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Individual and interpersonal correlates of cardiorespiratory fitness in adults - Findings from the German Health Interview and Examination Survey.

ABSTRACT: Cardiorespiratory fitness (CRF) is an established predictor of adverse health outcomes. The aim of this study is to investigate potential behavioral, interpersonal and socioeconomic correlates of CRF among men and women living in Germany using data from a population-based nationwide cross-sectional study. 1,439 men and 1,486 women aged 18-64 participated in the German Health Interview and Examination Survey (2008-2011) and completed a standardized sub-maximal cycle ergometer test. Maximal oxygen consumption ([Formula: see text]) in ml·min-1·kg-1 was estimated. Mean values of VO2max for various anthropometric, behavioral, interpersonal, and sociodemographic variables were estimated. Linear regression analyses using multiple imputations technique for missing values was performed to analyze the influence of potential correlates on CRF. Women with high alcohol consumption had higher [Formula: see text], (??=?2.20; 95% CI 0.98 to 3.42) than women with low alcohol consumption and women with high occupational status had higher [Formula: see text] (??=?1.83; 95% CI 0.21 to 3.44) in comparison to women with low occupational status. Among men, high fruit intake (??=?1.52; 95% CI 0.63 to 2.40), compared to low or medium fruit intake and performing at least 2.5?hours of total PA per week (??=?2.19; 95% CI 1.11 to 3.28), compared to less than 2.5?hours was associated with higher [Formula: see text]. Among both men and women, lower body mass index, lower waist circumference and higher levels of physical exercise were considerably associated with higher [Formula: see text]. Among women, those in higher age groups showed a considerably lower level of [Formula: see text] compared with those aged 18-24. Furthermore, mean estimated [Formula: see text] was higher among men (36.5; 95% CI 36.0 to 37.0) than among women (30.3; 95% CI 29.8 to 30.7). Despite the cross-sectional nature of the current study, we conclude that several behavioral, anthropometric, and sociodemographic factors are associated with CRF in the general adult population in Germany. These results can provide evidence to tailor prevention measures according to the needs of specific subgroups.

SUBMITTER: Zeiher J

PROVIDER: S-EPMC6965149 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Individual and interpersonal correlates of cardiorespiratory fitness in adults - Findings from the German Health Interview and Examination Survey.

Zeiher Johannes J Manz Kristin K Kuntz Benjamin B Perumal Nita N Perumal Nita N Keil Thomas T Mensink Gert B M GBM Finger Jonas D JD

Scientific reports 20200116 1

Cardiorespiratory fitness (CRF) is an established predictor of adverse health outcomes. The aim of this study is to investigate potential behavioral, interpersonal and socioeconomic correlates of CRF among men and women living in Germany using data from a population-based nationwide cross-sectional study. 1,439 men and 1,486 women aged 18-64 participated in the German Health Interview and Examination Survey (2008-2011) and completed a standardized sub-maximal cycle ergometer test. Maximal oxygen ...[more]

PMID: 31949174

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Project description:ObjectivesThis study aimed to investigate associations between occupational physical activity patterns (physical work demands linked to job title) and leisure time physical activity (assessed by questionnaire) with cardiorespiratory fitness (assessed by exercise test) among men and women in the German working population.DesignPopulation-based cross-sectional study.SettingTwo-stage cluster-randomised general population sample selected from population registries of 180 nationally distributed sample points. Information was collected from 2008 to 2011.Participants1296 women and 1199 men aged 18-64 from the resident working population.Outcome measureEstimated low maximal oxygen consumption ([Formula: see text]), defined as first and second sex-specific quintile, assessed by a standardised, submaximal cycle ergometer test.ResultsLow estimated [Formula: see text] was strongly linked to low leisure time physical activity, but not occupational physical activity. The association of domain-specific physical activity patterns with low [Formula: see text] varied by sex: women doing no leisure time physical activity with high occupational physical activity levels were more likely to have low [Formula: see text] (OR 6.54; 95% CI 2.98 to 14.3) compared with women with ≥2 hours of leisure time physical activity and high occupational physical activity. Men with no leisure time physical activity and low occupational physical activity had the highest odds of low [Formula: see text] (OR 4.37; 95% CI 2.02 to 9.47).ConclusionThere was a strong association between patterns of leisure time and occupational physical activity and cardiorespiratory fitness within the adult working population in Germany. Women doing no leisure time physical activity were likely to have poor cardiorespiratory fitness, especially if they worked in physically demanding jobs. However, further investigation is needed to understand the relationships between activity and fitness in different domains. Current guidelines do not distinguish between activity during work and leisure time, so specifying leisure time recommendations by occupational physical activity level should be considered.

