Article

All-Cause Mortality Associated With Physical Activity During Leisure Time, Work, Sports, and Cycling to Work

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Abstract

Physical activity is associated with low mortality in men, but little is known about the association in women, different age groups, and everyday activity. To evaluate the relationship between levels of physical activity during work, leisure time, cycling to work, and sports participation and all-cause mortality. Prospective study to assess different types of physical activity associated with risk of mortality during follow-up after the subsequent examination. Mean follow-up from examination was 14.5 years. Copenhagen University Hospital, Copenhagen, Denmark. Participants were 13,375 women and 17,265 men, 20 to 93 years of age, who were randomly selected. Physical activity was assessed by self-report, and health status, including blood pressure, total cholesterol level, triglyceride levels, body mass index, smoking, and educational level, was evaluated. All-cause mortality. A total of 2,881 women and 5,668 men died. Compared with the sedentary, age- and sex-adjusted mortality rates in leisure time physical activity groups 2 to 4 were 0.68 (95% confidence interval, 0.64-0.71), 0.61 (95% confidence interval, 0.57-0.66), and 0.53 (95% confidence interval, 0.41-0.68), respectively, with no difference between sexes and age groups. Within the moderately and highly active persons, sports participants experienced only half the mortality of nonparticipants. Bicycling to work decreased risk of mortality in approximately 40% after multivariate adjustment, including leisure time physical activity. Leisure time physical activity was inversely associated with all-cause mortality in both men and women in all age groups. Benefit was found from moderate leisure time physical activity, with further benefit from sports activity and bicycling as transportation.

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... Physical activity (PA) has many positive health effects, including an increased life expectancy (Andersen et al., 2000). Regular participation in physical activity is also associated with significant lower chances of being diagnosed with type 2 diabetes mellitus (T2DM) (Jeon et al., 2007). ...
... In our study, sport participation was associated with lower all-cause mortality, which is in agreement with the findings of several other studies (Andersen et al., 2000;Samitz et al., 2011). However, this finding was not statistically significant. ...
... Research shows that occupational physical activity may have opposite health effects compared to leisure time physical activity (Holtermann et al., 2012). In addition, Andersen et al. (2000) demonstrated that among all physically active individuals, those who participated in a sport experienced 50% less mortality than those who did not participate in a sport. The current research therefore includes two lifestyle indicators for physical activity: a general indicator for compliance with the Dutch guideline for sufficient physical activity and a more specific indicator for sport club membership. ...
Thesis
It is important to get a better understanding of the relationship between sport participation on the one hand and health and health care costs on the other. For that purpose, the research in this thesis shows that sport participation is positively associated to significantly lower risks of morbidity, type 2 diabetes, prediabetes and obesity. However, the relationship between sport participation and health differs between groups. For several health outcomes, the positive effects of sport participation are significantly greater for people with a healthy weight than for obese persons. Another finding is that socioeconomic inequalities in sports participation (with the most vulnerable groups participating the least) seem contribute considerably, and much more than physical activity, to the socioeconomic inequalities in health outcomes. The research also shows that there exists a strong socioeconomic gradient in health care costs in the Netherlands: controlling for the population structure, poor neighborhoods have substantially higher costs than affluent neighborhoods. In addition, neighborhoods with a higher percentage of voluntary sports club members have significantly lower average health care costs. This relationship seems to be independent of the socioeconomic level of a neighborhood. Finally, the research shows that the socioeconomic inequalities in physical activity behavior have increased significantly in the Netherlands due to the Covid-19 pandemic and the measures to prevent the spread of the virus. In conclusion, the research in this thesis demonstrates that sports participation can be an important preventive medicine for improving health, reducing socioeconomic health inequalities, as well as lowering health care costs.
... Physical activity was based on the following question: 'How would you characterize your leisure time physical activity within the last year?' and classified as sedentary, moderate, heavy activity or heavy activity at competition level. 17 Self-reported prevalent morbidity was based on the following question from the LOFUS study questionnaire: 'Do you suffer from any of the following diseases?' Participants were asked to mark either yes or no for each of the following categories: 'asthma', 'chronic bronchitis, hyperinflated lungs, chronic obstructive pulmonary disease (COPD), or emphysema', 'heart attack', 'atherosclerosis in the heart', 'angina', 'hypertension', 'diabetes' and 'cancer'. ...
... Notes: LLN is defined by normal values in a Danish population.17 Values are number (frequencies) for categorical values. ...
Article
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Background: COPD prevalence in Denmark is estimated at 18% based on data from urban populations. However, studies suggest that using the clinical cut-off for airway obstruction in population studies may overestimate prevalence. The present study aims to compare estimated prevalence of airway obstruction using different cut-offs and to present lung function data from the Lolland-Falster Health Study, set in a rural-provincial area. Methods: Descriptive analysis of participant characteristics and self-reported respiratory disease and of spirometry results in the total population and in subgroups defined by these characteristics. Airway obstruction was assessed using previously published Danish reference values and defined according to either FEV1 /FVC below lower limit of normal (LLN) 5% (as in clinical diagnosis) or 2.5% (suggested for population studies), or as FEV1 /FVC < 70%. Results: Using either FEV1 /FVC < 70% or LLN 5% cut-off, 19.0% of LOFUS participants aged 35 years or older had spirometry, suggesting airway obstruction. By the LLN 2.5% criterion, the proportion was considerably lower, 12.2%. The prevalence of airway obstruction was higher among current smokers, in participants with short education or reporting low leisure-time physical activity and in those with known respiratory disease. Approximately 40% of participants reporting known respiratory disease had normal spirometry, and 8.7% without known respiratory disease had airway obstruction. Conclusion: Prevalence of airway obstruction in this rural population was comparable to previous estimates from urban Danish population studies. The choice of cut-off impacts the estimated prevalence, and using the FEV1 /FVC cut-off may overestimate prevalence. However, many participants with known respiratory disease had normal spirometry in this health study.
... De vastes enquêtes transversales et observationnelles ont montré que les déplacements actifs sont indépendamment et significativement associés, sur le plan statistique, à une réduction du risque de maladie cardiovasculaire, de cancer et de mortalité toutes causes confondues [18][19][20][21][22][23][24][25][26] , ce qui a été confirmé par une récente revue systématique 27 . Plusieurs essais randomisés contrôlés effectués récemment ont corroboré ces résultats 21,28,29 . ...
... La pollution par le bruit est aussi directement liée à une baisse de la qualité de vie 42,43 , et elle serait également réduite par une baisse de la circulation motorisée 44,45 . Finalement, le temps passé assis dans une voiture est directement lié à de piètres issues de santé, dont l'obésité et la maladie cardiovasculaire 46 ; donc moins de temps au volant et plus de temps sur 2 roues mèneront directement à de meilleurs résultats de santé [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] . ...
Article
Objectif: Prendre connaissance de la littérature sur le cyclisme et la santé, et fournir un aperçu des données probantes publiées et en discuter. SOURCES D’INFORMATION: Une recherche a été effectuée sur PubMed à l’aide des mots-clés anglais bicycle et transportation. Les études cliniques, analyses de pratique et revues systématiques ont été incluses. Toutes les listes de références ont été examinées, à la recherche d’autres articles. Message principal: Le changement climatique est une menace à la santé. Au Canada seulement, les moyens de transport sont la deuxième source d’émissions de gaz à effet de serre. Le transport actif, qui est un moyen de transport propulsé par l’être humain, atténue les effets sur la santé de la crise climatique tout en améliorant la santé. L’activité physique améliore le bien-être général, ainsi que la santé physique et mentale. Le transport actif, particulièrement le vélo, est une façon commode d’atteindre les cibles d’activité physique, de réduire le risque de maladie et de mortalité toutes causes confondues, et de profiter des bienfaits sur la société et sur la santé mentale. La promotion du transport actif par les médecins de famille a augmenté les déplacements à vélo des patients en comparaison avec l’absence de cette promotion. Conclusion: Les médecins de famille peuvent contribuer à accroître le transport actif au niveau des patients individuels par l’éducation et les conseils visant à modifier les comportements; à l’échelle communautaire, par l’éducation communautaire et le plaidoyer politique; et au niveau des politiques, en s’associant à de plus vastes organisations.
... Cycling also has health benefits. The mortality rate is approximately 40 percent lower in city-dwellers who commute by cycling than those who use passive transport [79]. Approximately 23 to 25 percent of city-dwellers in Denmark, China and the Netherlands utilize the bike lane system for cycling to work [65]. ...
... By integrating cycling into the everyday routine, the level of physical activity can increase, and people who commute by cycling spend on average 30 min cycling [77]. Several studies demonstrate that regular walking and cycling activities have positive effects on all-cause mortality and various diseases [79][80][81]. ...
Article
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The primary objective of this research is to define a pedagogy framework for architecture Graduate Design Studio. The proposed pedagogy framework pursues the following three principal objectives: The first objective focuses on buildings and landscapes and the interconnection between them. Such connectivity facilitates a ground for walkability. The second goal is to incorporate green elements within buildings and landscapes with regard to increasing the percentage of available green spaces within contemporary and future cities, which may encourage human respect for nature. The third objective promotes the notion that contemporary and future built environments should be envisioned as environments wherein fresh local food can be cultivated, processed and distributed. It incorporates urban agriculture within buildings and landscapes. The Graduate Studio pedagogy focuses on the concept of social sustainability. The three mentioned objectives of the framework are in line with the core concept of social sustainability, which includes improving the well-being and quality of life of contemporary and future urban dwellers. Overall, the Graduate Studio envisions buildings and landscapes as pedestrian environments, as grounds where green elements are incorporated and local fresh food is cultivated. The mentioned framework has been implemented within the Graduate Studio. Four design project samples are presented as successful precedents.
... The extent to which a physically active individual can maintain high functional potential during aging remains a matter of considerable importance [9]. There is insufficient convincing evidence in the literature on the extent to which recreational running and cycling can affect an individual's functional capacity from youth to old age [10]. There is also relatively little data on the health benefits and physiological effects of recreational cycling and running when comparing different age groups of men and women [3]. ...
... A decrease in heart rate at standard, r. submaximal and maximum respiration load in the elderly is usually compensated for by an increase in systolic volume and by improving end-diastolic volume filling rates [25]. Similarly, the results of other studies in middle-aged and older athletes [7,10] document that the decrease in absolute values of work capacity due to increasing age can be compensated for by a number of physiological mechanisms that can maintain working capacity even in old age. ...
Article
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Abstract: Human physical activities may bring potential health benefits. The aim of our study was to compare body composition, lung function and aerobic fitness as a function of age in a cross-sectional study of 277 recreational cyclists (men: n = 163, women: n = 114) and 377 recreational runners (men: n = 239, women: n = 138) aged 20 to 60 years, with a training volume of about 2000 to 4000 km per year for cyclists and 25 to 60 km per week for runners. The survey focused on comparing the values of body composition, lung function and aerobic fitness in dependence on age. The results suggest that recreational cycling and running is associated with a favorable body composition and increased physical fitness, where the percentage of body fat in athletes corresponds to about 70–90% of the population norm, while physical fitness indices, maximum oxygen consumption and maximum exercise performance corresponded at about 140 to 150% of the population norms. The study confirms the assumption that the decrease in physiological functions and/or physical condition with age is much slower in those who participate in recreational sports than in the general nonsports population. Keywords: physical fitness; ageing; male and female recreational athletes; cycling; running; body composition; maximum oxygen consumption; pulmonary function
... 16 One study showed that commuting a distance of 3 km by bicycle was enough to lead to a statistically significantly increase in physical fitness. 17 Large cross-sectional observational surveys have shown that active commuting is statistically significantly and independently associated with a reduction in risk of cardiovascular disease, cancer, and all-cause mortality, [18][19][20][21][22][23][24][25][26] which has been confirmed in a recent systematic review. 27 Several recent randomized controlled trials have confirmed similar results. ...
... 44,45 Finally, time spent sitting in a car is directly associated with poor health outcomes, including obesity and cardiovascular disease 46 ; less time spent behind the wheel and more time spent on 2 wheels will lead directly to better health outcomes. [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Cycling also has substantial social benefits. Car ownership can be expensive; the average household in Canada spends a large proportion of its income on private vehicles and fuel. ...
Article
Objective: To review the literature about cycling and health, and to provide an overview and discussion of the available evidence. Sources of information: The MeSH terms bicycle and transportation were searched in PubMed. Clinical trials, practice reviews, and systematic reviews were included. All reference lists were reviewed for additional articles. Main message: Climate change is a threat to health. In Canada alone, transportation is the second largest source of greenhouse gas emissions. Active transportation, which is any form of human-powered transportation, can mitigate the health effects of the climate crisis while simultaneously improving the health of people. Physical activity improves overall well-being, as well as physical and mental health. Active transportation, particularly cycling, is a convenient way to meet physical activity targets, reduce risk of disease and all-cause mortality, and derive mental health and social benefits. Family physician advocacy for active transportation has been shown to increase cycling levels in patients compared with no physician advocacy. Conclusion: Family physicians can help to increase the level of active transportation at the individual patient level through patient education and behaviour change counseling; at the community level through community education and political advocacy; and at the policy level through partnerships with larger organizations.
