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Physical activity, both at work and during leisure, was assessed in 15 171 men aged 25-74 years. Heavy leisure activity was associated with lower mean serum cholesterol levels and blood pressure. In men under 60 years the same negative association was also noted between leisure activity and relative weight and cigarette smoking. Different degrees of physical activity at work were not associated with any differences in these risk factors, nor did the level of exercise at work seem to influence the negative association between leisure activity and risk factors. Heavy leisure activity in young and middle-aged men is associated with lower levels of certain coronary risk factors and, therefore, a lower risk of coronary heart disease. The often-reported reduction in coronary morbidity and mortality with physical exercise may not be the direct effect of the exercise itself.

STUDY OBJECTIVE—To analyse trends in socioeconomic differences in cardiovascular disease risk factors among an urban Chinese population using educational attainment as the socioeconomic indicator.
DESIGN—Population surveys with randomly selected independent samples were carried out in 1989 and in 1996. Educational attainment, blood pressure, body mass index, cigarette smoking and lack of leisure time physical activity were determined.
SETTING—Urban areas of the city of Tianjin, China.
PARTICIPANTS—A total of 14 275 respondents aged 25-64 years.
MAIN RESULTS—Diastolic blood pressure increased and the proportion of people without leisure time physical activity decreased in both sexes during the study period. The prevalence of smoking and the number of cigarettes smoked daily increased significantly among men. Smoking decreased in the least educated men and increased in those who had studied at least to college level. Body mass index decreased across all educational strata in women, but blood pressure increased in women with at least college level education.
CONCLUSIONS—These data reveal a different picture in trends in the association of education and cardiovascular risk factors from those depicted in developed countries. This highlights the need for an effective intervention programme in the study population.


Keywords: trends; socioeconomic status; cardiovascular disease risk factor

Background

Metabolic syndrome (MetS) is an important risk factor of cardiovascular disease (CVD) and type 2 diabetes (T2DM). Previous studies have suggested an inverse relationship between physical activity and MetS. However, these findings were inconsistent; and few investigators have examined these associations among South Americans. We estimated the prevalence of MetS and its association with leisure time physical activity (LTPA) among Peruvian adults.

Materials and methods

This cross-sectional study of 1,675 individuals (619 men and 1056 women) was conducted among residents in Lima and Callao, Peru. Information about LTPA, socio-demographic, and other lifestyle characteristics were collected by interview. The presence of MetS was defined using the Adult Treatment Panel III (ATP III) criteria.

Results

Overall, the prevalence of MetS was 26.9% and was more common among women (29.9%) than men (21.6%). Habitual participation in LTPA was associated with a 23% reduced risk of MetS (OR=0.77; 95% CI: 0.60–1.03). There was an inverse trend of MetS risk with amount of LTPA (p=0.016). Compared with non-exercisers, those who exercised < 150 minutes/week had a 21% reduced risk of MetS (AOR= 0.79; 95% CI 0.60–1.04). Individuals who exercised ≥ 150 minutes/week, compared with non-exercisers, had a 42% reduced risk of MetS (AOR=0.58; 95% CI: 0.36–0.93). Associations of similar magnitudes were observed when men and women were studied separately.

Conclusion

These data document a high prevalence of MetS and suggest an association with LTPA among urban dwelling Peruvians. Further prospective studies are needed to confirm these observations and to examine interventions that may promote increased physical activity in this population.

Background

This study examines leisure time sedentary behavior (LTSB) and usual occupational/domestic activity (UODA) and the relationship with metabolic syndrome and individual cardiovascular disease (CVD) risk factors, independent of physical activity level.

Methods

NHANES 2003–2006 data from men (n=1868) and women (n=1688) with fasting measures were classified as having metabolic syndrome by the AHA/NHLBI definition. LTSB was determined from self-reported TV viewing and computer usage. UODA was self-reported daily behavior (sitting, standing, walking, carrying loads).

Results

LTSB ≥4 hr/day was associated with odds of having metabolic syndrome of 1.94 (95% CI:1.24, 3.03) in men compared to ≤1 hr/day. LTSB ≥4 hr/day was also associated with higher odds of elevated waist circumference (1.88, CI:1.03, 3.41), low HDL-cholesterol (1.84, CI:1.33, 2.51), and high blood pressure (1.55, CI:1.07, 2.24) in men. LTSB 2–3 hr/day was associated with higher odds of elevated glucose (1.32, CI:1.00, 1.75) in men. In women, odds of metabolic syndrome were 1.54 (CI:1.00, 2.37) with ≥4 hr/day LTSB, but LTSB was not associated with risk of the individual CVD risk factors. Higher LTSB was associated with metabolic syndrome in inactive men (1.50, CI:1.07, 2.09), active men (1.74, CI:1.11, 2.71), inactive women (1.69, CI:1.24, 2.33), but not active women (1.62, CI:0.87,3.01). UODA was not associated with metabolic syndrome or CVD risk factors in either men or women.

