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Background The potential for prehabilitation programs to impact clinical outcomes is uncertain in abdominal cancer patients due to the short window of time to intervene and the weakened state of the patients. To improve the effectiveness of prehabilitation intervention, a multimodal sports science approach was implemented. Methods Prior to cancer-related surgery, 21 patients participated in a 4-week exercise and nutrition prehabilitation program comprised of blood flow restriction exercise (BFR) and a sports nutrition supplement. Retrospective data of 71 abdominal cancer patients who underwent usual preoperative care was used as a comparator control group (CON). At 90 days post-surgery, clinical outcomes were quantified. Results Prehabilitation was associated with a shorter length of hospital stay ( P = .02) with 5.5 fewer days (4.7 ± 2.1 vs 10.2 ± 1.2 days in CON) and decreased incidence of any complications ( P = .03). Prehabilitation was not related to incidence of serious complications ( P = .17) or readmission rate ( P = .59). The prehabilitation group recorded 58% more steps on day 5 after surgery ( P = .043). Discussion A 4-week home-based prehabilitation program composed of BFR training and sports nutrition supplementation was effective in reducing postoperative complications and length of hospital stay in older patients with abdominal cancer. ClinicalTrials.gov Identifier: NCT04073381.

This study explored body composition in female NCAA Division I rowers compared to controls; and the effect of season, boat category, and oar side on body composition. This retrospective analysis of 91 rowers, and 173 age, sex, and BMI-matched controls examined total and regional fat mass (FM), lean mass (LM), bone mineral content (BMC), bone mineral density (BMD), percent body fat (%BF), and visceral adipose tissue (VAT) measured using dual X-ray absorptiometry. Two-sample t-testing was used to assess differences between rowers and controls. Repeated measures ANOVA analyzed differences across seasons. ANOVA analyzed differences between boat categories. Paired t-testing analyzed oar side versus non-oar side. Rowers had greater height (174.2; 164.1 cm), weight (75.2; 62.6 kg), LM (51.97; 41.12 kg), FM (20.74; 19.34 kg), BMC (2.82; 2.37 kg), and BMD (1.24; 1.14 g/cm2); but lower %BF (30.5%; 27.1%), and VAT (168.1; 105.0 g) than controls (p

Bisch, KL, Bosch, TA, Carbuhn, A, Stanforth, PR, Oliver, JM, Bach, CW, and Dengel, DR. Positional body composition of female division I collegiate volleyball players. J Strength Cond Res 34(11): 3055-3061, 2020-The primary study objective was to measure positional differences in total and regional body composition among female NCAA Division I collegiate volleyball players using dual X-ray absorptiometry (DXA). The secondary objective was to examine normative age curves for fat and lean mass (LM) variables. Ninety female volleyball players from 5 universities received a DXA scan. Athletes were categorized by position: middle blocker (MB = 31), outside hitter (OH = 32), setter (ST = 9), and Libero (LB = 18). Height, body mass, total and regional fat mass (FM), LM, bone mineral density (BMD), and abdominal visceral adipose tissue were measured by DXA. Body mass distribution ratios were calculated. The secondary age analysis included a subset of 153 DXA scans (n = 83, ages 18-21 years). Front row players (i.e., MB and OH) had significantly greater total and regional LM and BMD measures (p < 0.05, all), compared with non-front row players (i.e., LB and ST). Differences in total LM (p < 0.001) were significantly influenced by height. Front row players had consistently lower mass distribution ratios compared with non-front row players (p < 0.05, all). Lean mass index (LMI, p = 0.752) and FM index (FMI, p = 0.392) were not significantly different across ages. Back row players have greater relative upper body mass, whereas mass in front row players is more evenly distributed between the upper and lower body. Bone mineral density differences may be influenced by repeated impact of jumping during the attacking and blocking actions of front row players. Minimal changes in LMI and fluctuations in FMI can be expected across an athlete's career.

The purpose of the present study was to generate normative values for total and regional body composition in male and female Division 1 collegiate track and field athletes using dual X-ray absorptiometry. We also sought to examine body composition by event and sex. Data were used from the Consortium of College Athlete Research group. A total of 590 (male [M]/female [F] = 274/316) athletes had their height, weight, total and regional fat mass (FM), lean mass, and bone mineral density (BMD) measured. Athletes were classified into 1 of 7 categories: Jumps (M/F = 28/30); Long Distance (M/F = 104/110), Middle Distance (M/F = 27/24), Multievent (M/F = 11/9), Pole Vault (M/F = 21/27), Sprints (M/F = 54/96), and Throws (M/F = 29/20). Total and regional differences between events and sex were assessed by analysis of variance. Except for male and female throwers, all other track and field athletes' mean percent body fat (M: 10.3%-12.6%, F: 17.5%-21.6%) and visceral FM (500 g) was low, but in a healthy range. As expected, throwers had significantly (p0.05) higher total and regional FM and lean mass than other events. In addition, male (1.55 ± 0.11 g/cm

The aim of the HERITAGE Family Study was to investigate individual differences in response to a standardized endurance exercise program, the role of familial aggregation, and the genetics of response levels of cardiorespiratory fitness and cardiovascular disease and diabetes risk factors. Here we summarize the findings and their potential implications for cardiometabolic health and cardiorespiratory fitness. It begins with overviews of background and planning, recruitment, testing and exercise program protocol, quality control measures, and other relevant organizational issues. A summary of findings is then provided on cardiorespiratory fitness, exercise hemodynamics, insulin and glucose metabolism, lipid and lipoprotein profiles, adiposity and abdominal visceral fat, blood levels of steroids and other hormones, markers of oxidative stress, skeletal muscle morphology and metabolic indicators, and resting metabolic rate. These summaries document the extent of the individual differences in response to a standardized and fully monitored endurance exercise program and document the importance of familial aggregation and heritability level for exercise response traits. Findings from genomic markers, muscle gene expression studies, and proteomic and metabolomics explorations are reviewed, along with lessons learned from a bioinformatics-driven analysis pipeline. The new opportunities being pursued in integrative -omics and physiology have extended considerably the expected life of HERITAGE and are being discussed in relation to the original conceptual model of the study.