... In addition, more public transport modes, including underground and light rail, should be introduced. It would also be beneficial to introduce more active transport modes such as shared bicycle schemes, as these increase fitness and improve mental health (Andersen et al., 2000;Liu et al., 2020b;Martin et al., 2014): ...
... Public transport systems in Huzhou and other Chinese cities should be further developed via the expansion of networks, increasing the service frequency, extending and upgrading the infrastructure and introducing new modes of transport such as light rail. Moreover, it is also beneficial to introduce active methods of travel such as shared bicycle schemes, as these increase fitness and well-being (Andersen et al., 2000;Lyu et al., 2020;Martin et al., 2014). 8. Did the Huzhou government provide subsidies during and after the pandemic? ...
Article
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During the COVID-19 crisis, a series of measures were taken to restrict travel and social activities outside the home in order to curb the pandemic and ameliorate its negative effects. These unprecedented measures have had a profound impact on the number and purposes of trips and modes of travel. In China, although the pandemic is now generally under control and transport availability has returned to nearly normal, the extent of the changes in travel behaviour wrought during and after the pandemic still remains unclear. Therefore, the aim of this paper is to investigate the differences in individual travel behaviours during and after the COVID-19 pandemic, using Huzhou as an example. Semi-structured interviews were used to examine the influence of COVID-19 on the travel behaviour and perceptions of different groups. The results indicate that, initially, travel demand was greatly reduced. Second, decreased travel reduced participation in activities, which can have adverse effects on people’s health as well as their subjective well-being. Third, the degree and duration of such impacts varied from person to person. Students, lower income cohorts, groups living in small communities with insufficient green spaces, and those working in tourism, catering, informal businesses and transport-related sectors were more vulnerable than others. Policymakers, urban and transport planners should therefore pay attention to the social inequities that arise from unequal access to transport and heterogeneity between individuals. Additionally, public transport systems require further development to promote social cohesion.
... One form of physical activity that would be particularly valuable for this validation is cycle commuting. This is since it has a potential to be incorporated into a daily life routine and contribute to population health through a reduction of morbidity (e.g., Hu et al., 2003;Hu et al., 2007;Pucher et al., 2010) and risk for premature mortality (Andersen et al., 2000;Matthews et al., 2007). At the same time, not much research is available concerning the physical activity bases for such health outcomes (Stigell and Schantz, 2015;Schantz, 2017;Schantz et al., 2020). ...
... The general importance of this can be viewed from the perspective of that, although health outcomes are coupled to a physical activity such as cycle commuting (e.g., Andersen et al., 2000;Hu et al., 2003Hu et al., , 2007, very little data is available concerning the physical activity bases for such health outcomes in terms of exercise intensities, trip durations and frequencies of exercise (Stigell and Schantz, 2015;Schantz, 2017;Schantz et al., 2020). This needs to be surveyed in local contexts, since cycling culture, demography, infrastructure and topography might induce qualitative differences in the commuter cycling. ...
Article
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PurposeQuantifying intensities of physical activities through measuring oxygen uptake (V̇O2) is of importance for understanding the relation between human movement, health and performance. This can in principle be estimated by the heart rate (HR) method, based on the linear relationship between HR and V̇O2 established in the laboratory. It needs, however, to be explored whether HR methods, based on HR-V̇O2 relationships determined in the laboratory, are valid for estimating spectrums of V̇O2 in field exercise. We hereby initiate such studies, and use cycle commuting as the form of exercise.Methods Ten male and ten female commuter cyclists underwent measurements of HR and V̇O2 while performing ergometer cycling in a laboratory and a normal cycle commute in the metropolitan area of Stockholm County, Sweden. Two models of individual HR-V̇O2 relationships were established in the laboratory through linear regression equations. Model 1 included three submaximal work rates, whereas model 2 also involved a maximal work rate. The HR-V̇O2 regression equations of the two models were then used to estimate V̇O2 at six positions of field HR: five means of quintiles and the mean of the whole commute. The estimations obtained were for both models compared with the measured V̇O2.ResultsThe measured quintile range during commuting cycling was about 45–80% of V̇O2max. Overall, there was a high resemblance between the estimated and measured V̇O2, without any significant absolute differences in either males or females (range of all differences: −0.03–0.20 L⋅min–1). Simultaneously, rather large individual differences were noted.Conclusion The present HR methods are valid at group level for estimating V̇O2 of cycle commuting characterized by relatively wide spectrums of exercise intensities. To further the understanding of the external validity of the HR method, there is a need for studying other forms of field exercises.
... In 2000 Andersen et. al. [56] published results from 2 cohort studies from Copenhagen on the health impacts of cycling. This source had been heavily cited in older health impact studies, including previous versions of HEAT [25,26,36,40]. ...
Thesis
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According to the World Health Organisation, about one third of the global population do not have sufficient levels of physical activity (PA). Active transport is viewed as an easy and effective way to introduce more PA into people’s everyday lives. In both transport and health science, there is increasing interest in assessing and modelling active transport and its associated health benefits. Household travel surveys (HTSs) could be a useful data source because they are more detailed than the PA questionnaires traditionally used in health studies. Transport modelling methods could offer new possibilities for forecasting the health impacts of active travel policy scenarios. However, these tools and techniques used by transport scientists might not be immediately suitable from a PA epidemiological perspective. A literature review of health studies using HTSs and transport modelling tools revealed methodological uncertainties. For example, it was difficult to study PA during public transport trips. Compensatory behaviour (e.g. an increase in cycling causing a reduction in walking) is also poorly understood. Furthermore, HTSs and transport models generally only consider behaviour on a single day, whereas health guidelines and modelling tools generally consider week-long behaviour. To better understand the potential for transport methods in health impact studies, this thesis investigates these uncertainties in detail. Specifically, it asks: how can transport assessment and modelling methods be adapted to more accurately evaluate PA and its health impacts? In the methodology, an adapted transport modelling framework is proposed. Indicators relevant to PA epidemiology were chosen; namely, the distribution of PA in the population and the estimated health impacts. The first half of this thesis covers assessment. An exploratory approach compares three national HTSs to investigate how different data collection methods influence PA assessment. These were Germany’s Mobilität in Deutschland and Mobilitätspanel (MOP) and England’s National Travel Survey. Afterward, the MOP was explored in further detail to learn more about the distribution of PA in the population, determinants of PA, week-long behavioural patterns, and the effects of using a 1-day diary rather than a 7-day diary. The second half of this thesis covers modelling, specifically trip generation and mode choice. First, the suitability of the trip-based paradigm is assessed. Afterward, using the proposed modelling framework, statistical analyses and discrete choice models are prepared from MOP data. Finally, to test the effectiveness of the proposed framework, predictions from the adapted mode choice model are compared with predictions from more traditional mode choice models. The exploratory cross-dataset analysis revealed several possible HTS adaptations that would permit more accurate PA assessment. The proposed framework also proved to be useful for more accurately modelling PA and its health impacts. However, not all of the proposed adaptations in the framework could be proven to be beneficial with respect to the indicators specified. Nevertheless, the analyses provided insight into the complexities of active travel, such as mandatory-discretionary relationships, compensatory behaviour, and stability in travel decisions. These findings address some of the limitations brought up in previous transport health impact studies. They also offer policy potential by introducing new possibilities for defining active travel polices, targeting specific behavioural groups, and plausibly predicting policy impacts.
... Walking and cycling are active modes of transportation that can reduce air pollution and traffic congestion, and endorse an active lifestyle, which in turn can improve public health (Bo Andersen et al. 2000;Mayor of London, 2004;Higgins, 2005;Jang et al. 2010;Vanparijs et al. 2015;Mueller et al. 2015;Nashad et al. 2016). However, vulnerable road users are more likely to encounter traffic accidents, particularly in countries where traffic laws are poorly imposed (Beck et al. 2007;Zegeer and Bushell, 2012;Songpatanasilp et al. 2015;Baldwin et al. 2018;Hampshire et al. 2020). ...
Article
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This study aims to employ the negative binomial model and empirical Bayes model to estimate the accident risk for vulnerable road users at the road intersections in Toyohashi, Japan. A comprehensive dataset including 831 pedestrians and 3874 bicycle accidents at 16,283 intersections over a 10-year period (previous five years and next five years) from 2009–2018 is utilized. The obtained results indicate that accident estimation with the empirical Bayes model is highly correlated (r = 0.882) with the previous accidents and moderately correlated (r = 0.445) with the future accidents, which are considerably better than those assessed by the negative binomial model (r = 0.269 and r = 0.266), for bicycle as well pedestrian accidents. Moreover, the empirical Bayes model reveals the effect of “intersection angle deviation” alone on each intersection by exposing the high-risk intersections, which is insignificant in the negative binomial model.
... Bicycling provides several health benefits stemming from increased physical activity and is related to improving societal health through reduced air and noise pollution (Mueller et al., 2015). Increased physical activity has been linked to better self-rated health (Eriksen et al., 2013), lower mortality (Andersen et al., 2000;Welsh et al., 2020) and improved well-being Mytton et al., 2016a,b). However, increased cycling also exposes cyclists to a greater risk of suffering crashes. ...
Article
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This study explores the interactions between the advantages of cycling for physical and mental health and possible health consequences of crash involvement. Data were derived from an online survey distributed via social media and cycling interest organisations and resulted in 382 responses from cyclists having crashed in the past two years and 855 non-crash cyclists. Firstly, we compared the distress symptoms reported by non-crashed cyclists, all crashed cyclists, and crashed cyclists considering their crash severe. Secondly, we performed structural equation models (SEMs) to identify latent distress constructs and their relation to person characteristics, cycling habits and possible injuries. Lastly, we investigated the relation between the latent distress constructs and the perceived quality of life (QoL for each of the following subgroups: non-crash cyclists, crashed cyclists and the subgroup of cyclists considering their crash severe. Our analyses show that the non-crash cyclists on average report more distress symptoms than the crashed cyclists. With the only significant difference between the cyclist groups being their cycling exposure (the crashed cyclists cycle significantly more) and gender, this result highlights the complex interaction between the positive health benefits of physical activity on one side and possible negative health impacts of crash involvement while being physically active on the other. Three latent distress constructs were identified: “General stress & exhaustion”, “Depression & anxiety”, “Physical impairment”. “Depression & anxiety” and “Physical impairment” are directly and negatively related to the perceived QoL. “General stress & exhaustion” is directly and positively related to the perceived QoL. Several person characteristics, cycling habits and injuries are associated with the latent distress constructs. “Depression & anxiety” showed the strongest relation to a poorer perceived QoL among the crashed cyclists. This highlights the importance of not only considering the physical aspects of crash related injuries but also the potential psychological and mental aspects of suffering a crash.
... Ribeiro et al. [34] corroborate our findings, in which active commuting was the domain that was most related to better aspects of HRQoL (among them: vitality, social aspects and mental health). Other studies have also reported positive associations between this PA domain and aspects related to HRQoL [15,35], strengthening evidence that practicing PA during leisure and locomotion can benefit related health aspects both the physical part as the mental, considering that they are domains that encompass physical and mental concepts. ...
Article
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Background It is estimated that, worldwide, 9% of deaths occur as a result of insufficient physical activity (PA) practice. Practicing PA can prevent and/or reduce the deleterious effects of different types of diseases and can improve general health aspects related to health-related quality of life (HRQoL). Purpose To analyze the relationship of different PA domains with different HRQoL domains over a two-year period. Methods This is an observational study with a two-year longitudinal design. The sample, composed of adults, was selected from a randomization of the streets of the different regions (north, south, east, west and center) covering individuals from all areas of the city. To assess the practice of PA, the Baecke questionnaire was used. The instrument Medical Outcomes Study SF-36-Item Short Form Health Survey was used to assess the HRQoL domains. Linear regression models were used to analyzed the association of different PA domains with changes in HRQoL. Multivariate statistical models were adjusted for gender, age, socioeconomic status, marital status, the respective PA score at baseline, smoking, body mass index, and morbidity. Results 331 adults were evaluated. There was a decrease in the practice of PA in the occupational domain and an increase in the leisure/locomotion domain. Regarding HRQoL, there was an increase in the scores of body pain and mental health, and a decrease in scores of general health, vitality, social aspects and emotional aspects. The PA practice in the occupational domain was inversely related to functional capacity (β = − 7.2 [CI 95% − 13.0; − 1.4]). The practice of PA through sports in leisure time was positively associated with vitality (β = 5.5 [CI 95% 0.2; 10.7]) and mental health (β = 15.2 [CI 95% 6.8; 23.7]). PA practice during leisure and locomotion was inversely associated with functional capacity (β = − 5.68 [CI 95% − 10.7; − 0.6]) and positively associated with vitality β = 4.8 [CI 95% 0.8; 8.7]) and mental health (β = 8.4 [CI 95% 2.0; 14.9]). The total PA practice was inversely associated with functional capacity (β = − 3.8 [CI 95% − 6.5; − 1.2]) and positively associated with pain in the body (β = 4.9 [CI 95% 0.3; 9.4]), vitality (β = 2.9 [CI 95% 0.7; 5.0]) and mental health (β = 5.7 [CI 95% 2.2; 9.2]). Conclusions It is suggested that practicing PA continuously within a period of two years can positively affect some physical aspects and some mental aspects related to HRQoL, but not all of them. A strategy for public policy actions is to explore these variables by domain and thus detect the real needs and improvements that can be made for the population.
