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Biomedical subjects

H W Kohl

Publications and source records attributed to H W Kohl.

At least 55 records · Page 3Linked to original sources
PubMed1993

Physical activity, physical fitness, and all-cause mortality in women: do women need to be active?

Physical inactivity is associated with higher mortality rates in most studies in men, but studies in women are more equivocal. The purpose of this study was to evaluate the relationship of sedentary living habits to all-cause mortality in women. A group of 3,120 adult women completed a preventive medical examination, and were followed for approximately 8 years for mortality. There were 43 deaths and a total of 25,433 person-years observed during follow-up. Physical fitness was assessed at baseline by a maximal exercise test on a treadmill, and physical activity was estimated by a self-administered questionnaire. Age-adjusted all-cause mortality rates were significantly inversely associated with physical fitness. Death rates were 40, 16, and 7 per 10,000 person-years of follow-up across low, moderate, and high categories of physical fitness, respectively. However, death rates did not differ across low, moderate, and high categories of physical activity. These findings are different than for men in the same study, where both physical activity and physical fitness were inversely associated with mortality risk. We attribute the lack of association between physical activity and mortality in women to be due to inadequate assessment of activity, and that this also is the likely explanation for the difference in results between women and men in published studies of physical activity and mortality.

Adult↗
PubMed1993

Surveillance of serious recreational injuries: a capture-recapture approach.

Serious injury from sport and recreation is a leading cause of morbidity and mortality in the United States. Historically, occurrences of diseases with substantial public health impact have been monitored via surveillance systems in order to obtain information concerning the frequency with which the diseases occur. Surveillance leads to efforts that identify risk factors, and eventually, control measures to reduce the incidence of disease. Currently, the surveillance of sports injury represents only limited coverage in the U.S. It is important to begin discussions regarding approaches toward the development of surveillance of these injuries. Methods based upon the communicable disease surveillance model could potentially be used to monitor serious sports injuries. One method of surveillance, using the statistical approach of capture-mark-recapture, is presented as an example by which a national system of surveillance of serious sports injury could be established.

Athletic Injuries↗
PubMed1992

Anxiety, depression, physical fitness, and all-cause mortality in men.

The association of low physical fitness with an increased risk of mortality is independent of physiological risk factors, but psychological variables such as anxiety and depression have not been evaluated as possible confounders for all-cause mortality. The purpose of this study was to evaluate the possible confounding effects of anxiety and depression on the relation between physical fitness and mortality in male patients who were given a preventive medical examination between 1977-1986. Physical fitness was measured by maximal exercise treadmill testing. Anxiety and depression were measured by the Clinical Analysis Questionnaire. During follow-up, 83 men died. These cases, aged 19-76 yr, were combined for analyses with 323 randomly selected comparison subjects aged 19-80 yr. The crude odds ratio (95% confidence intervals) for dying in the unfit men was 2.0 (1.1,3.5) compared to the physically fit men. This finding was essentially unchanged after adjustment for anxiety (2.0 (1.1,3.5)), depression (2.1 (1.2,3.8)), or anxiety and depression (2.1 (1.1,3.5)). The increased risk of death in unfit men is not confounded by anxiety or depression. Thus, the higher all-cause death rate in unfit men cannot be explained by higher levels of anxiety or depression.

Adult↗
PubMed1992

How much physical activity is good for health?

Research studies over the past several decades confirm the health benefits of regular physical activity, a concept with foundations in antiquity. The effects of activity on certain individual health conditions, the precise dose of activity that is required for specific benefits, the role (if any) of intensity of effort, and the elucidation of biological pathways whereby activity contributes to health are topics for further research. Although details remain to be clarified, it is now clear that regular physical activity reduces the risk of morbidity and mortality from several chronic diseases and increases physical fitness, which leads to improved function. Table 3 outlines the relationship of activity to several diseases, a judgment on the strength of the evidence, and a rough determination of the amount of research extant. Results from clinical exercise studies and epidemiological investigations can be integrated into a consistent and coherent theory of healthful physical activity. However, some differences between these two research streams need to be reconciled. Exercise physiologists have generally recommended relatively intensive activity and a formal approach to exercise prescription. The epidemiological studies suggest a linear dose-response relationship, at least up to a point, between physical activity and health and functional effects. These data support public health recommendations directed toward the most sedentary and unfit stratum of the population and emphasize doing at least moderate physical activity. If this group of adults would accumulate 30 minutes of walking per day (or the equivalent energy expenditure in other activities), they would receive clinically significant health benefits. An important point is that it does not matter what type of physical activity is performed: Sports, planned exercise, household or yard work, or occupational tasks are all beneficial. The key factor is total energy expenditure; if that is constant, improvements in fitness and health will be comparable. There are probably 40 million adults in the US whose sedentary habits place them at considerably increased risk of morbidity and mortality from several diseases. These same individuals also are more likely to have functional limitations, especially as they move into the later years of life. The sizable independent relative risk for impaired health in sedentary persons, and the large number at risk, leads to a substantial public health burden. This problem deserves continued and increased attention by physicians and other health professionals, scientists, and the public health establishment.

