Physical activity measured by accelerometry among adolescents participating in sports clubs and non-participating peers.

The purpose of this descriptive cross-sectional study is to describe the amount and intensity of physical activity (PA) measured by accelerometry among adolescents participating in organized sports (SCP) and age-matched non-participating peers (NP). SCPs (332) and NPs (139) wore an accelerometer on the hip for seven days. PA was reported using the 1-min exponential moving average. The current moderate-to-vigorous physical activity (MVPA) recommendation of at least an average of 60 min of MVPA daily was reached by 85% of SCPs and 45% of NPs (p < .001). During training days, the MVPA times among SCPs ranged from 153 ± 39 min in males and 109 ± 35 min in females participating in basketball to 113 ± 33 min in males participating in floorball and 83 ± 32 min in females participating in gymnastics. Sports participation contributes rather strongly to the accumulation of the recommended amount of MVPA. During training days, SCPs, except for females participating in gymnastics, accumulated more MVPA than NPs. During non-training days, only males participating in cross-country skiing and females participating in track and field accumulated more MVPA than NPs.HIGHLIGHTSPA of Finnish adolescents participating in nine different organized sports and age-matched non-participating peers was measured by accelerometry for one week and the results are reported using the 1-min exponential moving average.Adolescents participating in many organized sports accumulated more PA than non-participants; this was observed in meeting the PA recommendations, total amount of PA at different intensities, and step count.The current PA recommendation of at least an average of 60 min of MVPA per day was reached by 85% of SCPs and 45% of non-participating peers. Vigorous physical activity at least three times per week was incorporated by 96% of SCPs and 81% of NPs.During training days, males participating in soccer, basketball, and cross-country skiing spent more time in MVPA than females participating in the same sports. During non-training days, the time spent in MVPA was similar between males and females participating in sports clubs.

Acute and overuse injuries among sports club members and non-members: the Finnish Health Promoting Sports Club (FHPSC) study.

BACKGROUND: Physical activity in adolescence is promoted for its multi-dimensional health benefits. However, too intensive sports participation is associated with an increased injury risk. Our aim was to compare the occurrence of acute and overuse injuries in Finnish sports club members and non-members and to report training and competing habits associated with a higher injury risk in sports club members. METHODS: In this cross-sectional survey targeted at 14-16-year-old adolescents, a structured questionnaire was completed by 1077 sports club members and 812 non-members. The main outcome measures were self-reported acute and overuse injuries, their location and type. RESULTS: At least one acute injury in the past year was reported by 44.0% of sports club members and 19.8% of non-members (P < 0.001). The sex-adjusted odds ratio (OR) for acute injury in sports club members compared to non-members was 3.13 (95% confidence interval (95% CI) 2.54-3.87). Thirty-five percent of sports club members and 17.4% of non-members (P < 0.001) reported at least one overuse injury during the past year. The overuse injury OR for sports club members was 2.61 (95% CI 2.09-3.26). Sports club members who trained 7-14 h per week during training (OR 1.61, 95% CI 1.21-2.12, P = 0.001) or competition season (OR 1.55, 95% CI 1.18-2.06, P = 0.002) were more likely to report an injury compared to members who trained 3-6 h per week. Those sports club members who participated in forty competitions or more compared to 7-19 competitions per year were more likely to report an acute injury (OR 1.55, 95% CI 1.05-2.08, P = 0.028) or for an overuse injury (OR 1.53, 95% CI 1.02-2.30, P = 0.038). CONCLUSIONS: Both acute and overuse injuries are common among youth sports club members, and the number increases along with increasing amounts of training and competitions. More effective injury prevention is needed both for adolescents engaging in sports club activities and for other adolescents.

Low back and neck and shoulder pain in members and non-members of adolescents' sports clubs: the Finnish Health Promoting Sports Club (FHPSC) study.