This study’s purpose was to evaluate total, regional, and throwing versus non-throwing arm body composition measurements between various positions of NCAA Division I male baseball players using dual X-ray absorptiometry (DXA). Two hundred and one collegiate baseball athletes were measured using DXA. Visceral adipose tissue (VAT), total and regional fat mass (FM), lean mass (LM), and bone mineral density (BMD) were measured. Athletes were separated into: pitchers (n=92), catchers (n=25), outfielders (n=43), and infielders (n=41). ANOVA and Tukey’s honest significant difference assessed total and regional differences between positions. Infielders had significantly (p

BACKGROUND Complying with a prehabilitation program is difficult for patients who will undergo surgery, owing to transportation challenges and a limited intervention time window. Mobile health (mHealth) using smartphone apps has the potential to remove barriers and improve the effectiveness of prehabilitation. OBJECTIVE This study aimed to develop a mobile app as a tool for facilitating a multidisciplinary prehabilitation protocol involving blood flow restriction training and sport nutrition supplementation. METHODS The app was developed using “Appy Pie,” a noncoding app development platform. The development process included three stages: (1) determination of principles and requirements of the app through prehabilitation research team meetings; (2) app prototype design using the Appy Pie platform; and (3) app evaluation by clinicians and exercise and fitness specialists, technical professionals from Appy Pie, and non–team-member users. RESULTS We developed a prototype of the app with the core focus on a multidisciplinary prehabilitation program with accessory features to improve engagement and adherence to the mHealth intervention as well as research-focused features to evaluate the effects of the program on frailty status, health-related quality of life, and anxiety level among patients awaiting elective surgery. Evaluations by research members and random users (n=8) were consistently positive. CONCLUSIONS This mobile app has great potential for improving and evaluating the effectiveness of the multidisciplinary prehabilitation intervention in the format of mHealth in future.

The impact of prehabilitation remains controversial due to a short presurgical waiting period and the diminished capacity of the patient population. A strategy to augment and optimize the effectiveness of prehabilitations for abdominal cancer patients may be found in the unlikely field of sport science. We investigated the use of blood flow restriction training and sport nutrition supplementation to augment functional capacity and increase muscle strength in twenty-four abdominal cancer patients awaiting surgery.The sport science-based program was comprised of blood flow restriction exercise 5 to 6 times per week and a daily sports nutrition supplement containing l-citrulline, creatine monohydrate, and whey protein.After 4 weeks of prehabilitation, 6-min walk test, timed up and go, short physical performance battery, 5-chair stand test and physical component score of quality of life were significantly improved (all p 0.05). Total body and appendicular lean mass as assessed by dual energy X-ray absorptiometry increased by 0.73 ± 1.04 kg (p = 0.004) and 0.42 ± 0.64 kg (p = 0.006), respectively. Total body fat mass and trunk fat mass decreased (p = 0.004 and p = 0.021). There were no significant changes in hand grip strength, fear of falling, the mental component summary of quality of life, or fasting serum concentrations of myostatin, follistatin, and growth hormone.A multimodal prehabilitation program, which encompasses blood flow restriction training and sports nutrition supplements, is both feasible and effective in improving lean mass and physical function in abdominal cancer patients prior to surgery.

Jeon, W, Harrison, JM, Stanforth, PR, and Griffin, L. Bone mineral density differences across female Olympic lifters, power lifters, and soccer players. J Strength Cond Res 35(3): 638-643, 2021-Athletic training improves bone mineral density (BMD) through repeated mechanical loading. The location, intensity, and direction of applied mechanical pressure play an important role in determining BMD, making some sports more advantageous at improving BMD at specific regions. Thirty-seven (10 power lifters [PL], 8 Olympic lifters [OL], 8 soccer players [SP], and 11 recreationally active [RA]) women participated in a cross-sectional study. We measured lumbar spine (L1-L4), femoral neck, total-body BMD, and overall body composition (total fat mass, lean mass, percent body fat) with dual-energy x-ray absorptiometry. All athletic groups had greater total BMD than RA (p = 0.01 [PL]; p < 0.001 [OL]; p = 0.01 [SP]). Olympic lifters had the highest total BMD than all other athletic groups. Olympic lifters had the significantly greater total BMD than PL (p = 0.018), but there was no difference in total BMD between PL and SP. As compared with RA, OL showed greater BMD at both the total lumbar spine (p = 0.002) and the femoral neck (p = 0.007), whereas PL showed greater BMD only for the total lumbar spine (p = 0.019) and SP showed greater BMD only for the femoral neck (p = 0.002). Olympic-style lifting includes both high-impact and odd-impact loading modalities that are associated with the highest BMD at both the lumbar spine and femoral neck.

