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Relationships between Obesity, Cardiorespiratory Fitness, and Cardiovascular Function  [PDF]
Kade Davison,Stefan Bircher,Alison Hill,Alison M. Coates,Peter R. C. Howe,Jonathan D. Buckley
Journal of Obesity , 2010, DOI: 10.1155/2010/191253
Abstract: Background. Obesity and low cardiorespiratory fitness (CRF) have been shown to independently increase the risk of CVD mortality. The aim of this study was to investigate the relationship between CRF, body fatness and markers of arterial function. Method and Results. Obese (9 male, 18 female; BMI 35.3 ± 0.9 kg·m-2) and lean (8 male, 18 female; BMI 22.5 ± 0.3?kg·m-2) volunteers were assessed for body composition (DXA), cardiorespiratory fitness (predicted max), blood pressure (BP), endothelial vasodilatator function (FMD), and arterial compliance (AC) (via radial artery tonometry). The obese group had more whole body fat and abdominal fat (43.5 ± 1.2% versus 27.2 ± 1.6%; and 48.6 ± 0.9% versus 28.9 ± 1.8%; resp.), and lower FMD (3.2 ± 0.4% versus 5.7 ± 0.7%; ) than the lean subjects, but there was no difference in AC. AC in large arteries was positively associated with CRF ( ; ) but not with fatness. Conclusion. These results indicate distinct influences of obesity and CRF on blood vessel health. FMD was impaired with obesity, which may contribute to arterial and metabolic dysfunction. Low CRF was associated with reduced elasticity in large arteries, which could result in augmentation of aortic afterload. 1. Introduction Obesity and cardiorespiratory fitness (CRF) are independent predictors of cardiovascular (CV) and all-cause mortality [1–5]. Furthermore, it appears that CRF may be protective against the cardiovascular risk associated with obesity [6]. The mechanisms which mediate the relationships between obesity, CRF, and CV mortality risk are not entirely understood [5, 7]. However, given that the protective effects of CRF and the detrimental effects of obesity appear to influence CV mortality independently of other CV risk factors, it is of interest to investigate their influences on established markers of subclinical CV function. This will allow for a better understanding of the potential mechanisms by which obesity and CRF may influence the risk of CV mortality. Increased adiposity, in particular visceral adiposity, is associated with reduced vascular endothelial function [8, 9]. Endothelial function refers to the general functional capacity of vascular endothelial cells, primarily mediated by their capacity to synthesize and release nitric oxide (NO) [10]. Reduced synthesis and/or availability of NO is associated with increased vascular permeability, inflammation, adhesion and thrombosis, and a reduced vasodilatory capacity, and abnormalities of endothelial function have been associated with a number of CV risk factors [11]. The noninvasive
Physical activity, cardiorespiratory fitness, dietary content, and risk factors that cause a predisposition towards cardiovascular disease
Guedes, Dartagnan Pinto;Guedes, Joana Elisabete Ribeiro Pinto;
Arquivos Brasileiros de Cardiologia , 2001, DOI: 10.1590/S0066-782X2001000900005
Abstract: objective: to analyze associations between levels of physical activity, cardiorespiratory fitness, dietary content, and risk factors that cause a predisposition towards cardiovascular disease. methods: sixty-two individuals aged between 20 and 45 years were evaluated. levels of physical activity were established by estimates of energy demand corresponding to everyday activity; indices for cardiorespiratory fitness were obtained from estimates of maximal oxygen consumption; information about dietary content was obtained from dietary records kept on seven consecutive days. to indicate risk factors that cause a predisposition towards cardiovascular disease, use was made of body mass indexes, waist-hip circumference relationships, levels of arterial pressure and of plasma lipid-lipoprotein concentration. to establish associations between the variables studied, multiple regression analysis was used. results: physical activity levels and cardiorespiratory fitness levels were inversely correlated with the amount and distribution of body fat and arterial pressure. taken together, the two variables were responsible for between 16% and 19% of the variation in arterial pressure. total and saturated fat ingestion was associated with higher serum lipid levels. both dietary components were responsible for between 49% and 61% of the variation in ldl-cholesterol. conclusion: high ingestion of food rich in total and saturated fat and decreased levels of physical activity and of cardiorespiratory fitness are associated with an increased risk of cardiovascular disease, which supports previous data.
