Search

Purpose: Cardiorespiratory fitness (CRF) is known to be directly related to fat-free mass (FFM), therefore, it has been suggested that normalizing CRF to FFM (V˙O2peakFFM) may be the most accurate expression of CRF as related to exercise performance and cardiorespiratory function. However, the influence of V˙O2peakFFM (mL·kg FFM−1·min−1) on predicting mortality has been largely unexplored. This study aimed to primarily assess the relationship between V˙O2peakFFM and all-cause and disease-specific mortality risk in apparently healthy adults. Further, this study sought to compare the predictive ability of V˙O2peakFFM to V˙O2peak normalized to total body weight (V˙O2peakTBW) for mortality outcomes. Methods: Participants included 2905 adults (1555 men, 1350 women) who completed a cardiopulmonary exercise test between 1970 and 2016 to determine CRF. Body composition was assessed using the skinfold method to estimate FFM. Cardiorespiratory fitness was expressed as V˙O2peakTBW and V˙O2peakFFM. Participants were followed for 19.0 ± 11.7 yr after their cardiopulmonary exercise test for mortality outcomes. Cox-proportional hazard models were performed to determine the relationship of V˙O2peakFFM with mortality outcomes. Parameter estimates were assessed to compare the predictive ability of CRF expressed as V˙O2peakTBW and V˙O2peakFFM. Results: Overall, V˙O2peakFFM was inversely related to all-cause, cardiovascular disease, and cancer mortality, with a 16.2%, 8.4%, and 8.0% lower risk per 1 mL·kg FFM−1·min−1 improvement, respectively (P < 0.01). Further, assessment of the parameter estimates showed V˙O2peakFFM to be a significantly stronger predictor of all-cause mortality than V˙O2peakTBW (parameter estimates, −0.49 vs −0.16). Conclusions: Body composition is an important factor when considering the relationship between CRF and mortality risk. Clinicians should consider normalizing CRF to FFM when feasible, because it will strengthen the predictive power of the measure. [ABSTRACT FROM AUTHOR]

Objective: To explore the factor structure of the HERO Health and Wellbeing Best Practices Scorecard in Collaboration with Mercer (HERO Scorecard) to develop a reduced version and examine the reliability and validity of that version. Methods: A reduced version of the HERO Scorecard was developed through formal statistical analyses on data collected from 845 organizations that completed the original HERO Scorecard. Results: The final factors in the reduced Scorecard represented content pertaining to organizational and leadership support, program comprehensiveness, program integration, and incentives. All four implemented practices were found to have a strong, statistically significant effect on perceived effectiveness. Organizational and leadership support had the strongest effect (β = 0.56), followed by incentives (β = 0.23). Conclusion: The condensed version of the HERO Scorecard has the potential to be a promising tool for future research on the extent to which employers are adopting best practices in their health and well-being (HWB) initiatives. [ABSTRACT FROM AUTHOR]

Introduction: Over the past 30 years, cross-sectional studies have established an inverse relationship between cardiorespiratory fitness (CRF) and mortality. Exercise training typically leads to improvements in CRF. Given the strong association between CRF and mortality, the change in CRF post-exercise training could alter one's mortality risk. However, longitudinal analyses assessing the influence of short-term changes in CRF on mortality have not been assessed in apparently healthy adults. The primary purpose of this study was to assess the influence of post-exercise training (≤8 months) changes in directly measured CRF on all-cause mortality risk in a cohort of self-referred, apparently healthy men and women. Methods: Participants included 689 adults (410 men, 279 women; mean age: 42.7± 11.0 years) who underwent two maximal cardiopulmonary exercise tests (CPX) between 1970 and 2012 to determine CRF at baseline and post-exercise training. Participants were followed for 29.8 ± 10.7 years after their post-exercise CPX for mortality outcomes. Cox-proportional hazard models were performed to determine the relationship of CRF change with all-cause mortality outcomes. Results: During follow-up, 186 participants died (27%). Overall, the change in CPX-derived CRF was inversely related to all-cause mortality, with a 7% lower risk reduction per 1 ml·kg-1·min-1 improvement. Remaining unfit was associated with approximately 2-fold higher risk for all-cause mortality (hazard ratio 1.99, 95% CI 1.18-3.35), compared with those that stayed fit. The relationship remained significant when men and women were examined independently. Following multivariable adjustment an approximately 6 and 13% lower mortality risk was found per 1 ml·kg-1·min-1 improvement in men and women respectively (p<0.01). Conclusions: Improving CRF through exercise training can lower the risk for premature mortality. Therefore, clinicians should encourage individuals, especially those identified as unfit, to participate in an exercise training program to improve CRF, as it may provide survival benefit. [ABSTRACT FROM AUTHOR]

Purpose: To determine if individuals chronically (>1 year) prescribed antihypertensive medications have a normal BP response to peak exercise compared to unmedicated individuals., Methods: Participants included 2,555 adults from the Ball State Adult Fitness Longitudinal Lifestyle STudy cohort who performed a peak treadmill exercise test. Participants were divided into groups by sex and antihypertensive medication status. Individuals prescribed antihypertensive medications for >1 year were included. Exaggerated and blunted SBP within each group was categorized using the Fitness Registry and the Importance of Exercise: A National Database (FRIEND) and absolute criteria as noted by the Amercian Heart Association., Results: The unmedicated group had a greater prevalence (p < 0.05) of blunted SBP responses, whereas the medicated group had a higher prevalence (p < 0.05) of exaggerated SBP responses using both the FRIEND and absolute criteria. Peak SBP was higher (p < 0.01) in medicated compared to unmedicated participants in the overall cohort when controlling for age and sex, but not after controlling for resting SBP (p = 0.613), risk factors (p = 0.104), or cardiorespiratory fitness (p = 0.191). When men and women were assessed independently, peak SBP remained higher in the medicated women after controlling for age and resting SBP (p = 0.039), but not for men (p = 0.311). Individuals on beta-blockers had a higher peak SBP even after controlling for age, sex, risk factors and cardiorespiratory fitness (p = 0.022)., Conclusions: Individuals on antihypertensive medications have a higher peak SBP response to exercise. Given the prognostic value of exaggerated peak SBP, control of exercise BP should be considered in routine BP assessment and in the treatment of hypertension., Competing Interests: Conflict of Interest and Funding Source: The authors declare that they have no conflicts of interest regarding the publication of this paper. This research did not receive any specific grants from funding angencies in the public, commercial, or not-for-profit sectors., (Copyright © 2024 by the American College of Sports Medicine.)