Gender-specific effects of modifiable health risk factors on coronary heart disease and related expenditures. HERO Research Committee. Health Enhancement Research Organization.

There is a general lack of health-related research focusing on gender-specific differences within a working population. This research attempts to address that void. Our study relied on the Health Enhancement Research Organization (HERO) database, which consists of claims, enrollment information, and health risk data for 39,999 employees of six large employers. The research objective was to determine the gender-specific association between coronary heart disease (CHD) and (1) the prevalence of modifiable health risks and (2) medical expenditures. To accomplish this, the International Classification of Diseases, 9th Revision-Clinical Modification and Current Procedural Terminology codes were used to identify 2452 employees with CHD within the HERO database. These individuals made up the study group, which included 66% male and 34% female participants. Health risk data were obtained from voluntary participation in a health risk appraisal and biometric evaluation provided by the employers. Health risks evaluated were tobacco use, hypertension, obesity, elevated cholesterol, high blood glucose, sedentary lifestyle, stress, depression, and excessive use of alcohol. Descriptive and multivariate statistical techniques were used to analyze the HERO database. We found that obesity was the most consistent predictor of CHD. It was number one (of 10 health risks) in the male and female group, number two in the male-only group, and number one in the female-only group. High stress was the second most consistent predictor. There was no such consistency relative to medical expenditures. This lack of consistency across the male and female groups relative to the association between health risks and medical expenditures was demonstrated for nearly all other health risks evaluated. This study suggests that within a group of employees with CHD, there are important similarities and differences between men and women with respect to the prevalence of risk factors and the association between health risks and medical expenditures.

A one-year follow-up to physical activity and health. A report of the Surgeon General.

OBJECTIVES: A telephone survey of over 2000 American adults was conducted to determine their awareness of Physical Activity and Health: A Report of the Surgeon General and their knowledge of the health messages contained within the report. A related purpose was to determine if awareness and knowledge were a function of age, ethnicity, gender, and education level. METHODS: A random sample of American adults was drawn and a national telephone survey was conducted in the 48 contiguous states and the District of Columbia. RESULTS: Approximately one third of the adult population had heard of the report. Awareness was a function of age, ethnicity, and educational level. Knowledge of the relationship between physical inactivity and specific chronic diseases was a function of age, ethnicity, and gender. CONCLUSIONS: Differential awareness of the Report and its contents by various segments of the population has significant implications for the messages transmitted and interventions developed to help individuals adopt and maintain active lifestyles.

Nutritional status of nationally ranked elite bodybuilders.

The nutritional status of 11 female and 13 male elite bodybuilders at the first drug-tested USA Championship was examined through food records kept by subjects. Diets were repetitive and monotonous, and average daily energy and protein contents were relatively similar for men and women. Percent calories from protein, fat, and carbohydrate were 39%, 12%, and 48% for females, and 40%, 11%, and 49% for males, respectively. Females consumed 0% vitamin D, 52% calcium, 76% zinc (as percents of RDA) and below the Estimated Safe and Adequate Dietary Allowance amounts for copper and chromium. Males consumed 46% of vitamin D RDA. Although dietary magnesium intakes were above the RDA, serum magnesium levels in females were below reference values, which should be investigated. Serum zinc levels were high in men and women. Eighty-one percent of females reported recurrent contest-related amenorrhea for 2 +/- 1 months precontest. Dietary intakes of men were adequate but the restrictive intakes of women may place them at risk for calcium, copper, and chromium deficiencies.

Vitamin-mineral supplement use and nutritional status of athletes.

Dietary, anthropometric, and chronic disease risk factors (CDRF) including blood lipids and blood pressure (BP), were measured in 91 vitamin-mineral supplement users (SU) and nonusers (NU) representing a wide range of athletic interests. Supplements were used by 46 (51%) subjects; 100% of female athletes and 51% of male athletes used supplements while none of a group of 15 control female subjects currently used supplements. Both dietary intake and energy expenditure were measured using 7-day records. Adiposity was determined from body weight, body mass index, and skinfolds. Total cholesterol, high-density lipoprotein cholesterol, serum ferritin, hemoglobin, hematocrit, zinc, copper, and vitamin C were based on 12-hour fasting blood samples. Dietary intake (excluding supplements) for SU tended to be greater than NU for vitamin C, thiamin, riboflavin, niacin, B6, B12, folate, calcium, iron and magnesium. Plasma vitamin C levels were significantly higher among SU than NU of both gender groups (p < 0.05). Although SU may exhibit additional healthy lifestyle practices, lipid profiles for many of these athletes were unfavorable with regard to CDRF.

Differences in the effects of carbohydrate food form on endurance performance to exhaustion.