Conclusions

In men, high LTSB is associated with higher odds of metabolic syndrome and individual CVD risk factors regardless of meeting physical activity recommendations. In women, high LTSB is associated with higher odds of metabolic syndrome only in those not meeting the physical activity recommendations.

Background

This study examines leisure time sedentary behavior (LTSB) and usual occupational/domestic activity (UODA) and their relationship with metabolic syndrome and individual cardiovascular disease (CVD) risk factors, independent of physical activity level.

Methods

National Health and Nutrition Examination Survey (NHANES) 2003–2006 data from men (n = 1868) and women (n = 1688) with fasting measures were classified as having metabolic syndrome by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) definition. LTSB was determined from self-reported television viewing and computer usage. UODA was self-reported daily behavior (sitting, standing, walking, carrying loads).

Results

LTSB ≥4 hours/day was associated with odds of having metabolic syndrome of 1.94 (95% confidence interval [CI], 1.24, 3.03) in men compared to ≤1 hour/day. LTSB ≥4 hour/day was also associated with higher odds of elevated waist circumference (1.88, CI, 1.03, 3.41), low high-density lipoprotein cholesterol (HDL-C) (1.84, CI, 1.35, 2.51), and high blood pressure (1.55, CI, 1.07, 2.24) in men. LTSB 2–3 hours/day was associated with higher odds of elevated glucose (1.32, CI, 1.00, 1.75) in men. In women, odds of metabolic syndrome were 1.54 (CI, 1.00, 2.37) with ≥4 hours/day LTSB, but LTSB was not associated with risk of the individual CVD risk factors. Higher LTSB was associated with metabolic syndrome in inactive men (1.50, CI, 1.07, 2.09), active men (1.74, CI, 1.11, 2.71), inactive women (1.69, CI, 1.24, 2.33), but not active women (1.62, CI, 0.87,3.01). UODA was not strongly associated with metabolic syndrome or CVD risk factors in either men or women.

Conclusions

In men, high LTSB is associated with higher odds of metabolic syndrome and individual CVD risk factors regardless of meeting physical activity recommendations. In women, high LTSB is associated with higher odds of metabolic syndrome only in those not meeting the physical activity recommendations.

Background

Leisure-time physical activity (LTPA) and cardiorespiratory fitness contribute to mental health. Hopelessness has been linked to impaired mental health, cardiovascular events and mortality. Previous studies have focused on physical exercise and depression. We examined the associations of LTPA and cardiorespiratory fitness with feelings of hopelessness.

Methods

In this cross-sectional study leisure-time physical activity, maximal oxygen uptake (VO2max), hopelessness and cardiovascular risk factors were assessed in a population-based cohort of 2428 men aged 42 – 60 years old at baseline.

Results

Men feeling more hopeless about their future and reaching goals were less physically active, less fit and had a higher prevalence of many cardiovascular risk factors than men with lower levels of hopelessness. In a logistic regression model adjusted for age, smoking, alcohol consumption, cardiovascular disease and socioeconomic status, men engaging in less than 60 min/week of moderate-to-vigorous LTPA were 37% (95% CI 11 – 67%) more likely to feel hopeless than those engaging in at least 2.5 h/wk of LTPA. After further adjusting for elevated depressive symptoms the association of LTPA and hopelessness remained significant. VO2max was also associated with hopelessness, but not after adjustment for depressive symptoms.

Conclusion

Moderate and vigorous LTPA and cardiorespiratory fitness were inversely associated with hopelessness in these middle-aged men. These findings suggest that physical inactivity and poor cardiorespiratory fitness is an important associate of hopelessness, a distinct element of low subjective well-being.

Objectives

Men with low physical fitness and high occupational physical activity are recently shown to have an increased risk of cardiovascular disease and all-cause mortality. The association between occupational physical activity with cardiovascular disease and all-cause mortality may also depend on leisure time physical activity.

Design

A prospective cohort study.

Setting

The Copenhagen City Heart Study.