Project description:BackgroundThe positive association between parental socio-economic position (PSEP) and health among adolescents may be partly explained by physical activity behaviour. We investigated the associations between physical activity, aerobic fitness and PSEP in a population based sample of German adolescents.Methods5,251 participants, aged 11-17 years, in the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS) underwent a sub-maximal cycle ergometer test and completed a questionnaire obtaining information on physical activity and media use. The associations between physical activity, media use, aerobic fitness and PSEP were analysed with multivariate logistic regression models for boys and girls separately. Odds ratios (ORs) of PSEP (education, occupation and income) on the outcomes were calculated adjusted for age, region, and other influencing factors.ResultsParental education was more strongly associated with the outcome variables than parental occupation and income. After adjusting for age and region, a higher parental education level was associated with better aerobic fitness - with an OR of 1.5 (95% CI 1.2-1.9) for girls whose parents had secondary education and 1.9 (1.4-2.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 1.3 (1.0-1.6) and 1.6 (1.2-2.1), respectively. Higher parental education level was associated with lower media use: an OR of 2.1 (1.5-3.0) for girls whose parents had secondary education and 2.7 (1.8-4.1) for girls whose parents had primary education compared to girls whose parents had tertiary education. The corresponding ORs for boys were 1.5 (1.2-1.9) and 1.9 (1.5-2.5), respectively. Higher parental education level was associated with a higher physical activity level only among girls: an OR of 1.3 (1.0-1.6) for girls whose parents had secondary education and 1.2 (0.9-1.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 0.9 (0.8-1.2) and 0.8 (0.6-1.0), respectively.ConclusionsAdolescents of parents with low SEP showed a lower level of aerobic fitness and higher levels of media use than adolescents of parents with higher SEP. Health-promotion interventions need to reach adolescents of parents with low PSEP and stimulate physical activity.

Project description:BACKGROUND: We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined. METHODS: The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables. RESULTS: After adjusting for age and region, a higher education level was associated with more leisure-time activity - with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively. CONCLUSIONS: In Germany adults with a lower level of education are more physically active, both at work and overall, compared to adults with a higher education level, although they are less physically active in their leisure time. Higher work-related activity levels among adults with lower education may explain why they are less active in their leisure time.

Project description:BACKGROUND:Although patients in Germany are generally free to choose their primary healthcare provider, this role should mainly be assumed by general practitioners (GPs). While some predictors of the frequency of use of GP services have been reported in international studies, there is still a lack in knowledge what could deter people from contacting a GP in Germany. To improve healthcare, it is important to identify characteristics of people without a GP. METHODS:This cross-sectional analysis was based on the first wave of the "German Health Interview and Examination Survey for Adults" (DEGS1) conducted by the Robert Koch Institute in 2008-2011. Descriptive analyses and multiple logistic regression by gender were performed to analyze the association between having no GP and age, gender, residential area, socioeconomic status (SES), marital status, working hours per week, general state of health, chronic diseases and health insurance. RESULTS:Overall, 9.5% (95% confidence interval (CI): 8.4-10.7) of the 7755 participants stated to have no GP, more often men (11.4%) than women (7.6%). Life in urban areas (big cities vs. rural: adjusted odds ratio (aOR): 2.9, 95% CI: 2.1-3.9), younger age (18-29 years vs. 65-79 years: aOR: 4.4, 95% CI: 2.5-7.7) and the presence of chronic diseases (yes vs. no: aOR: 0.4, 95% CI: 0.3-0.6) showed significant associations of not having a GP. For men, the type of health insurance (private vs. statutory: aOR: 2.1, 95% CI: 1.5-3.0; other vs. statutory: aOR: 2.1, 95% CI: 1.4-3.1) and for women, SES (low vs. medium: aOR: 1.8, 95% CI: 1.2-2.7; high vs. medium: aOR: 2.1, 95% CI: 1.4-3.0) increased the risk of having no GP. CONCLUSIONS:Our analysis offers new insights into the use of GPs in Germany and revealed differences between men and women. Public health strategies regarding access to a GP have to focus on men and on women with a low SES. Further analyses are needed to determine whether men with private health insurance prefer to consult a specialist rather than a GP. For young adults, improving the transition process from a pediatrician to a GP could fill a gap in health care.

Project description:BACKGROUND:High-sensitivity C-reactive protein (hsCRP) is a sensitive biomarker of systemic inflammation and is related to the development and progression of cardiometabolic diseases. Beyond individual-level determinants, characteristics of the residential physical and social environment are increasingly recognized as contextual determinants of systemic inflammation and cardiometabolic risks. Based on a large nationwide sample of adults in Germany, we analyzed the cross-sectional association of hsCRP with residential environment characteristics. We specifically asked whether these associations are observed independent of determinants at the individual level. METHODS:Data on serum hsCRP levels and individual sociodemographic, behavioral, and anthropometric characteristics were available from the German Health Interview and Examination Survey for Adults (2008-2011). Area-level variables included, firstly, the predefined German Index of Socioeconomic Deprivation (GISD) derived from the INKAR (indicators and maps on spatial and urban development in Germany and Europe) database and, secondly, population-weighted annual average concentration of particulate matter (PM10) in ambient air provided by the German Environment Agency. Associations with log-transformed hsCRP levels were analyzed using random-intercept multi-level linear regression models including 6,768 participants aged 18-79 years nested in 162 municipalities. RESULTS:No statistically significant association of PM10 exposure with hsCRP was observed. However, adults residing in municipalities with high compared to those with low social deprivation showed significantly elevated hsCRP levels (change in geometric mean 13.5%, 95%CI 3.2%-24.7%) after adjusting for age and sex. The observed relationship was independent of individual-level educational status. Further adjustment for smoking, sports activity, and abdominal obesity appeared to markedly reduce the association between area-level social deprivation and hsCRP, whereas all individual-level variables contributed significantly to the model. CONCLUSIONS:Area-level social deprivation is associated with higher systemic inflammation and the potentially mediating role of modifiable risk factors needs further elucidation. Identifying and assessing the source-specific harmful components of ambient air pollution in population-based studies remains challenging.

Dataset Information

Individual and interpersonal correlates of cardiorespiratory fitness in adults - Findings from the German Health Interview and Examination Survey.

Publications

Individual and interpersonal correlates of cardiorespiratory fitness in adults - Findings from the German Health Interview and Examination Survey.

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