Bisch, KL, Bosch, TA, Carbuhn, A, Stanforth, PR, Oliver, JM, Bach, CW, and Dengel, DR. Positional body composition of female division I collegiate volleyball players. J Strength Cond Res 34(11): 3055-3061, 2020-The primary study objective was to measure positional differences in total and regional body composition among female NCAA Division I collegiate volleyball players using dual X-ray absorptiometry (DXA). The secondary objective was to examine normative age curves for fat and lean mass (LM) variables. Ninety female volleyball players from 5 universities received a DXA scan. Athletes were categorized by position: middle blocker (MB = 31), outside hitter (OH = 32), setter (ST = 9), and Libero (LB = 18). Height, body mass, total and regional fat mass (FM), LM, bone mineral density (BMD), and abdominal visceral adipose tissue were measured by DXA. Body mass distribution ratios were calculated. The secondary age analysis included a subset of 153 DXA scans (n = 83, ages 18-21 years). Front row players (i.e., MB and OH) had significantly greater total and regional LM and BMD measures (p0.05, all), compared with non-front row players (i.e., LB and ST). Differences in total LM (p0.001) were significantly influenced by height. Front row players had consistently lower mass distribution ratios compared with non-front row players (p0.05, all). Lean mass index (LMI, p = 0.752) and FM index (FMI, p = 0.392) were not significantly different across ages. Back row players have greater relative upper body mass, whereas mass in front row players is more evenly distributed between the upper and lower body. Bone mineral density differences may be influenced by repeated impact of jumping during the attacking and blocking actions of front row players. Minimal changes in LMI and fluctuations in FMI can be expected across an athlete's career.

Physical activity, and likely the motivation for it, varies throughout the day. The aim of this investigation was to create a short assessment (CRAVE) to measure motivation states (wants, desires, urges) for physical activity and sedentary behaviors. Five studies were conducted to develop and evaluate the construct validity and reliability of the scale, with 1,035 participants completing the scale a total of 1,697 times. In Study 1, 402 university students completed a questionnaire inquiring about the want or desire to perform behaviors “at the present moment (right now)”. Items related to physical activity (e.g., “move my body”) and sedentary behaviors (e.g., “do nothing active”). An exploratory structural equation model (ESEM) revealed that 10 items should be retained, loading onto two factors (5 each for Move and Rest). In Study 2, an independent sample (n= 444) confirmed these results and found that Move and Rest desires were associated with stage-of-change for exercise behavior. In Study 3, 127 community-residing participants completed the CRAVE at 6-month intervals over two years-two times each session. Across-session interclass correlations (ICC) for Move (ICC = .72-.95) and Rest (ICC = .69-.88) were higher than when when they were measured across 24-months (Move: ICC = .53; Rest: ICC = .49), indicating wants/desires have state-like qualities. In Study 4, a maximal treadmill test was completed by 21 university students. The CRAVE was completed immediately pre and post. Move desires decreased 26% and Rest increased 74%. Changes in Move and Rest desires were moderately associated with changes in perceived physical fatigue and energy. In Study 5, 41 university students sat quietly during a 50-minute lecture. They completed the CRAVE at 3 time points. Move increased 19.6% and Rest decreased 16.7%. Small correlations were detected between Move with perceived energy and tiredness, but not calmness or tension. In conclusion, the CRAVE scale has good psychometric properties. Data also support tenets of the WANT model of motivation states for movement and rest (Stults-Kolehmainen et al., 2020). Future studies need to explore how desires to move/rest relate to dynamic changes in physical activity and sedentarism.

The purpose of this study was to examine body composition of National Collegiate Athletic Association Division I female soccer players by position and season. One hundred seventy-five female athletes were categorized by positions of forward (n=47), midfielder (n=51), defender (n=57), and goalkeeper (n=20). A dual X-ray absorptiometry scan assessed percent body fat, total lean mass, total fat mass, arm and leg lean mass and fat mass, and visceral adipose tissue. Goalkeepers had significantly higher total, arm, and leg lean mass and fat mass compared to all other positions (p

This study aimed to examine body composition using dual X-ray absorptiometry (DXA) in male and female NCAA Division I collegiate basketball athletes. Two-hundred ten (male [M]/female [F]=88/122) basketball athletes’ total and regional fat mass, lean mass, bone mineral density, and visceral adipose tissue were measured. Athletes were classified as: point guards (M/F=27/34), shooting guards (M/F=18/27), small forwards (M/F=13/18), power forwards (M/F=21/27), and centers (M/F=9/16). ANOVA and Tukey’s HSD assessed positional differences by sex. In males, centers and power forwards had greater total fat mass (p

The purpose of this study was to evaluate total, regional, and throwing versus non-throwing arm body composition measures across the 4 major positions of NCAA Division I female softball players using dual X-ray absorptiometry (DXA) (n=128). Total and regional total mass (TM), fat mass (FM), lean mass (LM), bone mineral density (BMD), bone mineral content (BMC), and visceral adipose tissue were measured. Athletes were separated into: pitchers (n=32), catchers (n=13), outfielders (n=39), and infielders (n=44). ANOVA and Tukey’s HSD assessed total and regional differences between positions. Although no significant total or regional LM differences were observed across positions, outfielders had significantly (p=0.006–0.047) lower total-body, arm, and trunk TM and FM, leg FM, and leg BMC in comparison to pitchers. The throwing arm had significantly (p

