Cooper: Excercise for Life Presentation

Exercise for
for Life
Life
Exercise
Kenneth H. Cooper, M.D., M.P.H.
Chairman & Chief Executive Officer
Cooper Clinic
12200 Preston Road
Dallas, Texas
Boston.rev.4.24.09
1
American Adult Exercise Habits 1968
-1990
1968-1990
Exercising
Jogging
1968
< 24 %
< 100,000
1984
59 %
1990
40 %
34 million
30 million
48 % ↓ CVD
Boston.rev.4.24.09
Russia:
↑ 31 %
Poland:
↑ 36 %
Hungary:
↑ 40 %
Romania:
↑ 60 %
2
American Adult Exercise Habits 1968
-1990
1968-1990
Medical Treatment
33 %
1968 - 1990
Lifestyle Change
67 %
Cigarette Smoking
Blood Pressure Control
Cholesterol Reduction
Stress Management
Increased Activity
CV Deaths
↓ 48 %
News: Health & Behavior
June
June 7,
7, 2007
2007
Lowering Heart Risk Saves as Many Lives
as Treatment
1980 - 2000
Medical Treatment
48 %
CV Deaths
↓ 40 %
Lifestyle Change
52 %
Cigarette Smoking
Blood Pressure Control
Cholesterol Reduction
Increased Activity
*NN Eng
Eng JJ Med,
Med, Vol.
Vol. 356,
356, No.
No. 23,
23, June
June 7,
7, 2007,
2007, pp 2389-2398
2389-2398
Boston.rev.4.24.09
3
January
January 23,
23, 2008
2008
Cardiovascular Disease Death Rates 19991999-2005
Strokes / 100,000
Heart Disease / 100,000
1999
2005
195
144
25.8 %
24.4 %
Medical
Lifestyle Change
• Early Detection
• Treatment
• Cigarette Smoking
• Blood Pressure Control
• Cholesterol Reduction
• Increased Activity
January
January 23,
23, 2008
2008
Cardiovascular Disease Death Rates 19991999-2005
Early Detection
• Resting and Stress ECGs
• Resting and Stress
Echocardiograms
• Nuclear Scans
• CT Scans for Early
Calcification
• CT Angiograms
Boston.rev.4.24.09
61
47
Treatment
• Pharmaceutical
• Blood Lipids
• Angioplasties (with stents)
• Bypass Surgery
4
WARNING
““Signs
Signs of trouble loom
on the horizon, among
them twin epidemics of
diabetes and obesity in
young people.
people.””
National
National Center
Center for
for Health
Health Statistics,
Statistics, January
January 23,
23, 2008
2008
Adopting A Healthy Lifestyle
3 5 or more Fruits and Vegetables
3 Regular Exercise
3 No Smoking
3 BMI 18.5 – 29.9
•
•
•
15,708 Men and Women
-64 years of age
45
Women 4545-64
st
st
8.5%
1 visit:
visit:
8.5% all
all 44
6 years later:
8.4%
all
later: 8.4% all 44 (new
(new adopters)
adopters)
After only
4 years
NA
Total Mortality
CV Mortality
N/C
2.5%
4.2% (40% ↓)
11.7%
16.5% (35% ↓)
Dana
Dana King,
King, MD,
MD, MS,
MS, et
et al,
al, Am
Am JJ Med,
Med, July
July 2007
2007
Boston.rev.4.24.09
5
Adopting A Healthy Lifestyle
• The Healthy Aging & Longitudinal Study in Europe (HALE)
1507 men, 832 women, 70-90 years of age
70
70-90
3
3
3
3
3
3
3
3
After 10 yrs
Mediterranean
Mediterranean Diet
Diet
Moderate
Moderate Alcohol
Alcohol Use
Use
Physically
Physically Active
Active
No
No Smoking
Smoking
65%
-cause mortality
all
65% ↓
↓ in
in allall-cause
mortality and
and CV
CV disease
disease
• The Health Professionals Follow-Up Study
Follow
Follow-Up
Study (Men)
(Men)
3
3 55 Factors
Factors
After 16 yrs
62%
62% ↓
↓ in
in coronary
coronary events
events
Dana
Dana King,
King, MD,
MD, MS,
MS, et
et al,
al, Am
Am JJ Med,
Med, July
July 2007
2007
Multiple Cardiovascular Risk Factors
• 50% men and almost 40% women in the U.S. will
develop CVD.