Biological Evolution↗
PubMed1992

Cardiorespiratory fitness, glycemic status, and mortality risk in men.

OBJECTIVE: To determine the association of baseline cardiorespiratory fitness to all-cause mortality across the range of blood glucose levels. RESEARCH DESIGN AND METHODS: Data from a prospective study of 8715 men (average age 42 yr), followed for an average of 8.2 yr (range 1-15 yr), were analyzed. Cardiorespiratory fitness was assessed by maximal-exercise treadmill testing. Men with evidence of clinical vascular disease or who did not achieve 85% of their age-predicted maximum heart rate during exercise testing were excluded from analyses. RESULTS: Age-adjusted death rates increased with higher levels, of fasting blood glucose. Regardless of glycemic status, fit men had lower age-adjusted all-cause death rates than their less fit counterparts. For men with fasting blood glucose greater than or equal to 7.8 mM or physician-diagnosed non-insulin-dependent diabetes mellitus (NIDDM), the age-adjusted death rates per 10,000 person-yr of follow-up in unfit and fit subjects were 82.5 and 45.9, respectively. The age-adjusted relative risk of death due to all causes was significantly elevated in the lower-fitness group within each of three glycemic status levels: fasting blood glucose less than 6.4 mM; relative risk (RR) = 1.93 (95% confidence interval [95% CI] 1.15-3.26); fasting blood glucose 6.4-7.8 mM; RR = 3.42 (95% CI 2.27-5.15); and fasting blood glucose greater than or equal to 7.8 mM or with NIDDM, RR = 1.80 (95% CI = 1.25-2.58). Multivariate analyses, controlling for risk factors of mortality (age, resting systolic blood pressure, serum cholesterol, body mass index, family history of heart disease, follow-up interval, and smoking habit) showed a higher risk of death due to all causes for unfit compared with fit men. Multivariate risks of death associated with low fitness, compared with higher fitness (RR), in the three glycemic status groups were: fasting blood glucose less than 6.4 mM, RR = 1.38 (95% CI 1.09-1.74); fasting blood glucose 6.4-7.8 mM, RR = 1.61 (95% CI 0.91-2.86); and fasting blood glucose greater than or equal to 7.8 mM or with NIDDM, RR = 1.92 (95% CI 0.75-4.90).

Adult↗
PubMed1992

Musculoskeletal strength and serum lipid levels in men and women.

There currently is inconsistent information regarding the role that musculoskeletal strength (one component of musculoskeletal fitness) may have in lipid and lipoprotein metabolism, and consequently the risk of cardiovascular disease. Results of existing studies have been conflicting and have been influenced by several weaknesses. We provide cross-sectional analyses of the relation between muscular strength and serum lipid and lipoprotein status in a group of 1,193 women and 5,460 men. The large proportion of patients were not involved in formal weight training. As part of a preventive medical examination, patients were tested for maximal upper and lower body strength (one repetition maximum (1RM) bench and leg press). Fasting serum total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), triglyceride (TG), and high density lipoprotein (HDLC) were evaluated for their relation to muscle strength, after adjusting for simultaneous associations with age, body composition, and cardiovascular fitness. Results showed no association between muscular strength and serum TC or LDLC for either men or women and a direct association between upper and lower body strength and TG in men. The direct association between strength and TG in women was not significant. A statistically significant inverse association was seen between muscular strength and HDLC in men only. These data suggest no beneficial effect, and perhaps an adverse association of muscular strength on lipid and lipoprotein status.