Participants

7819 men and women aged 25–66 years without a history of cardiovascular disease who attended an initial examination in the Copenhagen City Heart Study in 1976–1978.

Outcome measures

Myocardial infarction and all-cause mortality. Occupational physical activity was defined by combining information from baseline (1976–1978) with reassessment in 1981–1983. Conventional risk factors were controlled for in Cox analyses.

Results

During the follow-up from 1976 to 1978 until 2010, 2888 subjects died of all-cause mortality and 787 had a first event of myocardial infarction. Overall, occupational physical activity predicted all-cause mortality and myocardial infarction in men but not in women (test for interaction p=0.02). High occupational physical activity was associated with an increased risk of all-cause mortality among men with low (HR 1.56; 95% CI 1.11 to 2.18) and moderate (HR 1.31; 95% CI 1.05 to 1.63) leisure time physical activity but not among men with high leisure time physical activity (HR 1.00; 95% CI 0.78 to 1.26) (test for interaction p=0.04). Similar but weaker tendencies were found for myocardial infarction. Among women, occupational physical activity was not associated with subsequent all-cause mortality or myocardial infarction.

Conclusions

The findings suggest that high occupational physical activity imposes harmful effects particularly among men with low levels of leisure time physical activity.

Article summary

Article focus

Men with low physical fitness and high occupational physical activity are recently shown to have an increased risk of cardiovascular disease and all-cause mortality.

It is unknown if the association between occupational physical activity with cardiovascular disease and all-cause mortality also depends on leisure time physical activity.

Key messages

This study shows that men with high occupational physical activity have an increased risk of all-cause mortality.

Leisure time physical activity was found to modify the positive association between occupational physical activity and risk of all-cause mortality. High occupational physical activity imposes harmful effects particularly among men with low levels of leisure time physical activity.

Strengths and limitations of this study

Study strengths include the long follow-up time, repeated assessment of the occupational physical activity, objective measures of several covariates from clinical examinations, information on outcomes obtained from valid registers, and participation of both sexes. Some limitations are the lack of control for psychosocial work factors and the self-reported exposures.

STUDY OBJECTIVE: To examine the risk of fatal stroke in relation to smoking habits in men screened for the Oslo study. DESIGN: The Oslo study is a prospective, cohort study of the epidemiology and preventive aspects of cardiovascular diseases in middle aged men. Screening started in May 1972 and results after 18 years of follow up are reported. PARTICIPANTS: There were 16209 men aged 40-49 years, of whom 16173 had no stroke history. Eighty five men died from stroke, of whom 48 were daily cigarettes smokers, 7 were pipe and cigar smokers, 15 smoked cigarettes and pipe or cigars daily, 11 were previous cigarette smokers, and 4 had never smoked cigarettes. MAIN RESULTS: Results of proportional hazards regression analysis adjusted for age, diastolic blood pressure, and glucose concentration showed the following rate ratios (RR) (95% confidence interval) of smoking groups compared with those who had never smoked or had previously smoked: combined cigarette and cigar or pipe smokers, RR = 6.1 (3.0, 12.5); cigarettes only, RR = 4.1 (2.3,7.4); and pipe and/or cigars only RR = 2.2 (0.9,5.5). The overall, age adjusted risk of smoking cigarettes daily was 3.5 and was found to increase with increasing cigarette consumption. Regardless of their smoking group, stroke cases had increased diastolic (DBP) and systolic blood pressure (SBP) when compared with men who had not had a stroke. The absolute differences in DBP and SBP between stroke cases and others for never and previous cigarette smokers versus daily smokers were twice as large: DBP, 12.1 mmHg versus 6.5 mmHg respectively and SBP, 16.0 mmHg versus 7.1 mmHg respectively. A high BMI increased the risk of fatal stroke of never and previous cigarette smokers. Men being treated for hypertension at the time of screening had three times the crude risk of fatal stroke of men who were not taking hypertensive treatment. CONCLUSIONS: Daily cigarette smoking increased the risk of fatal stroke three and a half times. Combined cigarette and pipe or cigar smoking had a higher risk than smoking cigarettes only. An increased risk was found in relation to increased daily cigarette consumption.

OBJECTIVE

To assess the effects of leisure-time physical activity (LTPA) and resistance training on metabolic syndrome (MetS) and its components in a post hoc analysis of the Finnish Diabetes Prevention Study, a randomized controlled lifestyle counseling trial.