• For men and women with no risk factors at age 50,
the risk of CVD had been essentially abolished.
• 3564 men, 4362 women (Framingham Study): No CVD
at age 50.
• Survival for men: 80 years
Survival for women: 86 years
• Obesity ↑ CVD risk: 58% for men, 43% for women
Circulation,
Circulation, Feb
Feb 14,
14, 2007
2007
Boston.rev.4.24.09
6
35 29
30 20
20
17
ru
gs
47 43
D
In
fe
ct
io
n
75
Se
x
90
lc
oh
ol
A
cc
o
ie
t/E
xe
rc
is
e
85
Tobacco
Sex Related
Motor Vehicles
Guns
G
un
s
100
eh
.*
300
*Alcohol-related
deaths:
1990 – 22,084
2000 – 16,653
D
To
Drugs
Diet/Exercise
Alcohol
Infection
365
M
.V
435
400
450
400
350
300
250
200
150
100
50
0
ba
Deaths (1000's)
Actual Causes of Death 1990 /2000
Source: JAMA, Mar 10, 2004, Vol. 291, No. 10.
Body Mass Index
BMI =
(Weight in pounds)
(Height in inches) x (Height in inches)
Examples
Range BMI
Boston.rev.4.24.09
130
65 x 65
x 703 = 21.7 BMI
165
65 x 65
x 703 = 27.5 BMI
< 25
25 – 30
> 30
x 703
Normal
Overweight (66 %)
Obese (34 %)
7
Obesity Trends* Among U.S. Adults
BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)
No Data
<10%
10%–14%
Obesity Trends* Among U.S. Adults
BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
Boston.rev.4.24.09
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
8
Source: “Mending Broken Hearts,” National Geographic, Feb. 2007
Diabetes Trends* Among Adults in the U.S.,
(Includes Gestational Diabetes)
BRFSS 2005
No Data
< 5%
5 – 5.9%
6 – 6.9%
7 – 7.9%
8+%
Source: Mokdad et al., Diabetes Care 2000;23:1278-83.
Boston.rev.4.24.09
9
Relative Risk of Death from Cancer
Contribution of Overweight and Obesity
to Mortality from Cancer in the United States
2
1.5
1
0.5
0
18.5 - 24.9 25.0 - 29.9
30.0 - 34.9 35.0 - 39.9
≥40
Body-Mass Index
Source: Cancer Prevention Study II, 1982 – 1998.
Boston.rev.4.24.09
Men
Women
10
How is Obesity Determined
In Children?
Boston.rev.4.24.09
11
Body Mass Index
BMI =
(Weight in pounds)
(Height in inches) x (Height in inches)
x 703
OR
PERCENT BODY FAT as determined by skinfold
measurements
Obese:
Overweight:
Top 5 percentile
Top 15 percentile
Proportion of Overweight Children
in the United States
1963-1970
1976-1980
1999-2000
2000-2004
18.8%
20%
15.5%
15.3%
15%
10%
6.5%
4.2%
4.6% 5%
5%
0%
6-12-year-olds
12-19-year-olds
Source: Centers for Disease Control and Prevention, 2003.
Boston.rev.4.24.09
12
Obesity Projections in America –
Adults and Children (2010 – 2048)
Overweight
2010
2030
2048
2030
Adults
Obese
66.3%
36%
Children
40%
20%
Adults
86.3
51%
Children
80%
40%
Adults
100% Overweight or Obese
Cost of Obesity = $860.7- $956.9 Billion
Black women and Mexican-American men most affected
Source: Obesity, Vol. 16, no. 10, October 2008
There is an epidemic of adult
-onset diabetes being
adult-onset
seen in children. It is estimated that among children
born after the year 2000:
• 1 out of 3 children will develop diabetes (higher in
Hispanics and African-Americans)
African
African-Americans)
If they develop adult
-onset diabetes before 14 years
adult-onset
of age, it is estimated that that will shorten their
lifespan by 17 to 27 years. As a result, this may be
the first generation in which parents live longer than
their children.