BACKGROUND: The objective of this study was to investigate the prevalence of self-reported low back pain (LBP) and neck and shoulder pain (NSP), and the related factors in members and non-members of adolescents' sports clubs. METHODS: This cross-sectional study was based on surveys of 14-16-year-olds as a part of the Finnish Health Promoting Sports Club (FHPSC) Study. The surveys on self-reported health behaviours, injuries, and musculoskeletal health were conducted among sports club members (n = 962) and non-members (n = 675). Binary logistic regression analysis was applied to study the associations between dependent variables of LBP and NSP, and the independent factors. RESULTS: The prevalence of LBP during the preceding 3 months was 35.0 % in girls and 24.5 % in boys (p < 0.05 for sex difference). The prevalence of NSP was 55.9 % in girls and 27.3 % in boys (p < 0.001 for sex difference). Being a sports club member increased the odds for LBP in boys (odds ratio [OR] 2.35, 95 % CI 1.48-3.72). On the other hand, sports club participation was associated with lower odds of frequent NSP in girls (OR 0.52, 95 % CI 0.33-0.82). No associations were found between other leisure-time physical activity and LBP or NSP. Higher screen time (computer games, TV/DVD, phone, Internet) during leisure-time increased the odds of NSP in boys and LBP in boys and girls. CONCLUSIONS: In this study, self-reported LBP and NSP were already relatively common among adolescents. Girls have a higher risk for reporting LBP and NSP. Measures that are more effective in the prevention of LBP in male sports club members are needed. Excessive screen time is weakly associated with LBP and NSP, which should be taken into account in health promotion among adolescents.

Correlates of low physical activity levels in aging men and women: the DR's EXTRA Study (ISRCTN45977199).

Recognizing correlates of low physical activity (PA) can help in targeting PA interventions for individuals who would benefit most from increasing their PA. We studied the associations of demographic, social, health, and lifestyle factors with low PA by sex in a population sample of 1,303 Finnish individuals aged 57-78 years. We defined low PA as no moderate or vigorous leisure-time PA reported in an interview. Altogether, 39% of men and 48% of women reported low PA. Satisfactory or poor perceived health and high BMI were independently associated with low PA in both sexes. In men, factors such as age, being divorced or separated, still working, having a weak social network, poor diet, and a health professional's suggestion to increase PA were associated with low PA. In women, cardiovascular disease and depressive symptoms were associated with low PA. These results can be applied in targeting PA interventions.

Combined low-saturated fat intake and high fitness may counterbalance diabetogenic effects of obesity: the DR's EXTRA Study.

We report associations of saturated fat (SF) intake with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), concurrent IFG+IGT and type 2 diabetes (T2DM) at different levels of cardiorespiratory fitness and body mass index (BMI). In a population-based sample (n=1261, age 58-78 years), oral glucose tolerance, 4-day food intake and maximal oxygen uptake were measured. High intake of SF (>11.4 E%) was associated with elevated risk for IFG (4.36; 1.93-9.88), concurrent IFG+IGT (6.03; 1.25-29.20) and T2DM (4.77; 1.93-11.82) in the category of high BMI (>26.5) and high fitness, whereas there was no significantly elevated risk in individuals reporting low intake of SF. Concurrent high BMI and low fitness were associated with elevated risks. In general, SF intake and fitness did not differentiate the risk of abnormal glucose metabolism among subjects with low BMI. Limited intake of SF may protect from diabetogenic effects of adiposity, but only in individuals with high level of fitness.

The current standard measure of cardiorespiratory fitness introduces confounding by body mass: the DR's EXTRA study.

OBJECTIVE: Cardiorespiratory fitness is currently estimated by dividing maximal oxygen consumption (VO(2max)) by body weight (per-weight standard). However, the statistically correct way to neutralize the effect of weight on VO(2max) in a given population is adjustment for body weight by regression techniques (adjusted standard). Our objective is to quantify the bias introduced by the per-weight standard in a population distributed across different categories of body mass. DESIGN: This is a cross-sectional study. SUBJECTS AND METHODS: Baseline measures from participants of the Dose-Responses to Exercise Training Study (DR's EXTRA), 635 men (body mass index (BMI): 19-47 kg m⁻²) and 638 women (BMI: 16-49 kg m⁻²) aged 57-78 years who performed oral glucose tolerance tests and maximal exercise stress tests with direct measurement of VO(2max). We compare the increase in VO(2max) implied by the per-weight standard with the real increase of VO(2max) per kg body weight. A linear logistic regression model estimates odds for abnormal glucose metabolism (either impaired fasting glycemia or impaired glucose tolerance or Type 2 diabetes) of the least-fit versus most-fit quartile according to both per-weight standard and adjusted standard. RESULTS: The per-weight standard implies an increase of VO(2max) with 20.9 ml min⁻¹ in women and 26.4 ml min⁻¹ in men per additional kg body weight. The true increase per kg is only 7.0 ml min⁻¹ (95% confidence interval: 5.3-8.8) and 8.0 ml min⁻¹ (95% confidence interval: 5.3-10.7), respectively. Risk for abnormal glucose metabolism in the least-fit quartile of the population is overestimated by 52% if the per-weight standard is used. CONCLUSIONS: In comparisons across different categories of body mass, the per-weight standard systematically underestimates cardiorespiratory fitness in obese subjects. Use of the per-weight standard markedly inflates associations between poor fitness and co-morbidities of obesity.

