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Re: JAMA. 2005;294 (23)

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Hi Al:

I would take issue with item number 3 on the basis that I do not

believe the measure they use as representing 'fitness' really does

represent fitness.

They seem to believe that O2max is a good measure of fitness.

I suggest they had taken a look at some of the results that can come

from using standard methods of measuring O2max and then see if they

agree with the conclusions, they might have decided to change the

measure they used.

Go to http://www.preventdisease.com/healthtools/tools.html

Click 'Rockport Walk Test'

Enter the following data: Gender: male; age 40; weight 140 pounds;

heart rate 165; time taken to walk the mile, 11 minutes 0 seconds.

Then click 'calculate'.

You will get an O2max of 51.2.

Next enter: Gender: male; age 65; weight 160 pounds; heart rate 135;

time 10 minutes 30 seconds. Click 'calculate'.

You will get an O2max of 46.3.

Now tell me who do you think is fitter? The person who is 25 years

older; weighs twenty pounds more, yet moves that extra weight thirty

seconds faster, and ends with a pulse rate 30 points lower?

You decide for yourself. But the lighter, slower person, whose pulse

rate was thirty points higher at the end of the exercise has a higher

O2max. Anyone think he is 'fitter'?

Input appreciated.

Rodney.

--- In , Al Pater <old542000@y...>

wrote:

>

> Hi All,

.......................................

> 3. Prevalence and Cardiovascular Disease Correlates of Low

Cardiorespiratory Fitness

> in Adolescents and Adults

> Mercedes R. Carnethon; Martha Gulati; Philip Greenland

> JAMA. 2005;294:2981-2988.

>

> ABSTRACT

>

> Context Population surveys indicate that physical activity levels

are low in the

> United States. One consequence of inactivity, low cardiorespiratory

fitness, is an

> established risk factor for cardiovascular disease (CVD) morbidity

and mortality,

> but the prevalence of cardiorespiratory fitness has not been

quantified in

> representative US population samples.

>

> Objectives To describe the prevalence of low fitness in the US

population aged 12

> through 49 years and to relate low fitness to CVD risk factors in

this population.

>

> Design, Setting, and Participants Inception cohort study using

data from the

> cross-sectional nationally representative National Health and

Nutrition Examination

> Survey 1999-2002. Participants were adolescents (aged 12-19 years;

n = 3110) and

> adults (aged 20-49 years; n = 2205) free from previously diagnosed

CVD who underwent

> submaximal graded exercise treadmill testing to achieve at least

75% to 90% of their

> age-predicted maximum heart rate. Maximal oxygen consumption

(O2max) was estimated

> by measuring the heart rate response to reference levels of

submaximal work.

>

> Main Outcome Measures Low fitness defined using percentile cut

points of estimated

> O2max from existing external referent populations; anthropometric

and other CVD risk

> factors measured according to standard methods.

>

> Results Low fitness was identified in 33.6% of adolescents

(approximately 7.5

> million US adolescents) and 13.9% of adults (approximately 8.5

million US adults);

> the prevalence was similar in adolescent females (34.4%) and males

(32.9%) (P = .40)

> but was higher in adult females (16.2%) than in males (11.8%) (P

= .03).

> Non-Hispanic blacks and Mexican Americans were less fit than non-

Hispanic whites. In

> all age-sex groups, body mass index and waist circumference were

inversely

> associated with fitness; age- and race-adjusted odds ratios of

overweight or obesity

> (body mass index 25) ranged from 2.1 to 3.7 (P<.01 for all),

comparing persons with

> low fitness with those with moderate or high fitness. Total

cholesterol levels and

> systolic blood pressure were higher and levels of high-density

lipoprotein

> cholesterol were lower among participants with low vs high fitness.

>

> Conclusion Low fitness in adolescents and adults is common in the

US population and

> is associated with an increased prevalence of CVD risk factors.

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Hi Al:

I would take issue with item number 3 on the basis that I do not

believe the measure they use as representing 'fitness' really does

represent fitness.

They seem to believe that O2max is a good measure of fitness.

I suggest they had taken a look at some of the results that can come

from using standard methods of measuring O2max and then see if they

agree with the conclusions, they might have decided to change the

measure they used.

Go to http://www.preventdisease.com/healthtools/tools.html

Click 'Rockport Walk Test'

Enter the following data: Gender: male; age 40; weight 140 pounds;

heart rate 165; time taken to walk the mile, 11 minutes 0 seconds.

Then click 'calculate'.

You will get an O2max of 51.2.

Next enter: Gender: male; age 65; weight 160 pounds; heart rate 135;

time 10 minutes 30 seconds. Click 'calculate'.

You will get an O2max of 46.3.

Now tell me who do you think is fitter? The person who is 25 years

older; weighs twenty pounds more, yet moves that extra weight thirty

seconds faster, and ends with a pulse rate 30 points lower?

You decide for yourself. But the lighter, slower person, whose pulse

rate was thirty points higher at the end of the exercise has a higher

O2max. Anyone think he is 'fitter'?

Input appreciated.

Rodney.

--- In , Al Pater <old542000@y...>

wrote:

>

> Hi All,

.......................................

> 3. Prevalence and Cardiovascular Disease Correlates of Low

Cardiorespiratory Fitness

> in Adolescents and Adults

> Mercedes R. Carnethon; Martha Gulati; Philip Greenland

> JAMA. 2005;294:2981-2988.

>

> ABSTRACT

>

> Context Population surveys indicate that physical activity levels

are low in the

> United States. One consequence of inactivity, low cardiorespiratory

fitness, is an

> established risk factor for cardiovascular disease (CVD) morbidity

and mortality,

> but the prevalence of cardiorespiratory fitness has not been

quantified in

> representative US population samples.

>

> Objectives To describe the prevalence of low fitness in the US

population aged 12

> through 49 years and to relate low fitness to CVD risk factors in

this population.

>

> Design, Setting, and Participants Inception cohort study using

data from the

> cross-sectional nationally representative National Health and

Nutrition Examination

> Survey 1999-2002. Participants were adolescents (aged 12-19 years;

n = 3110) and

> adults (aged 20-49 years; n = 2205) free from previously diagnosed

CVD who underwent

> submaximal graded exercise treadmill testing to achieve at least

75% to 90% of their

> age-predicted maximum heart rate. Maximal oxygen consumption

(O2max) was estimated

> by measuring the heart rate response to reference levels of

submaximal work.

>

> Main Outcome Measures Low fitness defined using percentile cut

points of estimated

> O2max from existing external referent populations; anthropometric

and other CVD risk

> factors measured according to standard methods.

>

> Results Low fitness was identified in 33.6% of adolescents

(approximately 7.5

> million US adolescents) and 13.9% of adults (approximately 8.5

million US adults);

> the prevalence was similar in adolescent females (34.4%) and males

(32.9%) (P = .40)

> but was higher in adult females (16.2%) than in males (11.8%) (P

= .03).

> Non-Hispanic blacks and Mexican Americans were less fit than non-

Hispanic whites. In

> all age-sex groups, body mass index and waist circumference were

inversely

> associated with fitness; age- and race-adjusted odds ratios of

overweight or obesity

> (body mass index 25) ranged from 2.1 to 3.7 (P<.01 for all),

comparing persons with

> low fitness with those with moderate or high fitness. Total

cholesterol levels and

> systolic blood pressure were higher and levels of high-density

lipoprotein

> cholesterol were lower among participants with low vs high fitness.

>

> Conclusion Low fitness in adolescents and adults is common in the

US population and

> is associated with an increased prevalence of CVD risk factors.

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