Stanforth, D, Lu, T, Stults-Kolehmainen, MA, Crim, BN, and Stanforth, PR. Bone mineral content and density among female NCAA Division I athletes across the competitive season and over a multi-year time frame. J Strength Cond Res 30(10): 2828-2838, 2016-Longitudinal and cross-sectional bone mineral content (BMC) and bone mineral density (BMD) comparisons were made among impact and nonimpact sports. Female collegiate athletes, 18-23 years of age, from basketball (BB; n = 38), soccer (SOC; n = 47), swimming (SW; n = 52), track sprinters and jumpers (TR; n = 49), and volleyball (VB; n = 26) had BMC/BMD measures preseason and postseason over 3 years. Control groups of 85 college females, 18-24 years of age, who completed 2 tests 1-3 years apart and of 170 college females, 18-20 years of age, were used for the longitudinal and cross-sectional analyses, respectively. A restricted maximum likelihood linear mixed model regression analysis with a compound symmetric heterogeneous variance-covariance matrix structure was used for all analyses (p ≤ 0.05). Increases from year-1 preseason to year-3 postseason included the following: total BMC (3.3%), total BMD (1.4%), and spine BMD (4.5%) for BB; total BMC (1.5%) and leg BMD (1.2%) for SOC; arm (1.8%), leg (1.9%), and total BMD (5.7%) for SW; total BMC (2.0%), arm (1.7%), leg (2.3%), pelvis (3.4%), spine (6.0%), and total BMD (2.3%) for TR; and arm (4.1%), leg (2.0%), pelvis (2.0%), spine (2.0%), and total BMD (2.7%) for VB. Comparisons among sports determined that BB had higher BMC and BMD values than all other sports for all variables except spine and total BMD; BB, SOC, TR, and VB had higher total BMC (11-29%), leg BMD (13-20%), and total BMD (9-15%) than SW and CON, and there were few differences among SOC, TR, and VB. In conclusion, small, significant increases in many BMC and BMD measures occur during female athlete's collegiate careers. The BMC and BMD differences between impact and nonimpact sports are large compared with smaller differences within impact sports.

Background and aims: The relation between adiposity and arterial stiffness remains controversial. We determined whether abdominal and visceral adipose tissue may be a better predictor of arterial stiffness than general obesity in middle-aged adults. Methods and results: A total of 146 participants (76 men, 70 women; 50 years) were studied. The automatic vascular screening device (Omron VP-1000plus) was used to measure blood pressure simultaneously in the arms and ankles and to determine arterial stiffness by pulse wave velocity (PWV). Using multiple linear regressions, the relations between indicators of obesity and arterial stiffness were examined after adjustment for confounders. Both carotid-femoral PWV and brachial-ankle PWV were significantly associated with BMI (both P < 0.05) but not with body fat percentage. Measures of abdominal obesity, including waist circumference and visceral fat mass (via DXA), were strongly associated with PWV and remained positively associated with arterial stiffness after adjustment for age and gender. Cardiovascular fitness as assessed by maximal oxygen consumption was related to body fat percentage but not with visceral fat. More favorable cardiovascular health profile was associated with both lower visceral fat mass and PWV (both P < 0.001). Conclusion: Abdominal obesity and visceral fat are associated with large artery stiffness. These findings support the importance of adiposity measures as a risk factor for arterial stiffening in middle-aged adults.

Body composition can affect athletic performance. Numerous studies have documented changes in body composition in female collegiate athletes from pre- to postseason; however, longitudinal studies examining changes across years are scarce. Therefore, the primary purpose of this study was to assess longitudinal body composition changes among female collegiate athletes across 3 years. Two hundred twelve female athletes from basketball (BB; n = 38), soccer (SOC; n = 47), swimming (SW; n = 52), track (sprinters and jumpers; TR; n = 49), and volleyball (VB; n = 26) with an initial mean age of 19.2 ± 1.2 years, height of 172.4 ± 8.9 cm, and total mass of 66.9 ± 9.0 kg had body composition assessments using dual-energy x-ray absorptiometry pre- and postseason over 3 years. A restricted maximum-likelihood linear mixed model regression analysis examined body composition differences by sport and year. Changes (p < 0.05) over 3 years included the following: Lean mass increased in VB from year 1 to 2 (0.7 kg), year 2 to 3 (1.1 kg), and year 1 to 3 (1.8 kg) and in SW from year 1 to 3 (0.6 kg); and percent body fat (%BF) increased in BB from year 1 to 3 (1.7%). There were no changes in SOC or TR. These results indicate that during their college careers, female collegiate athletes can be expected to maintain their %BF and athletes in sports like SW and VB can anticipate an increase in lean mass, but the increases may be less than many athletes, coaches, and trainers envision.

Bosch, TA, Carbuhn, AF, Stanforth, PR, Oliver, JM, Keller, KA, and Dengel, DR. Body composition and bone mineral density of Division 1 collegiate football players: a consortium of college athlete research study. J Strength Cond Res 33(5): 1339-1346, 2019-The purpose of this study was to generate normative data for total and regional body composition in Division 1 collegiate football players using dual-energy x-ray absorptiometry (DXA) and examine positional differences in total and regional measurements. Data were used from the Consortium of College Athlete Research (C-CAR) group. Four hundred sixty-seven players were included in this study. Height, body mass, total and regional fat mass, lean mass, and bone mineral density were measured in each athlete in the preseason (June-August). Players were categorized by their offensive or defensive position for comparisons. Linemen tended to have the higher fat and lean mass measures (p ≤ 0.05 for all) compared with other positions. Positions that mirror each other (e.g. linemen) had similar body composition and body ratios. All positions were classified as overweight or obese based on body mass index (BMI) (>25 kg·m), yet other than offensive and defensive linemen, all positions had healthy percent body fat (13-20%) and low visceral fat mass (

The aim of this study was to determine whether quantity of fat is different across the central (i.e., android, trunk) and peripheral (i.e., arm, leg, and gynoid) regions among young African-American (AA), Asian (AS), Hispanic (HI), and non-Hispanic white (NHW) women. A cohort of 1,161 women (18-30 years) from university physical activity classes were assessed for body composition via dual-emission X-ray absorptiometry (DXA). The mean total body fat percent (TBF%, x = 31.0 ± 7.36%, range = 11.4-54.4%) indicates sufficient variability for the aims. A linear mixed model (LMM) revealed an ethnicity by region fat% interaction (P0.0001). Differences existed between ethnicities for each region fat% (all P's0.0001) except between HI and AA for the arm region (P = 0.0086) and between AS and NHW for all peripheral regions (P0.05). AAs had the highest fat% and HI had the second highest fat% for each region. AS had the third highest fat% for the trunk and android regions. For each ethnicity, the gynoid region had the greatest fat%, followed by the android region, whereas the arm region had the lowest fat%. Future research needs to determine if ethnic differences in central body fat in young women are associated with health outcomes such as cardiovascular disease and insulin resistance.

