Patrick De Smet

The Combined Relationship of Occupational and Leisure-Time Physical Activity With All-Cause Mortality Among Men, Accounting for Physical Fitness

The aim of this study was to assess the combined relationship of occupational physical activity and leisure-time physical activity with all-cause mortality among men, while accounting for physical fitness. The prospective Belgian Physical Fitness Study included 1,456 male workers aged 40-55 years who were free of coronary heart disease at baseline. Baseline data were collected through questionnaires and clinical examinations from 1976 to 1978. To estimate physical fitness, a submaximal graded exercise test was performed on a bicycle ergometer. Total mortality was registered during a mean follow-up period of 16.9 years. Main results were obtained through Cox proportional hazards regression analysis. A total of 145 deaths were registered during follow-up. After adjustment for confounders, a significantly increased mortality rate was observed in workers who had low levels of both physical activity types (hazard ratio = 2.07, 95% confidence interval: 1.03, 4.19) but also in workers combining high occupational physical activity and low leisure-time physical activity (hazard ratio = 2.04, 95% confidence interval: 1.07, 3.91); the latter finding was particularly pronounced among workers with a low physical fitness level. The present results confirm the existence of a complex interplay among different physical activity settings and fitness levels in predicting mortality.

Trends and Regional Differences in Coronary Risk Factors in Two Areas in Belgium: Final Results from the MONICA Ghent–Charleroi Study

Objective To study regional differences and trends in coronary risk factors and in predicted coronary risk calculated on the basis of multiple logistic function equations for the general population aged 25–64 years in two areas in Belgium during the period 1985–1992. Design A comparison of cross-sectional data on coronary risk factors between two cities and different survey periods. Method In the cities of Ghent (in Flanders) and Charleroi (in Walloonia) in Belgium, three consecutive cross-sectional age-stratified and sex-stratified random samples of 2000 subjects each were selected from the general population. We studied their coronary risk factors between 1985 and 1992. The field work was carried out according to the protocol of the international WHO-MONICA project. Results We observed a significant decrease in the prevalence of smoking among men in the two cities over the three surveys, while a gradual increase in diastolic blood pressure for all subgroups in Ghent was seen (this was statistically significant for men aged 45–64 years and women aged 25–44 years). The overall coronary risk predicted on the basis of multiple-logistic-function equations did not however, exhibit significant trends over time in either city. Comparisons between the two centres revealed significantly higher mean serum levels of total cholesterol in Charleroi than in Ghent (for all subgroups except women aged 45–64 years) and significantly higher mean systolic blood pressures in Charleroi for all subgroups defined in terms of age and sex. Prevalences of hypertension in Ghent were significantly lower than those in Charleroi for individuals aged 25–44 years, while the prevalence of obesity in all subgroups in Ghent was also significantly lower. The overall predicted coronary risk in Charleroi was also significantly higher, except for men aged 45–64 years. The differences in mean predicted risk ranged from 5.0% for men aged 45–64 years to 21.2% for women aged 45–64 years. Conclusions From the data in this article it seems that the trends in overall coronary risk profiles in Ghent and Charleroi are not in accordance with the observed trends in incidence of coronary heart disease (CHD) in these two cities, On the other hand, the differences in predicted coronary risk between the two cities are in the same direction as the observed differences in incidence of CHD between the two cities, but are however too small to explain fully the observed difference in incidence of CHD between the two centres.