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Biomedical subjects

Urho M Kujala

Publications and source records attributed to Urho M Kujala.

At least 19 recordsLinked to original sources
PubMed2006

Genetic influences on exercise participation in 37,051 twin pairs from seven countries.

BACKGROUND: A sedentary lifestyle remains a major threat to health in contemporary societies. To get more insight in the relative contribution of genetic and environmental influences on individual differences in exercise participation, twin samples from seven countries participating in the GenomEUtwin project were used. METHODOLOGY: Self-reported data on leisure time exercise behavior from Australia, Denmark, Finland, Norway, The Netherlands, Sweden and United Kingdom were used to create a comparable index of exercise participation in each country (60 minutes weekly at a minimum intensity of four metabolic equivalents). PRINCIPAL FINDINGS: Modest geographical variation in exercise participation was revealed in 85,198 subjects, aged 19-40 years. Modeling of monozygotic and dizygotic twin resemblance showed that genetic effects play an important role in explaining individual differences in exercise participation in each country. Shared environmental effects played no role except for Norwegian males. Heritability of exercise participation in males and females was similar and ranged from 48% to 71% (excluding Norwegian males). CONCLUSIONS: Genetic variation is important in individual exercise behavior and may involve genes influencing the acute mood effects of exercise, high exercise ability, high weight loss ability, and personality. This collaborative study suggests that attempts to find genes influencing exercise participation can pool exercise data across multiple countries and different instruments.

Adult↗
PubMed2006

Increased physical activity decreases hepatic free fatty acid uptake: a study in human monozygotic twins.

Exercise is considered to be beneficial for free fatty acid (FFA) metabolism, although reports of the effects of increased physical activity on FFA uptake and oxidation in different tissues in vivo in humans have been inconsistent. To investigate the heredity-independent effects of physical activity and fitness on FFA uptake in skeletal muscle, the myocardium, and liver we used positron emission tomography (PET) in nine healthy young male monozygotic twin pairs discordant for physical activity and fitness. The cotwins with higher physical activity constituting the more active group had a similar body mass index but less body fat and 18 +/- 10% higher (P < 0.001) compared to the less active brothers with lower physical activity. Low-intensity knee-extension exercise increased skeletal muscle FFA and oxygen uptake six to 10 times compared to resting values but no differences were observed between the groups at rest or during exercise. At rest the more active group had lower hepatic FFA uptake compared to the less active group (5.5 +/- 4.3 versus 9.0 +/- 6.1 micromol (100 ml)(-1) min(-1), P = 0.04). Hepatic FFA uptake associated significantly with body fat percentage (P = 0.05). Myocardial FFA uptake was similar between the groups. In conclusion, in the absence of the confounding effects of genetic factors, moderately increased physical activity and aerobic fitness decrease body adiposity even in normal-weighted healthy young adult men. Further, increased physical activity together with decreased intra-abdominal adiposity seems to decrease hepatic FFA uptake but has no effects on skeletal muscle or myocardial FFA uptake.

Adipose Tissue↗
PubMed2006

Relationship between local perfusion and FFA uptake in human skeletal muscle-no effect of increased physical activity and aerobic fitness.

We investigated heredity-independent effects of increased physical activity and aerobic fitness on skeletal muscle free fatty acid (FFA) uptake, perfusion, and their heterogeneity at rest and during exercise. Also, the relationship between local skeletal muscle FFA uptake and perfusion was studied. Nine young adult male monozygotic twin pairs with significant difference in physical activity [229 min (SD 156) average time spent for conditioning exercise per week in more and 98 min (SD 71) in less active twins, P = 0.013] and aerobic fitness [18% (SD 10) difference in maximum O2 uptake] between brothers were studied using positron emission tomography. Submaximal knee-extension exercise increased perfusion, FFA uptake, and oxygen uptake in quadriceps femoris muscles 6-10 times compared with resting values (P < 0.001). More active twins tended to utilize more oxygen, while no differences were found in muscle perfusion or FFA uptake between groups. Mean perfusion and FFA uptake correlated strongly at a whole muscle level, both at rest (r = 0.97, P = 0.03 in more and r = 0.98, P = 0.02 in less active twins) and during exercise (r = 0.99, P = 0.01 and r = 0.94, P = 0.06), but at the voxel level (87 mm3) correlation was only moderate during exercise [r = 0.73 (SD 0.08) vs. r = 0.74 (SD 0.10), P = 0.92] and weak at rest [r = 0.28 (SD 0.13) vs. r = 0.33 (SD 0.21), P = 0.58]. Exercise decreased both perfusion and FFA uptake heterogeneity within the muscles (P < 0.001) similarly in both groups. In conclusion, long-term history of moderately increased physical activity tends to enhance muscle oxidative metabolism, but it does not have any significant influence on the FFA uptake or perfusion rates or their heterogeneity in skeletal muscle. Submaximal knee-extension exercise decreases heterogeneity of muscle FFA uptake and perfusion and improves matching between local muscle perfusion and FFA uptake. Thus it seems that the genetic influence is more important to determine the heterogeneity of perfusion and FFA uptake in skeletal muscle than exercise training.