RESEARCH DESIGN AND METHODS

A cohort of 486 middle-aged overweight men and women with impaired glucose tolerance were followed for an average of 4.1 years. The intervention and control groups were combined in the analyses. LTPA was assessed by questionnaires, dietary intake by food records, and features of the MetS by anthropometric and biochemical measures annually. Resistance training sessions were documented for 137 participants.

RESULTS

Increased moderate-to-vigorous LTPA, even after adjustments for changes in dietary intakes of total and saturated fat, fiber, and energy, and change in BMI was associated with a greater likelihood for resolution (29.7 vs. 19.1%; P = 0.004 in the upper versus lower third of change) and a lesser likelihood for development (23.5 vs. 44.7%; P = 0.041) of the MetS. Of the components of the MetS, the increase in moderate-to-vigorous LTPA was associated most strongly with improvement of glycemia. Among the 137 participants who participated in resistance training, MetS components were favorable in individuals who were in the upper third of participation rate (median 51 times/year) compared with individuals in the lowest third (median 8.5 times/year).

CONCLUSIONS

Increased moderate-to-vigorous LTPA was associated with a decreased likelihood of developing the MetS and an increased likelihood of its resolution in individuals at high risk for type 2 diabetes.

Objective: To evaluate levels of physical activities at work, leisure, and sports and to correlate them with socioeconomic and health factors.

Methods: Validated questionnaire administered to a random sample of 406 adults. Items covered demographic data, health status, smoking, and duration, frequency, intensity of physical activities. Indices of physical activity at work, leisure, and sports were analysed.

Results: Adults (both sexes) with poor self perceived health status and less than 13 years of education, regardless of their body mass index, perform no or few physical activities during their leisure time.

Conclusions: The correlations of physical activity with socioeconomic and health factors differ significantly for work, leisure, and sports. Physicians should differentiate physical activities by type and intensity during anamneses.

STUDY OBJECTIVE--The aim was to investigate the associations between physical fitness, leisure physical activity, and coronary risk factors. DESIGN--This was a cross sectional study of a random sample of men and women, following a population survey. SETTING--The municipality of Tromsø, Norway in 1986-1987. PARTICIPANTS--All men born 1925-1966 and all women born 1930-1966 were invited to the survey; 21,826 subjects attended (81% of the eligible population): of these, 297 men and 312 women, randomly selected, attended the present study (attendance rates 94% in men and 89% in women). MEASUREMENTS AND MAIN RESULTS--Fitness was tested by bicycle ergometry. Physical activity was reported on a questionnaire. Multiple regression analysis was performed with fitness and leisure activity as dependent variables, and coronary risk factors as independent variables. Fitness and leisure activity were positively related (p less than 0.05). Prominent findings for fitness were negative associations with age and smoking (p less than 0.05), and positive associations with body mass index in both sexes (p less than 0.01). HDL cholesterol and systolic blood pressure were significant predictors of fitness in men (p less than 0.01). Smoking emerged as a strong negative predictor for leisure activity in women (p less than 0.01), and a negative relation between leisure activity and total cholesterol was found in men (p less than 0.01). CONCLUSIONS--The study indicates that coronary risk factors are more closely linked to physical fitness than to leisure physical activity.

This study aimed to examine whether a dose-response relationship exists between psychological distress and types of physical activity (total, occupational, and leisure-time). The study subjects (233 men and 313 women) were recruited for a study on cardiovascular disease in the Yangpyeong community located in South Korea. The type and characteristics of physical activity were measured with a modified version of the Stanford 5 city project's questionnaire by well-trained interviewers using a standard protocol. The Psychological Well-being Index-Short Form was used to assess psychological distress. Both the intensity and duration of time in either total physical activity or occupational physical activity (OPA) were not related to the distress score. However, a long duration of time (1 hr/day) in severely intensive (≥6 metabolic equivalent) OPA was related to a high distress score in men (14.1 for none vs. 19.7, p-for-trend=0.005), even after the adjustment for leisure-time physical activity (LTPA). A long duration in time (1 hr/day) in LTPA was related to a lower distress score in men independent of their OPA (16.7 for none vs. 13.1, p-for-trend=0.02). In conclusion, the dose-response relationship of physical activity on psychological distress appeared to differ among the different types of activities. The type of activity may be an important determinant of whether physical activity produces psychological benefits.

Aim

To investigate the association between life-style and socioeconomic factors and coping strategies in a community sample in Iran.