Objective: To replicate previous research that concluded exercise affects health via a placebo effect: simply telling workers with physically active jobs that their “work is exercise” improves health. Method: A convenience sample of university building service workers (n=53) learned “their work is exercise” or about job safety. Results: Groups demonstrated similar outcomes at 4 and 8 weeks for weight, percent fat, waist circumference, and behavioral measures. Both groups increased self-perception as “regular exercisers”; blood pressure was reduced only in the intervention group. Conclusion: This research did not support the placebo effect. Although enticing, simply changing mind-set does not alter the relationship between exercise and health.

The purpose of this study was to investigate the influence of age, ethnicity, and sex on the body fat percentage (BF%) threshold, the point above which visceral adipose tissue (VAT) increases more rapidly. Participants were 1,756 females and 1,455 males, 18-75 years of age, who had a dual X-ray absorptiometry scan. Using segmented linear regression models for each sex and ethnicity category, the BF% thresholds were identified. The BF% thresholds for females were: Asian 29.2%, Black 35.6%, Hispanic 31.7%, and White 34.2%. For males, they were: Asian 25.3%, Black 23.9%, Hispanic 24.3%, and White 22.8%. Post-threshold, the impact of BF% was amplified for older females (β = 0.28, SE =0.03, p < .001) and males (β = 0.81, SE = 0.06, p < .001). BF% had a weaker association with VAT mass for Black compared to White females (β = -3.05, SE = 1.44, p < .05) and Asian compared to White males (β = -11.40, SE = 2.30, p < .001). The BF% threshold was higher in females and varied more with ethnicity in females. Post-threshold the association of BF% with VAT differed by age and ethnicity, although the influence of ethnicity was different in females than males.

The purpose of this research was to investigate the effects of apriori estrogen replacement therapy (ERT) and endurance exercise training in postmenopausal women on abdominal visceral fat (AFV) and other selected variables related to body composition and the metabolic syndrome (MS). Forty-eight healthy and previously sedentary postmenopausal women (mean age, 54.3 years) who were enrolled in the HERITAGE Family Study (HFS) served as subjects. Of these 48 women, 18 were currently taking ERT and the remaining 30 were taking no supplemental estrogen (NHRT). Computed tomography (CT) scans were used to assess AVF as well as total abdominal fat (TAF) and abdominal subcutaneous fat (ASF). Body mass index (BMI) and waist-to-hip ratios (WHR) were calculated while body fat percentage (%FAT) and total fat mass (FATM) was assessed using underwater weighing. Blood assays for HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), and triglycerides (TG) were conducted at a Centers for Disease Control (CDC) certified laboratory, while blood pressure measurements were assessed using an automated system. All measurements were obtained in duplicate before and after a regimen of endurance exercise training. Analysis of variance (ANOVA) showed AVF to be an average of 31.6 cm(2) less in the women receiving ERT, but lost statistical significance when AVF was adjusted for FATM. Mean values for TAF, ASF, and waist girth were also less in the women receiving ERT, but only waist girth achieved statistical significance. No differences were found in BMI or %FAT, but mean WHR was 5% smaller in the ERT group. Baseline values for HDL-C was higher and LDL-C lower in the ERT group. Prevalence of the MS tended to be greater in the NHRT group, but did not achieve statistical significance. There were no differences in training responses in any of the body composition variables between groups, however, in the ERT group LDL-C decreased with training while TG increased. It was concluded that postmenopausal women taking ERT tended to have lower values of AVF and other indicators of body composition, a more favorable lipid profile, and a slightly reduced risk of the MS when compared with women not taking supplemental hormones. Also exercise training did not improve the overall MS status of either group, as LDL-C status improved in the ERT group while TG decreased in the NHRT group.

Current methods for measuring regional body fat are expensive and inconvenient compared to the relative cost-effectiveness and ease of use of a stereovision body imaging (SBI) system. The primary goal of this research is to develop prediction models for android and gynoid fat by body measurements assessed via SBI and dual-energy x-ray absorptiometry (DXA). Subsequently, mathematical equations for prediction of total and regional (trunk, leg) body adiposity were established via parameters measured by SBI and DXA.A total of 121 participants were randomly assigned into primary and cross-validation groups. Body measurements were obtained via traditional anthropometrics, SBI, and DXA. Multiple regression analysis was conducted to develop mathematical equations by demographics and SBI assessed body measurements as independent variables and body adiposity (fat mass and percentage fat) as dependent variables. The validity of the prediction models was evaluated by a split sample method and Bland-Altman analysis.The R(2) of the prediction equations for fat mass and percentage body fat were 93.2% and 76.4% for android and 91.4% and 66.5% for gynoid, respectively. The limits of agreement for the fat mass and percentage fat were -0.06 ± 0.87 kg and -0.11% ± 1.97% for android and -0.04 ± 1.58 kg and -0.19% ± 4.27% for gynoid. Prediction values for fat mass and percentage fat were 94.6% and 88.9% for total body, 93.9% and 71.0% for trunk, and 92.4% and 64.1% for leg, respectively.The three-dimensional (3D) SBI produces reliable parameters that can predict android and gynoid as well as total and regional (trunk, leg) fat mass.