Physical activity, cardiorespiratory fitness, dietary content, and risk factors that cause a predisposition towards cardiovascular disease  [cached]
Guedes Dartagnan Pinto,Guedes Joana Elisabete Ribeiro Pinto
Arquivos Brasileiros de Cardiologia , 2001,
Abstract: OBJECTIVE: To analyze associations between levels of physical activity, cardiorespiratory fitness, dietary content, and risk factors that cause a predisposition towards cardiovascular disease. METHODS: Sixty-two individuals aged between 20 and 45 years were evaluated. Levels of physical activity were established by estimates of energy demand corresponding to everyday activity; indices for cardiorespiratory fitness were obtained from estimates of maximal oxygen consumption; information about dietary content was obtained from dietary records kept on seven consecutive days. To indicate risk factors that cause a predisposition towards cardiovascular disease, use was made of body mass indexes, waist-hip circumference relationships, levels of arterial pressure and of plasma lipid-lipoprotein concentration. To establish associations between the variables studied, multiple regression analysis was used. RESULTS: Physical activity levels and cardiorespiratory fitness levels were inversely correlated with the amount and distribution of body fat and arterial pressure. Taken together, the two variables were responsible for between 16% and 19% of the variation in arterial pressure. Total and saturated fat ingestion was associated with higher serum lipid levels. Both dietary components were responsible for between 49% and 61% of the variation in LDL-cholesterol. CONCLUSION: High ingestion of food rich in total and saturated fat and decreased levels of physical activity and of cardiorespiratory fitness are associated with an increased risk of cardiovascular disease, which supports previous data.
Relationships between Obesity, Cardiorespiratory Fitness, and Cardiovascular Function  [PDF]
Kade Davison,Stefan Bircher,Alison Hill,Alison M. Coates,Peter R. C. Howe,Jonathan D. Buckley
Journal of Obesity , 2010, DOI: 10.1155/2010/191253
Abstract: Background. Obesity and low cardiorespiratory fitness (CRF) have been shown to independently increase the risk of CVD mortality. The aim of this study was to investigate the relationship between CRF, body fatness and markers of arterial function. Method and Results. Obese (9 male, 18 female; BMI 35.3 ± 0.9 kg·m-2) and lean (8 male, 18 female; BMI 22.5 ± 0.3 kg·m-2) volunteers were assessed for body composition (DXA), cardiorespiratory fitness (predicted ?VO2max), blood pressure (BP), endothelial vasodilatator function (FMD), and arterial compliance (AC) (via radial artery tonometry). The obese group had more whole body fat and abdominal fat (43.5 ± 1.2% versus 27.2 ± 1.6%; <.001 and 48.6 ± 0.9% versus 28.9 ± 1.8%; <.001, resp.), and lower FMD (3.2 ± 0.4% versus 5.7 ± 0.7%; <.01) than the lean subjects, but there was no difference in AC. AC in large arteries was positively associated with CRF (R=0.5; <.01) but not with fatness. Conclusion. These results indicate distinct influences of obesity and CRF on blood vessel health. FMD was impaired with obesity, which may contribute to arterial and metabolic dysfunction. Low CRF was associated with reduced elasticity in large arteries, which could result in augmentation of aortic afterload.