Boston.rev.4.24.09
13
Stanford Achievement Test
Ninth Edition
(SAT-9)
2004
FITNESSGRAM®® Tests
AEROBIC CAPACITY
#1 PACER (Progressive Aerobic Cardiovascular Endurance
Run)
Set to music, a paced, 20-meter shuttle run increasing in
20
20-meter
intensity as time progresses.
Or:
• One-Mile Run
One
One-Mile
Students run (or walk if needed) one mile as fast as they can.
• Walk Test
Students walk one mile as fast as they can (for ages 13 or
above since the test has only been validated for this age
group).
Boston.rev.4.24.09
14
FITNESSGRAM®® Tests
BODY COMPOSITION
#2 Skin Fold Test
Measuring percent body fat by
testing the triceps and calf areas.
Or:
• Body Mass Index (BMI)
Calculated from height and
weight
FITNESSGRAM®® Tests
MUSCULAR STRENGTH AND ENDURANCE
#3 Curl-Up
Curl
Curl-Up
Measuring abdominal strength
and endurance, students lie
down with knees bent and feet
unanchored.
Set to a specified pace, students
complete as many repetitions as
possible to a maximum of 75.
Boston.rev.4.24.09
15
FITNESSGRAM®® Tests
MUSCULAR STRENGTH AND ENDURANCE
#4 Trunk Lift
Measuring trunk extensor
strength, students lie face
down and slowly raise their
upper body long enough for
the tester to measure the
distance between the floor
and the student’
’s chin.
student
student’s
FITNESSGRAM®® Tests
MUSCULAR STRENGTH AND ENDURANCE
#5 Push-Up
Push
Push-Up
Measuring upper body strength and endurance,
students lower body to a 90-degree elbow
90
90-degree
elbow angle
angle
and push up. Set to a specific pace, students
complete as many repetitions as possible.
Or:
• Modified Pull-Up (proper equipment required)
Pull
Pull-Up
With hands on a low bar, legs straight and
feet touching the ground, students pull up as
many repetitions as possible.
• Flexed Arm Hang
Students hang their chin above a bar as long
as possible.
Boston.rev.4.24.09
16
FITNESSGRAM®® Tests
FLEXIBILITY
#6 Back-Saver Sit and Reach
Back
Back-Saver
Testing one leg at a time,
students sit with one knee bent
and one leg straight against a
box and reach forward.
Or:
• Shoulder Stretch
With one arm over the shoulder
and one arm tucked under behind
the back, students try to touch their
fingers and then alternate arms.
Boston.rev.4.24.09
17
2004 CST* Scores in Math
by Number of Fitness Standards
Grade 5 – 371,198 Students
Grade 7 – 366,278 Students
Grade 9 – 63,028 Students**
CST Math Score
Grade 5
Grade 7
Grade 9
370
360
350
340
330
320
310
300
290
280
0
1
2
3
4
5
6
Number of Fitness Standards Achieved
*California Standards Test
** Grade 9 Students who took CST geometry
Source: California Physical Fitness Test, 2004 Results, Calif. Dept. of Ed., April 2005
2004 CST* Scores in English-Language Arts
English
English-Language
by Number of Fitness Standards
Grade 5 – 371,198 Students
Grade 7 – 366,278 Students
Grade 9 – 298,910 Students
Grade 5
Grade 7
Grade 9
CST E-LA Score
360
350
340
330
320
310
300
290
0
1
2
3
4
5
6
Number of Fitness Standards Achieved
*California Standards Test
Source: California Physical Fitness Test, 2004 Results, Calif. Dept. of Ed., April 2005
Boston.rev.4.24.09
18
2004 CST* Scores in English-Language Arts in Grade 5
English
English-Language
By Gender and Number of Fitness Standards
371,198 Students
(182,287 Female and 188,921 Male)
Female
Male
CST E-LA Score
370
360
350
340
330
320
310
300
0
1
2
3
4
5
6
Number of Fitness Standards Achieved
*California Standards Test
Results using math scores were consistent with those using English-Language Arts scores.