This investigation examined the metabolic and performance effects of ingesting solid compared to slurried carbohydrate food (bananas) between two prolonged exhaustive exercise bouts. Eight highly trained male triathletes performed four exhaustive endurance tests (ET), each separated by at least 2 weeks. Each ET consisted of a 90-min run followed by 90 min of cycling, both at 70% VO2max. Workloads were then gradually increased on the cycle, and subjects continued to cycle until exhausted. They then rested for 20 min and ingested one of the following: an artificially sweetened placebo drink (P), slurried bananas (SL), or solid bananas (SO). Bananas were given in equal portions relative to each subject's body weight. Subjects cycled to exhaustion a second time at 70% of their VO2max, at which point the mean blood glucose concentration for the combined carbohydrate treatments was significantly higher than that from the P treatment. The mean glucose concentration from the SL treatment did not differ significantly from the SO treatment. These data demonstrate that solid bananas are as effective as slurried bananas in maintaining plasma glucose and in enhancing endurance exercise performance.

Plasma amino acid responses of trained athletes to two successive exhaustion trials with and without interim carbohydrate feeding.

The purpose of this research was to measure changes in selected plasma amino acids (AA) during two successive exercise trials to exhaustion. Eleven trained male athletes completed these trials at weeks 4, 6, 8 and 12. Blood samples for each test were collected after a 12-hour fast at times (in minutes) 0 (Resting), 45, 90, 135, 180, at exhaustion (EI), after a 20-minute recovery period, and at the second exhaustion (EII). At the end of EI, subjects consumed an artificially sweetened water replacement (placebo) treatment or a carbohydrate (CHO) replacement (1.1 g CHO/kg BW) in order to determine any effect of CHO replacement on changes in energy substrates or AA, adjusted for plasma volume changes. From baseline to EI, alpha-aminobutyric acid, alanine, glycine, isoleucine, serine, valine threonine, and tyrosine decreased significantly (p less than or equal to 0.05), while taurine increased significantly. During the recovery period following EI, isoleucine, leucine, ornithine, phenylalanine, tyrosine, urea and valine increased significantly. From the end of recovery until EII, alanine, aspartic acid, glycine, isoleucine, leucine, ornithine, phenylalanine, serine, threonine, tyrosine and valine decreased significantly. CHO replacement had no effect on the mean change scores for any AA from EI to the end of the recovery period and affected only serine, citrulline, glycine and threonine from the end of the recovery period to EII.

Effects of coenzyme athletic performance system as an ergogenic aid on endurance performance to exhaustion.

This study examined the effects of the Coenzyme Athletic Performance System (CAPS) on endurance performance to exhaustion. CAPS contains 100 mg coenzyme Q10, 500 mg cytochrome C, 100 mg inosine, and 200 IU vitamin E. Eleven highly trained male triathletes were given three daily doses of either CAPS or placebo (dicalcium phosphate) for two 4-week periods using a double-blind crossover design. A 4-week washout period separated the two treatment periods. An exhaustive performance test, consisting of 90 minutes of running on a treadmill (70% VO2max) followed by cycling (70% VO2max) until exhaustion, was conducted after each treatment period. The mean (+/- SEM) time to exhaustion for the subjects using CAPS (223 +/- 17 min) was not significantly different (p = 0.57) from the placebo trial (215 +/- 9 min). Blood glucose, lactate, and free fatty acid concentrations at exhaustion did not differ between treatments (p < 0.05). CAPS had no apparent benefit on exercise to exhaustion.

Vitamin C intake and lipid profiles of competitive male and female bodybuilders.

This research compared nutrient intake data with blood lipids and anthropometric data. Height, weight, and seven skinfolds were collected 3 days prior to competition at the official weigh-in. The lipids measured were total cholesterol (TC), HDL-cholesterol (HDL-C), and the HDL2 and HDL3 cholesterol subfractions. The subjects were 17 males and 17 females. Descriptive data are presented as means and standard deviations of the means. Protein, fat, and carbohydrate provided about 40, 12, and 48%, respectively, of total energy intake; vitamin C was > 200 mg/day. Only dietary fat was significantly (p < 0.05) associated with TC for females. Fiber was significantly associated with HDL-C and HDL2-C for males and with HDL-C for females. Vitamin C was significantly associated with HDL-C,HDL2-C, and HDL3-C for males, and with HDL-C and HDL3-C for females. These findings are consistent with those reported by Bazzarre et al. in farmers and suggest that vitamin C may favorably influence HDL-C metabolism.

Associations of cardiovascular disease risk factors with measures of energy expenditure and caloric intake in a farm population.