... Active commuting is associated with higher general physical activity levels and lower body weight in adults (Wanner et al., 2012). It is also associated with approximately 30 % of reduced risk of mortality for all causes (Andersen et al., 2000). Those who engage in active mobility on a regular basis seem to exceed the WHO recommendations for physical activity, e.g. in Switzerland by as much as double (approx. ...
Technical Report
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The PASTA project ran from October 2013-October 2017, and was about getting individuals to be more physically active by integrating physical activity (PA) into their daily transport activities through walking and cycling. This report reflects the work and findings from the first work package of the PASTA project. In a nutshell, this report looks at what active mobility (AM) is, what can be done to increase active mobility, and what factors affect active mobility.
... Previous studies have shown that not only prolonged sitting activity on a non-working day but also occupational sitting activity and total sitting time per week were associated with all-cause mortality 27,28 . Several investigators showed that leisure-time sedentary behavior (e.g., watching television, using a computer, and sitting in a car) is a predictor of cardiovascular events 4,29,30 . ...
Article
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We divided the 466 subjects into two groups based on information on sitting time on a non-working day and evaluated flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID). FMD was smaller in subjects with sitting time on a non-working day of ≥6 h/day than in subjects with sitting time on a non-working day of <6 h/day (2.5 ± 2.6% vs. 3.7 ± 2.9%; p < 0.001). NID was smaller in subjects with sitting time at non-working day of ≥ 8 h/day than in subjects with sitting time on a non-working day of < 8 h/day (10.1 ± 5.6% vs. 11.5 ± 5.0%; p = 0.01). After adjustment for confounding factors for vascular function, the odds of having the lowest tertile of FMD was significantly higher in subjects with sitting time on a non-working day of ≥6 h/day than in subjects with sitting time on a non-working day of <6 h/day. The odds of having the lowest tertile of NID was significant higher in subjects with sitting time on a non-working day of ≥ 8 h/day than in subjects with sitting time on a non-working day of < 8 h/day. These findings suggest that prolonged sitting time on a non-working day is associated with blunted FMD and blunted NID.
... On the other hand, some leisure preferences are beneficial for the user's health and wellbeing, including meditation [9] or physical activity [26][27][28], or spending time in nature [14,29]. However, excessive engagement in some types of "user-friendly" leisure preferences might also result in wellbeing and health-related challenges [30]. ...
Article
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This study intended to explore which leisure preferences contribute to mindfulness, psychological capital, and life satisfaction and assess whether mindfulness, psychological capital, and life satisfaction are associated with different leisure preferences. This study applied the Satisfaction with Life Scale (SWLS), the Psychological Capital Questionnaire (PCQ-12), the Mindful Attention Awareness Scale (MAAS), and the instrument to evaluate the prevalence of leisure preferences. A sample consisted of 586 participants, 104 males and 478 females. The mean age of participants was 42.06, SD = 13.29. The results show that respondents who did not spend free time watching television scored higher on life satisfaction, mindfulness, and psychological capital. Participants who preferred attending events scored higher on life satisfaction and psychological capital. Participants who preferred spending time with family as a leisure preference scored significantly higher on life satisfaction, mindfulness, and psychological capital, including PsyCap overall, PsyCap work, PsyCap relationship, and PsyCap health. The findings also reveal that time spent with family is significantly associated with life satisfaction. Besides, males’ life satisfaction was significantly associated with time spent in nature, while females’ satisfaction was associated with spending time with family and participating in events. Males’ mindfulness was significantly associated with book reading, and females’ mindfulness was associated with not watching television. Males’ psychological capital was significantly associated with spending time with family and book reading, and females’ psychological capital was associated with not watching television but spending time with family, participating in events, and spending time in nature. The findings also showed that mindfulness mediated the link between watching television and life satisfaction, and psychological capital mediated links between spending time with family, participating in events, and life satisfaction. The findings demonstrate that life satisfaction is also significantly associated with spending time with family as a leisure preference. This study also revealed a significant negative association between age and spending time with friends or family, evidencing the possible loneliness of elderly respondents. Due to limitations of this study, including sample size and characteristics, cultural context, and research design, the research findings would preferably be regarded thoughtfully.
... Daily bouts of walking and cycling can have a major influence on health and longevity due to increased rates of energy expenditure (Ainsworth et al., 2000). Up to 40% reduction in mortality rates was found in Danish men and women who cycled daily to work (Andersen et al., 2000). European citizens with high rates of walking and cycling have less obesity than do people in Australia and North America who are very car dependent (Bassett et al., 2008). ...
... It is therefore important to motivate employees who perform no or very little physical activity to perform at least some physical activity, as the potential gain in health/reduction in sickness absence is greater among such employees than when increasing the amount of physical activity among employees who almost meet physical activity recommendations (Supplemental material). This confirms results from other studies [43]. However, using a cut point for low physical activity that includes only employees who answered they perform no activity or only 30 minutes of physical activity per week in their spare time includes <3% of the surveyed employees. ...
Article
Objectives: Work-related stress and certain lifestyles have been associated with sickness absence among employees. We analysed relations between stress and lifestyles (as risk factors) and short-term sickness absence among employees of a large Danish industrial company. Moreover, we analysed the impact of risk factors on short-term sickness absence. Methods: A self-administered questionnaire was completed by 7753 employees (67% response rate). Relations between risk factors (dyssomnia, low physical activity, alcohol, smoking, unhealthy food habits, overweight and stress) and short-term sickness absence were analysed by calculating etiologic fractions and binary logistic regression. Relations between the number of risk factors and short-term sickness absence were also analysed. Finally, the cost of short-term sickness absence from risk factors was estimated to illustrate the potential savings in avoided loss of productivity that could be gained from intervention programmes. Results: Stress, overweight, smoking and dyssomnia are significantly related to short-term sickness absence. Etiologic fractions revealed that these factors were associated with between 29.8% and 37.8% of short-term sickness absence. The number of risk factors was also related to the risk and length of sickness absence. Conclusions: This study identified risk factors that could be addressed by intervention programmes to reduce short-term sickness absence. Based on the results, focus on the risk factors that account for most short-term sickness absence and reduction of the number of risk factors could potentially reduce short-term sickness absence. A 30% reduction is equivalent to an avoidance of a loss of productivity of 4.5%, corresponding to €9.4 million per year.
... The favorable effects of exercise training are not limited to the prevention and management of EH but also positively affect also prognosis, including the reduction of mortality. In general, there is the evidence that LTPS is inversely associated with all-cause mortality in both men and women [66]. ...
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Nowadays, there are robust clinical and pathophysiological evidence supporting the beneficial effects of physical activity on cardiovascular (CV) system. Thus, the physical activity is considered a key strategy for CV prevention. In fact, exercise training exerts favourable effects on all risk factors for CV diseases (i.e. essential hypertension, type 2 diabetes mellitus, hypercholesterolemia, obesity, metabolic syndrome, etc…). In addition, all training modalities such as the aerobic (continuous walking, jogging, cycling, etc.) or resistance exercise (weights), as well as the leisure-time physical activity (recreational walking, gardening, etc) prevent the development of the major CV risk factors, or delay the progression of target organ damage improving cardio-metabolic risk. Exercise training is also the core component of all cardiac rehabilitation programs that have demonstrated to improve the quality of life and to reduce morbidity in patients with CV diseases, mostly in patients with coronary artery diseases. Finally, it is still debated whether or not exercise training can influence the occurrence of atrial and ventricular arrhythmias. In this regard, there is some evidence that exercise training is protective predominantly for atrial arrhythmias, reducing the incidence of atrial fibrillation. In conclusion, the salutary effects evoked by physical acitvity are useful in primary and secondary CV prevention.
... Kent içi yolculuklarda otomobil yerine bisikletin tercih edilmesi önemli ölçüde karbon emisyonunu azaltmaktadır. Çevre kirliliğini azaltarak hava kalitesinin artmasında fayda sağlayan ve yakıt tasarrufuna imkan veren çevre dostu bir ulaşım aracı olan bisikletler aynı zamanda güvenli bisiklet yolları ile desteklendiğinde trafik sorunlarını engelleyerek ağır hasarlı trafik kazalarının önüne geçilmesine katkı sağlayabilmektedir (Sağlık Bakanlığı, 2013;Basset, ve ark., 2008;OBIS, 2011;Götschi, 2015;WHO, 2002;Davis ve Cavill, 2007;Andersen, 2000;Foltynova, ve Kohlova, 2002;Wang, ve ark., 2005). Sosyal anlamda; bisiklet kullanımı insanların hareketliliğini artırarak sağlık sorunlarını azaltmakta ve dolayısıyla yaşam kalitelerini yükseltmek-7 Bu politika sayesinde, gençlerin toplu taşıta daha fazla entegre olması sağlanacağı gibi, bu uygulama bisiklet kullanımının yaygınlaşması açısından da önemli bir politik adım olabilir. ...
... A prospective study has demonstrated that people who cycled as transportation to work, spending on average three hours per week, had a significant reduction of approximately 30% in risk of mortality. 17 Other studies also have shown the association between walking and cycling with reducing the incidence of chronic non-communicable diseases. Thus, this simple, ecologic, and economic strategy could be a relevant measure to be encouraged in concomitance with safety precautions when commuting. ...
... Many studies proved less physical activity increases the risk factor of mortality, (Andersen, 2000) ...
Article
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Cardiovascular disease (CVD) is one of the most leading causes for morbidity and mortality in the worldwide. Age and other genetic factors are not only primarily responsible other factors including diabetes, hypertension lifestyles are some of the major risk factors associated with CVD. The study was designed to understand the nutritional status of the cardiovascular disease. The present study was an observational study which was carried out in Pinnacle hospital Arilova in Vishakhapatnam Andhra Pradesh. The study was designed to investigate the impact of nutritional status of cardiovascular disease patients in the age group of 40 to 70 years. A total of 100 samples were taken and the data was gathered through qualitative methods like questionnaire and interview methods. Anthropometric measurement, Biochemical parameters, clinical parameters, dietary intake was assessed by 24hours recall method and diet counselling was given. Among 100 samples 76 were male and 24 were female, stated physical status of the sample's states that majority of the samples go for walking (25%) everyday, 27% twice a week. 12% once a week and 36% never go for any physical activity. Majority of the samples (52) suffer from hypertension, (42) with atherosclerosis, (25) samples with myocardia infraction and 18 with angina pectoris, 8 with rheumatic heart disease and 4 with stroke. The study concludes the prevalence of hypertension, kidney disorders and diabetes are increasing with increase in CVD, the sedentary lifestyle and lack of physical exercise was one of the major route causes for CVD. High consumption of saturated fatty acids leads to obesity. Consumption of good dietary habits along with medication with physical activity helps in prevention and treatment of CVD.
... Insufficient physical activity (PA) is the fourth leading cause of mortality globally [1], and is associated with large direct and indirect economic consequences for society [2][3][4][5]. Despite the strong evidence for the health benefits of engaging in PA, such as decreasing risk of non-communicable diseases and all-cause mortality [1,[6][7][8][9], it is estimated that 45% of adults (≥16 years) in Northern Ireland [10] do not achieve the current recommended level of 150 min of PA per week [11]. Furthermore, Hallal and colleagues [12] estimated that physical inactivity levels (≥15 years) in the United Kingdom (UK) were 63.3%, considerably higher than the European average of 34.8%. ...
Article
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Active travel (AT) has gained increasing attention as a way of addressing low levels of physical activity. However, little is known regarding the relationship between income and AT. The aim of this study was to investigate characteristics associated with undertaking AT in an adult population and by low- and high-income groups. Data collected from the Physical Activity and the Rejuvenation of Connswater (PARC) study in 2017 were used. Participants were categorised into socio-economic groups according to their weekly household income, and were categorised as participating in ‘no’ AT or ‘some’ AT and ‘sufficient’ AT. Multivariable logistic regression explored characteristics associated with AT in the full cohort, and the low- and high-income groups separately. Variables associated with AT in the low-income group were body mass index (BMI), physical activity self-efficacy, marital status, long term illness, difficulty walking and housing tenure. For the high-income group, BMI, marital status, housing tenure and education were associated with AT. For both income groups, there were consistent positive associations with the action/maintenance phase of the stage of change model across all AT categories. The findings suggest that population sub-groups may benefit from targeted initiatives to support engagement in AT and prevent further widening of inequalities.