Cardiorespiratory Fitness, Metabolic Risk, and Inflammation in Children  [PDF]
Antonios D. Christodoulos,Helen T. Douda,Savvas P. Tokmakidis
International Journal of Pediatrics , 2012, DOI: 10.1155/2012/270515
Abstract: The aim of this study was to investigate the independent associations among cardiorespiratory fitness, metabolic syndrome (MetS), and C-reactive protein (CRP) in children. The sample consisted of 112 children (11.4??±??0.4 years). Data was obtained for children’s anthropometry, cardiorespiratory fitness, MetS components, and CRP levels. MetS was defined using criteria analogous to the Adult Treatment Panel III definition. A MetS risk score was also computed. Prevalence of the MetS was 5.4%, without gender differences. Subjects with low fitness showed significantly higher MetS risk ( ) and CRP ( ), compared to the high-fitness pupils. However, differences in MetS risk, and CRP between fitness groups decreased when adjusted for waist circumference. These data indicate that the mechanisms linking cardiorespiratory fitness, MetS risk and inflammation in children are extensively affected by obesity. Intervention strategies aiming at reducing obesity and improving cardiorespiratory fitness in childhood might contribute to the prevention of the MetS in adulthood. 1. Introduction The prevalence and severity of obesity is increasing dramatically among children and adolescents in many parts of the world, whereas prevalence rates are estimated to increase in the next decades [1]. In children, excess body fat appears to be strongly associated with the clustering of risk factors, such as hyperglycemia, dyslipidemia, and hypertension, which play a key role in the pathogenesis of the metabolic syndrome (MetS) [2]. Obesity and the MetS risk in children have been recently associated with systemic inflammatory markers, in particular C-reactive protein (CRP) [3, 4], implying that low-grade inflammation can already exist in childhood and may be a potential link between the obesity and the MetS. Among behavioral variables, cardiorespiratory fitness has a protective role in MetS and inflammatory factors; however, it is not entirely clear if the interrelations among cardiorespiratory fitness, MetS risk, and inflammation in children are independent or partly due to the mediating effect of obesity, since the existing data are limited and equivocal [5, 6]. Recent evidence indicates that the prevalence rates of childhood obesity in Greece remain high [1, 7] and often coexist with low cardiorespiratory fitness [8] and an unfavorable cardiometabolic risk profile [9]. For the Greek pediatric population these data suggest an increased cardiovascular morbidity in adulthood, given that high-risk children and adolescents are likely to become high-risk adults [10]. Although the
Can a cardiorespiratory field parameter assess both cardiovascular and respiratory fitness in schoolchildren?  [PDF]
Louisa Ming Yan Chung, Lina Pui Yu Chow, Eric Cheuk Kuen Tsang, Joanne Wai Yee Chung
Health (Health) , 2014, DOI: 10.4236/health.2014.61006
Abstract:

Background: Cardiorespiratory fitness involves both cardiovascular and respiratory capacities. However, existing methods have been criticised for reflecting cardiovascular fitness, but not pulmonary fitness. The objective of this study was to investigate the relationship between these two testing parameters. Methods: A cross-sectional population-based physical fitness assessment was conducted in 23 schools. The body height and weight, lung capacity, and step test results of students aged 10-18 were recorded. Criterion-referenced standards from the China Sports Bureau were adopted, as they include separate measurements for cardiovascular and pulmonary fitness. Results: The Pearson coefficients of lung capacity and the step test index from 13,028 schoolchildren ranged from 0.007 to 0.086 and from 0.026 to 0.105 for boys and girls, respectively, showing that poor correlations exist between the two parameters. Cluster analysis resulted in three clusters of children with similar characteristics. A good degree of similarity was found between the two parameters in children obtaining an “excellent” grade, but only a moderate degree of similarity between the two parameters in those obtaining a “good”, “pass” or “fail” grade. Conclusion: When cardiovascular fitness and pulmonary fitness are considered separately, there is a poor correlation between them, thus indicating further studies of cardiopulmonary fitness measurements is necessary.

