Ron Hager

The effects of an intensive lifestyle modification program on carotid artery intima-media thickness: a randomized trial.

Purpose. This study evaluated the effect of the Dr. Dean Ornish Program for Reversing Heart Disease on cardiovascular disease as measured by the intima-media thickness of the common carotid artery and compared this effect to outcomes from patients participating in traditional cardiac rehabilitation. Design. Randomized clinical trial. Setting. SwedishAmerican Health System. Subjects. Ninety three patients with clinically confirmed coronary artery disease were randomly assigned to the intervention (n = 46) or traditional cardiac rehabilitation (n = 47). Intervention. Dr. Dean Ornish Program for Reversing Heart Disease. Measures. Ultrasound of the carotid artery and other cardiovascular risk factors were measured at baseline, 6, and 12 months. Analysis. Intent-to-treat analysis. Results. There was no significant reduction in the carotid intima-media thickness of the carotid artery in the Ornish group or the cardiac rehabilitation group. Ornish Program participants had significantly improved dietary habits (p < .001), weight (p < .001), and body mass index (p < .001) as compared with the rehabilitation group. The decrease in the number of patients with angina from baseline to 12 months was 44% in Ornish and 12% in cardiac rehabilitation. Conclusions. The Ornish Program appears to causes improvements in cardiovascular risk factors but does not appear to change the atherosclerotic process as it affects the carotid artery.

Sit to stand transfer: performance in rising power, transfer time and sway by age and sex in senior athletes

Objective: To observe the differences in performance variables of the sit to stand transfer (as measured on the NeuroCom Balance Master) in a population of senior athletes. Method: A convenience sample of 173 subjects aged 50 years and older. Data were obtained from voluntary participation in a health fair offered at the annual Huntsman World Senior Games in St George, Utah, USA. All sit to stand tests were performed on the NeuroCom Balance Master. The measured parameters were weight transfer time (WTT), rising power (force exerted to rise), and centre of gravity sway (COG sway) during the rising phase. Results: A significant difference was found between stratified age groups (50–64 and 65+ years) on rising power. There was also a sex difference in rising power. No significant differences were found in weight transfer time or COG sway. Conclusion: While rising power decreases with increasing age in senior athletes, WTT and COG sway remain similar regardless of age or sex. The maintenance of these other two variables (WTT and COG sway) may be attributable to physical activity and/or participation in sport.

A Critical Look at Physical Education and What Must Be Done to Address Obesity Issues

JOPERD • Volume 82 No. 4 • April 2011 P hysical education (PE) and physical education teacher education (PETE) are no strangers to change over the past 100 years, growing and morphing in order to meet changing societal interests and demands. From its beginnings in the late 19th century as a vehicle for health promotion (under the direction of physicians), to the immediacy of military preparedness (1917-1945), then for recreation and leisure pursuits (1950s-present), PE has reinvented itself over and over again (Corbin, 1993). Curiously, due to national crises such as obesity and other lifestyle issues, PE finds itself having come full circle—to once again fill a role as a health promotion tool. Park, as early as 1989, labeled PE as the renaissance field of the 21st century, but many others in the field hesitate to make changes that would lead to such a rebirth or even resist such changes. The target has moved, and some find it extremely unsettling. Johnson (2002) described dealing with moving targets in a delightful allegory involving four mice that are forced to deal with change when someone moves their cheese. Well, someone has moved our collective cheese, and we now have to deal with it! This article takes a frank look at the need for educational reform in physical education. It discusses the past and present failings and the implications of those failures. It presents only six PE teachers’ opinions, but it is an informed opinion, based on a combined 123 years in the business both as PE teachers and as PETE and wellness professors. This article is not exhaustive in scope, but a beginning that is intended to promote dialogue and action aimed at making PE not only a player in this national debate but the go-to player. Our examination is guided by Collins’s (2001) “good-to-great” framework, which identifies the characteristics of companies that made a remarkable transformation from being average to becoming great by outperforming comparison companies and the market as a whole. To make the leap from good to great, each company had to develop one essential aspect: an unflinching willingness to face the most brutal facts of one’s situation. We propose that PE must examine, with unflinching honesty, its past failings and current realities in order to move forward—to move from good to great. While we remain optimistic about the value of and future for PE in public schools, the problems that PE faces have convinced us that it must make its own dramatic transformation. This transformation, however, must not be haphazard nor piecemeal. Cautioning against maintaining the status quo or attempting insufficient change, Lawrence A Critical Look at Physical Education and What Must Be Done to Address Obesity Issues

Assessing Body Composition of Children and Adolescents Using Dual-Energy X-Ray Absorptiometry, Skinfolds, and Electrical Impedance