The purpose of this study was to examine the relationships of several cardiovascular disease risk factors [blood pressure (BP), total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-C), and the HDL-C:TC ratio], as well as the body mass index (BMI) and percent body fat with daily energy intake (EI) and daily energy expenditure (EE) of North Carolina farmers and their wives. Data were collected from 195 subjects. Daily EI and EE were estimated from 4-day food and 4-day activity records, respectively, collected on the same days. Pearson correlation coefficients for chronic disease risk factors with both EI and EE were generally low. When compared to EI, EE was more highly correlated with both lean body mass (r = 0.88) and BMI (r = 0.73), and was less time consuming and easier for the subjects to use. EE obtained from a reliable activity record may be a more practical tool for assessing the possible relationship(s) of energy metabolism to chronic disease risk factors.

Chronic disease risk factors in vitamin/mineral supplement users and nonusers in a farm population.

Dietary, anthropometric, and chronic disease risk factors (CDRF) in vitamin/mineral supplement users (U) and non-users (NU) were measured in a farm population consisting of 162 subjects (46% females and 54% males; 20-79 years of age, mean age: 52 years). Subjects were white, except for two black males. Supplements were used by 62 subjects (38%); 47% of females and 31% of males used supplements; 43% of subjects over 50 years of age and 32% of subjects age 50 or under used supplements. Both dietary intake and energy expenditure were measured using 4-day records. Indices of adiposity included body weight, BMI, and estimated body fat. Total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-C), serum ferritin, hemoglobin, hematocrit, zinc, copper, and vitamin C were based on 12-hr fasting blood samples. Dietary intake (excluding supplements) for vitamin/mineral U was greater than NU for vitamin C (p = 0.006), thiamin (p = 0.01), riboflavin (p = 0.03), niacin (p = 0.02), folic acid (p = 0.001), vitamin B6 (p = 0.01), and magnesium (p = 0.019). Vitamin C levels were significantly higher and the sum of four skinfolds was significantly lower among U than NU. In this population, 24% of males and 18% of females had TC levels over 240 mg%; 8% of both males and females had blood pressures (BP) greater than 140/90 mm Hg, while 49% of males and 46% of females had BP between 120/80 and 140/90; and 71% of males were more than 25% fat, and 56% of females were more than 35% fat. Despite the high prevalence of CDRF, there were no significant differences between supplement U and NU.

Metabolic profiles, diet, and health practices of championship male and female bodybuilders.

To obtain a more complete view of their general health and health care habits, 27 bodybuilders (19 men and 8 women) competing at the 1988 National Physique Committee's Junior USA Bodybuilding Championships participated in this study. Data pertaining to demographics and pre-competition nutrition, training, health, and drug abuse practices were collected by self-administered and interview surveys and records. Anthropometric and blood pressure measurements and casual blood samples were collected on -site at the competition registration. Multi-drug abuse was reported by 15% to 40% of the subjects, and 20% to 40% of subjects left the drug use questions unanswered. Severe fluid restrictions and dehydrating practices were reported by all subjects. Eleven men and two women agreed to have blood drawn. Plasma glucose values were at the low end of the normal fasting range. Hemoglobin levels were elevated, indicating hypohydration; magnesium levels were slightly low. Percent body fat, estimated by seven-site skinfold measures, was low for both sexes (men, 6.0 +/- 1.8; women, 9.8 +/- 1.5); 75% of the women reported normal menstrual cycles. The men reported high-protein, low-fat hypocaloric diet patterns. Women had a moderate zinc intake and a remarkably deficient calcium intake despite an adequate energy intake. This research demonstrates that bodybuilders partake in a multitude of practices that may place them in high-risk health categories. It is essential that health care workers in contact with bodybuilding athletes intervene and educate them about healthy dietary and training alternatives.

Nutrition knowledge and dietary practices of college coaches.

The objectives of this study were to measure nutrition knowledge of college coaches, to identify educational and demographic factors that affect nutrition knowledge of college coaches, to describe dietary practices recommended by these coaches, and to identify major sources of nutrition information used by coaches. Questionnaires were mailed to 296 coaches of senior and junior colleges in North Carolina using a listing from the National Directory of College Athletics. Coaches of the following sports were included: track and field, cross country, swimming, tennis, basketball, gymnastics, golf, football, and wrestling. The response rate was 36%. Seventy percent of the 15 nutrition knowledge test items were answered correctly; however, only one-third of the coaches indicated a high degree of certainty for the correctness of their responses. There were no significant relationships between nutrition knowledge and sex, age, collegiate conference, course work in nutrition, win/loss record, and years of coaching experience. Major dietary problems of college athletes reported by coaches were consumption of "junk food," poor eating habits, and consumption of an unbalanced diet. The authors recommend an annual workshop for coaches, trainers, and dietitians to develop criteria for nutrition assessment and body composition for college athletes and to develop training diets. Special workshops for foodservice personnel are also recommended.