Adult↗
PubMed1991

Physical fitness effects on substance abuse risk factors and use patterns.

In this study, seventy-four adolescents in either a school, community or hospital based drug intervention program received and eight to nine week structured fitness activity class as an integrated element of their respective prevention or treatment program. Prepost assessments indicated significant gains in the field fitness tests of one mile run, 1 minute situp, 1 minute pushup, percent fat and flexibility for the total sample. Based upon prepost change on the one mile run time (less than 1:00) subjects were categorized as improvers (n = 38) and non-improvers (n = 36). Improvers demonstrated a significant increase in the self concept risk factor (Piers Harris Self Concept Scale) and a significant decrease in anxiety and depression risk factors (General Well-Being Scale) compared to the non-improvers. At posttest, the improvers self reported substance use patterns were significantly lower compared to the non-improvers for percentage of the sample who were multiple drug users and alcohol uses per week and were significantly higher for the percentage of the sample demonstrating total abstinence. These findings are suggestive of the usefulness of physical training as a supplemental intervention for adolescent substance abusers.

Adolescent↗
PubMed1991

Physical fitness and all-cause mortality in hypertensive men.

All-cause death rates in normotensive and hypertensive men were examined across physical fitness levels. Subjects were 10,224 healthy normotensive men and 1,832 men who reported a history of hypertension, but were otherwise healthy. Physical fitness was determined by maximal treadmill exercise testing. Baseline preventive medical examinations were given during 1970-1981, and mortality surveillance was conducted on the cohort through 1985. There were 240 deaths in the normotensive men and 78 deaths in hypertensive men. Age-adjusted all-cause mortality rates per 10,000 man-years of follow-up in normotensive men ranged from 64.0 in the least fit quintile to 18.6 in the most fit quintile. Corresponding rates for hypertensive men were 110.5 to 24.8. Subjects were further classified into lower and higher blood pressure groups by baseline resting systolic blood pressure (less than 140 mmHg and greater than or equal to 140 mmHg). Normotensive and hypertensive men who were more fit had lower death rates compared to less fit men within both of the measured blood pressure strata. The relation between fitness and all-cause mortality held in multiple logistic regression analyses after adjustment for the influence of age, serum cholesterol, resting systolic blood pressure, body mass index, current smoking habit, and length of follow-up. We conclude that low levels of physical fitness result in an increased risk for all-cause mortality in normotensive and hypertensive men.

Adult↗
PubMed1990

Effect of intrinsic sympathomimetic activity on the ability of hypertensive patients to derive a cardiorespiratory training effect during chronic beta-blockade.

The effect of intrinsic sympathomimetic activity (ISA) on the ability of patients with high blood pressure (BP) to derive a cardiorespiratory training effect during long-term beta-blocker therapy was studied. Fifty sedentary hypertensive subjects were randomly assigned to propranolol (n = 23) or pindolol (n = 27) therapy for a 22 week double-blind parallel study. Over the first 2 weeks, during which subjects remained sedentary, drug doses were titrated to produce equipotent, clinically significant BP reductions. Subjects subsequently continued drug therapy and completed 20 weeks of exercise training. Although pindolol tended to preserve submaximal exercise heart rates to a greater degree than propranolol, the initial 2 weeks of drug therapy resulted in equivalent reductions in maximal oxygen uptake with propranolol (6% reduction) and pindolol (8% reduction). Likewise, 20 weeks of training induced similar, statistically significant (P = .0001) increases in maximal oxygen uptake during propranolol (10% increase) and pindolol (11% increase) treatment. We therefore conclude that ISA does not confer any advantage to patients with high BP who receive chronic beta-blocker therapy and wish to improve their cardiorespiratory fitness by participating in exercise training.

Adrenergic beta-Antagonists↗
PubMed1990

Effect of a high carbohydrate diet on core temperature during prolonged exercise.

This study compared the effects of a high-carbohydrate and a mixed diet on core temperature responses to prolonged exercise in six male competitive cyclists (age = 22.2 +/- 1.9 years). This study, the first to investigate the effect of a high-carbohydrate diet on exercise core temperature in humans, therefore suggests that three days of increased dietary carbohydrate intakes do not evoke any deleterious thermoregulatory responses during prolonged submaximal exercise.