Results for seventh- and ninth-grade students were consistent with those for fifth graders.
Source: California Physical Fitness Test, 2004 Results, Calif. Dept. of Ed., April 2005
2004 CST* Scores in English-Language Arts in Grade 5
English
English-Language
by Socioeconomic Status** and Number of Fitness Standards
371,198 Students (203,726 NSLP and 167,472 Non-NSLP)
Non-NSLP
NSLP
CST E-LA Score
380
370
360
350
340
330
320
310
300
0
1
2
3
4
5
6
Number of Fitness Standards Achieved
*California Standards Test
**National School Lunch Program
Results using math scores were consistent with those using English-Language Arts scores.
Results for seventh- and ninth-grade students were consistent with those for fifth graders.
Source: California Physical Fitness Test, 2004 Results, Calif. Dept. of Ed., April 2005
Boston.rev.4.24.09
19
Early-Onset Obesity and Its Effect on I.Q.
106
120
120
78
I.Q. Score
Score
I.Q.
100
100
80
80
63
60
60
40
40
20
20
00
Prader-Willi Syndrome*
(19 children & 5 adults)
*Prader-Willi Syndrome is a genetic
deficiency which causes marked obesity
before age 6.
Siblings:
150% Ideal Weight
before age 6
(18 children & adults)
Siblings:
Normal Weight
(24 children &
adults)
Source: Miller, et al, J of Ped, Vol. 149, Issue 2, Aug 2006, 192-198.e3
“… discovered a link between marked obesity in
toddlers and lower IQ scores, cognitive delays,
and brain lesions similar to those seen in
Alzheimer’s disease patients.”
Source: Miller, et al, J of Ped, Vol. 149, Issue 2, Aug 2006, 192-198.e3
Boston.rev.4.24.09
20
" … emerging research showing that physical
activity sparks biological changes that
encourage brain cells to bind to one another.
For the brain to learn, these connections must
be made."
" … exercise provides an unparalleled stimulus,
creating an environment in which the brain is
ready, willing, and able to learn."
"Exercise is fertilizer for the brain."
"Spark: The Revolutionary New Science of Exercise and the Brain," John J Ratey, MD, 2008.
Senate Bill
Bill 530
530
Senate
Passed by
by Texas
Texas State
State
Passed
House of
of Representatives
Representatives and
and
House
Senate on
on May
May 27,
27, 2007
2007
Senate
Signed into
into Law
Law by
by
Signed
Governor Rick
Rick Perry
Perry
Governor
on June
June 13,
13, 2007
2007
on
approved as
as official
official testing
testing
Fitnessgram approved
Fitnessgram
vehicle by
by the
the Texas
Texas Education
Education Agency
Agency
vehicle
on September
September 27,
27, 2007
2007
on
®®
Boston.rev.4.24.09
21
Senate Bill 530
Exercise Requirements (Sep 2007)
Grades 1 – 5
• 30 minutes 5 times/week or
• 45 minutes 3 times/week (135 minutes total)
• 225 minutes over 2 weeks (45 minutes 3 times the
first week, 45 minutes 2 times the second week)
Grades 6 – 8
• Same as above, but only 4 of 6 semesters are required
Grades 9 – 12
• No physical education requirement
Testing Requirements (using the Fitnessgram®
Fitnessgram®)
• Beginning in the 20072007-08 school year, all students
grades 3 - 12 will be required to be tested annually at
some time during the school year.