Blood Flow Velocity↗
PubMed2006

Muscle fiber-type distribution predicts weight gain and unfavorable left ventricular geometry: a 19 year follow-up study.

BACKGROUND: Skeletal muscle consists of type-I (slow-twitch) and type-II (fast-twitch) fibers, with proportions highly variable between individuals and mostly determined by genetic factors. Cross-sectional studies have associated low percentage of type-I fibers (type-I%) with many cardiovascular risk factors. METHODS: We investigated whether baseline type-I% predicts left ventricular (LV) structure and function at 19-year follow-up, and if so, which are the strongest mediating factors. At baseline in 1984 muscle fiber-type distribution (by actomyosin ATPase staining) was studied in 63 healthy men (aged 32-58 years). The follow-up in 2003 included echocardiography, measurement of obesity related variables, physical activity and blood pressure. RESULTS: In the 40 men not using cardiovascular drugs at follow-up, low type-I% predicted higher heart rate, blood pressure, and LV fractional shortening suggesting increased sympathetic tone. Low type-I% predicted smaller LV chamber diameters (P < or = 0.009) and greater relative wall thickness (P = 0.034) without increase in LV mass (concentric remodeling). This was explained by the association of type-I% with obesity related variables. Type-I% was an independent predictor of follow-up body fat percentage, waist/hip ratio, weight gain in adulthood, and physical activity (in all P < or = 0.001). After including these risk factors in the regression models, weight gain was the strongest predictor of LV geometry explaining 64% of the variation in LV end-diastolic diameter, 72% in end-systolic diameter, and 53% in relative wall thickness. CONCLUSION: Low type-I% predicts obesity and weight gain especially in the mid-abdomen, and consequently unfavourable LV geometry indicating increased cardiovascular risk.

Adult↗
PubMed2006

Physical and psychological functioning of daily living in relation to physical activity. A longitudinal study among former elite male athletes and controls.

BACKGROUND AND AIMS: Physical exercise plays an important role in the prevention and reduction of disabilities in elderly people. The aim of this study was to determine the role of physical activity in the physical and psychological functioning of daily living in a cohort of former elite male athletes representing different sports, and controls of middle and old age. METHODS: Subjects were 664 former elite male athletes (mean age 64.4 years) and 500 controls (62.0 years) in middle and old age. Subjects were mailed "Physical activity and health survey" questionnaires in 1985 and 1995. The primary outcomes the physical and psychological functioning of daily living--were assessed in 1995 using items from the Mini-Finland Health Survey. Logistic regression was used for longitudinal as well as cross-sectional analyses to estimate odds ratios (OR) for poor physical and psychological functioning of daily living in relation to recreational physical activity adjusted for age, sport group, life-style, BMI, mood, chronic diseases, personality characteristics, life-events and socio-economic status. RESULTS: In the longitudinal analysis, low levels of physical activity (lowest MET quintile vs highest quintile) in 1985 (OR 4.91, 95% confidence interval (CI) 2.02-11.9), older age (> or =70 yrs vs under 60 yrs OR 9.93, 95% CI 4.90-20.2), depression (OR 2.03, 95% CI 1.01-4.09) and anxiety in 1995 (OR 2.67, 95% CI 1.34-5.32) increased the risk of poor physical functioning of daily living in 1995, whereas an increase in a physical activity between 1985-1995 (OR 0.89, 95% CI 0.83-0.95) protected against poor physical functioning of daily living. A history of participating in specific types of sports, especially among certain power sports (weight-lifting and track & field throwers) (OR 0.19, 95% CI 0.06-0.60) and team sports (OR 0.34, 95% CI 0.15-0.81) did reveal a significant protective effect against poor psychological functioning of daily living in the longitudinal analysis. CONCLUSIONS: This study suggests that an increase in physical exercise supports physical daily functionality. A specific history of sports participation promotes psychological well-being at an older age.