Diet, fitness and metabolic syndrome--the DR's EXTRA study.

BACKGROUND AND AIMS: To study the independent and combined associations of diet and cardiorespiratory fitness with the prevalence of the metabolic syndrome (MetS). METHODS AND RESULTS: We studied a population-based random sample of 663 men and 671 women 57-78 years of age at baseline of an ongoing randomised controlled trial. Based on a 4-day food record a diet score was created according to goals achieved (vegetables ≥400 g/day, fish ≥2 servings/week, fibre ≥14 g/1000 kcal, saturated fat <10 E%/day). Cardiorespiratory fitness was measured as maximal oxygen uptake (VO(2 max)) in a maximal symptom-limited bicycle ergometer test. MetS was defined by the National Cholesterol Education Program criteria. The lowest prevalence of MetS (5%) was observed among individuals in the highest VO(2 max) tertile and achieving 3-4 dietary goals. The highest prevalence (55%) was observed among those in the lowest VO(2 max) tertile and achieving none of the dietary goals. Among individuals in the highest VO(2 max) tertile, the odds ratio of having MetS was 0.04 (95% CI 0.02-0.10) for those achieving 3-4 dietary goals, 0.07 (0.04-0.14) for those achieving 1-2 dietary goals, and 0.16 (0.07-0.37) for those achieving none of the dietary goals compared with individuals in the lowest VO(2 max) tertile and achieving none of the goals after adjustment for confounding factors. CONCLUSION: Healthy diet and higher levels of cardiorespiratory fitness are associated with a reduced risk of having MetS. However, fitness seems to have a stronger association with MetS than diet.

Two-minute heart rate recovery after cycle ergometer exercise and all-cause mortality in middle-aged men.

BACKGROUND: A slow heart rate recovery (HRR) after an exercise test is associated with an increased risk of all-cause mortality in asymptomatic individuals, but the data regarding additional prognostic information provided by HRR beyond other exercise test variables are inconsistent. We investigated the prognostic significance of HRR for premature death, particularly in relation to other exercise test variables. METHODS: The study subjects were a representative population-based sample of 1102 men (42-61 years of age) without cardiovascular disease, cancer or diabetes. HRR was defined as the difference between maximal HR and HR 2 min after a maximal symptom-limited exercise test using a cycle ergometer. The association between HRR and premature mortality was examined with Cox regression models. RESULTS: During an average follow-up of 18 years, 238 deaths occurred. HRR was an independent predictor of death [for a decrease of 12 beats min(-1) , relative risk (RR) 1.16, 95% CI 1.02-1.33, P = 0.02] after adjustment for age and established risk factors. When added in a Cox model with chronotropic response (decrease of 12 beats min(-1) , RR 1.09, 95% CI 0.93-1.27, P = 0.26) or cardiorespiratory fitness (decrease of 12 beats min(-1) , RR 1.12, 95% CI 0.98-1.30, P = 0.08), the association between a slow HRR and an increased risk of death was clearly weaker. CONCLUSION: A slow 2-min HRR after a cycle ergometer exercise test was an independent predictor of death in healthy middle-aged men after accounting for demographic and clinical characteristics. However, it was no longer predictive after accounting for chronotropic response and exercise capacity.

Cardiorespiratory fitness in aging men and women: the DR's EXTRA study.

