I learned that about 12% of high fit 80+ year olds die annually. Seems a bit unfair. But 27% of low fit 60-69 year olds die annually! No typo. High fit 80-yr olds are HALF AS LIKELY TO DIE as low fit 60-yr olds. Are we talking about 80-yr old Olympians? Nope. High fit is top 40%. Low fit = bottom 20%. Not too hard.

Prof Steve Blair (giving the audience both barrels of evidence, below) provided the data and reminded us that 150 minutes of moderately vigorous activity weekly (walking to and from the fridge) will leave the low fitness group in the dust. Alternatively, 70 minutes of vigorous walking to the fridge will do it. Not a big ask. As he said, the folks who are ‘too busy’ to do this generally have 3-4 hours a day to watch TV. And I guess there’ll be a few who have 10-20 years in the grave to think about it. Sounds non-PC but is actually just a fact.

Prof Dan Lieberman, ‘the Barefoot Professor’ wore black slipper type shoes to remind us not to polarize the debate into ‘barefoot’ vs ‘shod’ running. He highlighted the evolutionary advantage that humans have to run down game in the heat. 9-15 km daily, daily, daily back in the day. He really argued for the benfits of forefoot strike to prevent injuries. He’s doing an interview with the BMJ team tomorrow and there’ll be a session on running shoes/orthoses/etc. with Benno Nigg too. In the meantime see orthotics and patellofemoral pain in the BMJ.

The FIFA research team (F-MARC) including Philippe Tscholl, Mario Bizzini and Jiri Dvorak (photo above) shared the facts that 2010 World Cup football players used medication including NSAIDs and cortisone at a remarkable rate – comparable to that of osteoarthritic octogenarians in a care facility.  A concern. Doctors must do better. No lessons learned from previous World Cups in Germany and France. In a nutshell – FIFA 11+ prevents lower limb injuries and is being rolled out around the world. Football for Health — health messages with players as ambassadors and school children as the target is proving effective and electric. Great uptake – a lesson in implementation which is the theme of January’s BJSM issue (2012). No hyperlink there just yet. BJSM Blog gives you today’s news but not tomorrow’s!

We are hours away from freshening up the podcast page with a suite of interviews. Just need to get the switch at BMA house. We’ll tweet you when it’s ready (@BJSM_BMJ).

And if you add a question for any conference speaker below we’ll try to get it answered. No promises though! Or via Twitter.

PS: Thanks to our terrific team from BMJ for being at UKsem 2011. I am sure you have earned a spot for 2012!

By Sarmax.

In many practical situations such as the treatment of hypertension, it is important to determine whether an improvement of condition following exercise prescription is due to an increase in aerobic fitness, or whether it simply reflects a reduction in body fat content (1) A previous review of 61 studies of training-induced changes in resting blood pressure (2) concluded that any reduction in resting pressures could not be attributed to concomitant weight loss, since the changes in systolic and diastolic readings showed very small and statistically non-significant correlations with changes in body mass.

In their recent paper, Barrone et al. (1) wished to test whether the same was true of exercise hypertension, and in support of such a conclusion they claim to have demonstrated independent correlations of delta fitness and delta fat with changes of pressure through the use of generalized estimating equations. A variety of valid measures of body fatness were obtained on their subjects, but unfortunately an inappropriate measure of aerobic fitness was chosen for the analysis. The outcome is reported as a change in peak oxygen transport, expressed in ml/kg/min. This is dimensionally incorrect, but let us assume that the authors intended to indicate a relative change of oxygen transport, expressed in ml/[kg.min]. Aerobic fitness is in fact the overall ability of the cardio-respiratory system to transport litres of oxygen to the working tissues. Any accumulation of body fat reduces the utility of this transport in terms of daily activities (including treadmill running). To take a practical example, a man with a body mass of 70 kg and an aerobic fitness of 3.5 l/min has a relative VO2max of 50ml/[kg.min]. If that same person accumulates an extra 14 kg of body fat, the aerobic fitness may remain at 3.5 l/min. but the relative VO2max decreases to 41.7 ml/[kg.min]. Plainly, the relative units of oxygen transport confound the influence of fitness and fatness, and cannot be used to distinguish the importance of changes in fitness relative to changes in fatness.

The authors must have the data to make a more convincing independent analysis of the two variables, and I would encourage them to do so.

REFERENCES.

1. Barone BB, Wong N-Y, Bacher AC et al. Decreased exercise blood presure in older adults after exercise training: contributions of
increased fitness and decreased fatness. Br J Sports Med 2009; 43: 52-56.

2. Hagberg JM, Park J-J, Brown MD. The role of exercie training in the treatment of hypertension. An Update. Sports Med 2000; 30: 193-206.