Method

As part of a community-based study called Isfahan Healthy Heart Program, we studied 17 593 individuals older than 19 living in the central part of Iran. Demographic and socioeconomic factors (age, sex, occupation status, marital status, and educational level) and lifestyle variables (smoking status, leisure time physical activity, and psychological distress), and coping strategy were recorded. Data were analyzed by Pearson correlation and multiple linear regression.

Results

Not smoking (women β = -11.293, P < 0.001; men β = -3.418, P = 0.007), having leisure time physical activity (women β = 0.017, P = 0.046; men β = 0.005, P = 0.043), and higher educational level (women β = 0.344, P = 0.015; men β = 0.406, P = 0.008) were predictors of adaptive coping strategies, while smoking (women β = 11.849, P < 0.001; men β = 9.336, P < 0.001), high stress level (women β = 1.588, P = 0.000; men β = 1.358, P < 0.001), and lower educational level (women β = -0.443, P = 0.013; men β = -0.427, P = 0.013) were predictors of maladaptive coping strategies in both sexes. Non-manual work was a positive predictor of adaptive (β = 4.983, P < 0.001) and negative predictor of maladaptive (β = -3.355, P = 0.023) coping skills in men.

Conclusion

Coping strategies of the population in central Iran were highly influenced by socioeconomic status and life-style factors. Programs aimed at improving healthy life-styles and increasing the socioeconomic status could increase adaptive coping skills and decrease maladaptive ones and consequently lead to a more healthy society.

Objectives

Left ventricular diastolic dysfunction with preserved systolic function (DD-PSF) is associated with an increased risk of morbidity and mortality. Population-based surveys studying the associations between DD-PSF and lifestyle-associated risk factors, such as leisure time physical activity (LTPA) and smoking, are scarce. Thus, the aims were to explore the associations between DD-PSF and LTPA and smoking, employing optimal echocardiographic techniques.

Design

Cross-sectional study conducted from 2001 to 2003.

Setting

The study was conducted in a random sample of a rural Swedish population.

Subjects

Men and women of 30–75 years of age were consecutively invited for conventional echocardiography and tissue velocity imaging (n = 1149). Structured questionnaires and physical examinations were conducted using standardized methods.

Main outcome measures

DD-PSF was defined according to the European Society of Cardiology criteria excluding subjects with ejection fraction < 45%, or a self-reported history of heart failure.

Results

Complete information was available in 500 men and 538 women. In a multivariate model, DD-PSF was independently associated with sedentary LTPA and smoking in females; sedentary LTPA odds ratio (OR) 2.91, 95% confidence interval (CI) 1.02 to 8.27, and smoking OR 3.42, 95% CI 1.35 to 8.64. The probability of identifying DD-PSF in females with a sedentary LTPA was 37% and increased to 80% if they also had hypertension and were obese.

Conclusions

Sedentary LTPA and smoking are independently associated with DD-PSF in females. Identification of a sedentary lifestyle in females increases the probability of diagnosing DD-PSF.

During 1968 to 1970, approximately 17 000 middle-aged male executive grade civil service officers, all of them engaged in sedentary or very light work, recorded on a Monday morning their leisure time activities over the previous Friday and Saturday. In 1971 a sample of 509 of these men completed further questionnaires for medical, social, and smoking history; these men had a resting electrocardiogram, and height, weight, skinfold thickness, blood pressure, and plasma total cholesterol were measured. Vigorous exercise in leisure time had previously been reported by 125 (25%) of the men, and these as a group had significantly fewer electrocardiographic abnormalities (changes compatible with myocardial ischaemia, ectopic beats, and sinus tachycardia) than the men not reporting vigorous exercise (P less than 0-02). This difference remained when all men with any history suggestive of cardiovascular disease were excluded from the analysis. Blood pressure, plasma total cholesterol, and smoking habits were examined with respect both to vigorous exercise and to the electrocardiogram, but the only relation found was that electrocardiographic abnormality increased with increasing blood pressure. Even among men with higher pressures, however, those reporting vigorous exercise had fewer electrographic abnormalities than the others. The results provide further support for the association of habitual physical activity with coronary health.

Introduction

There is a remarkable increase in cardiovascular disease after menopause. On the other hand, metabolic syndrome as a collection of risk factors has a known effect on cardiovascular diseases. Hormone changes are considered as one of the main relevant factor regarding cardiovascular disease as well as some recognized relationship with metabolic syndrome's components. This study was carried out in order to search for prevalence of metabolic syndrome during menopausal transition.