Adult↗
PubMed1990

Exercise tolerance and alcohol intake. Blood pressure relation.

The relations of systolic and diastolic blood pressures to alcohol intake and exercise tolerance levels in 15,612 men and 3,855 women were investigated. Alcohol intake was assessed by questionnaire and stratified into seven levels for men and six for women according to the ounces of ethanol consumed per week. Exercise tolerance was determined by maximal treadmill exercise testing and was categorized into six age-specific by sex-specific levels. Both systolic and diastolic blood pressure were significantly related to both alcohol intake and exercise tolerance levels in both men and women. These relations, which were positive for alcohol and negative for exercise tolerance, remained after covariance adjustment for age, body mass index, and cigarette smoking. Alcohol intake was not significantly correlated with exercise tolerance. The relation of blood pressure to alcohol was not linear because the blood pressure of moderate consumers of alcohol tended to be slightly lower than that of nondrinkers. Higher blood pressure was found only in drinkers whose ethanol intake exceeded 9.5 ounces (approximately 285 ml or 19 drinks) per week. However, heavy drinkers in high exercise tolerance categories had no higher blood pressure than nondrinkers in low exercise tolerance groups. Exercise tolerance or physiological fitness appears to be important in quantifying the relation between alcohol intake and blood pressure and should be considered in describing this relation.

Adolescent↗
PubMed1990

Intake and food sources of dietary fat among schoolchildren in The Woodlands, Texas.

To investigate the nutrient intake and food use patterns among schoolchildren, diet was assessed among 138 children and adolescents in grades 5 through 12 using three random, nonconsecutive, 1-day food records. Mean intake of total fat, saturated fat, and polyunsaturated fat as percent of calories was 35.6%, 13.4%, and 6.6%, respectively. Among all subjects, 17% consumed diets containing less than 30% of calories from fat, 34% consumed greater than or equal to 38% of calories from fat, 7% consumed less than 10% of calories from saturated fatty acids, and greater than 97% ate less than 300 mg of cholesterol per day. While intake of calories, sodium, and beta-carotene per 1000 kcal was higher in subjects consuming higher fat diets, intake of other micronutrients was either higher among those eating low-fat diets or did not differ by level of fat intake. Differences were seen in the amount of saturated fat and cholesterol that individual food sources contributed to the diets of subjects eating high and low fat diets. These cross-sectional data show that a substantial proportion of children and adolescents in this population are consuming diets low in fat and cholesterol without systematic differences in intake of other nutrients, suggesting that current dietary guidelines regarding fat intake are attainable within the current food use pattern of healthy, school-aged children and adolescents.

Adolescent↗
PubMed1990

An empirical evaluation of the ACSM guidelines for exercise testing.

The American College of Sports Medicine (ACSM) has published exercise guidelines identifying individuals who should have an exercise test prior to clearance for exercise participation and whether a physician should supervise the test. These age and health status criteria (apparently healthy, higher risk, and diseased) were developed using clinical judgement and opinion rather than empirical data. Thus, there is a need to validate the recommendations with actual data. We studied the results of 24,332 maximal treadmill tests in men (n = 18,076) and women (n = 5,626) as they associated with age and baseline health status. Commonly accepted criteria for abnormal exercise tests were used (i.e., 1 mm ST segment depression at 0.08 s, systolic blood pressure drop with exercise, complex ventricular ectopy, etc.). There were 895 and 183 abnormal exercise tests in men and women, respectively. Men and women who were apparently healthy had lower abnormality rates per 1,000 tests than those considered to be at higher risk for coronary heart disease and those who had preexisting disease. Further, when those who were at higher risk were considered, those men with only one risk factor had significantly lower abnormality rates than did men with more than one risk factor (95% confidence intervals (CI) per 1,000 tests: 1 risk factor = 36.1-46.4; greater than 1 risk factor = 47.5-62.5). Abnormality rates in women with 1 risk factor were also lower than those in their peers with greater than 1 risk factor, but not statistically so (95% CI per 1,000 tests: 1 risk factor = 24.9-43.0; greater than 1 risk factor = 25.3-54.4).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