... Typically, when considering exercise dose about health outcomes, exercise is characterized by type, intensity, and volume (session duration and frequency) according to the age, weight, fitness level and pathologies of each patient [13]. Recent studies have shown that intensity is the most relevant feature in prescribing physical exercise [14,15] because it determines the amount of energy expenditure and can be seen as the "dose" of the prescription [16]. Since controlling exercise intensity avoids overtraining patients, which can affect their rehabilitation and make them suffer health consequences (i.e., physical, or physiological complications) [17][18][19]. ...
Article
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Physical exercise contributes to the success of rehabilitation programs and rehabilitation processes assisted through social robots. However, the amount and intensity of exercise needed to obtain positive results are unknown. Several considerations must be kept in mind for its implementation in rehabilitation, as monitoring of patients’ intensity, which is essential to avoid extreme fatigue conditions, may cause physical and physiological complications. The use of machine learning models has been implemented in fatigue management, but is limited in practice due to the lack of understanding of how an individual’s performance deteriorates with fatigue; this can vary based on physical exercise, environment, and the individual’s characteristics. As a first step, this paper lays the foundation for a data analytic approach to managing fatigue in walking tasks. The proposed framework establishes the criteria for a feature and machine learning algorithm selection for fatigue management, classifying four fatigue diagnoses states. Based on the proposed framework and the classifier implemented, the random forest model presented the best performance with an average accuracy of ≥98% and F-score of ≥93%. This model was comprised of ≤16 features. In addition, the prediction performance was analyzed by limiting the sensors used from four IMUs to two or even one IMU with an overall performance of ≥88%.
... Furthermore, in adults, cycling can anticipate weight gain due to increased use of energy reserves in the form of glycogen and triglycerides, support weight loss when combined with diet, improves cardiovascular and muscle fitness, decrease depression, and in older adults, cycling can help to maintain better cognitive function [2]. A cohort study conducted in Copenhagen Denmark involving 13.375 female and 17.265 male respondents and followed for 14.5 years concluded that cycling to work reduces all causes of death by 28% [3]. ...
Article
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Background Cycling is a physical exercise that is widely performed to improve physical fitness. Regular physical exercise will lead to adaptations to exercise. This adaptation is useful in suppressing the production of reactive oxygen stress (ROS) generated in response to cellular metabolism that uses oxygen. Transforming growth factor beta-1 (TGF-β1) plays a role in increasing the production of ROS, thus, when the concentration is low, it would lead to an improvement in physical fitness. This study aims to compare levels of TGF-β1 between recreational cyclists and sedentary groups. In addition, this research also compares several other parameters, which are fasting blood sugar levels and lipid profiles (triglycerides, total cholesterol, HDL cholesterol, and LDL cholesterol) between cyclists and sedentaries. Methods This was an observational analytical study with a cross-sectional design. The research subjects consisted of 2 groups, each consisting of 21 participants, namely the recreational cyclist and the sedentary group. Anthropometric examinations were carried out, including body weight, height, body mass index, waist circumference, and body fat percentage. Fasting blood glucose concentration and lipid profile (Triglyceride – TG, Total Cholesterol – Total C, HDL Cholesterol – HDL-C, and LDL Cholesterol – LDL-C) were determined by the enzymatic colorimetric methods, and TGF-β1 levels were determined using the fluorescence of specific antibodies for TGF-β1 (pg/ml) using ELISA method. Statistical analysis was performed using IBM SPSS v. 25. Results The anthropometric variables, other than body height, did not differ significantly between the two groups, so did the fasting blood glucose concentration. Nevertheless, the lipid profile (TG, Total C, HDL-C and LDL-C) were found to be significantly better in the cyclist group (p < 0.05). The mean level of TGF-β1 in recreational cyclists was 8, 908.48 pg/ml, lower than the control group, 10, 229.28 pg/ml. The results of the unpaired t-test showed significant mean differences between the two groups, (p = 0.001; p < 0.05). Conclusion The levels of TGF-β1 in the recreational cyclist group were lower than the sedentary group. Regular physical exercise will trigger exercise adaptations that can suppress latent TGF-β1 activation.
... Among the many modifiable factors that can increase the risk of morbidity and mortality in kidney transplant (KT) recipients, physical inactivity is often neglected. This attitude is certainly questionable since a sedentary lifestyle has been widely recognized as a "silent killer" and a major health issue in the general population, particularly in more economically developed countries [1][2][3]. It is now well-known that physical inactivity is independently associated with a higher risk of cardiovascular disease (CVD), diabetes mellitus, obesity, osteoporosis, and breast and colonic cancer [4,5]. ...
Article
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In patients with chronic kidney disease, sedentary behavior is widely recognized as a significant risk factor for cardiovascular disease, diabetes, obesity, osteoporosis, cancer, and depression. Nevertheless, the real impact of physical inactivity on the health of kidney transplant (KT) recipients remains uncertain. Over the last decade, there has been a renewed interest in exploring the effects of regular physical exercise on transplant-related outcomes. There is now mounting evidence that physical activity may reduce the burden of cardiovascular risk factors, preserve allograft function, minimize immunosuppression requirement, and ameliorate the quality of life of KT recipients. Many positive feedbacks can be detected in the early stages of the interventions and with a minimal exercise load. Despite these encouraging results, the perceived role of physical activity in the management of KT candidates and recipients is often underrated. The majority of trials on exercise training are small, relatively short, and focused on surrogate outcomes. While waiting for larger studies with longer follow-up, these statistical limitations should not discourage patients and doctors from initiating exercise and progressively increasing intensity and duration. This narrative review summarizes current knowledge about the deleterious effects of physical inactivity after KT. The benefits of regular physical exercise are also outlined.
... Commonly, the training plan considers the activities, frequency, time, and intensity of training [25]. Studies have shown that the intensity is the most relevant feature at prescribing PE [26,27] because it determines the amount of energy expenditure and can be seen as the "dose" of the prescription [3]. Moreover, it is used to allocate the exercises in three groups: low-intensity exercises (LIEs), moderate-intensity exercises (MIEs) and high-intensity exercises (HIEs) [3,23]. ...
Article
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Physical exercise (PE) has become an essential tool for different rehabilitation programs. High-intensity exercises (HIEs) have been demonstrated to provide better results in general health conditions, compared with low and moderate-intensity exercises. In this context, monitoring of a patients’ condition is essential to avoid extreme fatigue conditions, which may cause physical and physiological complications. Different methods have been proposed for fatigue estimation, such as: monitoring the subject’s physiological parameters and subjective scales. However, there is still a need for practical procedures that provide an objective estimation, especially for HIEs. In this work, considering that the sit-to-stand (STS) exercise is one of the most implemented in physical rehabilitation, a computational model for estimating fatigue during this exercise is proposed. A study with 60 healthy volunteers was carried out to obtain a data set to develop and evaluate the proposed model. According to the literature, this model estimates three fatigue conditions (low, moderate, and high) by monitoring 32 STS kinematic features and the heart rate from a set of ambulatory sensors (Kinect and Zephyr sensors). Results show that a random forest model composed of 60 sub-classifiers presented an accuracy of 82.5% in the classification task. Moreover, results suggest that the movement of the upper body part is the most relevant feature for fatigue estimation. Movements of the lower body and the heart rate also contribute to essential information for identifying the fatigue condition. This work presents a promising tool for physical rehabilitation.
... with aging such as type 2 diabetes, cardiovascular diseases, weight gain, cognitive impairments and depression, and is associated with lower all-cause mortality [9][10][11][12]. Furthermore, engaging in SA has the potential to facilitate social interactions that promote autonomy, selfconfidence and quality of life [13,14], and the change in daily routines during the transition to retirment provides more opportunities for SA [15,16]. ...
Article
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Background There are substantial socioeconomic status (SES) differences in sports activity (SA) during the transition to retirement. In line with social-ecological models, the aim of this longitudinal study was to examine the association of perceptions of social and physical neighborhood factors with changes in SA across the retirement transition and to examine potential interactions with SES factors. Methods Data from 6 waves of the German Ageing Survey (DEAS) provided 710 participants (at baseline: mean age 61.1, 52.9% of men) who retired between baseline (1996, 2002, 2008, 2011) and their 6-year follow-up assessment. Associations between changes in SA (increases and decreases compared to retaining) and individual SES and neighborhood factors were estimated using multinomial logistic regression analysis. Results Increases were observed in 18.45% of participants, decreases in 10%. Occupational prestige was a risk factor for decreases, education a resource for increases in SA. Interactions between household income and several neighborhood factors were observed. Conclusions In line with social-ecological models, individual, neighborhood factors and interacting associations were found. In particular safety perceptions could be a resource for promotion SA in older adults who experience disadvantage.
... Cycling for transportation is also associated with improved cardiovascular fitness and reduced cardiovascular risk factors [7,10]. Two prospective cohort studies reported that it can reduce the risk of premature mortality by around 40% [11,12]. Despite the numerous potential benefits, only 1.4% of Canadian commuters reported cycling as their main travel mode to work according to data from the 2011 National Household Survey, and this proportion decreased with age [13]. ...
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The role of infrastructure in encouraging transportation cycling in smaller cities with a low prevalence of cycling remains unclear. To investigate the relationship between the presence of infrastructure and transportation cycling in a small city (Lethbridge, AB, Canada), we interviewed 246 adults along a recently-constructed bicycle boulevard and two comparison streets with no recent changes in cycling infrastructure. One comparison street had a separate multi-use path and the other had no cycling infrastructure. Questions addressed time spent cycling in the past week and 2 years prior and potential socio-demographic and psychosocial correlates of cycling, including safety concerns. Finally, we asked participants what could be done to make cycling safer and more attractive. We examined predictors of cycling using gender-stratified generalized linear models. Women interviewed along the street with a separate path reported cycling more than women on the other streets. A more favorable attitude towards cycling and greater habit strength were associated with more cycling in both men and women. Qualitative data revealed generally positive views about the bicycle boulevard, a need for education about sharing the road and for better cycling infrastructure in general. Our results suggest that, even in smaller cities, cycling infrastructure may encourage cycling, especially among women.
... There is no greater risk if one rides a bicycle for an appropriate time and with an intensity appropriate to the current level of physical activity, health and physical functions of a given person (Smith et al., 2018). The health benefits have been proven many times, in all age groups (Andersen & Cooper, 2011;Andersen, Schnohr, Schroll, & Hein, 2000;Götschi, Garrard, & Giles-Corti, 2015;Kelly et al., 2014;Matthews et al., 2007). For the elderly, the benefits will be: improving the mental health, strengthening the immune system, slowing the ageing process, reducing the risk and symptoms of Alzheimer's disease, less stress on the joints, improving balance and reducing the risk of falls, and the opportunity to meet new people and increase social contacts (George, nd). ...
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The study aims to analyse the prevalence of the Polish adult population in cycling in terms of their socio-demographic characteristics. This can make an important contribution to the dissemination of this environmentally, socially and economically sustainable form of physical activity, and in building national recommendations. The study was based on the representative data from the Ministry of Sport and Tourism of the Republic of Poland from five large-scale surveys in years 2014-2018. The sample comprised 7,347 Poles aged 15-69. In each survey long version of the International Physical Activity Questionnaire was used. The independence tests and non-parametric test were applied to search for statistically significant difference between the studied variables. In order to capture relationships between commuter cycling prevalence and a set of explanatory variables, a predictive model was built. The prevalence of the Polish adult population in commuting by bicycle systematically increases (in 2014 16.3%; in 2015 17.4%; in 2016-21.5%; in 2017 19.9%; in 2018 29.8%). The average energy expenditure of this effort is also increasing. Poles most often cycle 1-3 times a week (17.7% once a week; 23% twice a week; 18.2% 3 times a week). There are no statistical differences in this regard, neither by the number of cycling days nor by the gender. Hierarchically, the most important factor in determining whether someone does or does not commute by bike, is age. People who are the most probable to cycle are those aged 15-29 (30%), and among them, people living in villages (35%), with primary education (42.6%). In the 30-59 age group, 20.6% are active. They are usually from the countryside (24.3%), mostly women (27%). Among people aged 60 or more, 14.2% cycle. Most often they are men (17.3%). National recommendations should be developed for individual age groups. Educational and motivational programs (scope depending on age), practical classes increasing the self-confidence of bicycle traffic participants and activities improving the bicycle infrastructure (including the implementation of intermodal transport) are necessary.