Assessment of Cardiorespiratory Fitness without Exercise in Elderly Men with Chronic Cardiovascular and Metabolic Diseases  [PDF]
Geraldo A. Maranh?o Neto,Antonio P. de Leon,Vitor A. Lira,Paulo T. V. Farinatti
Journal of Aging Research , 2012, DOI: 10.1155/2012/518045
Abstract: Low cardiorespiratory (CRF) is associated with health problems in elderly people, especially cardiovascular and metabolic disease. However, physical limitations in this population frequently preclude the application of aerobic tests. We developed a model to estimate CRF without aerobic testing in older men with chronic cardiovascular and metabolic diseases. Subjects aged from 60 to 91 years were randomly assigned into validation ( ?? = 6 7 ) and cross-validation ( ?? = 2 9 ) groups. A hierarchical linear regression model included age, self-reported fitness, and handgrip strength normalized to body weight ( ?? 2 = 0 . 7 9 ; SEE?=?1.1 METs). The PRESS (predicted residual sum of squares) statistics revealed minimal shrinkage in relation to the original model and that predicted by the model and actual CRF correlated well in the cross-validation group ( ?? = 0 . 8 5 ). The area under curve (AUC) values suggested a good accuracy of the model to detect disability in the validation (0.876, 95% CI: 0.793–0.959) and cross-validation groups (0.826, 95% CI: 0.677–0.975). Our findings suggest that CRF can be reliably estimated without exercise test in unhealthy elderly men. 1. Introduction Cardiorespiratory fitness (CRF) maintenance is important for functional independence and physical capacity throughout aging [1, 2]. Substantial declines in the ability to tolerate physical exertion generally predict mobility problems and cardiovascular morbidity and mortality, particularly in the sedentary elderly [3, 4]. Despite the importance of CRF assessment, very low functional capacity and frailty may hinder the use of exercise tests in this population [5, 6]. In this context, nonexercise prediction models become practical alternatives to estimate CRF [7] and may have important applications both in clinical and epidemiological settings. These models are developed by means of regression-based equations that usually include variables of simple and fast assessment, such as anthropometric measures, demographic characteristics, and daily habits [8]. Recently, Mailey et al. [7] cross-validated an equation developed primarily in middle-aged adults by Jurca et al. [9] and suggested that nonexercise models could be used to estimate the CRF of older adults. The sample studied was mainly composed by healthy old women (~60%). However, the prevalence of chronic diseases such as cardiovascular disease and diabetes increases dramatically with age [10], and is associated to lower physical capacity, inactivity, and limitations in the ability to exercise [2]. It would be therefore important
Level of physical activity, cardiorespiratory fitness and cardiovascular disease risk factors in a rural adult population in Sogn og Fjordane
Ane Kristiansen Solbraa,Asgeir Mamen,Geir K?re Resaland,Jostein Steene- Johannessen
Norsk Epidemiologi , 2011,
Abstract: Background: Physical activity (PA) and high cardiorespiratory fitness (CRF) are associated with reduced risk of cardiovascular disease (CVD). Sogn og Fjordane County has the reputation of being the most healthy county in Norway. The level of PA and/or CRF may partly explain this health status. However, only one study with regional objectively measured PA data and one study with regional data on CRF currently exist. Thus, the aim of this study was to describe levels of PA, CRF and CVD risk factors in an adult population in the county of Sogn og Fjordane. Methods: In total, 314 (♀:178 ♂:136) 40-42-year-olds and 308 (♀:175 ♂:133) 53-55-yearolds participated in this cross-sectional study. PA was measured objectively by accelerometry, while CRF was measured directly. Results: There were no sex differences in total PA level. For the 40-42-year-olds, women spent 6.0min/day [95% CI: –11.7 to –0.3] less participating in moderate PA compared to men. For the 53-55- year-olds, women were inactive for 36.0 min/day [95% CI: –55.2 to –16.8] less and they participated in light activity for 26.4 min/day [95% CI: 7.7 to 45.2] more than men. In total, 30.0% [95% CI: 24.8 to 35.2] of the 40-42-year-olds and 30.2% [95% CI: 25.0 to 35.4] of the 53-55-year-olds met the Norwegian recommendations for PA. CRF was 49.0 ml·kg–1·min–1 for men and 41.6 ml·kg–1·min–1 for women for the 40-42-year-olds. For 53-55-year-olds CRF was 41.2 ml·kg–1·min–1 for men and 33.9 ml·kg–1·min–1 for women. Conclusions: These results suggest that the level of PA and CRF are higher compared to other available data. This might explain the advantageous health status in Sogn og Fjordane.