Method

In a cross sectional study in urban and rural areas of Isfahan, Najafabad and Arak cities, 1596 women aged more than 45 years were investigated using Isfahan Healthy Heart Program's (IHHP) samples. Participants were categorized into three groups of pre-menopause, menopause and post-menopause. Leisure time physical activity and global dietary index were included as life style factors. The association of metabolic syndrome and its components with menopausal transition considering other factors such as age and life style was analyzed.

Results

there were 303, 233 and 987 women in premenopausal, early menopausal and postmenopausal groups respectively. Metabolic syndrome was found in 136(44.9%) premenopausal participants and significantly increased to 135(57.9%) and 634(64.3%) in early menopausal and postmenopausal participants respectively, when age was considered (P = 0.010). Except for hypertension and hypertriglyceridemia, there was no significant difference between three groups of menopausal transition when metabolic syndrome's components were considered.

Conclusion

In contrary to the claims regarding the role of waist circumference and blood glucose in increasing of metabolic syndrome during the menopausal transition, this study showed this phenomenon could be independence of them.

Background

Physical activity is known to have health benefits across population groups. However, less is known about changes over time in socioeconomic differences in leisure-time physical activity and the reasons for the changes. We hypothesised that class differences in leisure-time physical activity would widen over time due to declining physical activity among the lower occupational classes. We examined whether occupational class differences in leisure-time physical activity change over time in a cohort of Finnish middle-aged women and men. We also examined whether a set of selected covariates could account for the observed changes.

Methods

The data were derived from the Helsinki Health Study cohort mail surveys; the respondents were 40-60-year-old employees of the City of Helsinki at baseline in 2000-2002 (n = 8960, response rate 67%). Follow-up questionnaires were sent to the baseline respondents in 2007 (n = 7332, response rate 83%). The outcome measure was leisure-time physical activity, including commuting, converted to metabolic equivalent tasks (MET). Socioeconomic position was measured by occupational class (professionals, semi-professionals, routine non-manual employees and manual workers). The covariates included baseline age, marital status, limiting long-lasting illness, common mental disorders, job strain, physical and mental health functioning, smoking, body mass index, and employment status at follow-up. Firstly the analyses focused on changes over time in age adjusted prevalence of leisure-time physical activity. Secondly, logistic regression analysis was used to adjust for covariates of changes in occupational class differences in leisure-time physical activity.

Results

At baseline there were no occupational class differences in leisure-time physical activity. Over the follow-up leisure-time physical activity increased among those in the higher classes and decreased among manual workers, suggesting the emergence of occupational class differences at follow-up. Women in routine non-manual and manual classes and men in the manual class tended to be more often physically inactive in their leisure-time (<14 MET hours/week) and to be less often active (>30 MET hours/week) than those in the top two classes. Adjustment for the covariates did not substantially affect the observed occupational class differences in leisure-time physical activity at follow-up.

Conclusions

Occupational class differences in leisure-time physical activity emerged over the follow-up period among both women and men. Leisure-time physical activity needs to be promoted among ageing employees, especially among manual workers.

The relationship between grade of employment, coronary risk factors, and coronary heart disease (CHD) mortality has been investigated in a longitudinal study of 17 530 civil servants working in London. After seven and a half years of follow-up there was a clear inverse relationship between grade of employment and CHD mortality. Men in the lowest grade (messengers) had 3.6 times the CHD mortality of men in the highest employment grade (administrators). Men in the lower employment grades were shorter, heavier for their height, had higher blood pressure, higher plasma glucose, smoked more, and reported less leisure-time physical activity than men in the higher grades. Yet when allowance was made for the influence on mortality of all of these factors plus plasma cholesterol, the inverse association between grade of employment and CHD mortality was still strong. It is concluded that the higher CHD mortality experienced by working class men, which is present also in national statistics, can be only partly explained by the established coronary risk factors.