Article
Introduction The health impacts of nonmotorized travel behavior (i.e., walking and bicycling) and the built environment have been widely investigated in the past. However, nationwide studies probing the association between the neighborhood built environment and individuals' nonmotorized travel and health status remain scarce. Utilizing national-level databases from the U.S., the present study examines the role of nonmotorized travel and neighborhood-level built environment attributes in residents’ self-assessed overall health status. Methods This research relies on data from the 2017 National Household Travel Survey and employs ordered probit modeling techniques to relate self-assessed overall health status to various variables representing the extent of nonmotorized travel and physical activity as well as the built and social environment attributes of the residential location. Results The results indicate that individuals’ self-assessed health status is associated with i) their person-level attributes including the levels of their walking and bicycling travel and other physical activity; ii) the social environment attributes of both their household and their residential neighborhood including income and vehicle ownership levels; and iii) the built environment attributes of their neighborhood including the extent of: compactness, mixed-use development, transit accessibility, and automobile-friendliness of the road network within the neighborhood. Furthermore, average marginal effects computations indicate that the most important neighborhood built environment factor in increasing the likelihood of reporting a very good or excellent health status is higher levels of transit accessibility. Conclusions The findings of this study suggest that more effective policies to promote individuals' health through changes targeting their travel behavior and their neighborhood's built environment may be the ones that: a) encourage walking and bicycling travel, and b) foster neighborhood designs that support more active lifestyles through increased levels of transit accessibility, activity density, and land use diversity, as well as through decreased levels of automobile-friendliness of the street network.
Article
There is ample evidence regarding positive health effects of cycling or walking to work (active commuting [AC]). However, little is known about the effects of AC on work ability. Therefore, we examined 422 Thai chicken meat industry workers who assessed their current work ability (CWA) compared to their lifetime best by assigning scores ranging from 0 to 10. The CWA was compared between active and non-active commuters using linear regression, cumulative distributions, and quantile regression. Overall, 46 workers (11%) were active commuters. The average CWA score was 8.2 (standard deviation, 1.3; range, 4–10). It was higher by 0.5 units (95% confidence interval: 0.2–0.8) in active commuters. Cumulative distributions showed higher CWA scores among active commuters throughout the CWA scale, with the greatest difference (one CWA unit) at scores of 8–9. This benefit of AC persisted after adjustments and was observed at the 33rd, 50th, and 67th percentiles of CWA but not at percentiles higher or lower than the aforementioned ones. The model-predicted CWA scores for selected combinations of personal and work-related factors were up to two units higher among active commuters. In conclusion, active commuters have better work ability than non-active commuters. However, the potential effects may be limited to workers with good work ability. Relevance to the industry: Since commuting is a necessary daily activity for most of the working population, AC may offer great potential to produce positive effects on work ability and health. AC should be encouraged and included in health promotion programs at national and organizational levels.
Article
Purpose: Regular sports activities are associated with multiple physical and psychological health benefits. However, sports also may lead to injuries and the development of osteoarthritis (OA). This systematic review investigated the association between sports activity, sports type, and the risk of developing OA. Methods: A systematic review was performed by assessing studies that have investigated the risk of OA development in sports. Data extracted included general information, study design, number of participants, related body mass index, sports type, and assessment of OA. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. Results: A total of 63 studies were included in this systematic review. The overall Newcastle-Ottawa Scale score was 6.46±1.44 demonstrating a good methodological quality of the articles included in the present study. A total of 628,036 participants were included, with a mean follow-up of 8.0±8.4 years. The mean age of the included athletes was 45.6±15.8, with a mean body mass index of 24.9±2.3 kg/m2. Conclusion: Football and soccer players seem to be at higher risk for the development of OA, although the injury status of the joint should be considered when assessing the risk of OA. High equipment weight and increased injury risk also put military personnel at a higher risk of OA, although elite dancing leads to more hip labral tears. Femoroacetabular impingement was also often diagnosed in ice-hockey players and ballet dancers.
Article
Objectives The aim of this mixed-method study was to explore maintenance of physical activity and health effects one year after completion of exercise interventions in transport and leisure-time domains of everyday life. We hypothesised that routinisation of active commuting would lead to better maintenance of physical activity and health effects compared with leisure-time exercise. Study design Mixed-methods follow-up study. Methods Individuals with overweight/obesity, who completed a 6-month exercise intervention (active commuting by bike (BIKE), moderate (MOD) or vigorous intensity leisure-time exercise (VIG)), were after one year invited to participate in a follow-up visit which included measurements of cardiorespiratory fitness during an incremental bicycle test and body composition using dual-energy X-ray absorptiometry. Variability in maintenance practices was assessed in a sub-sample of participants who experienced the greatest improvements (‘VO2peak improvers’) and reductions (‘VO2peak reducers’), respectively, in cardiorespiratory fitness. Semi-structured interviews were conducted (15–30 min) and analysed using systematic text condensation to identify barriers and facilitators associated with maintenance of physical activity. Results Out of the 74 participants completing an exercise intervention, 46 (62%) completed follow-up (BIKE: n = 14; MOD: n = 14; VIG: n = 18). Improvements in VO2peak and reductions in fat mass were maintained in BIKE and VIG. Body weight decreased in BIKE and fat free mass increased in VIG. Changes in VO2peak and anthropometry at follow-up did not differ between BIKE and MOD + VIG. Fat mass decreased and recreational physical activity increased in ‘VO2peak improvers’. Findings from the interviews suggested that self-monitoring, collective exercising, and new personal exercise challenges facilitate maintenance of a physically active lifestyle. Conclusion Completion of a structured exercise intervention consisting of 6 months of active commuting or vigorous intensity leisure-time exercise was associated with long-term maintenance of improvements in VO2peak and body composition, whereas moderate intensity leisure-time exercise was not. In contrast to our hypothesis, active commuting was not associated with better maintenance of physical activity and health effects after the intervention compared with leisure-time exercise.
Article
It remains unknown whether maintenance of a healthy lifestyle after endoscopic polypectomy could still confer benefit for colorectal cancer (CRC) incidence and mortality. In this study, we defined a healthy lifestyle score based on body mass index, smoking, physical activity, alcohol consumption, and diet (range, 0‐5). We used Cox proportional hazards regression to estimate the hazard ratios (HRs) for the associations of healthy lifestyle score and individual lifestyle factors with CRC incidence and all‐cause mortality. During a median of 10 years of follow‐up of 24668 participants who underwent endoscopic polypectomy, we documented 161 CRC cases and 4857 all‐cause deaths. A higher healthy lifestyle score after endoscopic polypectomy was associated with lower risk of CRC and all‐cause mortality. Compared to individuals with 0‐1 healthy lifestyle factors, those with 2, 3, and 4‐5 healthy lifestyle factors had a HR for CRC risk of 0.86 [95% confidence interval (CI), 0.60‐1.24], 0.73 (95% CI, 0.47‐1.14), and 0.52 (95% CI, 0.27‐1.01), respectively (Ptrend=0.03). The corresponding HR (95% CI) for all‐cause mortality was 0.83 (95% CI, 0.76‐0.90), 0.63 (95% CI, 0.56‐0.70), and 0.56 (95% CI, 0.48‐0.65), respectively (Ptrend<0.0001). In the joint analysis of pre‐ and post‐polypectomy periods, patients with a healthy post‐polypectomy lifestyle had a lower incidence of CRC regardless of their pre‐polypectomy exposure, whereas those with a healthy lifestyle in both periods had a lower mortality than those with an unhealthy lifestyle in either period. In conclusion, adherence to a healthy lifestyle after polypectomy may confer significant benefit for CRC prevention and reduction in all‐cause mortality. This article is protected by copyright. All rights reserved.
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Background/Aim: The mandible makes up a substantial part of the lower face, and is susceptible to injury. Even in helmeted cyclists, accidents may lead to fractures of the mandible because conventional helmets provide little protection to the lower part of the face. In addition, some studies indicate that helmets may lead to an increased risk of mandibular fractures. Thus, the aim of this study was to examine the anatomic distribution of mandibular fractures in injured cyclists and to assess if helmet use influenced the fracture locations. Material and Methods: Data from a Norwegian Level 1 trauma center were collected in the Oslo University Hospital Trauma Registry over a 12-year period. Of 1543 injured cyclists, the electronic patient charts of 62 cyclists with fractures of the mandible were retrospectively evaluated in detail. Demographic data, helmet use, and fracture type were assessed. Results: Sixty-two patients (4%) had fractures of the mandible, and women had an increased risk (OR 2.49, 95% CI 1.49–4.16, p< .001). The most common fracture site was the mandibular body, followed by the condyle. Isolated mandibular fractures occurred in 45% of the patients and 55% had other concomitant facial fractures. There were 42% of the patients with fractures in multiple sites of the mandible, and 42% had a concomitant dentoalveolar injury. Half of the cyclists were wearing a helmet at the time of the accident and 39% were not. There was no significant difference in fracture distribution between the helmeted and non-helmeted groups. Conclusions: Fracture of the mandibular body was the most prevalent mandibular fracture type following bicycle accidents. Women had an increased risk of mandibular fractures compared with men, whereas helmet wearing did not affect the anatomical fracture site.
Article
As a typical example of an Intelligent Transport System (ITS) in a smart city, the bicycle sharing is developing so fast and changing the citizens’ travel habits to a large extent in China. However, its disorder development brings a heavy burden for city, and it is considered as a junk of city in many citizens’ opinions. In our previous work, we proposed the concept of Internet of Shared Bicycle (IoSB) to solve some problems in technique. In this paper, we devote to how to enable bicycle sharing playing a more important role in the construction of smart city, instead of being treated only as a type of traffic mode. We summarize some of the current research status of bicycle sharing in smart cities and put forward some of our own views. Then the Bicycle Sharing System (BSS) is be further studied and explored the possibility of being deployed as a terminal in the city in terms of technology. When a serious disaster comes, it serves as an auxiliary communication system for the city and becomes a measure of the city’s emergency network. In particular, we describe a special role of bicycle sharing during public health events. In addition, the feasibility in some interesting cases with great potential in the future is also discussed.
Article
Objective: To determine the effects if cycling and rowing on serum prostate-specific antigen (PSA) levels. Methods: Male volunteers (n = 101), aged 20-80 (mean, 49.9) years were randomized to exercise at the first or second study visit. They performed 1 h of either cycling or rowing on a stationary machine. To determine exercise-induced effects on the PSA level, serum total PSA (tPSA) and free PSA (fPSA) concentrations were evaluated before and after exercise and another sampling was performed at the second study visit. Pre-exercise and postexercise tPSA and fPSA concentrations were compared using the Wilcoxon matched-pairs test. The results were analyzed using the Mann-Whitney U-test. Results: A significant (p < 0.001) average increase in tPSA after exercise (1.14 ± 1.11 ng/ml to 1.24 ± 1.26 ng/ml [mean, +8.8%]) was observed after both cycling and rowing, without significant differences between the sports (p = 0.54). The exercise-induced increase in PSA concentration affected participants aged ≥50 years (difference, 0.16 ± 0.37; p < 0.001), but not those aged <50 years (difference, 0.01 ± 0.06; p = 0.23). The effect size was clinically irrelevant in all except two outliers, in whom a distinct increase of PSA level by averages of 1.80 ng/ml (+55%) for tPSA and 1.25 ng/ml (+227%) for fPSA following cycling was observed. Conclusion: Rowing and cycling generally do not have a clinically relevant effect on PSA levels. However, outliers exist. Our findings do not support abstaining from exercise during the days approaching PSA sampling.
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Introduction Interventions that increase physical activity behavior can reduce morbidity and prolong life, but long-term effects in large populations are unproven. This study investigates the association of medical fitness facility membership and frequency of attendance with all-cause mortality and rate of hospitalization. Methods A propensity weighted retrospective cohort study was conducted by linking individuals who attended medical fitness facilities in Winnipeg, Canada to provincial health administrative databases. Members aged ≥18 years who had ≥1 year of provincial health coverage from their index date between January 1, 2005 and December 31, 2015 were included. Controls were assigned a pseudo-index date at random on the basis of the frequency distribution of index dates in the intervention group. Members were stratified into low-frequency attenders (<1 weekly visit), moderate-frequency attenders (1–3 weekly visits), and high-frequency attenders (>3 weekly visits). The primary outcomes were time to all-cause mortality and rate of hospitalizations. Statistical analyses were performed between 2018 and 2020. Results Among 19,300 adult members and 515,810 controls, members had a 60% lower risk of all-cause mortality during the first 651 days and 48% after 651 days. Membership was associated with a 13% lower risk of hospitalizations. A dose–response effect was apparent because higher weekly attendance was associated with a lower risk of hospitalizations (low frequency: 9%, moderate frequency: 20%, high frequency: 39%). Conclusions Membership at a medical fitness facility was associated with a reduced risk of all-cause mortality and hospitalizations. Healthcare systems should consider the medical fitness model as a preventative public health strategy to encourage physical activity participation.