Objective To study the effects of sex, age and race on the relation between body mass index (BMI) and measured percent body fat (%fat). Design Cross-sectional validation study of sedentary individuals. Subjects The Heritage Family Study cohort of 665 black and white men and women who ranged in age from 17 to 65 y. Measurements Body density determined from hydrostatic weighing. Percentage body fat determined with gender and race-specific, two-compartment models. BMI determined from height and weight, and sex and race in dummy coded form. Results Polynomial regression showed that the relationship between %fat and BMI was quadratic for both men and women. A natural log transformation of BMI adjusted for the non-linearity. Test for homogeneity of log transformed BMI and gender showed that the male-female slopes were within random variance, but the intercepts differed. For the same BMI, the %fat of females was 10.4% higher than that of males. General linear models analysis of the women's data showed that age, race and race-by-BMI interaction were independently related to %fat. The same analysis applied to the men's data showed that %fat was not just a function of BMI, but also age and age-by-BMI interaction. Multiple regression analyses provided models that defined the bias. Conclusions These data and results published in the literature show that BMI and %fat relationship are not independent of age and gender. These data showed a race effect for women, but not men. The failure to adjust for these sources of bias resulted in substantial differences in the proportion of subjects defined as obese by measured %fat.

To investigate the influences of menopause, hormone replacement, and endurance exercise training on cardiovascular hemodynamics and oxygen uptake parameters during exercise in women.Subjects were 338 premenopausal women, 29 postmenopausal women taking hormone replacement, and 28 postmenopausal women not taking hormone replacement, all enrolled in the HERITAGE Family Study. Hemodynamic and oxygen uptake data were gathered on a cycle ergometer at 50 watts (W), 60% peak oxygen uptake, and at peak exercise, both before and after a 20-wk regimen of endurance exercise training on a cycle ergometer.Systolic blood pressure (SBP) during peak exercise was found to be an average of 14 mm Hg less in postmenopausal women receiving hormones than in those not receiving hormones. Furthermore, menopause was associated with a 26.2 mm Hg higher SBP at 50 W power output, which remained physiologically significant after adjustment for age. At 50 W, postmenopausal women not taking hormones showed a 13.8 mm Hg greater training-induced reduction in SBP than those taking hormones.It was concluded that hormone replacement may be associated with a vasodilatory reserve at high exercise intensities and that endurance exercise training elicits favorable hemodynamic and oxygen uptake adaptations during exercise that are, in most instances, independent of menstrual status or hormone replacement.

The purpose of this study was to determine the relationship between changes in maximal oxygen uptake (VO2 max) and submaximal markers of aerobic fitness and changes in risk factors for cardiovascular disease (CVD) and non-insulin-dependent diabetes mellitus (NIDDM) consequent to a 20-week endurance training program. The 502 participants in this study were healthy and previously sedentary men (n = 250) and women (n = 252) of varying age (17 to 65 years) and race (blacks n = 142; whites n = 360) who had completed the HERITAGE Family Study testing and training protocol. Following baseline measurements, participants trained on cycle ergometers 3 days/week for a total of 60 exercise sessions starting at the heart rate (HR) associated with 55% of VO2 max for 30 minutes/session. This was progressively increased to the HR associated with 75% of VO2 max for 50 minutes/session, which was maintained during the last 6 weeks. VO2 max, heart rate at 50 W, power output at 60% of VO2 max, lipids and lipoproteins, resting blood pressure, body composition including abdominal fat (computed tomography [CT] scan), and blood glucose and insulin at rest and at peak following an intravenous glucose tolerance test (IVGTT) were determined both before and after training. Following training, there were significant increases in VO2 max (16%) and the power output at 60% of VO2 max and a significant decrease in HR at 50 W. These changes in markers of aerobic fitness were significantly correlated only to the changes in the body composition variables and the lipids and lipoproteins. Further, there was considerable individual variation in response for all variables studied. Finally, when risk factor data were analyzed by quartile of change in VO2 max, there were few significant relationships. It is concluded that there is a significant relationship between changes in markers of aerobic fitness and changes in several risk factors for CVD and NIDDM. However, the magnitude of these relationships is small.

Purpose: The purpose of this study was to determine the magnitude of changes in cardiac output (Qc), stroke volume (SV), and arterial-mixed venous oxygen difference (a-vO 2 diff) during submaximal exercise following a 20-wk endurance training program, with the primary focus on identifying differences in response by race, sex, and age. Methods: The participants in this study (N = 631) were healthy and previously sedentary men (N = 277) and women (N = 354) of varying age (17-65 yr) and race (blacks, N = 217; whites, N = 414) who had completed the HERITAGE Family Study protocol. After baseline measurements, participants trained on cycle ergometers 3 d.wk -1 for a total of 60 exercise sessions starting at the HR associated with 55% of maximal oxygen uptake (VO 2max ) for 30 min/session and building to the HR associated with 75% of VO 2max for 50 min/session, which was maintained during the last 6 wk. HR, Qc (CO 2 rebreathing), and SV (Qc/HR) were determined in duplicate at 50 W and at 60% of VO 2max on two different days both before and after training. Results: After training, there were significant decreases in HR and Qc, and significant increases in SV and a-vO 2 diff at 50 W (except for no change in a-vO 2 diff in black men). The changes in HR differed by sex and age, and the changes in SV, Qc, and a-vO 2 diff differed by race. Qc decreased by 0.6 L.min -1 at 50 W for the total sample, consistent with the decrease in VO 2 at this power output. At 60% of VO 2max , HR decreased, and SV, Q, and a-vO 2 diff increased. There were small differences in response by sex (HR and SV), race (HR), and age (HR and Qc). Conclusion: It is concluded that the cardiovascular systems of men and women, blacks and whites, and younger and older subjects are not limited in their ability to adapt to endurance training.