STUDY OBJECTIVES: To compare associations of childhood and adult socioeconomic position with cardiovascular risk factors measured in adulthood. To estimate the effects of adult socioeconomic position after adjustment for childhood circumstances. DESIGN: Cross sectional survey, using the relative index of inequality method to compare socioeconomic differences at different life stages. SETTING: The Whitehall II longitudinal study of men and women employed in London offices of the Civil Service at study baseline in 1985-88. PARTICIPANTS: 4774 men and 2206 women born in the period 1930-53 who were administered questions on early socioeconomic circumstances. MAIN RESULTS: Adult occupational position (employment grade) was inversely associated (high status-low risk) with current smoking and leisure time physical inactivity, with waist/height, and with metabolic risk factors HDL cholesterol, triglycerides, post-load glucose and fibrinogen. Associations of these variables with childhood socioeconomic position (father's Registrar General Social Class) were weaker or absent, with the exception of smoking in women. Childhood social position was associated with adult weight in both sexes and with current smoking, waist/height, HDL cholesterol and fibrinogen in women. Height, a measure of health capital or constitution, was weakly linked with father's social class and more strongly linked with own employment grade. The combination of childhood disadvantage (low father's class) together with a low status clerical occupation in men was particularly associated with higher body mass index as an adult (interaction test p < 0.001). Adjustment for earlier socioeconomic position--using father's class and own education level simultaneously--did not weaken the effects of adult socioeconomic position, except in the case of smoking in women, when the grade effect was reduced by 59 per cent. CONCLUSIONS: Cardiovascular risk factors in adulthood were in general more strongly related to adult than to childhood socioeconomic position. Among women but not men there was a strong but unexplained link between father's class and adult smoking habit. In both sexes degree of obesity was associated with both childhood and adulthood social position. These findings suggest that the socially patterned accumulation of health capital and cardiovascular risk begins in childhood and continues, according to socioeconomic position, during adulthood.

 

Objectives

To explore the relative importance of leisure time physical activity (LTPA), walking and jogging on risk of developing the metabolic syndrome (MS).

Design

A prospective cohort study.

Setting

The Copenhagen City Heart Study.

Participants

10 135 men and women aged 21–98 years who attended an initial examination in 1991–1994 and were re-examined after 10 years.

Outcome measures

The association of LTPA, jogging, walking speed and walking volume with MS at baseline and at 10-year follow-up was investigated by multiple logistic regression analyses.

Results

Baseline prevalence of MS was 20.7% in women and 27.3% in men. In both women and men, MS prevalence was associated with lower LTPA and walking speed and was lower in joggers compared to non-joggers. In subjects free of MS at baseline, 15.4% had developed MS at 10-year follow-up. Risk of developing MS was reduced in subjects with moderate or high LTPA, higher walking speed and in joggers whereas a higher volume of walking was not associated with reduced risk. After multiple adjustment, odds ratio (OR) of developing MS in moderate/high LTPA was 0.71 (95% CI 0.50 to 1.01), fast walking speed 0.51 (0.33 to 0.80) and joggers 0.60 (0.37 to 0.95) and walking >1 h daily 1.22 (0.91 to 1.65).

Conclusions

Our results confirm the role of physical activity in reducing MS risk and suggest that intensity more than volume of physical activity is important.

OBJECTIVE--The aim was to examine the relationship between social network and activities and causes of death. DESIGN--The study was a prospective cohort study of middle aged men examined in 1973 and followed for 12 years. SETTING--Gothenburg, Sweden. SUBJECTS--The subjects were 769 60 year old and 220 50 year old men who had participated in a health examination. MEASUREMENTS AND MAIN RESULTS--Main outcome measures were mortality from cardiovascular diseases, cancer and other causes. In multivariate analyses cardiovascular mortality was related to baseline blood pressure (p less than 0.001), smoking habits (p = 0.002), myocardial infarction or stroke (p less than 0.001), and a low level of social activities (p = 0.04). Cancer mortality was related to age (p = 0.003) and smoking habits (p = 0.001). Other causes of death were related to poor perceived health (p = 0.02) and a low level of home activities (p = 0.004). In univariate analyses the above risk factors were strongly related to all three causes of death. In addition cardiovascular mortality was related to age, a low level of home and outside home activities, few persons in the household, and poor perceived health. Cancer mortality was related to poor perceived health, few persons in the household, and a low level of social activities. Other causes of death were related to living alone, poor perceived health, and a low level of social and outside home activities. CONCLUSIONS--Well known risk factors for premature mortality like smoking, hypertension, and major cardiovascular disease are verified. Middle aged men with a good "social network" (here measured as a high level of social, home, and outside home activities) may be partly protected against non-cancer mortality.

Background

We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined.

Methods

The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables.

Results

After adjusting for age and region, a higher education level was associated with more leisure-time activity – with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively.

Conclusions

In Germany adults with a lower level of education are more physically active, both at work and overall, compared to adults with a higher education level, although they are less physically active in their leisure time. Higher work-related activity levels among adults with lower education may explain why they are less active in their leisure time.

