Scott B Going

The purpose of this study was to analyze the single and independent associations of whole body composition and fat distribution with cardiovascular disease (CVD) risk factors and fitness in middle-aged men. Sixty-two healthy Caucasian men (37.6 +/- 2.9 yr, 81.8 +/- 11.3 kg, 171.5 +/- 4.9 cm) participated in the study. Dual-energy x-ray absorptiometry (DXA) was used to assess total and regional body composition. The triceps, biceps, midthigh, calf, subscapular, chest, abdominal and suprailiac skinfolds, and the waist, hip and midthigh circumferences, and sagittal diameter were estimated. Cardiovascular fitness was estimated with a submaximal test. Bivariate and partial correlation analysis were used to study the association of total body percent fat (%fat), DXA trunk fat and trunk skinfolds (sum of subscapular, chest, abdominal, and suprailiac) and fitness with insulin, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), TC/HDL-C, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), apolipoprotein AI (apo AI), apolipoprotein B (apo B), lipoprotein(a) [Lp(a)], and diastolic and systolic blood pressure. All anthropometric and DXA body composition variables were significantly correlated with TC/HDL-C (from .26 to .50, P .05). Similar relationships were found for insulin, HDL-C, and systolic blood pressure (r from .26 to .47, P .05). Cardiovascular fitness was significantly (P .05) associated with insulin (r = -.36), HDL-C (r = .27), TC/HDL (r = -.27), and with systolic blood pressure (r = -.37). After controlling for trunk skinfolds, none of the anthropometric and DXA body composition variables were correlated with any of the CVD risk factors. Similarly, when controlling for trunk skinfolds, cardiovascular fitness was not related to any of the metabolic variables. After adjusting for %fat, DXA trunk fat, and cardiovascular fitness, trunk skinfolds remained significantly (P .05) related to insulin (r = .35), HDL-C (r = -.40), TC/HDL-C (r = .43), and apo AI (r = -.39). In conclusion, this study suggests that subcutaneous truncal fat, as estimated by skinfolds, is an independent predictor of CVD risk factors, and that the association between cardiovascular fitness and these risk factors may be mediated by the levels of abdominal subcutaneous fat in Caucasian middle-aged men.

PMID: 20631644;PMCID: PMC3152309;Abstract:

Physical activity (PA) is critical for maximizing bone development during growth. However, there is no consensus on how well existing PA measurement tools predict bone strength. Purpose: The purposes of this study were to compare four methods of quantifying PA (pedometer, 3-d PA recall (3DPAR), bone-specific PA questionnaire (BPAQ), and past year PA questionnaire (PYPAQ)), in young girls and to evaluate their ability to predict indices of bone strength. Methods: A total of 329 girls aged 8-13 yr completed a pedometer assessment, the 3DPAR, the BPAQ, and a modified PYPAQ. Peripheral quantitative computed tomography was used to assess bone strength index (BSI) at metaphyseal (4% distal femur and tibia) sites and strength-strain index (SSI) at diaphyseal (femur = 20%, tibia = 66%) sites of the nondominant leg. Correlations and hierarchical multiple regression were used to assess relationships among PA measures and indices of bone strength. Results: After adjusting for maturity, correlations between PA measures and indices of bone strength were positive, although low (r = 0.01-0.20). Regression models that included covariates (maturity, body mass, leg length, and ethnicity) and PA variables showed that PYPAQ score was significantly (P 0.05) associated with BSI and SSI at all sites and explained more variance in BSI and SSI than any other PA measure. Pedometer steps were significantly (P 0.05) associated with metaphyseal femur and tibia BSI, and 3DPAR score was significantly (P 0.05) associated with metaphyseal femur BSI. BPAQ score was not significantly (P > 0.05) associated with BSI or SSI at any sites. Conclusions: A modified PYPAQ that accounts for the duration, frequency, and load of PA predicted indices of bone strength better than other PA measures. © 2011 by the American College of Sports Medicine.

PMID: 19279507;Abstract:

OBJECTIVE:: To assess the effects of a 16-week progressive, individualized, high-intensity strength training program on muscle strength, pain, and function in patients with rheumatoid arthritis (RA). METHODS:: Twenty-four RA patients (men, n = 5; women, n = 19) receiving infliximab participated in a randomized controlled trial. The strength training (ST) group (n = 16) participated in a supervised program 3 times per week, and the control (C) group (n = 8) continued with standard of care as overseen by their rheumatologist. Assessments were completed at baseline and at weeks 8 and 16. Strength was measured by 3 repetition maximum (3RM), isometric hand dynamometer, and isokinetic dynamometer. A 100-mm visual analogue scale was used to assess pain. Functional performance was derived from a timed 50-foot walk and the Health Assessment Questionnaire Disability Index. RESULTS:: The mean percent increase in strength (3RM) for the ST group from baseline to week 16 was 46.1% ± 31.6% (P 0.01) (mean of all three 3RM exercises: hammer curl, leg press, and incline dumbbell press), with mean gains in strength up to 4 times that of baseline values reported in all strength training exercises (upper and lower body) performed during exercise sessions. On average, right-hand grip strength increased by 2.9 ± 4.0 kg in the ST group, in comparison with a loss of 1.2 ± 3.0 kg in the C group over 16 weeks. The ST group had a 53% reduction in pain, in comparison with almost no change in the C group. The ST group had a significant improvement in 50-foot walk time, with a mean reduction of-1.2 ± 1.6 seconds, in comparison with the C group (mean increase of 0.8 ± 1.0 seconds; P = 0.01) over the 16 weeks. There was a clinically important difference (predefined as mean change ±0.25) in the Health Assessment Questionnaire Disability Index in the ST group (-0.4 ± 0.4) but not in the C group (-0.1 ± 0.4). CONCLUSION:: High-intensity strength training in RA patients with varying levels of disease activity and joint damage had a large, significant effect on strength, and led to improvements in pain and function, with additive patient benefits beyond the effect of their infliximab use. © 2009 by Lippincott Williams & Wilkins.

Abstract:

Loss of mobility is important to everyone, particularly the elderly. The purpose of this retrospective, longitudinal study was to determine the long- term (5-year) effects of exercise on the shoulder and hip range of motion of a group of 12 women aged 50-71 years. Shoulder flexion, shoulder extension, shoulder transverse extension, hip flexion, and hip rotation were measured a minimum of five times throughout the 5-year period. A flexometer was used to measure range of motion. The results of the study indicated that range of motion increased significantly (p 0.05) throughout the study in four of the five measurements. The fifth measurement (shoulder flexion) also improved but not significantly. These data indicate that aging women can improve and/or maintain shoulder and hip range of motion through participation in regular exercise done three times per week for 5 years.