The purpose of this study was to determine the magnitude of change in resting and exercise heart rate (HR) and blood pressure (BP), by race, sex, and age, after a 20-wk endurance training program in 507 healthy and previously sedentary subjects from the HERITAGE Family Study.After baseline measurements, subjects exercised on cycle ergometers 3 d x wk(-1) for a total of 60 exercise sessions starting at 55% of VO2max for 30 min x session(-1) and building to 75% of VO2max for 50 min x session(-1) for the last 6 wk. HR and BP at rest and during exercise (50 W, 60% of VO2max maximal exercise) were each determined in duplicate on two different days both before and after training (resting values at 24-h and 72-h posttraining).After the period of training, there was a small decrease in resting HR (-2.7 to -4.6 beats x min(-1) across groups at 72-h posttraining), and small changes (i.e.,3 mm Hg) in resting systolic (SBP), diastolic (DBP), and calculated mean BP (MBP), which varied by race, sex, and age. During exercise at the same absolute work rate (50 W), HR, SBP, DBP, and MBP were all significantly reduced, with greater reductions in HR in women compared with men, and greater reductions in BP in blacks and older subjects compared with whites and younger subjects, respectively. At the same relative work rate (60% VO2max), HR, DBP, and MBP were reduced, but SBP remained unchanged. Blacks had a greater reduction in DBP, but whites had a greater reduction in HR. Finally, at maximal exercise, there was a small decrease in HR, with men and whites decreasing more than women and blacks; an 8 mm Hg increase in SBP, with men increasing more than women; a 4 mm Hg decrease in DBP, with blacks decreasing more than whites; and no change in MBP.In conclusion, the reductions in resting HR and BP with training were generally small, but the reductions during exercise were substantial and clinically important, with the older and the black populations experiencing greater reductions.

PURPOSE: This study determined the reproducibility of resting systolic and diastolic blood pressure, mean arterial pressure, and heart rate (the average of three measures/day). METHODS: The data were obtained on two separate days prior to an exercise training intervention in a sample of 822 subjects participating in the HERITAGE Family Study. The same protocol was conducted across three days in an intracenter quality control substudy, which included an additional 60 subjects. RESULTS: Reproducibility estimates included technical error, coefficient of variation within subjects, and intraclass correlation with results expressed by sex, race, age, cuff size, BMI, and %fat. Since the data were collected across four Clinical Centers, the reproducibility estimates were also computed separately for each Center. The systolic, diastolic, and mean arterial blood pressures were highly reproducible with technical errors less than 5.1 mmHg, coefficients of variation of less than 7.0% and intraclass correlations > 0.75. The heart rates were slightly less reproducible. These results were fairly consistent across subject populations and across all four Clinical Centers. CONCLUSION: It is concluded that within subject day-to-day variations are small compared to between subject variance for resting systolic, diastolic, and mean arterial blood pressure and heart rate at each of the Clinical Centers for all of the HERITAGE Family Study data. This makes it appropriate to pool the data and analyze it for changes subsequent to endurance exercise training and to determine the possible genetic basis for these changes.

Background Obesity is a major public health problem in the United States. The role of physical activity and formal exercise in controlling body weight has not been clearly determined. Objective This study determined the magnitude of change in body weight and composition across sex, race, and age in response to 20 wk of endurance training. Design Men and women (n = 557) of various ages (16-65 y) and 2 races (black and white) exercised on cycle ergometers 3 d/wk for a total of 60 exercise sessions starting at 55% of maximal oxygen consumption (VO(2)max) for 30 min/session and building to 75% of VO(2)max for 50 min/session, where it was maintained during the last 6 wk. Skinfold-thickness measurements, circumferences, body composition (by hydrostatic weighing), and body fat distribution (by computed tomography scan at L4-L5 and the waist-hip ratio) were determined before and after training. Results All skinfold-thickness and circumference measures, waist-hip ratio, body mass index, total body mass, fat mass, percentage body fat, and computed tomography scan measures of total, subcutaneous, and visceral abdominal fat decreased with training, whereas total body density and fat-free mass increased. These changes were significant, but small. There were several differences in training response by sex and race, but not by age. Conclusions A short-term exercise intervention can induce favorable changes in body composition, but the magnitude of these changes is of limited biological significance. Increasing physical activity likely has a major effect on body-composition and fat distribution characteristics only when it is of a greater magnitude and sustained for much longer periods

The Resistaball® is an inflatable plastic ball designed for “stability training” of the trunk. The purpose of this study was to compare traditional floor work (T) with Resistaball® exercise (R) in training the abdominal and back extensor muscles. Fifty-five female subjects ranging in age from 20 to 40 years participated in the study. The T group (15 subjects) and R group (20 subjects) participated in pretesting, 10-weeks of exercise, and post-testing; while the non-exercising controls (C group; 20 subjects) participated only in pretesting and post-testing. The exercise program for both the T and R groups consisted of crunches, oblique twists, and back extensions on the floor (T) or ball (R). Subjects performed no other abdominal or back training over the 10-week period. The pretest and post-test consisted of double leg lowering (DLL), trunk flexion (AB), and back extension (BE). For DLL, each subject was supine with hips flexed at 90° and was asked to slowly lower both legs. The point at which there was any movement at the lower back or pelvis was measured using a Universal goniometer. The AB and BE tests were conducted on Cybex® machines. Subjects self-selected a resistance they determined to be “somewhat hard to hard” and flexed or extended repeatedly against that resistance to volitional failure or until they were unable to perform the movement correctly. During post-testing, subjects completed the AB and BE tests to volitional failure using the pretest resistance. A one-way ANOVA with paired t-tests and General Linear Model were used to analyze the data for initial differences, net gain, percent gain, and group factor. For DLL, those in the R group using the Resistaball® improved significantly more than either those who used traditional floor work or controls ( p < 0.05). For AB, there was no significant difference between any of the groups ( p > 0.05). For BE, both those who used Resistaball® training and those who used traditional floor work improved significantly more than controls ( p < 0.05), but there was no difference between the R and T groups ( p > 0.05). In conclusion, exercise training with the Resistaball® was comparable to traditional floor work for training the abdominal and back muscles and may be of greater benefit for functional activities that require spinal and pelvic stabilization.