Boston.rev.4.24.09
22
Texas
Texas Youth
Youth Evaluation
Evaluation Project
Project 2008
2008
Total
-12: 2,658,665
33-12:
Total ## of
of Students
Students Grades
Grades 32,658,665
Grade
FITNESSGRAM® Test
% Achieving Healthy Fitness Zone on all 6 tests
Total # Students
Girls
Boys
3
102,342
33.25
28.60
4
80,539
28.50
21.14
5
66,798
23.82
17.89
6
60,663
23.08
17.60
7
55,441
21.32
17.26
8
48,971
18.99
17.88
9
39,456
13.90
15.04
10
28,650
12.42
13.70
11
21,152
10.68
12.24
12
13,040
8.18
8.96
6,532 campuses out of 9,212 (70.91%)
1,074 districts out of 1,267 (84.77%)
Texas Education Agency
Physical Fitness Assessment Initiative
10 Variables Compared with Levels of Fitness
• Attendance Rate
• Eligible for free lunch program
• Eligible for reduced lunch program
• TAKS
• Occurrence of substance abuse
• Occurrence of violence
• Occurrence of weapons
• Occurrence of truancy
_____________________________
• Obesity
• Diabetes
Boston.rev.4.24.09
23
Dallas, Texas Tuesday, March 10, 2009
Association Between Fitness and
School Attendance Rates
0.52
Correlation Coefficient
0.6
All students from all
eligible schools
0.5
0.4
0.3
0.18
0.2
0.1
Spearmen correlations
between % achieving
HFZ and %
attendance
(PEIMS data) adjusted
for SES, minority %
and school size
0
CV (HFZ)
BMI (HFZ)
Higher Levels of Fitness Associated with Better School Attendance
Texas Youth Fitness Study
Boston.rev.4.24.09
24
Association Between Fitness and
Academic Performance (TAKS)
0.54
Correlation Coefficient
0.6
All students from all
eligible schools
0.5
0.4
0.30
0.3
0.2
0.1
Spearmen correlations
between % achieving
HFZ and % achieving
TAKS standards
adjusted for SES,
minority % and school
size
0
CV (HFZ)
BMI (HFZ)
Higher Levels of Fitness Associated with Better Academic Performance
Texas Youth Fitness Study
Association Between Fitness and
School Incidence Rates
-0.52
-0.24
0
All students from all
eligible schools
Correlation Coefficient
-0.1
-0.2
Spearmen correlations
between % achieving
HFZ and % of negative
incidence adjusted
for SES, minority % and
school size
-0.3
-0.4
-0.5
-0.6
CV (HFZ)
BMI (HFZ)
Higher Levels of Fitness Associated with Fewer Negative School Incidents
Texas Youth Fitness Study
Boston.rev.4.24.09
25
Percent Achieving Standards
CV Fitness Corresponds with Academic Performance
when Schools Stratified by State Rating System
100
90
80
70
60
50
40
30
20
10
0
ry
pla
m
e
Ex
CV
TAKS
ed
ni z
og
c
Re
pta
ce
Ac
ble
ta
ep
cc
a
Un
bl e
School Ratings
Texas Youth Fitness Study
Summary of Texas Youth Fitness Study
Initial Results
•
Significant associations were consistently found
between physical fitness and various indicators of
academic achievement.
•
The results were controlled for the influence due to
school social economic status, minority status and
school size.
•
The consistent relationships observed support the
thesis that physical fitness is associated with academic
achievement in school aged youth. These are crosssectional results and cannot be used to infer causality.
Boston.rev.4.24.09
26
How do we measure
cardiovascular fitness?
