Influence of physical education on moderate-to-vigorous physical activity of urban public school children in St. Louis, Missouri, 2011-2014.

We quantified the moderate-to-vigorous physical activity (MVPA, heart rate ≥140 bpm) of urban public elementary school children on school days with and schooldays without physical education (PE) class by using continuous heart rate monitoring. The heart rate of 81 students (93.8% black) in grades 3 and 5 was recorded in 15-second intervals. On the basis of 575 school-day observations (mean 7.1 days/student), students accumulated 44.4 (standard deviation [SD], 34.4) minutes of MVPA on days with PE and 30.6 (SD, 29.9) MVPA minutes on days without PE (P < .001). School policies should promote daily PE to help children in under-resourced areas achieve the recommended 60 minutes per day of MVPA.

Exercise and cardiometabolic risk factors in graduate students: a longitudinal, observational study.

OBJECTIVE: To evaluate cardiometabolic risk of students longitudinally and compare them with age-matched national samples. PARTICIPANTS: Participants are 134 graduate students enrolled between August 2005 and May 2010. METHODS: Students were assessed at the beginning and end of their 3-year curriculum. Comparative samples included 966 National Health and Nutrition Examination Survey participants and 5,154 National College Health Assessment respondents. RESULTS: Most students had desirable weight, blood glucose, lipids, and fitness at both time points. However, 26.9% had elevated blood pressure, 29.9% performed aerobic exercise < 3 days/week, and 80.6% consumed < 5 fruits/vegetables daily. Relative to young adults nationwide, these students exhibited more favorable exercise patterns, dietary patterns, and cardiometabolic indices. Over time, increases in adiposity and decreases in exercise frequency correlated with adverse changes in lipid concentrations and fitness. CONCLUSIONS: Small changes in lifestyle behaviors and adiposity within a healthy cohort of young adults significantly influenced cardiometabolic indices during their graduate career.

Arm exercise stress perfusion imaging predicts clinical outcome.

Treadmill exercise capacity in resting metabolic equivalents (METs) and stress hemodynamic, electrocardiographic (ECG), and myocardial perfusion imaging (MPI) responses are independently predictive of adverse clinical events. However, limited data exist for arm ergometer stress testing (AXT) in patients who cannot perform leg exercise because of lower extremity disabilities. We sought to determine the extent to which AXT METs, hemodynamic, ECG, and MPI responses to arm exercise add independent incremental value to demographic and clinical variables for prediction of all-cause mortality, myocardial infarction (MI), or late coronary revascularization, individually or as a composite. A prospective cohort of 186 patients aged 64 ± 10 (SD) yr, unable to perform lower extremity exercise, underwent AXT MPI for clinical reasons between 1997 and 2002, and were followed for 62 ± 23 mo, to an endpoint of death or 12/31/2006. Average annual rates were 5.4% for mortality, 2.2% for MI, 2.5% for late coronary revascularization, and 8.0% for combined events. After adjustment for age and clinical variables, AXT METs [P < 0.05; hazard ratio (HR) = 0.59; confidence interval (CI) = 0.35-0.84] and abnormal MPI (P < 0.01; HR = 2.48; CI = 2.15-2.81) were independently predictive of mortality. A positive AXT ECG (P < 0.05; HR = 2.61; CI = 2.13-3.10) was predictive of MI. Death and MI combined were prognosticated by METs (P < 0.05; HR = 0.63; CI = 0.41-0.85), MPI (P < 0.05; HR = 1.77; CI = 1.49-2.05), and a positive AXT ECG (P < 0.05; HR = 1.86; CI = 1.55-2.17). In conclusion, for high risk older patients who cannot perform leg exercise because of lower extremity disabilities, AXT METs are as important as MPI for prediction of mortality alone and death and MI combined, and a positive AXT ECG prognosticates MI alone and death and MI combined.

Worksite Opportunities for Wellness (WOW): effects on cardiovascular disease risk factors after 1 year.

OBJECTIVE: To evaluate the effectiveness of a worksite health promotion program on improving cardiovascular disease risk factors. METHODS: In St Louis, Missouri from 2005 to 2006, 151 employees (134 F, 17 M, 81% overweight/obese) participated in a cohort-randomized trial comparing assessments + intervention (worksite A) with assessments only (worksite B) for 1 year. All participants received personal health reports containing their assessment results. The intervention was designed to promote physical activity and favorable dietary patterns using pedometers, healthy snack cart, WeightWatchers(R) meetings, group exercise classes, seminars, team competitions, and participation rewards. Outcomes included BMI, body composition, blood pressure, fitness, lipids, and Framingham 10-year coronary heart disease risk. RESULTS: 123 participants, aged 45+/-9 yr, with BMI 32.9+/-8.8 kg/m(2) completed 1 year. Improvements (P< or =0.05) were observed at both worksites for fitness, blood pressure, and total-, HDL-, and LDL-cholesterol. Additional improvements occurred at worksite A in BMI, fat mass, Framingham risk score, and prevalence of the metabolic syndrome; only the changes in BMI and fat mass were different between worksites. CONCLUSION: A multi-faceted worksite intervention promoted favorable changes in cardiovascular disease risk factors, but many of the improvements were achieved with worksite health assessments and personalized health reports in the absence of an intervention.

Arm exercise testing predicts clinical outcome.

BACKGROUND: Treadmill exercise testing provides prognostic and clinical information that is not available for patients with lower extremity disabilities who undergo pharmacologic stress tests. We sought to determine whether arm ergometer (AXT) exercise capacity in resting metabolic equivalents (METs) and hemodynamic and electrocardiographic responses to AXT are predictors of survival, myocardial infarction (MI), or coronary revascularization, individually or as a composite. METHODS: A prospective cohort of 359 veterans aged 63 +/- 11 (SD) years, who were unable or unwilling to perform treadmill exercise, underwent AXT stress testing for clinical reasons between 1997 and 2002 and were followed for 63 +/- 24 months to an end point of death or December 31, 2006. Average annual mortality, MI, revascularization, and combined event rates were 5.2%, 1.7%, 2.2%, and 7.1%, respectively. RESULTS: By univariate analysis, AXT METs were highly predictive of survival (P < .01; hazard ratio 0.58, 95% confidence interval 0.46-0.70). A greater delta (peak-rest) heart rate, peak exercise systolic blood pressure, and rate pressure product were associated with survival and event-free outcome (all P < .02). A positive exercise electrocardiogram was predictive of death, revascularization, and combined events (all P < .01), and borderline predictive of MI (P = .058). By Wald chi(2) analysis, age, clinical variables, exercise capacity in METs, a positive exercise electrocardiogram, and delta heart rate all had statistically significant incremental prognostic value (P < .05) for survival. CONCLUSION: In older veterans with lower extremity disabilities and more comorbidities than most study populations, arm exercise capacity, delta heart rate, and a positive electrocardiogram were independently predictive of survival and/or adverse cardiovascular outcomes.