Combined Impact of Cardiorespiratory Fitness and Visceral Adiposity on Metabolic Syndrome in Overweight and Obese Adults in Korea  [PDF]
Sue Kim, Ji-Young Kim, Duk-Chul Lee, Hye-Sun Lee, Ji-Won Lee, Justin Y. Jeon
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0085742
Abstract: Background Obesity, especially visceral obesity, is known to be an important correlate for cardiovascular disease and increased mortality. On the other hand, high cardiorespiratory fitness is suggested to be an effective contributor for reducing this risk. This study was conducted to determine the combined impact of cardiorespiratory fitness and visceral adiposity, otherwise known as fitness and fatness, on metabolic syndrome in overweight and obese adults. Methods A total of 232 overweight and obese individuals were grouped into four subtypes according to their fitness level. This was measured by recovery heart rate from a step test in addition to visceral adiposity defined as the visceral adipose tissue area to subcutaneous adipose tissue area ratio (VAT/SAT ratio). Associations of fitness and visceral fatness were analyzed in comparison with the prevalence of metabolic syndrome. Results The high visceral fat and low fitness group had the highest prevalence of metabolic syndrome [Odds Ratio (OR) 5.02; 95% Confidence Interval (CI) 1.85–13.61] compared with the reference group, which was the low visceral adiposity and high fitness group, after adjustments for confounding factors. Viscerally lean but unfit subjects were associated with a higher prevalence of metabolic syndrome than more viscerally obese but fit subjects (OR 3.42; 95% CI 1.27–9.19, and OR 2.70; 95% CI 1.01–7.25, respectively). Conclusions Our study shows that visceral obesity and fitness levels are cumulatively associated with a higher prevalence of metabolic syndrome in healthy overweight and obese adults. This suggests that cardiorespiratory fitness is a significant modifier in the relation of visceral adiposity to adverse metabolic outcomes in overweight and obese individuals.
Indices of Abdominal Adiposity and Cardiorespiratory Fitness Test Performance in Middle-School Students  [PDF]
Ryan Burns,James C. Hannon,Timothy A. Brusseau,Barry Shultz,Patricia Eisenman
Journal of Obesity , 2013, DOI: 10.1155/2013/912460
Abstract: Background. Previous research suggests that use of BMI as a screening tool to assess health in youth has limitations. Valid alternative measures to assess body composition are needed to accurately identify children who are aerobically fit, which is an indicator of health status. The purpose of this study was to examine the associations between select anthropometric measures and cardiorespiratory fitness test performance in middle-school students. Methods. Participants included 134 students (65 boys and 69 girls) recruited from the 6th, 7th, and 8th grades. Anthropometric measures consisted of BMI, waist circumference (WC), waist-to-height ratio (WHtR), and percent body fat estimated from two-site skinfolds (%BF-SKF), as well as the hand-held OMRON BIA device (%BF-BIA). Cardiorespiratory fitness tests included the one-mile run and PACER test. Data were collected on four separate testing days during the students’ physical education classes. Results. There were statistically significant moderate correlations between the %BF estimations, WHtR, and cardiorespiratory fitness test scores in both genders . BMI at best only displayed weak correlations with the cardiorespiratory fitness test scores. Conclusions. The results suggest that alternative measures such as %BF-SKF, %BF-BIA, and WHtR may be more valid indicators of youth aerobic fitness lending to their preferred use over BMI. 1. Introduction The current pediatric obesity epidemic manifests concerns for adverse cardiovascular risk factors among overweight youth. However, Eisenmann et al. [1], using body mass index (BMI) as the marker of adiposity, found that youth in both the low- and high-BMI categories were associated with a more favorable cardiovascular disease (CVD) risk-factor profile than individuals whose BMIs were in the “healthy” range. This paradox leads to a significant issue in assessing health and fitness in youth when using BMI. Research has also suggested that along with body composition, aerobic fitness must also be considered to accurately assess health status in a population. Lee et al. [2] found that unfit lean men had a higher risk of cardiovascular disease and all-cause mortality than fit but overweight men. These findings suggest that fitness offers some protection against CVD risk even if the individual is overweight. Similar results have been reported for the female population [3]. Using skinfold thickness as the measure of body fatness and stratifying youth into high-fat/high-fitness, high-fat/low-fitness, low-fat/high-fitness, and low-fat/low-fitness groups, it was found that
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