Boston.rev.4.24.09
27
22
18
BALKE
10
At 25:00 min speed
Increases 0.2 mph/per min
6
Grade (%)
14
PROTOCOL
2
Calculated 3.3 mph Speed
0
26
2
4
6
8
10
12
14
16
18
20
22
24
Minutes
Definitions Of Fitness Categories
For Males
Fitness
Fitness
Category*
Category*
<30
<30
30
30 -- 39
39
40
40 -- 49
49
50-59
50-59
Very
Very Poor
Poor
<14:59
<14:59
<13:59
<13:59
<12:29
<12:29
<10:02
<10:02
Poor
Poor
15:00-18:06
15:00-18:06
14:00
14:00 –– 16:59
16:59
12:30
12:30 15:29
15:29
10:03
10:03 –– 12:59
12:59
Fair
Fair
18:07
18:07 –– 22:05
22:05
17:00
17:00 –– 20:59
20:59
15:30
15:30 –– 19:59
19:59
13:00
13:00 –– 16:59
16:59
Good
Good
22:06
22:06 –– 26:00
26:00
21:00
21:00 –– 24:42
24:42
20:000
20:000 –– 23:13
23:13
17:00
17:00 20:29
20:29
Excellent
Excellent
26:01
26:01 –– 28:59
28:59
24:43
24:43 –– 27:09
27:09
23:14
23:14 –– 26:15
26:15
20:30
20:30 –– 23:59
23:59
Superior
Superior
29:00+
29:00+
27:10+
27:10+
26:16+
26:16+
24:00+
24:00+
*Based
*Based on
on the
the Cooper
Cooper Clinic
Clinic
modified
modified Balke
Balke treadmill
treadmill
protocol
protocol
Boston.rev.4.24.09
28
Definitions Of Fitness Categories
For Females
Fitness
Fitness
Category*
Category*
<30
<30
30-39
30-39
40-49
40-49
50-59
50-59
Very
Very Poor
Poor <10:29
<10:29
<9:29
<9:29
<7:59
<7:59
<6:14
<6:14
Poor
Poor
10:30
10:30 –– 13:15
13:15
9:30
9:30 –– 11:59
11:59
8:00
8:00 –– 10:29
10:29
6:15
6:15 –– 8:29
8:29
Fair
Fair
13:16
13:16 –– 17:27
17:27
12:00
12:00 –– 15:20
15:20
10:30
10:30 –– 13:59
13:59
8:30
8:30 –– 11:20
11:20
Good
Good
17:28
17:28 –– 20:59
20:59
15:21
15:21 –– 18:59
18:59
14:00
14:00 –16:59
–16:59
11:21-11:21-- 14:03
14:03
Excellent
Excellent
21:00
21:00 –24:18
–24:18
19:00
19:00 –– 21:59
21:59
17:00
17:00 –– 20:09
20:09
14:04
14:04 –– 17:00
17:00
Superior
Superior
24:19+
24:19+
22:00+
22:00+
20:10+
20:10+
17:01+
17:01+
**Based
Based on
on the
the Cooper
Cooper Clinic
Clinic modified
modified Balke
Balke treadmill
treadmill protocol
protocol
Boston.rev.4.24.09
29
Age--Adjusted All
All--Cause Mortality
Mortality/10,000
/10,000
Age
PY
Boston.rev.4.24.09
Age
-Adjusted All
-Cause Mortality
Age-Adjusted
All-Cause
by Fitness Groups, Men
70
70
60
60
50
50
40
40
30
30
20
20
10
10
00
Low
Low
22
33
44
High
High
Fitness Groups
30
Age--Adjusted All
All--Cause Mortality/
Age
10,000 PY
Fitness and All
-Cause Mortality, Men
All-Cause
70
70
60
60
Unfit
50
50
Fit
40
40
30
30
20
20
10
10
00
Very Poor
Poor
Fair
Good
Excellent/Superior
Health & Longevity
Fitness
Aerobic Fitness
Exercising and Aging
• Telomeres are protective tips on bundles
of genes inside cells
• Every time a cell divides, telomeres get
shorter
• Aging occurs as cells reach the end of the
telomere and die ─ muscle weakens, skin
wrinkles, and thinking clouds
Arch of Int Med, Jan 28, 2008
Boston.rev.4.24.09
31
Exercise and Aging
• 2,401 British Twins
Long-term study, length of telomeres measured
Long
Long-term
Exercise
(min/wk)
Reduction in Age
(years)
16:00
Baseline
100:00
5.0 - 6.0
