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ABSTRACT: The aim of this study was to determine the reliability and validity of the modified Chinese Baecke Questionnaire, using a 3-day activity diary as a reference, in Hong Kong Chinese population. A total of 198 Chinese subjects aged 18 to 65 years were recruited in Hong Kong. Validity of the questionnaire was assessed using a 3-day activity diary as the reference method. Two-week test-retest reliability was also evaluated. Good reliability for the modified Chinese Baecke Questionnaire was demonstrated (correlation coefficients ranged from 0.65 to 0.90). Cohen's κ was 41.0% for men and 56.7% for women. High correlation between the weighted total index computed from the questionnaire and daily energy expenditure obtained from the diaries (r = 0.61) was demonstrated (r = 0.56, P < .01 for men and r = 0.59, P < .01 for women). Overall, 2.1% and 4.8% gross misclassifications were found for men and women, respectively. In conclusion, the modified Chinese Baecke Questionnaire was found to be reliable and valid for measuring habitual physical activity in the Hong Kong Chinese adult population.
Asia-Pacific Journal of Public Health 07/2011; · 1.06 Impact Factor
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ABSTRACT: Low levels of cardiorespiratory fitness have proven to be associated with a higher risk of premature death from all causes, specifically from cardiovascular disease. However, there has been no study conducted to describe the cardiorespiratory fitness normative values in Chinese midlife and elderly.
To provide normative values of cardiorespiratory fitness expressed as maximal oxygen uptake (VO(2max)) and its association with body composition and physical activity in Chinese midlife and elderly women in Hong Kong.
659 Chinese women aged from 55 to 94 years were recruited from two existing cohorts: the carotid atherosclerosis in women Hong Kong cohort study and the Osteoporotic Fractures in Women (MsOS) Hong Kong cohort study. Symptom-limited maximal exercise testing on an electrically braked bicycle ergometer was performed to assess VO(2max), where the subject was connected to a calibrated metabolic cart for gas analysis. Their body composition and physical activity data were also assessed.
The body mass index was 23.4 kg/m(2) and the mean fat mass and lean body mass were 16.6 kg and 37.3 kg, respectively. The mean VO(2max) was 20.3±4.1 ml/kg/min (range, 7.9-35.7 ml/kg/min). VO(2max) decreased with age, with the rate of decline 0.25 ml/kg/min/yr (7.1% per decade). In a subgroup of 475 women from the MsOS study, the decline in VO(2max) was found to depend on ageing (β=0.31, P<0.001), body mass index (β=-0.30, P<0.001) and levels of physical activity (β=0.02, P<0.001). Fat mass was also independently associated with VO(2max) (β=-0.20, P<0.001).
This study describes the normative values of VO(2max) in a sample of Chinese midlife and elderly women which provides a valuable reference to assess health and fitness in Chinese elderly. Results from this study also suggested that body composition and levels of physical activity were important determinants of the age-related decline in VO(2max).
Maturitas 06/2011; 69(4):348-53. · 2.77 Impact Factor
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ABSTRACT: To study the relationship between dietary intake and the development of type 2 diabetes among Chinese adults.
A prospective cohort study. Dietary assessment was carried out using a validated FFQ. Principal component analysis was used to identify dietary patterns. Dietary glycaemic load and variety of snacks were also calculated.
A hospital-based centre at the Queen Mary Hospital in Hong Kong SAR, China.
A total of 1010 Chinese adults aged 25-74 years who participated in a territory-wide dietary and cardiovascular risk factor prevalence survey in 1995-1996 were followed up for 9-14 years for the development of diabetes.
A total of 690 (68·3 %) individuals completed follow-up during 2005-2008 and seventy-four cases of diabetes were identified over the follow-up period. Four dietary patterns were identified ('more snacks and drinks', 'more vegetables, fruits and fish', 'more meat and milk products' and 'more refined grains'). After adjustment for age, sex, BMI, waist-to-hip ratio, smoking, alcohol intake, participation in exercise/sports and family history of diabetes, the more vegetables, fruits and fish pattern was associated with a 14 % lower risk (OR per 1 sd increase in score = 0·76; 95 % CI 0·58, 0·99), whereas the more meat and milk products pattern was associated with a 39 % greater risk of diabetes (OR per 1 sd increase in score = 1·39; 95 % CI 1·04, 1·84). Dietary glycaemic load, rice intake, snack intake and variety of snacks were not independently associated with diabetes.
The more vegetables, fruits and fish pattern was associated with reduced risk and the more meat and milk products pattern was associated with an increased risk of diabetes.
Public Health Nutrition 04/2011; 14(7):1133-41. · 2.17 Impact Factor
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ABSTRACT: The Chinese diet is low in calcium, including among adolescent girls, with an average intake around 500 mg per day. In this study, we compared the percentage change in bone mineral density and content of the spine and hip region in a 1-year follow-up study between 104 adolescent girls aged 14 to 16 years receiving 375 ml calcium-fortified soymilk supplementation and 95 girls in the control group. The mean percentage changes of bone mineral density/content (BMD/BMC) and standard deviation (SD) at 1 year for the supplementation and control groups were as follows: neck of the femur BMD 2.7+/-2.94%, 1.8+/-3.49% (P = 0.08); trochanter BMD 3.3+/-3.27%, 1.6+/-2.94% (P < or = 0.001); intertrochanter BMD 3.6+/-3.05%, 2.32+/-2.95% (P = 0.002); total hip BMD 3.1+/-2.39%, 2.05+/-2.22% (P = 0.001); total hip BMC 3.8+/-3.05%, 2.6+/-2.96% (P = 0.006). The percent difference between the percentage of bone changes in the supplementation and control groups [100x (soymilk-control)/control] ranged from 45 to 113%. We observed no differences in the spine BMD/C and no differences in changes of height and weight between the soymilk supplementation and control groups, which yielded similar results. Stepwise multivariate regression analysis including height, weight, growth stage, dietary energy, protein, calcium from usual diet and physical activity also showed that supplementation was significantly associated with a percentage increase in BMD/C at the hip. We conclude that 375 ml calcium-fortified soymilk supplementation, or an equivalent of about two glasses, is among the effective strategies for bone acquisition and the optimization of peak bone mass in adolescent girls.
Osteoporosis International 12/2005; 16(12):1907-16. · 4.58 Impact Factor