Activities of Daily Living↗
PubMed2006

A twin study on the heritability of walking ability among older women.

BACKGROUND: This study examined the role of genetic and environmental factors explaining individual differences in women's walking ability in old age. METHODS: A maximal walking speed test over 10 meters and a 6-minute walking endurance test were done under standard conditions among 92 monozygotic and 105 dizygotic pairs of twin sisters reared together, aged 63-75 years. RESULTS: The mean maximum walking speed was 1.73 +/- 0.32 m/s and the mean distance covered in the 6-minute walking test was 525.6 +/- 77.3 m. Multivariate genetic modeling showed that a minor part of the variances in walking speed (16%, 95% confidence interval [CI]: 0%-54%) and endurance (20%, 95% CI: 0%-56%) were accounted for by genetic influences, and that the genetic influences were common to both traits. The corresponding proportions for common environmental factors were 37% (95% CI: 4%-58%) and 26% (95% CI: 0%-52%), and for individual environmental factors 46% (95% CI: 35%-59%) and 54% (95% CI 42%-68%), respectively. The environmental effects were partially common to both traits. CONCLUSIONS: Among relatively healthy older women, a modest portion of the variances of walking speed and endurance were accounted for by genetic factors, whereas shared and individual environmental factors explained most of the variance in both traits.

Aged↗
PubMed2006

Health of master track and field athletes: a 16-year follow-up study.

OBJECTIVE: To study different aspects of health in master athletes. DESIGN: A 16-year follow-up study. SETTING: Finland. PARTICIPANTS: All male Finnish master athletes (N=102, mean age 58.3 years) who in 1985 participated in track and field athletic World Veterans Games. Controls were men, who as young adults had been classified as completely healthy (N=777, mean age 55.0 years). MAIN OUTCOME MEASUREMENTS: Health questionnaires at baseline (in 1985) and at 10-year and 16-year follow-ups. RESULTS: During follow-up, the master athletes self-rated their health as better (P<0.001) and they coped better with leisure-time daily activities (P=0.024) than controls. The adjusted risk for shoulder region (odds ratio 2.84, P<0.03) and Achilles tendon rupture (14.87, P<0.01) after the age of 45 years was higher in the athletes than in the controls. At the 16-year follow-up, none of the athletes, but 9% of controls reported having diabetes mellitus. The adjusted odds ratio of having at least 1 metabolic syndrome disease was 0.43 (P=0.01) in the athletes compared with the controls. At follow-up among subjects without reported coronary heart disease in 1985, the age-adjusted hazard ratio (HR) in the athletes compared with the controls of death from natural-cause was 0.41 (P<0.01). CONCLUSIONS: Master athletes had a lower risk of chronic diseases than the controls. It remains to be determined how far this advantage is due to initial selection and/or incomplete adjustment for covariates. CLINICAL RELEVANCE: There seems to be no such health risks as to why those who have good training background and feel healthy should avoid participating in master athletics.

Adult↗
PubMed2005

Muscle fiber-type distribution as a predictor of blood pressure: a 19-year follow-up study.

The known association between physical activity and low blood pressure may be influenced by inherited characteristics. Skeletal muscle consists of type I (slow-twitch) and type II (fast-twitch) muscle fibers, with proportions highly variable between individuals and mostly determined by genetic factors. A high percentage of type I fibers (type I%) has been associated with low blood pressure in cross-sectional studies. We investigated whether type I percentage predicts future blood pressure levels and explains part of the association between physical activity and blood pressure. At baseline, in 1984, muscle fiber-type distribution, physical activity, and body mass index (BMI) were determined in 64 healthy men (age, 32 to 58 years). At follow-up, in 2003, blood pressure, physical activity, and BMI were determined in these men. In subjects without antihypertensive medication (n=43), type I percentage accounted for 5%/18% of the variation in systolic/diastolic blood pressure. A high type I percentage predicted, independent of both baseline (in 1984) and follow-up (in 2003), physical activity, BMI, and low systolic and diastolic blood pressure. Adjusted for all baseline covariates, a 20-unit higher type I percentage predicted a 11.6-mm Hg lower systolic blood pressure (P=0.018) and a 5.0-mm Hg lower diastolic blood pressure (P=0.018). High levels of physical activity in 1984 predicted low diastolic blood pressure, but this association was lost when type I percentage was included into the model. A high proportion of type I fibers in skeletal muscle is an independent predictor of low blood pressure and explains part of the known association between high levels of physical activity and low blood pressure.