Article
Background: Routine physical activity stimulates numerous morphologic and functional adaptations of the cardiac system, which are commonly referred to as exercise-induced cardiac remodeling (EICR). EICR has been well documented in elite and recreational athletes, but comparatively little is known about the "reverse" cardiac adaptations during detraining in an athletic population. Objective: To assess the morphologic and functional cardiac effects of detraining in athletes. Methods: Eligible studies were identified in PubMed from inception to May 2020. Studies were included if they assessed the cardiac effects of detraining periods in athletes. Results: A total of 16 studies from the literature search were identified and included in this review. These studies included athletes from multiple different sporting disciplines and detraining periods ranged from 3 weeks to 13 years. Detraining periods led to significantly decreased right ventricular and left (LV) ventricular dimensions, LV mass, and LV wall thickness, but only limited changes in systolic and diastolic functional parameters were observed. Conclusions: From the limited data available in this population, cardiac atrophy has been observed with short periods of detraining (1-8 weeks) but often spares systolic and diastolic heart function. Supplemental exercise training during times of rehabilitation to combat cardiac regression has not been vigorously studied in athletes, so the ideal frequency, intensity, and modality of exercise needed to maintain EICR remains unclear.
Article
Introduction While the health benefits of cycling and walking have been well established, questions remain about whether these benefits hold in varying socioeconomic contexts, including across demographic groups and in the context of neighborhood change. This study examines this relationship, identifying associations between cycling or walking and self-reported health, whether socioeconomic status moderates these associations, and whether gentrification influences the potential moderating effects. Methods This study uses the 2017 US National Household Travel Survey, subset to adults who lived in central cities (n = 91,541). Weighted logistic regression models with interaction terms were fit to estimate self-reported health status separately for cycling and walking. Gentrification was measured using an indicator based on previous research using US Census data. Results Cycling in the previous week and each additional walking trip were associated with higher odds of reporting better health. Socioeconomic status moderated the positive associations between active transportation and health for a few variables. Cyclists of color had smaller health effects from cycling for utilitarian trips, while race and ethnicity had only a marginal moderating effect on the association between walking and health. Gentrification was an insignificant moderating factor in general. Conclusions Findings suggest planning efforts that continue to support programs that promote cycling and walking are crucial tools in the public health toolbox. The health gains from active transportation might be experienced in a variety of neighborhood contexts. Nevertheless, infrastructure investments and policy must be attentive to inequities across neighborhoods.
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Cahiers de l'Observatoire de la mobilité de la Région Bruxelles-Capitale, 2020 Ce septième Cahier vient compléter la collection des Cahiers de l’Observatoire de la mobilité de la Région de Bruxelles-Capitale (RBC). Après avoir traité de l’offre de transport, des pratiques de déplacement en général et de celles liées au travail et à l’école en particulier, de logistique et de transport de marchandises, ou encore de partage de l’espace public entre tous les modes, ce nouveau Cahier s’arrête pour la première fois sur un mode spécifique : le vélo. Cette publication comporte trois parties. La première offrira une brève histoire du vélo racontée depuis Bruxelles et évitera d’emblée toute naturalisation du phénomène : le lent déclin du vélo au cours de la seconde moitié du 20e siècle résulte d’évolutions structurelles et non d’explications selon lesquelles Bruxelles ne serait " pas faite pour le vélo ". Cette première partie comportera également une mise en contexte institutionnelle afin d’identifier qui sont les acteurs compétents en matière de politique cycliste et la place occupée par celle-ci dans les outils réglementaires et planologiques régionaux, ainsi que dans ses budgets. Elle se terminera par une définition et une typologie des vélos et autres engins de déplacement légers. La deuxième partie du Cahier abordera la pratique du vélo en RBC à travers une analyse approfondie du parc vélo et des déplacements à vélo. Enfin, la troisième partie analysera la cyclabilité de la Région : les aménagements pour le vélo en mouvement, la sécurité et l’insécurité des cyclistes, le stationnement des élos et les services liés au vélo. Une conclusion générale viendra clore ce vaste exercice de synthèse. À noter que les données mobilisées dans ce Cahier ont été arrêtées en juillet 2019. Il va de soi qu’une actualisation régulière de cette synthèse sera nécessaire pour suivre l’évolution de ce secteur en pleine ébullition.
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Objective To determine the prevalence and sociodemographic factors associated with active commuting and leisure-time physical activity (LTPA) among adults in western Nepal. Design Cross-sectional study. Setting Adults from semiurban areas in western Nepal. Participants 2815 adults aged 25–65 years who participated in the ‘Community-Based Management of Hypertension in Nepal (COBIN)’ Study. Multiple logistic regression analysis was used to identify the sociodemographic factors associated with active commuting and LTPA. Outcome Self-reported participation in active commuting and LTPA. Results Most study participants (96%) commuted actively (walked or cycled) from one place to another. Our results showed that only a small proportion (3.7%) of participants engaged in moderate or vigorous LTPA. Compared with those in paid employment, the odds of commuting actively were higher among people working in agriculture or as labourers (OR: 4.57, 95% CI: 2.46 to 8.48), those retired/unemployed (OR: 2.98, 95% CI: 1.42 to 6.25) and those in unpaid employment (OR: 1.85, 95% CI: 1.06 to 3.22). Adults who were overweight or had obesity were less likely to commute actively. Compared with adults aged 25–34 years, older adults were less likely (OR: 0.35, 95% CI: 0.17 to 0.72) to engage in LTPA. Women were 0.46 times less likely to engage in LTPA compared with men. Conclusion Most adults engaged in active commuting for work or travel. Less than 5% participated in any form of moderate or vigorous LTPA. Longitudinal studies incorporating objective assessment of physical activity and a range of individual, interpersonal, and environmental factors will help understand how to promote active commuting and LTPA among Nepalese adults. Trial registration number : ClinicalTrials.gov NCT02428075 .
Article
Problem, research strategy, and findings: Although the physical health benefits of utilitarian bicycling are well documented, there is little empirical evidence to demonstrate the mental health benefits. We investigated a) the association between utilitarian bicycling behavior and mental wellbeing and b) the role of the built environment in promoting utilitarian bicycling and improving mental wellbeing. We used data from a large, representative survey (N = 30,105) conducted in Victoria (Australia) and applied a structural equation model (SEM) to explore the relationships between the built environment, utilitarian bicycling, and mental wellbeing. Overall, we found that utilitarian bicycling is positively associated with life satisfaction and negatively associated with psychological distress, and that these effects vary significantly by gender and age. We also found that highly bikeable neighborhoods are associated with better mental health, though this correlation is fully mediated by bicycling and walking behavior. Takeaway for practice: These findings suggest that promoting utilitarian bicycling may help increase mental health and boost life satisfaction, particularly in women and older adults. Therefore, mental health should be addressed in the literature on the benefits of utilitarian biking. These findings also suggest that planning efforts to promote bicycling among women and older adults should focus not only on improving safety but also on providing infrastructure that enhances the psychological pleasure of bicycling. Finally, these findings suggest that a highly bikeable neighborhood is not just a healthy but a happy one.
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While cardiorespiratory fitness is strongly associated with mortality and diverse outcomes, routine measurement is limited. We used smartphone-derived physical activity data to estimate fitness among 50 older adults. We recruited iPhone owners undergoing cardiac stress testing and collected recent iPhone physical activity data. Cardiorespiratory fitness was measured as peak metabolic equivalents of task (METs) achieved on cardiac stress test. We then estimated peak METs using multivariable regression models incorporating iPhone physical activity data, and validated with bootstrapping. Individual smartphone variables most significantly correlated with peak METs (p-values both < 0.001) included daily peak gait speed averaged over the preceding 30 days (r = 0.63) and root mean square of the successive differences of daily distance averaged over 365 days (r = 0.57). The best-performing multivariable regression model included the latter variable, as well as age and body mass index. This model explained 68% of variability in observed METs (95% CI 46%, 81%), and estimated peak METs with a bootstrapped mean absolute error of 1.28 METs (95% CI 0.98, 1.60). Our model using smartphone physical activity estimated cardiorespiratory fitness with high performance. Our results suggest larger, independent samples might yield estimates accurate and precise for risk stratification and disease prognostication.
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In this issue of JAMA Internal Medicine, Ried-Larsen and colleagues¹ report a longitudinal study of the benefits of cycling in a large cohort of persons with diabetes, with 110 944 person-years of follow-up, from 10 Western European countries. Cycling was associated with at least a 24% lower all-cause mortality when compared with noncyclists, independent of other physical activities and possible confounders.
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Abstract Importance: Premature death from all causes and cardiovascular disease (CVD) causes is higher among persons with diabetes. Objective: To investigate the association between time spent cycling and all-cause and CVD mortality among persons with diabetes, as well as to evaluate the association between change in time spent cycling and risk of all-cause and CVD mortality. Design, setting, and participants: This prospective cohort study included 7459 adults with diabetes from the European Prospective Investigation into Cancer and Nutrition study. Questionnaires regarding medical history, sociodemographic, and lifestyle information were administered in 10 Western European countries from 1992 through 2000 (baseline examination) and at a second examination 5 years after baseline. A total of 5423 participants with diabetes completed both examinations. The final updated primary analysis was conducted on November 13, 2020. Exposures: The primary exposure was self-reported time spent cycling per week at the baseline examination. The secondary exposure was change in cycling status from baseline to the second examination. Main outcomes and measures: The primary and secondary outcomes were all-cause and CVD mortality, respectively, adjusted for other physical activity modalities, diabetes duration, and sociodemographic and lifestyle factors. Results: Of the 7459 adults with diabetes included in the analysis, the mean (SD) age was 55.9 (7.7) years, and 3924 (52.6%) were female. During 110 944 person-years of follow-up, 1673 deaths from all causes were registered. Compared with the reference group of people who reported no cycling at baseline (0 min/wk), the multivariable-adjusted hazard ratios for all-cause mortality were 0.78 (95% CI, 0.61-0.99), 0.76 (95% CI, 0.65-0.88), 0.68 (95% CI, 0.57-0.82), and 0.76 (95% CI, 0.63-0.91) for cycling 1 to 59, 60 to 149, 150 to 299, and 300 or more min/wk, respectively. In an analysis of change in time spent cycling with 57 802 person-years of follow-up, a total of 975 deaths from all causes were recorded. Compared with people who reported no cycling at both examinations, the multivariable-adjusted hazard ratios for all-cause mortality were 0.90 (95% CI, 0.71-1.14) in those who cycled and then stopped, 0.65 (95% CI, 0.46-0.92) in initial noncyclists who started cycling, and 0.65 (95% CI, 0.53-0.80) for people who reported cycling at both examinations. Similar results were observed for CVD mortality. Conclusion and relevance: In this cohort study, cycling was associated with lower all-cause and CVD mortality risk among people with diabetes independent of practicing other types of physical activity. Participants who took up cycling between the baseline and second examination had a considerably lower risk of both all-cause and CVD mortality compared with consistent noncyclists.
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Purpose: Evidence of shared physical activity (PA) habits within families is inconsistent. The present study aimed at examining intra-family resemblance in PA during different time segments of the week. Method: This cross-sectional study used data from the Danish household-based population study Lolland-Falster Health Study. We assessed time spent in various PA intensities and behaviours using a dual-accelerometer system (Axivity AX3). At least one parent and one child per household provided data for a minimum of three weekdays and one weekend day. We analysed three time segments: early weekdays, late weekdays, and weekends. A linear mixed model regression analysis was used to estimate intraclass correlation coefficients (ICCs) of the total family, parent-child dyads, siblings, and parent-parent dyads for PA outcomes, adjusting for sex, age, parental education, and the interaction between sex and age. Results: We included 774 parents (57.9% female, 42.8±7 years) and 802 children (54.2% girls, 11.1±4.3 years) nested within 523 families. The clustering among the total family was stronger during late weekdays (ICCs 0.11-0.31) and weekends (ICCs 0.14-0.29) than during early weekdays (ICCs 0.02-0.19). We found stronger clustering among siblings (ICCs 0.08-0.47) and between parents (ICCs 0.02-0.52) than between parents and children (ICCs <0.01-0.37). Generally, the clustering was strongest for light PA, and among PA behaviours, walking showed the highest resemblance across all subgroups. Conclusion: Initiatives to promote children's PA that involve parent or sibling co-participation may focus on the time segment and activity types with the highest resemblance. For the family as a whole, promoting walking or limiting sedentary activities may be a potential target for interventions during late weekdays and weekends.Trial registrationClinicaltrials.gov (NCT02482896).
