Background: To assess the joint and stratified associations between cardiorespiratory fitness (CRF), incidence, and mortality from cancer in never, former, and current male smokers. Methods: CRF (treadmill exercise test) was assessed in 4694 men (never smokers [n = 1715]; former smokers [n = 1602], 32.4 [30.5] pack-years; and current smokers [n = 1377], 40.3  pack-years) aged 58.1 (17.3) years, and prospectively followed for 12.7 (7.5) years. Multivariable Cox hazard models were analyzed. Results: In joint analyses, where high CRF in never smokers was used as a reference, hazard ratios and 95% (confidence intervals) for cancer incidence and cancer mortality were as follows: moderate CRF 1.41 (1.0–1.9) and 3.0 (1.7–5.5) in never smokers, 1.65 (1.3–2.2) and 3.7 (2.1–6.6) in former smokers, and 1.3 (0.9–1.7) and 3.4 (1.9–6.1) in current smokers, respectively. The corresponding values for low CRF were 1.53 (1.1–2.2) and 5.1 (2.7–9.5), 1.84 (1.3–2.5) and 6.6 (3.7–11.8), and 1.5 (1.1–2.2) and 5 (2.7–9.3), respectively. In stratified analyses by smoking status, compared with low CRF, moderate and high CRF were associated with a 32% to 78% reduction in cancer mortality risk (P trend for all <.001). Conclusion: Higher CRF is associated with lower risk of incidence and mortality from cancer regardless of smoking status, supporting the potential preventive benefits for public health.
Baruch Vainshelboim, Zhongming Chen, Ricardo M. Lima and Jonathan Myers
Heather Hayes Betz, Jonathan Myers, Alyssa Jaffe, Kimberly Smith and Ronald Dalman
Quantifying lifetime physical activity using self-reported measures is challenging due to reliance on recall, especially in older populations. The purpose of this study was to determine the 1-year reproducibility of the Veterans Physical Activity Questionnaire (VAPAQ) in a cohort of patients with documented abdominal aortic aneurysm disease (AAA).
Subjects included men (n = 52) and women (n = 3) enrolled in AAA STOP, a randomized trial designed to test the ability of supervised exercise training to modify AAA biology and early disease progression.
The overall correlation coefficient for lifetime recreational energy expenditure between the 2 examinations was 0.93 (P < .001), with an overall difference of 26 kcal/week, a typical error (standard deviation of the differences) of 171 kcals/week, and a coefficient of variation (CV) of 15.5%.
The VAPAQ is a reproducible tool to quantify lifetime energy expenditure in older adults with documented vascular disease.
Jonathan Myers, Mandi Dupain, Andrew Vu, Alyssa Jaffe, Kimberly Smith, Holly Fonda and Ronald Dalman
As part of a home-based rehabilitation program, 24 older adult patients (71 ± 3 years) with abdominal aortic aneurysm (AAA) disease underwent 3 days (12 awake hr/day) of activity monitoring using an accelerometer (ACC), a pedometer, and a heart rate (HR) monitor, and recorded hourly activity logs. Subjects then underwent an interview to complete a 3-day activity recall questionnaire (3-DR). Mean energy expenditure (EE) in kcals/ day for HR, ACC, and 3-DR were 1,687 ± 458, 2,068 ± 529, and 1,974 ± 491, respectively. Differences in EE were not significant between 3-DR and ACC, but HR differed from both ACC (p < .001) and 3-DR (p < .01). ACC and 3-DR had the highest agreement, with a coefficient of variation of 7.9% and r = .86. Thus, ACC provided a reasonably accurate reflection of EE based the criterion measure, an activity recall questionnaire. ACC can be effectively used to monitor EE to achieve an appropriate training stimulus during home-based cardiac rehabilitation.