OBJECTIVE\nThe purpose of this study was to determine the independent and joint associations of cardiorespiratory fitness (CRF) and BMI with the incidence of type 2 diabetes in women.\n\n\nRESEARCH DESIGN AND METHODS\nAn observational cohort of 6,249 women aged 20-79 years was free of baseline cardiovascular disease, cancer, and diabetes. CRF was measured using a maximal treadmill exercise test. BMI was computed from measured height and weight. The incidence of type 2 diabetes was identified primarily by 1997 American Diabetes Association criteria.\n\n\nRESULTS\nDuring a 17-year follow-up, 143 cases of type 2 diabetes occurred. Compared with the least fit third, the multivariate (including BMI)-adjusted hazard ratio (HR) (95% CI) was 0.86 (0.59-1.25) for the middle third and 0.61 (0.38-0.96) for the upper third of CRF. For BMI, the multivariate (including CRF)-adjusted HR (95% CI) was 2.34 (1.55-3.54) for overweight individuals and 3.70 (2.12-6.44) for obese individuals, compared with normal-weight patients. In the combined analyses, overweight/obese unfit (the lowest one-third of CRF) women had significantly higher risks compared with normal-weight fit (the upper two-thirds of CRF) women.\n\n\nCONCLUSIONS\nLow CRF and higher BMI were independently associated with incident type 2 diabetes. The protective effect of CRF was observed in individuals who were overweight or obese, but CRF did not eliminate the increased risk in these groups. These findings underscore the critical importance of promoting regular physical activity and maintaining normal weight for diabetes prevention.

A Prospective Study of Cardiorespiratory Fitness and Risk of Type 2 Diabetes in Women: 667

This article includes an historical review of research on physical activity and health, and how the findings have contributed to physical activity participation and promotion today. In the 20th century, research began to accumulate on the effects of exercise on physiological functions, and later on the relation between regular activity and various health outcomes. In the latter half of the 20th century, it became clear that physical inactivity is one of the major public health problems in the world. This prompted numerous organizations and governments to issue recommendations for increasing physical activity in the population. The United States now has official governmental guidelines for physical activity. In addition, numerous public and private organizations have collaborated to develop and implement a U.S. National Physical Activity Plan.

The Evolution of the Physical Activity Field

The role of ‘best investment’ methodology in shaping priorities in many health policy areas is becoming increasingly prominent. Whilst this has traditionally been seen as a technocratic exercise, the social and political context of such practices and the constructed nature of decisions are now considered significant. In this context, this article reports on a longitudinal case study of such a process that sought to identify ‘best investments’ in public health interventions related to promoting physical activity. Drawing on a series of conceptual resources, we describe and reflect upon the complex and invested elements that contributed to the grounded decision-making process. In conclusion we suggest the need to adopt a multifaceted and nuanced approach to resource investment decision making, including: deploying a range of appraisal assessment resources; maintaining a long-term processual perspective; involving a variety of stakeholders; accepting and embracing fallibility; and accommodating theoretical and empirical evidence-based principles.

Investment decisions on physical activity promotion: a locality case study in complex public health policy making

Background: There is little understanding about which sets of environmental features could simultaneously predict intensity-specific leisure-time physical activity (LTPA) among Brazilians. The objectives were to identify the environmental correlates for intensity-specific LTPA, and to build the best-fit linear models to predict intensity-specific LTPA among adults of Curitiba, Brazil. Methods: Cross sectional study in Curitiba, Brazil (2009, n = 1461). The International Physical Activity Questionnaire and Abbreviated Neighborhood Environment Assessment Scale were used. Ninety-two perceived environment variables were categorized in 10 domains. LTPA was classified as walking for leisure (LWLK), moderate-intensity leisure-time PA (MLPA), vigorous-intensity leisure-time PA (VLPA), and moderate-to-vigorous intensity leisure-time PA (MVLPA). Best fitting linear predictive models were built. Results: Forty environmental variables were correlated to at least 1 LTPA outcome. The variability explained by the 4 best...

Intensity-specific leisure-time physical activity and the built environment among Brazilian adults: a best-fit model.

History of Physical Activity Contributions to Public Health

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History of Physical Activity Contributions to Public Health