Adult↗
PubMed2005

Cardiac structure and function in monozygotic twin pairs discordant for physical fitness.

Cross-sectional studies in athletes and untrained subjects suggest that exercise training induces adaptations in cardiac structure and function. However, the role of genetic variation on the results has largely been ignored in these studies. The purpose of this study was to investigate the effects of long-term volitionally increased physical activity on electrocardiographic and echocardiographic parameters in male monozygotic twin pairs discordant for physical activity and fitness. On the basis of the mailed questionnaires, a telephone interview, and the inclusion criteria, 12 pairs of young adult male monozygotic twins were recruited from a Finnish twin cohort. All subjects completed a maximal oxygen uptake (.VO2 (max)) test and electrocardiography and echocardiography studies. Nine pairs had at least 9% difference in .VO2(max) and were selected for further analysis and for a second echocardiography study. Twins were divided into the more (MAG) and less active group (LAG), according to their VO2(max). On average, MAG had 18% higher VO2(max) compared with LAG. In electrocardiography, MAG had 29% (P = 0.02) higher Cornell voltage and 37% (P = 0.01) higher right-side hypertrophy index. In echocardiography, no significant differences were observed between the groups, and left ventricular mass index was only 7% (P = 0.16) higher in MAG. These results show that the volitionally increased physical activity that has led to an 18% increase in cardiorespiratory fitness induces greater changes in electro- than echocardiographic parameters. Electrocardiographic changes were suggestive of left ventricular hypertrophy, and echocardiography showed a similar but statistically nonsignificant trend.

Adult↗
PubMed2005

Cumulative incidence of achilles tendon rupture and tendinopathy in male former elite athletes.

OBJECTIVE: To study the cumulative incidence of Achilles tendon rupture and tendinopathy among former top-level athletes. DESIGN: Historical cohort study. SETTING: Finland. PARTICIPANTS: Male former elite athlete cohort members (n = 785; median age, 69 years when responding to the questionnaire; range, 54-97) and their matched controls (n = 416; median age, 68 years; range, 56-94). OUTCOME MEASUREMENTS: Questionnaire-reported Achilles tendinopathy and tendon rupture diagnosed by physicians before the age of 45 years and within the subjects' lifetimes. RESULTS: Cumulative incidence of Achilles tendinopathy before the age of 45 was high for middle and long-distance runners (adjusted odds ratio, 31.2 compared with controls; P < 0.001), and cumulative incidence of Achilles tendon rupture was high for sprinters (odds ratio, 14.9; P < 0.001). CONCLUSIONS: Achilles tendon problems seem to constitute clinically significant and common problems in specific sports.

Achilles Tendon↗
PubMed2004

Primary cartilage lesions and outcome among subjects with patellofemoral pain syndrome.

We investigated the association between cartilage lesion and future symptoms in two groups of subjects with patellofemoral pain syndrome (PFPS). Group A consisted of 31 men (mean age 20.9 years, range 19-32) and group B of 28 consecutive patients (12 men and 16 women; mean age 27.8 years, range 15-50) operated on for PFPS. The mean follow-up time was 3.4 (range 1-7) years in group A and 4.9 (range 1-6) years in group B. At follow-up the subjects in group A with severe cartilage lesion (n = 10) reported more knee symptoms as measured by their Kujala score (mean 75.1, SE 3.6 vs. 88.5, SE 2.4) than those with minor cartilage lesion (n = 21) (age and follow-up time-adjusted P < 0.01). In group B the subjects with severe cartilage lesion tended to report more knee symptoms according to their Kujala score (mean 71.0, SE 7.0 vs. 86.1, SE 5.9; age, sex and follow-up time-adjusted P = 0.15) and VAS score (mean 51.8, SE 11.8 vs. 12.7, SE 10.4; adjusted P = 0.04) than the subjects without cartilage lesion. Our study shows that among the patients with PFPS, the subjects with severe cartilage lesion of the patella or femoral trochlea reported more subjective symptoms and functional limitations at follow-up than those without or with small cartilage lesion of the patella or femoral trochlea.