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Este capítulo visa à orientação de técnicos, gestores e políticos no sentido da inclusão da bicicleta como meio de transporte no planejamento da mobilidade nas cidades. Nesse contexto, primeiro apresentam-se ações de regulamentação e implantação de planos cicloviários, com alguns detalhamentos, os quais incluem diretrizes de implantação e, ainda, recomendações para a execução de um diagnóstico da ciclomobilidade. Posto isso, são introduzidos diferentes tipos de infraestruturas cicloviárias e, também, de sistemas de bicicletas compartilhadas, enquanto, paralelamente, são trazidos alguns critérios para seleção e dimensionamento da infraestrutura e sistema mais adequados. Enfim, evidenciam-se os potenciais econômicos, social e de saúde associados à maior disseminação doso das bicicletas.
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OBJECTIVE--To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention. PARTICIPANTS--A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented. EVIDENCE--The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles. CONSENSUS PROCESS--Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise \"public health message was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine. CONCLUSION--Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the weekType: CONSENSUS DEVELOPMENT CONFERENCEType: JOURNAL ARTICLEType: REVIEWLanguage: Eng
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Our review focuses on all articles in the English language that provide sufficient data to calculate a relative risk or odds ratio for CHD at different levels of physical activity. The inverse association between physical activity and incidence of CHD is consistently observed, especially in the better designed studies; this association is appropriately sequenced, biologically graded, plausible, and coherent with existing knowledge. Therefore, the observations reported in the literature support the inference that physical activity is inversely and causally related to the incidence of CHD. The two most important observations in this review are, first, better studies have been more likely than poorer studies to report an inverse association between physical activity and the incidence of CHD and, second, the relative risk of inactivity appears to be similar in magnitude to that of hypertension, hypercholesterolemia, and smoking. These observations suggest that in CHD prevention programs, regular physical activity should be promoted as vigorously as blood pressure control, dietary modification to lower serum cholesterol, and smoking cessation. Given the large proportion of sedentary persons in the United States (91), the incidence of CHD attributable to insufficient physical activity is likely to be surprisingly large. Therefore, public policy that encourages regular physical activity should be pursued.
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We studied the association between behavioral and demographic risk factors and 17-year mortality in members of the Alameda County (California) Study who were 60-94 years of age at baseline. In this age group, increased risk of death is associated with being male, smoking, having little leisure-time physical activity, deviating from moderate weight relative to height, and not regularly eating breakfast. These increased risks were independent of age, race, socioeconomic position (SEP), other behavioral risk factors, and baseline physical health status. Further examination of the group aged 70 or more revealed the same patterns of heightened risk.
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To evaluate the associations between social class as defined by occupation, health behaviour, and mortality from all causes and coronary heart disease among middle aged men and women in eastern Finland. Prospective observational study of two independent, random population samples examined in 1972 and 1977. North Karelia and Kuopio, Finland. 8967 men and 9694 women aged 30-64 years at the beginning of the follow up study. The subjects were followed up for mortality up till 1987 by using the National Death Registry. Altogether 1429 men and 620 women died during the follow up, 603 men and 164 women of coronary heart disease. Among both sexes, compared with white collar workers unskilled blue collar workers had more adverse risk factors and also higher mortality due to coronary heart disease, other cardiovascular diseases, cancer, violent causes, and all other causes. Among men the age adjusted relative risk for all cause mortality in unskilled blue collar workers v white collar workers was reduced from 1.86 (95% confidence interval 1.55 to 2.22) to 1.47 (1.23 to 1.77) when adjusted for smoking, serum cholesterol concentration, hypertension, body mass index, and physical activity in leisure time. Among women the corresponding reduction in hazard ratio was from 1.49 (1.15 to 1.92) to 1.39 (1.07 to 1.81). The respective hazard ratios for coronary heart disease were 1.54 (1.16 to 2.02) and 1.22 (0.92 to 1.61) among men and 1.74 (1.05 to 2.90) and 1.66 (0.99 to 2.79) among women. Unfavourable cardiovascular risk factors and high mortality are concentrated among lower social classes in Finland. Among men about half of the excess coronary and all cause mortality among unskilled blue collar workers was associated with their unfavourable risk factor profile. The association was smaller in women.
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This study examined the association between recreational physical activity among physically capable older adults and functional status, incidence of selected chronic conditions, and mortality over 3 and 6 years. Data are from three sites of the Established Populations for Epidemiologic Studies of the Elderly. A high level of recreational physical activity reduced the likelihood of mortality over both 3 and 6 years. Moderate to high activity reduced the risk of physical impairments over 3 years; this effect diminishes after 6 years. A consistent relationship between activity and new myocardial infarction or stroke or the incidence of diabetes or angina was not found after 3 or 6 years. Findings suggest that physical activity offers benefits to physically capable older adults, primarily in reducing the risk of functional decline and mortality. Future work must use more objective and quantifiable measures of activity and assess changes in activity levels over time.
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The Copenhagen City Heart Study, a prospective cardiovascular population study, was initiated in 1975. The ultimate goal of the study was to obtain information of risk factors that might be useful for prevention of ischaemic cardiovascular diseases in the Danish population. The Copenhagen City Heart Study differs from most other cardiovascular epidemiological surveys, by including a large sample, namely 20,000 persons aged 20 years and more, and by including as many women as men. The present book of tables contains breakdowns according to sex and age, of all data collected during the first and second examination of the study, performed with a five year interval (1976-78) and (1981-83).
Article
Objective: To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention. Participants: A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented. Evidence: The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles. Consensus process: Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise "public health message" was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine. Conclusion: Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week.
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The analysis of censored failure times is considered. It is assumed that on each individual are available values of one or more explanatory variables. The hazard function (age-specific failure rate) is taken to be a function of the explanatory variables and unknown regression coefficients multiplied by an arbitrary and unknown function of time. A conditional likelihood is obtained, leading to inferences about the unknown regression coefficients. Some generalizations are outlined. LIFEtables are one of the oldest statistical techniques and are extensively used by medical statisticians and by actuaries. Yet relatively little has been written about their more formal statistical theory. Kaplan and Meier (1958) gave a comprehensive review of earlier work and many new results. Chiang in a series of papers has, in particular, explored the connection with birth-death processes; see, for example, Chiang (1968). The present paper is largely concerned with the extension of the results of Kaplan and Meier to the comparison of life tables and more generally to the incorporation of regression-like arguments into life-table analysis. The arguments are asymptotic but are relevant to situations where the sampling fluctuations are large enough to be of practical importance. In other words, the applications are more likely to be in industrial reliability studies and in medical statistics than in actuarial science. The procedures proposed are, especially for the two-sample problem, closely related to procedures for combining contingency tables; see Mantel and Haenzel (1959), Mantel (1963) and, especially for the application to life tables, Mantel (1966). There is also a strong connection with a paper read recently to the Society by R. and J. Peto (1972). We consider a population of individuals; for each individual we observe either the time to "failure" or the time to ccloss" or censoring. That is, for the censored individuals we know only that the time to failure is greater than the censoring time. Denote by T a random variable representing failure time; it may be discrete or continuous. Let F(t) be the survivor function, %(t) = pr (T2 t)
Article
The analysis of censored failure times is considered. It is assumed that on each individual are available values of one or more explanatory variables. The hazard function (age‐specific failure rate) is taken to be a function of the explanatory variables and unknown regression coefficients multiplied by an arbitrary and unknown function of time. A conditional likelihood is obtained, leading to inferences about the unknown regression coefficients. Some generalizations are outlined.
Article
The association between physical activity at work and at leisure, coronary risk factors, social class and mortality has been studied in about 15000 Oslo men, aged 40–49, without known cardiovascular disease or diabetes at a screening examination for coronary risk factors. Four-year total and CHD mortality showed a decrease with increasing degree of leisure activity, and an increase with increasing work activity. The three conventional coronary risk factors—serum cholesterol, systolic blood pressure (SBP) and number of cigarettes—associated negatively with physical leisure activity, whereas they all associated positively with physical activity at work. Men in lower social classes were less active at leisure but more active at work than men in the higher classes. In a multivariate analysis of variance with coronary risk score (based on SBP, serum total cholesterol and number of cigarettes), social class and physical activity, the predictive power of physical leisure activity for future death was almost as good as the coronary risk score. Physical activity at work, on the other hand, was not an independent risk factor either for total or for CHD mortality.
Article
To appraise the role of physical activity in reducing coronary mortality among longshoremen, 6351 men, 35 to 74 years old upon entry, were followed for 22 years or to death or to the age of 75. Their longshoring experience was computed in terms of work-years according to categories of high, medium and low caloric output. Individual work assignments were reclassified annually to allow for effect of job transfers. The age-adjusted coronary death rate for the high-activity category was 26.9 per 10,000 work-years, and the medium and low catgories had rates of 46.3 and 49.0 which were little different from each other. This protective "threshold" effect was seen especially for the sudden-death syndrome, in which the death rate for heavy workers was 5.6, as contrasted with 19.9 for moderate and 15.7 for light workers. We conclude that repeated bursts of high energy output established a plateau of protection against coronary mortality, and that several different mechanisms may explain this finding.
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The Glostrup Population Studies, 1964-92, comprise descriptive and analytical, clinical epidemiological studies. Since 1964, different birth cohorts have been examined. More than 20,000 persons, randomly selected from the background population of 300,000 inhabitants (Copenhagen County), have been invited to participate. The project started in 1964 with a survey of the 1914 population on risk factors for coronary heart disease. As the 1914 population has been followed and new cohorts added, a time-sequential design, suited for studies of aging, has been constructed. The staff has been kept in the unit for up to 28 years. Doctoral candidates in medical science and Ph.D candidates have defended their analyses of Glostrup data in several fields and continue to belong to the group of representatives, supporting the board of leaders. The head of Medical Department C serves as chairman, thus maintaining a close connection with clinical medicine.
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The effect of habitual leisure time physical activity (LTPA) on the 10.5-year total and cause-specific mortality rates was studied in 12,138 middle-aged men at high risk for coronary heart disease (CHD) who participated in the MRFIT. The level of LTPA as determined by the Minnesota questionnaire was inversely related to rate of death from cardiovascular (CVD), coronary heart disease (CHD), and all-causes, but was unrelated to the cancer death rate. The least active men (LTPA tertile 1) had excess mortality rates of 22%, 27%, and 15% for CVD, CHD, all-causes, respectively, as compared to more active men in the middle third (tertile 2). Additional LTPA (tertile 3) was not associated with further attenuation of mortality rates. Proportional hazards regression analysis only slightly weakened risk differentials. This study supports previous observations that regular LTPA is associated with a reduced rate of CVD mortality, independent of other risk factor levels.
Article
The Adventist Mortality Study provides 26-year follow-up through 1985 for 9484 males who completed a lifestyle questionnaire in 1960. The relationship of self-reported physical activity and all cause and disease-specific mortality was examined by survival analysis and with the Cox proportional hazards model, controlling for demographic and lifestyle characteristics. Moderate activity was associated with a protective effect on cardiovascular and all cause mortality in both analyses. In the Cox model, age-specific estimates of relative risk (RR) were obtained for several endpoints due to a significant interaction between level of physical activity and attained age (age at death or end of follow-up). This model permits calculation of the age at which the RR = 1.0, or the age at crossover of risk. For moderate activity, this age was 95.6 years (95% confidence intervals, 81.7-109.4 years) for all cause mortality and 91.5 years (95% confidence intervals, 79.0-104.0 years) for cardiovascular mortality. While the protective effect on mortality associated with moderate activity decreased with increasing age, it remained significant to the verge of the present life span.
Article
Nine thousand three hundred and seventy six male civil servants, aged 45-64 at entry, with no clinical history of coronary heart disease, were followed for a mean period of 9 years and 4 months during which 474 experienced a coronary attack. The 9% of men who reported that they often participated in vigorous sports or did considerable amounts of cycling or rated the pace of their regular walking as fast (over 4 mph, 6.4 km/h) experienced less than half the non-fatal and fatal coronary heart disease of the other men. In addition, entrants aged 55-64 who reported the next lower degree of this vigorous aerobic exercise had rates less than two thirds of the remainder; entrants of 45-54 did not show such an effect. When these forms of exercise were not vigorous they were no protection against the disease, nor were other forms of exercise or high totals of physical activity per se. A history of vigorous sports in the past was not protective. Indications in these men are of protection by specific exercise: vigorous, aerobic, with a threshold of intensity for benefit and "dose response" above this threshold, exercise that has to be habitual, and continuing, which suggests that protection is against the acute phases of the disease. Those men who took vigorous aerobic exercise were demonstrably a favourably "selected" group; they suffered less of the disease, however, whether at low risk or high by the several risk factors that were studied. Men with exercise-related reduction in coronary heart disease also had lower death rates from the total of other causes, and so lower total death rates than the rest of the men.