180:00
9.0
Arch of Int Med, Jan 28, 2008
Fitness, Body Composition and Distribution,
and Mortality in ACLS Men
●
Cohort of 21,925 men, followed an average of 8 years
(176,742 manman-years)
●
Baseline exclusion for MI, stroke, or cancer
●
Outcomes
− AllAll-cause mortality (428 deaths)
− CVD mortality (144 deaths)
●
Exposures
− CRF from a maximal exercise test on a treadmill as an
objective marker of habitual physical activity patterns
− Body composition and fat distribution determined by
hydrostatic weighing, sum of 7 skinfolds, and waist
circumference
Lee CD et al. Am J Clin Nutr 1999
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Adjusted RR for All-Cause Mortality
by Fitness and % Body Fat
Fit
Unfit
2.5
Adj RR*
2
*adj for age,
exam year,
smoking,
alcohol, &
fam history
1.5
1
0.5
0
Lean
Normal
Obese
<17%
17-<25%
≥25%
Body Fat
Lee CD et al. Am J Clin Nutr 1999
Adjusted RR for CVD Mortality
by Fitness and % Body Fat
4.5
Fit
Unfit
4
Adj RR*
3.5
*adj for age,
exam year,
smoking,
alcohol, &
fam history
3
2.5
2
1.5
1
0.5
0
Lean
<17%
Normal
17-<25%
Body Fat
Obese
≥25
%
Lee CD et al. Am J Clin Nutr 1999
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Body Fat (BMI), Fitness, and Cancer Mortality
(34,410
-year followup)
17
(34,410 men,
men, average
average age
age 43.8,
43.8, 1717-year
Fit
man--years
Rate/10,000 man
(top 80%)
Unfit
(lower 20%)
25
20
15
10
5
0
18.5-24.9
P = 0.001
25.0-29.9
P<0.001
>30
P = 0.01
BMI, kg/m2
ACSM, 2006
Quality of Life Variables by Fitness States
(10,331
(10,331 Men
Men and
and Women)
Women)
Low
(n = 1077)
%
Moderate
High
(n = 3555) (n = 5679)
%
%
P for
Trend
Unexplained Fatigue
25.8
16.3
11.2
< 0.001
Problematic Snoring
49.9
34.8
21.9
< 0.001
Frequent Heartburn
30.9
22.1
12.1
< 0.001
Sexual Problems
11.0
7.4
5.0
< 0.001
29.8
22.2
19.6
< 0.001
9.7
(932*)
7.2
(3126*)
4.6
(4910*)
< 0.001
Decreased Sex
Drive
Impotence (men
only)
* % (n)
Source: ACLS, The Cooper Institute, January 2006
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Quality of Life Variables by Fitness States
(10,331
(10,331 Men
Men and
and Women)
Women)
Low
(n = 1077)
%
Moderate
High
(n = 3555) (n = 5679)
%
%
P for
Trend
Chronic Joint or
Muscle Pain
34.0
29.3
23.5
< 0.001
Low Back Pain
44.8
41.5
35.4
< 0.001
Frequent Headaches
16.7
15.0
12.0
< 0.001
Difficulty Sleeping
28.7
24.9
21.9
< 0.001
Depression
20.9
15.9
12.9
< 0.001
Anxiety
20.2
16.4
13.6
< 0.001
Source: ACLS, The Cooper Institute, January 2006
Aerobic Fitness
35 Aerobic points/week
Run 2.0 miles < 20:00 minutes 4x/week
Walk 3.0 miles < 45:00 minutes 5x/week
Aerobic dance 45:00 minutes 4x/week
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Health and Longevity Fitness
15 aerobic points /week
Walk 2.0 miles < 30:00 minutes 3x/week
Walk 2.0 miles < 35:00 minutes 4x/week
Walk 2.0 miles < 40:00 minutes 5x/week
Walk 3.0 miles < 45:00 minutes 2x/week
Aerobic dance 45:00 minutes 2x/week
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