To determine the validity and reliability of percent body fat estimates in 177 boys and 154 girls between 12–17 years of age, percent body fat was assessed once using dual-energy X-ray absorptiometry and twice using the sum of two skinfolds and three bioelectrical impedance analysis devices. The assessments were repeated on 79 participants on a second day. The agreement between the percent body fat estimates from the four prediction methods and dual-energy X-ray absorptiometry was evaluated using Bland–Altman analyses and a mixed linear model. All methods were reliable within and between days. The sum of two skinfolds (±6.8% body fat), OMRON (OMRON Healthcare Inc., Vernon Hills, Illinois, USA) bioelectrical impedance analysis (0 ± 7.3% body fat), and TANITA 521 (TANITA Corporation, Tokyo, Japan) bioelectrical impedance analysis (±7.6% body fat) had wide prediction intervals and are acceptable for use in large population-based studies. The TANITA 300A bioelectrical impedance analysis is not recommended for use in children and adolescents due to its wide prediction interval (±8.1% body fat) and large bias. A criterion method should be used when the accurate assessment of body composition of an individual is critical.

Predicting VO2max in College-Aged Participants Using Cycle Ergometry and Perceived Functional Ability

The purpose of this study was to develop a multiple linear regression model to predict treadmill VO2max scores using both exercise and non-exercise data. One hundred five college-aged participants (53 male, 52 female) successfully completed a submaximal cycle ergometer test and a maximal graded exercise test on a motorized treadmill. The submaximal cycle protocol required participants to achieve a steady-state heart rate equal to at least 70% of age-predicted maximum heart rate (220-age), while the maximal treadmill graded exercise test required participants to exercise to volitional fatigue. Relevant submaximal cycle ergometer test data included a mean (±SD) ending steady-state heart rate and ending workrate equal to 164.2 ± 13.0 bpm and 115.3 ± 27.0 watts, respectively. Relevant non-exercise data included a mean (±SD) body mass (kg), perceived functional ability score, and physical activity rating score of 74.2 ± 15.1, 15.7 ± 4.3, and 4.7 ± 2.1, respectively. Multiple linear regression was used to generate the following prediction of (R = .91, standard error of estimates (SEE) = 3.36 ml·kg−1·min−1): VO2max = 54.513 + 9.752 (gender, 1 = male, 0 = female) – .297 (body mass, kg) + .739 (perceived functional ability, 2–26) + .077 (work rate, watts) – .072 (steady-state heart rate). Each predictor variable was statistically significant (p < .05) with beta weights for gender, body mass, perceived functional ability, exercise workrate, and steady-state heart rate equal to .594, –.544, .388, .305, and –.116, respectively. The predicted residual sums of squares (PRESS) statistics reflected minimal shrinkage (RPRESS = .90, SEEPRESS = 3.56 ml·kg−1·min−1) for the multiple linear regression model. In summary, the submaximal cycle ergometer protocol and accompanying prediction model yield relatively accurate VO2max estimates in healthy college-aged participants using both exercise and non-exercise data.

Assessment and Interpretation of Body Composition in Physical Education

JOPERD • Volume 77 No. 7 • September 2006 T he physical educator’s role is evolving into that of a teacher who is well educated in the areas of teaching, skill acquisition and development, motor learning, exercise physiology, physical conditioning, weight management, health, and lifestyle management. In an era when childhood obesity is at an all-time high, body composition assessments are an important component of a physical education curriculum that is centered on the development of skills, lifetime physical activity, and health behaviors. In a well-rounded physical education program, assessment of body composition can be one component of a complete fi tness appraisal, included in a unit on physical fi tness or physical activity and health, or it can be an informational booth at a school’s health fair. A physical educator can also assess the body composition of boys and girls on an athletic team that they coach. In any case, physical educators must be able to accurately assess body composition in children and adolescents, interpret the results correctly, discuss the results in an appropriate manner with students, and conduct meaningful research. The purpose of this article is to provide relevant background information about body composition and its assessment as well as the interpretation of results in an appropriate context for physical educators. Table 1 provides defi nitions of a number of terms used in this article.

Long-Distance Interval Training Following Pre-Cooling With an Ice Vest

This study evaluated how preparing for an interval workout, while wearing a cooling vest, affects core temperature (Tc), heart rate (HR), and interval time in long-distance runners. Nineteen male collegiate cross-country runners exercised under two different conditions: (a) wearing a Nike PreCool™ ice vest for one hour prior to the workout (30 minutes resting with the vest and 30 minutes while performing their warm-up); and (b) a control condition utilizing a traditional warm-up. Subjects performed 8 × 1000 m intervals. HR and Tc were measured prior to warm-up, immediately before the first interval, and after each interval. Tc measured before the first interval was significantly lower in the vest condition (difference = 0.37° ± 0.2°C). Differences persisted through the sixth interval. Differences in HR and interval times were nonsignificant between conditions for all intervals Wearing an ice vest prior to and during warm-up effectively lowers Tc during long-distance interval training.