OBJECTIVE: To determine the reproducibility of anthropometric and body composition measures using the HERITAGE Family Study protocol. DESIGN: Anthropometric and body composition measures were obtained on three separate days within a 3-wk period at each of the four HERITAGE Clinical Centers. SUBJECTS: Sixty men and women representative of the HERITAGE subject population, 15 from each of four Clinical Centers. MEASUREMENTS: Anthropometric measures included eight skinfolds, three girths and one length; and body composition measures included stature, mass, hydrostatic weight, residual volume, and body density, from which relative fat, fat mass and fat-free mass were estimated. RESULTS: Reproducibility as determined by technical error, coefficient of variation, and intraclass correlations was very high for the total sample. For example, intraclass correlations for the total sample generally ranged from 0.95–0.99 for the anthropometric measures, and from 0.97–1.00 for the body composition measures. The results across Clinical Centers were in close agreement with each other and with the pooled data. CONCLUSIONS: The reproducibility of anthropometric and body composition measures using the HERITAGE Family Study protocol is sufficiently high that it should be possible to detect small changes in any of these measures and to determine the genetic basis of these changes consequent to a 20 wk endurance training program.

This study determined the effects of a 20-wk endurance training program (The HERITAGE Family Study) on resting heart rate (HRrest). HRrest was obtained on a sample of 26 men and 21 women during sleep; during resting metabolic rate and resting blood pressure measurement periods in the early morning following a 12-h fast and 24-h post-exercise; and at rest prior to a maximal bout of exercise. Following training, the subjects exhibited a 16.0 +/- 9.4% (mean +/- SD) increase in VO2max (P0.05), but the HRrest for each of the resting conditions was decreased by only 1.9 to 3.4 bpm (P0.05), or an average across the three conditions of 2.7 bpm. In a larger sample of 253 HERITAGE subjects, HRrest obtained only at the time of the resting blood pressure measurement decreased by only 2.6 bpm, while VO2max increased 17.7 +/- 10.0%. It is concluded that there is a significant, but small, decrease in resting heart rate as a result of 20 wk of moderate- to high-intensity endurance training; which suggests a minimal alteration in either, or both, intrinsic heart rate and autonomic control of HRrest.

Objective: The aim of this study was to determine whether the quantity of fat is different across the central (that is, android, trunk) and peripheral (that is, arm, leg and gynoid) regions among young African-American (AA), Asian (AS), Hispanic (HI) and non-Hispanic White (NHW) men. Subjects and Methods: A cohort of 852 men (18–30 years; mean total body fat percent (TBF%)=18.8±7.9, range=3.7–45.4) were assessed for body composition in five body regions via dual-emission X-ray absorptiometry (DXA). Results: HI men (21.8±8.3) had higher TBF% than AA (17.0±10.0), NHW (17.9±7.2) and AS (18.9±8.0) groups (P-values

This paper reports the evaluation tests on the reliability and validity of a 3-dimensional (3D) laser body scanner for estimation of body volume and % fat. Repeated measures of body imaging were performed for reproducibility analysis. Validity of the instrument was assessed by comparison of measures of body volume by imaging to hydrodensitometry, and body fat was compared to hydrodensitometry and dual energy X-ray absorptiometry. Reproducibility analysis showed little difference between within-subjects measurements of volume (ICC ≥ 0.99, p < 0.01). Body volume estimations by laser body scanner and hydrodensitometry were strongly related (r = 0.99, p < 0.01), and agreement was high (ICC = 0.99, p < 0.01). Measurements of % body fat also agreed strongly with each other between methods (ICC = 0.86, p < 0.01), and mean % fat estimates by body imaging did not differ from criterion methods (p > 0.05). These findings indicate that the 3D laser body scanner is a reliable and valid technique for the estimation of body volume. Furthermore, body imaging is an accurate measure of body fat, as compared to dual energy X-ray absorptiometry. This new instrument is promising as a quick, simple to use, and inexpensive method of body composition analysis.

The purpose of this study was to: (1) verify the aerobic requirement (AR) of bench stepping (BS); (2) determine the effect of leg length (LL), bench height (BH), stepping rate (SR), body weight (BW), and fat free mass (FFM) on the AR of BS; and (3) compare the HR and VO2 of BS with treadmill walking/running (TM). Twenty-eight females completed randomly assigned BS sessions with hands on hips at 30 and 32 step cycles.min-1. Sessions consisted of four 5 min. bouts at BH of 15.2, 30.4, 25.4 and 30.5 cm. A 4 x 2 repeated measures ANOVA determined that VO2 was significantly different between each BH and SR (p0.01) with no significant interaction between BH and SR (p0.05). A stepwise multiple regression determined that BH, BW, SR, FFM, and LL significantly affected BS VO2 (p0.05) with BH and BW accounting for 83% of the VO2. A series of t-tests found no significant difference (p0.05) between measured VO2 and that predicted by the ACSM equation (1) at 15.2, 20.3 and 25.4 cm. Measured VO2 was significantly greater than predicted at 30.5 cm (p0.01). A repeated measures ANCOVA determined that the VO2/HR slopes for BS and TM were not parallel (p0.01). Point testing determined that the HR elicited by TM at a specific VO2 was significantly higher than the BS HR until 34 ml.kg-1 x min-1, but the SEE revealed large overlapping of HR.(ABSTRACT TRUNCATED AT 250 WORDS)