Adolescent↗
PubMed2004

Relative roles of heredity and physical activity in adolescence and adulthood on blood pressure.

Part of the association between physical activity and low blood pressure (BP) may be a consequence of genetic selection. We investigated the association of genetic factors and physical activity in adolescence and adulthood with BP. BP was measured with a Finapres device in 71 monozygotic and 104 dizygotic male twin pairs using no antihypertensive medication. Subjects' mean age was 50.4 yr (range 40-72 yr). Subjects were interviewed about their lifetime exercise and other health habits. Exercise was classified as aerobic, power, or other, and these were further divided into adolescence (12-20 yr of age), the previous year, and lifetime. Genetic modeling was conducted to estimate genetic and environmental components of variance of systolic and diastolic BP. Aerobic exercise in adolescence and high-intensity aerobic exercise throughout the lifetime were associated with low diastolic BP in adulthood. Of the variance in diastolic BP, genetic factors accounted for 35% and aerobic exercise in adolescence for 5%. For systolic BP, genetic factors accounted for 39% of the variance. In turn, genetic factors accounted for 44% of the variance in aerobic exercise in adolescence. The genetic factors in part accounting for the variance in diastolic BP and those in part accounting for variance in aerobic exercise in adolescence were correlated. The association between aerobic exercise in adolescence and low diastolic BP in adulthood is a new finding, as is the observation that the factors partly share the same genes.

Adolescent↗
PubMed2004

Exercise therapy for people with rheumatoid arthritis and osteoarthritis.

Exercise therapy would appear to be effective at increasing aerobic capacity and muscle strength in patients with rheumatoid arthritis (RA), and no detrimental effects on disease activity or pain compared with controls has been observed. Exercise therapy--at least in the short-term, improves pain, muscular strength and function in elderly people with mild osteoarthritis (OA) of the hip or knee. For the treatment of both OA and RA the knowledge of the optimal type, frequency, duration and intensity of exercise is still limited, but the exercise should not include high-impact loads or high injury risk. Long-term compliance is important in achieving long-term benefits. Supervised classes appears to be as effective as treatments provided on a one-to-one basis, group-based exercise programme thus providing a cost-effective alternative. Adherence to home programmes seems to be lower. Future research should focus on finding optimal type and dose of exercise, ways of optimally maintaining the beneficial effects of exercise therapy over time as well as on the effects of exercise on the long-term progression of the disease and cost-effectiveness of the therapy.

Arthritis, Rheumatoid↗
PubMed2004

Evidence for exercise therapy in the treatment of chronic disease based on at least three randomized controlled trials--summary of published systematic reviews.

Final evidence for the overall benefits of exercise therapy in the treatment/rehabilitation of specific chronic disease comes from randomized controlled trials (RCTs). This paper summarizes current evidence that is based on a systematic review including data from at least three RCTs with contrast for exercise only. The quality of specific RCTs as well as the quality of systematic reviews varies, the newest ones usually being of higher quality than the older ones. The most consistent finding of the studies is that aerobic capacity and muscular strength of patients can be improved without causing detrimental effects on disease progression. Severe complications during these carefully tailored programs were rare. The treatment periods and follow-up times of the majority of the RCTs are of a too short duration to document group differences in disease progression. However, exercise reduces disease-related symptoms in many diseases, such as osteoarthritis, asthma and chronic obstructive pulmonary disorder. Also, RCTs studying patients with coronary heart disease as well as patients with heart failure show that all-cause mortality is lower in exercisers than in controls.

Chronic Disease↗
PubMed2003

Use of medications and dietary supplements in later years among male former top-level athletes.