Article
The association of physical activity level with the risk of death was analysed for a cohort of 636 healthy Finnish men aged 45-64 years followed up for 20 years. 39% of the cohort were classed as highly active physically at baseline in 1964. Up to 1984 there were 287 deaths, 106 of them due to coronary heart disease (CHD). During the first-two thirds of the follow-up, men with high physical activity had a lower risk of death than did men with low physical activity. During the last third, the survival curves of the men with high and low physical activity gradually converged. Of the men who died, those with high physical activity lived 2.1 years longer (p = 0.002) than those with low physical activity, after adjustment for age, smoking, blood pressure, serum cholesterol, and body mass index. This difference was due mainly to fewer CHD deaths among the highly active group. Low physical activity was clearly weaker than smoking as a predictor of risk of death. High physical activity may thus independently prevent premature death among middle-aged men, but it probably does not prolong the maximum achievable life-span.
Article
The relation of leisure time and occupational physical activity to the risk of death from ischemic heart disease was investigated in a cohort of 15,088 persons aged 30-59 years who had no history of cardiovascular disease or other condition which hindered physical activity. Two population samples were randomly chosen from eastern Finland. During a six-year follow-up, persons who were sedentary in leisure time (relative risk = 1.3, 95% confidence interval (CI) = 1.1-1.6) or at work (relative risk = 1.3, 95% CI = 1.1-1.6) had an excess risk of ischemic heart disease death when adjusted for age, health status, family history, and body mass index in multivariate logistic models. Adjustment for years of education, social network participation, cigarette consumption, serum cholesterol level, and blood pressure level weakened the residual association of low leisure time physical activity with the risk of ischemic heart disease death (relative risk = 1.2, 95% CI = 1.0-1.5), whereas the association for low occupational physical activity remained unchanged. The lack of leisure time physical activity and a sedentary occupation are associated with an increased risk of ischemic heart disease death, and the excess risk due to lack of leisure time physical activity is, in part, accounted for by other ischemic heart disease risk factors.
Article
We examined the physical activity and other life-style characteristics of 16,936 Harvard alumni, aged 35 to 74, for relations to rates of mortality from all causes and for influences on length of life. A total of 1413 alumni died during 12 to 16 years of follow-up (1962 to 1978). Exercise reported as walking, stair climbing, and sports play related inversely to total mortality, primarily to death due to cardiovascular or respiratory causes. Death rates declined steadily as energy expended on such activity increased from less than 500 to 3500 kcal per week, beyond which rates increased slightly. Rates were one quarter to one third lower among alumni expending 2000 or more kcal during exercise per week than among less active men. With or without consideration of hypertension, cigarette smoking, extremes or gains in body weight, or early parental death, alumni mortality rates were significantly lower among the physically active. Relative risks of death for individuals were highest among cigarette smokers and men with hypertension, and attributable risks in the community were highest among smokers and sedentary men. By the age of 80, the amount of additional life attributable to adequate exercise, as compared with sedentariness, was one to more than two years.
Article
In a prospective population study of middle aged women socioeconomic factors and physical activity as initially reported were related to the 12 year incidence of ischaemic heart disease and to total mortality. There was a significant age specific correlation between low socioeconomic status according to the husband's occupation and myocardial infarction. No such association was seen between the socioeconomic status of the women themselves and myocardial infarction. Women with a low educational level had a significantly increased age specific incidence of angina pectoris. There was no significant correlation between marital status or number of children and incidence of ischaemic heart disease or overall mortality. Women who initially reported low physical activity at work during the last year had a significantly increased age specific 12 year incidence of stroke and death, as did those who reported low physical activity during leisure hours in whom the incidence of myocardial infarction and electrocardiographic changes indicating ischaemic heart disease were also increased. Multivariate analyses showed that the association between low educational level and incidence of angina pectoris was independent of socioeconomic group, smoking habits, systolic blood pressure, indices of obesity, serum triglycerides, and serum cholesterol. Similarly, low physical activity during leisure hours seemed to be an independent risk factor for stroke, and low physical activity at work was an independent risk factor for overall mortality.
Article
Seventy five subjects having had a previous myocardial infarction (MI) and 165 subjects with angina pectoris (AP) found in a prevalence study of 5,249 Copenhagen males aged 40-59 yr were compared to the subjects free from MI or AP with regard to prevalence of other previous diseases, physical characteristics, physical activity, and drug use. A positive family history of MI was found more frequently among the MI cases than in the controls, but not in the AP cases. Peptic ulcer was found more frequently among the MI cases than in the controls, perhaps due to the common exogenic factor smoking. A history of gout was found more frequently among the AP cases than in the controls. A history of cough or shortness of breath was more frequent in both MI and AP cases, smoking being a possible common factor. Systolic blood pressure was higher in both the MI and AP cases than in the controls; diastolic blood pressure was higher only in the MI cases. The physical work capacity (pulse response during bicycle exercise) was lower in both the MI and AP cases than in controls. Physical activity in leisure time was lower in both the MI and AP group, while physical activity at work was higher in the AP group than in the controls. Physical activity at work did not differ in the MI cases. Smoking habits revealed a pattern of heavy smoking (current smoking and previous smoking) in both the MI and AP group. In both groups the percentage of exsmokers exceeded that of the control group. No difference in alcohol consumption was found, but use of tranquillizers and sleeping drugs was higher in both the MI and AP cases. The findings in the present study are similar to the results of previous cardiovascular survey studies conducted in other western countries. Thus, results from future controlled cardiovascular survey studies conducted in other western countries may, with reasonable certainty, be considered of relevance for planning and executing preventive measures against coronary heart disease in Denmark.
Article
Physical fitness, defined as indirectly measured maximal oxygen uptake, of 5249 middle aged Copenhagen males was related to factors relevant to coronary heart disease. Physical fitness was lower in subjects with a positive history of diabetes mellitus, heart disease, or hypertension than in normals. Subjects having symptoms of cough, angina pectoris, or intermittent claudication similarly had lower physical fitness than the rest of the material. Physical fitness decreased with age about 2 ml O2/kg/min for each 5 yr age increase. Weight and relative weight was inversely correlated to fitness. Both systolic and diastolic blood pressure were inversely correlated to fitness, also after adjusting the influence of weight. Occupational physical activity was not found to be related to physical fitness, in contrast to leisure time physical activity. Smokers were found to have significantly higher fitness than the total group of nonsmokers, but no difference in fitness was observed between subjects who had never smoked and the smokers. The comparison performed between physically fit and less fit middle aged males suggests that the fit male has a lower overall risk of coronary heart disease.
Article
Blood lipids, red cell volume, heart volume, dynamic spirometry, electrocardiograms made at rest and during exercise, and maximal oxygen uptake were determined in 29 former athletes 45 to 70 years old. The subjects had been very successful competitors in endurance events before the age of 30, but for at least 10 years preceding this study had been sedentary. Maximal oxygen uptake averaged 40 ml/kg/min which is 20% higher than that of sedentary middle-aged men but 25% lower than that of still active athletes of the same ages. Vital capacity, forced expiratory volume, and maximal voluntary ventilation showed normal values. Heart volume was large in relation to maximal oxygen uptake and was of the same magnitude as in still active athletes. Red cell volume was also large in relation to maximal oxygen uptake, but normal in relation to the body weight. Cholesterol in serum averaged 260 mg/100 ml. Values for neutral fat averaged 1.6 mM, which was higher than that for still active athletes. In the athletes still active, the frequency of S-T changes was as common as in unselected healthy old men but in the former athletes the frequency was reduced. This was also true for the frequency of right bundle-branch block, ST-junction elevation and high T waves.
Article
Regular physical activity decreases the mortality rate in middle-aged men and probably in middle-aged women. It is unknown whether this is also true in the elderly. We studied 285 men and women aged 75 years or older who were free of cardiovascular disease. Subjects were ranked by baseline physical activity levels and grouped into quartiles. After adjustments were made for cardiac risk factors, chronic obstructive pulmonary disease, and cancer, women in the second most active quartile had a much lower risk of mortality at 10 years (relative risk 0.24, 95% confidence interval 0.12 to 0.51). There was no statistically significant difference in men. There appeared to be an excess of sudden cardiac deaths in the most active women, although this group still lived longer than the least active women. We conclude that women aged 75 years or older who are more active live longer. This benefit may be attenuated in those who are extremely active.
Article
In 1983 a representative sample of Danish adolescents 16-19 yr of age were selected to participate in a study to determine risk profile for coronary heart disease. Eight years later (1991), we performed a follow-up study of the same participants 23-27 yr of age to compare risk factors. In the young adults power was generally high, 48.0 (SD +/- 7.8) and 39.6 (SD +/- 6.5) ml.min-1.kg-1 for men and women, respectively. Only 30% of the men and 26% of the women did not regularly participate in sport activities. Seventy-five percent of both genders bicycled daily, 50% of the men and 42% of the women as their daily transportation year round. Twenty percent, more men than women, were considered to be inactive. Women had a higher ratio of HDL-C/C than men (0.32 for women vs 0.26 for men). Mean values for blood pressure were 134/83 mm Hg and 122/78 mm Hg for men and women, respectively. Thirty-eight percent of the men and 10% of the women had an elevation above 140/90 mm Hg in either systolic blood pressure (SBP) or diastolic blood pressure (DBP). Cholesterol levels were high (10%) when compared with the U.S. population, but triglyceride levels were substantially lower (40%). Comparing the 1991 adults with the 1983 adolescents, the ranges were wider. In conclusion, the risk factor profile changes in men were less favorable than the profile for women; the changes in high risk groups were larger than changes in mean values.
Article
Physical inactivity is associated with higher mortality rates in most studies in men, but studies in women are more equivocal. The purpose of this study was to evaluate the relationship of sedentary living habits to all-cause mortality in women. A group of 3,120 adult women completed a preventive medical examination, and were followed for approximately 8 years for mortality. There were 43 deaths and a total of 25,433 person-years observed during follow-up. Physical fitness was assessed at baseline by a maximal exercise test on a treadmill, and physical activity was estimated by a self-administered questionnaire. Age-adjusted all-cause mortality rates were significantly inversely associated with physical fitness. Death rates were 40, 16, and 7 per 10,000 person-years of follow-up across low, moderate, and high categories of physical fitness, respectively. However, death rates did not differ across low, moderate, and high categories of physical activity. These findings are different than for men in the same study, where both physical activity and physical fitness were inversely associated with mortality risk. We attribute the lack of association between physical activity and mortality in women to be due to inadequate assessment of activity, and that this also is the likely explanation for the difference in results between women and men in published studies of physical activity and mortality.
Article
In 1968–1969, a population-based sample of Swedish women aged 38–60 years was recruited for a health survey, and 20-year survival was later ascertained from national registries. Occupational and leisure-time physical activity data from the baseline and 6–year follow-up examinations were evaluated in relation to all-cause mortality among 1,405 women who were initially free of major diseases. In comparison with being inactive, the mortality relative risk associated with being somewhat active was 0.28 (95% confidence interval 0.17–0.46) for occupational activity and 0.56 (95% confidence interval 0.39–0.82) for leisure-time activity. Being in the most active occupational or leisure activity category further decreased mortality risk to a minor extent. A within-subject decrease in leisure activity over 6 years was also a significant risk factor for all-cause mortality (relative risk = 2.07, relative to no change), although there was no evidence of a benefit from increasing physical activity levels. Since exclusion of early endpoints did not affect the associations in any significant way, underlying illness is unlikely to have played a major role in these analyses. It is concluded that decreases in physical activity as well as low initial levels are strong risk factors for mortality in women, and that their predictive value persists for many years. Am J Epidemiol 1996;143:54–62
Article
Valid generalizations of results from population-based epidemiological surveys requires knowledge about how representative the sample is. The Copenhagen Center for Prospective Population Studies have assessed mortality on the basis of pooled data from three research programmes in the region of Copenhagen. In two of the studies, subjects were randomly selected, using the Danish Central Population Registry, within certain age groups and area-restricted sectors of the Greater Copenhagen. In the third study, men employed in 14 companies participated. Participation rates were between 78% and 87% in the three programmes. Standardized mortality rates (SMR) were calculated in relation to mortality rates in the municipality of Copenhagen and in the whole country in three age groups and the two genders. SMR values in the whole sample including non-participants were similar to rates for Copenhagen in the Copenhagen City Heart Study, whereas mortality rates in the Glostrup Population Studies were similar to rates for the whole country. The mortality rates among participants were lower than in the whole sample, and differences existed in relation to region and selection criteria of the cohorts. The Copenhagen Male Study, where only employed men were included, showed the lowest mortality rates, and higher rates were found in the study from the central part of the City (the Copenhagen City Heart Study) compared to the study from the suburbs (the Glostrup Population Studies). The difference between mortality rates in the cohorts and in Copenhagen City decreased with increasing age. The SMR converged towards 1.00 with increasing observation time. In conclusion, high participation rates were found in all three studies, resulting in SMR values for participants only slightly lower than in the source population in the two randomly selected samples, but 30% lower values in the sample of employed men. As mortality rates in the total samples including non-participants were markedly higher than among the participants, generalizations of results for participants to the whole population should be made with caution, especially during the first years of observation.
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