The aim of the study was to describe the levels and to create reference values of cardiorespiratory fitness, expressed as maximal oxygen consumption (VO(2max) ), maximal metabolic equivalents (METs) and maximal workload in aging men and women. We measured VO(2max) directly by a breath-by-breath method during a maximal exercise stress test on a bicycle ergometer with a linear workload increase of 20 W/min in a representative population sample of 672 men and 677 women aged 57-78 years. We presented the age and sex-specific categories of cardiorespiratory fitness (very low, low, medium, high and very high) based on variable distribution and non-linear regression models of VO(2max) , maximal METs and maximal workload. The linear age-related decrement of VO(2max) was -0.047 L/min/year (-2.3%) and -0.404 mL/kg/min/year (-1.6%) in men and -0.027 L/min/year (-1.9%) and -0.328 mL/kg/min/year (-1.6%) in women. After exclusion of diseased individuals, the rate of VO(2max) decrement remained similar. The number of chronic diseases (0, 1, 2 or ≥3) was inversely associated with VO(2max) in men (P<0.001) and women (P<0.001). The present study provides clinically useful reference values of cardiorespiratory fitness for primary and secondary prevention purposes in aging people.

Workload at the heart rate of 100 beats/min and mortality in middle-aged men with known or suspected coronary heart disease.

OBJECTIVE: To investigate whether a workload which an individual is able to perform at the heart rate (HR) of 100 beats/min (WL(100)) independently predicts mortality in middle-aged men with known or suspected coronary heart disease (CHD). DESIGN: Prospective population-based study based on 365 middle-aged men with known or suspected CHD at baseline. RESULTS: During an average follow-up of 11.1 years, there were 75 deaths (20.5%). In Cox multivariable models mortality increased by 72% (95% CI 32% to 122%, p<0.001) with 1 SD (34 Watts) decrement in WL(100) after adjustment for age, examination year, alcohol consumption, body mass index, cigarette smoking, cardiac insufficiency, history of myocardial infarction, diabetes, myocardial ischaemia during exercise test, serum low-density lipoprotein and high-density lipoprotein cholesterol, systolic and diastolic blood pressure at rest, testing protocol, and use of HR-lowering medication. The risk of death was 2.4 (95% CI 1.5 to 4.0, p<0.001) times higher in 130 men with WL(100) <55 W than in 235 men with WL(100) >or=55 W. In men using and not using HR-lowering medication the risk of death increased 72% (95% CI 14% to 163%, p = 0.01), and 54% (95% CI 14% to 108%, p = 0.005) with 1 SD decrement in WL(100), respectively. WL(100 )improved the predictive power of the adjusted Cox models including other HR and exercise test variables. CONCLUSIONS: WL(100) predicts mortality in men with known or suspected CHD. The association of WL(100) with mortality was not explained by other well-established HR and exercise test variables. WL(100) is derived from a submaximal test which avoids the cardiovascular risks associated with a high-intensity exertion.

Effects of cycling alone or in a sheltered position on subsequent running performance during a triathlon.

PURPOSE: The purpose of this study was to compare the responses during a triathlon in which cycling was performed alone, as well as in a drafting position. METHODS: Eight male triathletes of international level performed a sprint-distance triathlon (0.75-km swim, 20-km bike, 5-km run) on two different occasions, one completely alone (TA), the other as a drafter during the bike leg of the event (TD). The speed during drafted cycling remained at all times identical to the no-draft situation. RESULTS: The results revealed that expiratory flow (VE), oxygen uptake (VO2), heart rate (HR), and blood lactate concentrations ([La-]) were significantly lower when drafting on the bike as opposed to biking alone (112.1 vs. 162.2 L x min(-1), 55.2 vs. 64.2 mL x min(-1) x kg(-1), 155 vs. 166.8 beats x min(-1), and 4.0 vs. 8.4 mmol x L(-1), respectively). The results also showed that running after biking in a drafting situation (for similar bike speeds) significantly improved the running speed compared with that of the no-draft modality (17.8 vs. 17.1 km x h(-1)). Furthermore, VE, VO2, HR, and [La-] were significantly higher during TD run compared with TA run (161.6 vs. 141.4 L x min(-1), 70.9 vs. 67.1 mL x min(-1) x kg(-1), 175.3 vs. 167.98 beats x min(-1), and 8.1 vs. 7.6 mmol x L(-1), respectively). CONCLUSIONS: These results showed that drafting allows triathletes to save significantly on energy during the bike leg of a triathlon and creates the conditions for an improved running performance, with higher benefits for the strong runners.