BACKGROUND: The association between sports participation and later need of medications and dietary supplements is unknown. SUBJECTS AND METHODS: Male athletes (N = 2026) who had represented Finland in international events from 1920 through 1965 and 1401 control subjects who had been classified healthy at the age of 20 years participated in this population-based cohort study. MAIN OUTCOME MEASURES: The main outcome measures were reimbursable medications for hypertension, cardiac insufficiency, coronary heart disease, diabetes, and asthma identified from the national registry from 1970 through 1998 as well as the use of nonsteroidal anti-inflammatory drugs, antacids, and specific vitamin and mineral supplements for at least 60 days during the past year reported by questionnaire in 1985. RESULTS: Among former top-level athletes compared with controls, the probability of initiating medication was decreased for cardiac insufficiency (age-adjusted hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.50-0.74; P<.001), coronary heart disease (age-adjusted HR, 0.72; 95% CI, 0.58-0.89; P=.002), and asthma (age-adjusted HR, 0.47; 95% CI, 0.36-0.66; P<.001). Furthermore, the risk of initiation of treatment with regular medication for hypertension (age-adjusted HR, 0.73; 95% CI, 0.54-1.00; P=.046) and diabetes (age-adjusted HR, 0.38; 95% CI, 0.20-0.73; P=.004) was reduced for endurance athletes but not for power athletes. In 1985, compared with control subjects, athletes used fewer nonsteroidal anti-inflammatory drugs (age-adjusted odds ratio [OR], 0.48; 95% CI, 0.35-0.67; P<.001) and antacids (age-adjusted OR, 0.49; 95% CI, 0.31-0.77; P=.002) but more vitamin A (age-adjusted OR, 1.87; 95% CI, 1.24-2.82; P=.003), vitamin B (age-adjusted OR, 2.26; 95% CI, 1.64-3.12, P<.001), vitamin C (age-adjusted OR, 1.96; 95% CI, 1.45-2.63; P<.001), selenium (age-adjusted OR, 1.62; 95% CI, 1.15-2.28; P=.006), and iron (age-adjusted OR, 2.35; 95% CI, 1.33-4.15; P=.003) supplements. CONCLUSION: The need for long-term therapy for cardiac disease and asthma as well as for treatment with nonsteroidal anti-inflammatory drugs and antacids is reduced among former top-level athletes, but the use of dietary supplements is increased.

Aged↗
PubMed2003

Occurrence of chronic disease in former top-level athletes. Predominance of benefits, risks or selection effects?

Former elite athletes from most sports disciplines have lower overall morbidity risk and enjoy better self-rated health in later years compared with the general population and matched controls who were healthy at young age. This is seen particularly among former endurance athletes who have a lower incidence of coronary heart disease and type 2 diabetes mellitus. Most often data are available only for men. Based on the available data, participation in elite sports cannot be regarded as an overall health hazard. However, aside from a high risk of acute injury in specific sports, possible negative effects of long-standing athletic activity on the development of osteoarthritis should not be neglected. It should also be remembered that elite athletes are a biologically and genetically select group who are not representative of the population at large. Given the nature of the available data, the possible health consequences of recent changes in different characteristics of sports, such as training practices, professionalism and use of doping, cannot be properly predicted.

Aged↗
PubMed2002

Modifiable risk factors as predictors of all-cause mortality: the roles of genetics and childhood environment.

The authors studied familial aggregation of mortality risk factors and their association with future deaths in the Finnish Twin Cohort. Cohort members (n = 15,904) aged 24-60 years and healthy at the end of 1981 who had responded to questionnaires in 1975 and 1981 were followed up for death through June 30, 2001. In individual-based analyses, the age- and sex-adjusted risk of death was higher among persons who were not participating in vigorous leisure physical activity in 1975 and 1981 than in those who were (p < 0.001), and risk was increased among smokers (p < 0.001) and heavy users of alcohol (p < 0.001). The study sample included data on both members of 3,551 dizygotic same-sex twin pairs and 1,772 monozygotic same-sex twin pairs. In pairwise analyses of discordant dizygotic pairs, risks of death were increased among co-twins who were not participating in vigorous activity (p = 0.05), co-twins who were smokers (p < 0.001), and co-twins who were heavy alcohol users (p < 0.001). Correspondingly, among monozygotic twin pairs, a difference in risk was seen only for smoking (p = 0.03). The authors conclude that, after adjustment for childhood environment, a low level of leisure physical activity, smoking, and heavy use of alcohol are associated with increased risks of death, but genetic selection may account for some of the association concerning physical activity and heavy use of alcohol.

Adult↗