Prediction of VO2max in Children and Adolescents Using Exercise Testing and Physical Activity Questionnaire Data

Purpose: The purpose of this study was to evaluate the use of a treadmill walk-jog-run exercise test previously validated in adults and physical activity questionnaire data to estimate maximum oxygen consumption (VO2max) in boys (n = 62) and girls (n = 66) aged 12 to 17 years old. Methods: Data were collected from Physical Activity Rating (PA-R) and Perceived Functional Ability (PFA) questionnaires, a walk-jog-run submaximal treadmill exercise test, and a maximal graded exercise test. Results: Regression analysis resulted in the development of 2 models to predict VO2max. Submaximal exercise test data were used to build the following model (R2 = .73; SEE = 4.59 mL + kg− 1 + min− 1): VO2max (mL + kg− 1 + min− 1) = 26.890+(5.877 × Gender; 0 = female; 1 = male) − (0.782 × Body Mass Index [BMI])+(0.438 × PFA Score) +(2.712 × Treadmill Speed; mph) +(0.746 × Age) +(0.449 × PA-R Score). Maximal exercise test data were used to build the following model (R2 = .83; SEE = 3.63 mL + kg− 1 + min− 1): VO2max (mL + kg− 1 + min− 1) = 10.716+(1.334 × Maximal Treadmill Grade) +(5.203 × Treadmill Speed; mph) +(3.494 × Gender; 0 = female; 1 = male) − (0.413 × BMI) +(0.249 × PFA). Conclusions: The results of this study demonstrate, for the first time, that regression equations that use both exercise data and physical activity questionnaire data can accurately predict VO2max in youth. The submaximal and maximal exercise tests that use self-selected treadmill speeds can be used to assess cardiorespiratory fitness of youth with a wide range of fitness levels.

In Vivo Correlates Between Daily Physical Activity and Intervertebral Disc Health

Physical activity impacts health and disease in multiple body tissues including the intervertebral discs. Fluid flow within the disc is an indicator of disc health that can be observed using diffusion weighted magnetic resonance imaging. We monitored activity levels of 26 participants, age 35–55u2009yrs, using Actigraph accelerometers for 4 days to evaluate vigorous‐intensity activity, moderate to vigorous intensity activity, and sedentary time. Participants underwent structural and diffusion weighted magnetic resonance imaging to evaluate intervertebral disc health and fluid flow. They also underwent bone density scans, carotid artery ultrasounds, a treadmill test, and a physical exam for pain, range of motion, and instability. These measures were used to correlate MRI indicators of intervertebral disc health with participant activity levels. Participants with any vigorous‐intensity physical activity compared with no vigorous‐intensity activity had significantly greater L5/S1 apparent diffusion coefficient values (pu2009=u20090.002), corresponding to higher freedom of diffusive movement for cellular nutrients and metabolic waste. Sagittal T2 values in the L5/S1 were also higher (pu2009=u20090.004), corresponding to a higher water content in the discs. Higher apparent diffusion coefficients were also found in participants with more than 30u2009min compared with less than 30u2009min of daily moderate to vigorous physical activity (pu2009=u20090.03), and in participants with less than 67% awake time as sedentary time compared with more than 67% sedentary time (pu2009=u20090.03). Increased dynamic loading through physical activity and decreased static loading from sedentary time benefit intervertebral disc health. Physical activity, particularly vigorous activity, is beneficial in helping maintain intervertebral disc health.

Identifying Chronic Conditions and Other Selected Factors That Motivate Physical Activity in World Senior Games Participants and the General Population

This study assesses chronic disease or disease-related conditions as motivators of physical activity. It also compares these and other motivators of physical activity between Senior Games participants (SGPs) and the general population. Analyses are based on an anonymous cross-sectional survey conducted among 666 SGPs and 177 individuals from the general population. SGPs experienced better general health and less obesity, diabetes, and depression, as well as an average of 14.7 more years of regular physical activity (p < .0001), 130.8 more minutes per week of aerobic activity (p < .0001), and 42.7 more minutes of anaerobic activity per week (p < .0001). Among those previously told they had diabetes, high blood pressure, high cholesterol, or depression, 74.2%, 72.2%, 70.4%, and 60.6%, respectively, said that it motivated them to increase their physical activity. Percentages were similar between SGPs and the general population. SGPs were more likely motivated to be physically active to improve physical and mental health in the present, to prevent physical and cognitive decline in the future, and to increase social opportunities. The Senior Games reinforces extrinsic motivators to positively influence intrinsic promoters such as skill development, satisfaction of learning, enjoyment, and fun.