As a part of a survey for cardiovascular risk factors high-density lipoprotein cholesterol (HDL-C) was determined in 15 942 men and women aged 20-53. Women had on average 0.24 mmol/l higher HDL-C concentration than men. The difference was of the same magnitude at all ages. For both sexes HDL-C increased with age. The increase was partly influenced by other variables affecting the HDL-C concentration. After adjusting for the effect of height, weight, cigarette-smoking, physical activity in leisure time, and ethnic origin the age-related change was more pronounced, 0.13 mmol/l and 0.16 mmol/l difference between the youngest and the oldest age group for men and women respectively. The population comprised three ethnic groups. HDL-C did not differ among the women of different ethnic origin, but among men those of Lappish origin had higher HDL-C concentrations than the other groups. This difference was reduced after adjusting for other variables and was probably due more to external factors influencing the HDL-C concentration than specific ethnic-genetic traits.

Background

In the Mexican population metabolic syndrome (MS) is highly prevalent. It is well documented that regular physical activity (PA) prevents coronary diseases, type 2 diabetes and MS. Most studies of PA have focused on moderate-vigorous leisure-time activity, because it involves higher energy expenditures, increase physical fitness, and decrease the risk of MS. However, for most people it is difficult to get a significant amount of PA from only moderately-vigorous leisure activity, so workplace activity may be an option for working populations, because, although may not be as vigorous in terms of cardio-respiratory efforts, it comprises a considerable proportion of the total daily activity with important energy expenditure. Since studies have also documented that different types and intensity of daily PA, including low-intensity, seem to confer important health benefits such as prevent MS, we sought to assess the impact of different amounts of leisure-time and workplace activities, including low-intensity level on MS prevention, in a sample of urban Mexican adults.

Methods

The study population consisted of 5118 employees and their relatives, aged 20 to 70 years, who were enrolled in the baseline evaluation of a cohort study. MS was assessed according to the criteria of the National Cholesterol Education Program, ATP III and physical activity with a validated self-administered questionnaire. Associations between physical activity and MS risk were assessed with multivariate logistic regression models.

Results

The prevalence of the components of MS in the study population were: high glucose levels 14.2%, high triglycerides 40.9%, high blood pressure 20.4%, greater than healthful waist circumference 43.2% and low-high density lipoprotein 76.9%. The prevalence of MS was 24.4%; 25.3% in men and 21.8% in women. MS risk was reduced among men (OR 0.72; 95%CI 0.57–0.95) and women (OR 0.78; 95%CI 0.64–0.94) who reported an amount of ≥30 minutes/day of leisure-time activity, and among women who reported an amount of ≥3 hours/day of workplace activity (OR 0.75; 95%CI 0.59–0.96).

Conclusion

Our results indicate that both leisure-time and workplace activity at different intensity levels, including low-intensity significantly reduce the risk of MS. This finding highlights the need for more recommendations regarding the specific amount and intensity of leisure-time and workplace activity needed to prevent MS.

Purpose and Methods

Leisure physical activity was assessed using questionnaires with different time frames in the Diabetes Prevention Program (DPP) cohort of 3234 overweight individuals aged > 25 yr with impaired glucose tolerance (IGT) from 27 centers across the United States. The three questionnaires were the Modifiable Activity Questionnaire (MAQ; past year), the Low-Level Physical Activity Recall (LOPAR; past 7 d), and the Third National Health and Nutrition Examination Survey (NHANES III; past month). This provided the opportunity to examine the relationship between the three activity measures and to compare activity levels of the DPP sample with that of a national sample with IGT.

Results

Leisure activity determined by the three questionnaires significantly correlated with each other, although the correlations between MAQ and NHANES III were stronger (men: rho = 0.52; women: rho = 0.49; P < 0.01) than between LOPAR and either measure (men: rho = 0.20 for MAQ, 0.24 for NHANES; women: rho = 0.10 for MAQ, 0.13 for NHANES). In the DPP, measures of obesity and glucose tolerance were significantly correlated with activity levels determined by MAQ and NHANES, but not LOPAR. Activity levels in DPP participants determined by the NHANES III questionnaire were generally higher than those reported by individuals meeting DPP eligibility criteria who were part of the NHANES cohort for similar age, body mass index, and race or ethnicity.

Conclusion

If the DPP participants were more active than a national sample of individuals with IGT, this would have implications for translation when using the DPP lifestyle intervention in less active or less motivated populations. Finally, the weak relationship between activity levels obtained with MAQ and LOPAR may result from the fact that they encompass different time frames and different components of leisure activity.