0415270707

Table of Contents


	List of Figures	x
	List of Tables	xvi
	List of Boxes	xviii
	Foreword	xix
	Authors’ Preface	xxi
	Personal Acknowledgements	xxii
	Illustrations Acknowledgements	xxiii
	Conversion Factors for Commonly Used Units	xxvii
PART I	ASSESSING the EVIDENCE	1
1	Introduction	3
	Early Observations	3
	Modern Trends	4
	Physical Activity Levels in Populations	6
	Temporal Changes in Physical Activity	12
	National Surveys of Fitness	13
	Definitions of Key Terms	14
	Summary	15
	Study Tasks	15
	Notes	16
	Further Reading	16
2	Nature of the Evidence	17
	Introduction	17
	What is Epidemiology?	18
	Assessment of Physical Activity and Fitness in Epidemiology	23
	Laboratory-Based Research	27
	Error: Nature, Sources and Implications	30
	Establishing Causality	33
	Summary	34
	Study Tasks	35
	Notes	35
	Further Reading	35
3	Physical Activity and Total Mortality	36
	Introduction	36
	Physical Activity and All-Cause Mortality	37
	Physical Fitness and All-Cause Mortality	38
	Changes in Physical Activity and All-Cause Mortality	41
	Changes in Physical Fitness and All-Cause Mortality	43
	Physical Fitness, Body Composition and All-Cause Mortality	44
	Exercise for Longevity	48
	Summary	50
	Study Tasks	51
	Further Reading	51
PART II	EFFECTS OF PHYSICAL ACTIVITY ON THE RISK OF DISEASE	53
4	Cardiovascular Disease	55
	Introduction	55
	What is Cardiovascular Disease?	56
	Atherosclerosis	58
	Epidemiology of Physical Activity and CHD	59
	Epidemiology of Fitness and CHD	65
	Changes in Physical Activity or Fitness and CHD	67
	Dose-Response: What Level of Activity or Fitness Confers Protection Against CHD?	69
	Are Physical Inactivity and Low Fitness Causal Factors for CHD?	70
	Stroke	71
	Hypertension	73
	Summary	74
	Study Tasks	74
	Notes	75
	Further Reading	75
5	Risk Factors for Cardiovascular Disease	76
	Introduction	76
	CVD Risk Factors	77
	Lipoprotein Metabolism	78
	Blood Pressure	85
	Endothelial Function	88
	Coagulation and Fibrinolysis	88
	Insulin Resistance	90
	Overweight and Obesity	90
	Summary	90
	Study Tasks	91
	Further Reading	91
6	Type 2 Diabetes	93
	Introduction	93
	Types of Diabetes	94
	Aetiology of Type 2 Diabetes	94
	Prevalence of Type 2 Diabetes	98
	Obesity and Type 2 Diabetes	98
	Evidence That Physical Activity Prevents Type 2 Diabetes	101
	Mechanisms of Interaction Between Exercise and Type 2 Diabetes	108
	Summary	111
	Study Tasks	112
	Further Reading	112
7	Obesity and Energy Balance	114
	Introduction	114
	Definition of Obesity	115
	Prevalence of Obesity	117
	Health Risks of Obesity	119
	Genetic Influence on Obesity	120
	Energy Balance and Obesity	122
	Exercise, Resting Metabolic Rate and Obesity	123
	Physical Inactivity as a Cause of Obesity	126
	Summary	129
	Study Tasks	129
	Further Reading	129
8	Insulin Resistance Syndrome	131
	Introduction	131
	Definition of the Insulin Resistance Syndrome	132
	Prevalence	133
	Abnormalities Associated with Insulin Resistance	133
	Influence of Physical Activity	137
	Exercise and Postprandial Lipoprotein Metabolism	141
	Prevention	144
	Summary	145
	Study Tasks	146
	Notes	146
	Further Reading	146
9	Cancer	147
	Introduction	147
	Carcinogenesis	148
	Physical Activity and Colorectal Cancer	150
	Physical Activity and Breast Cancer	154
	Physical Activity and Other Cancers	156
	Potential Mechanisms	157
	Population-Attributable Risk	161
	Summary	162
	Study Tasks	163
	Notes	163
	Further Reading	163
	Web-Based Resources	164
10	Skeletal Health	165
	Introduction	165
	Biology of Bone	166
	Bone Mineral Density	169
	Adaptation to Load-Bearing	169
	Osteoporosis: Definition, Consequences and Prevalence	172
	Physical Activity and Risk of Hip Fracture	174
	BMD and Physical Activity	175
	Physical Activity and Risk of Falls	182
	Preventive Possibilities	183
	Summary	184
	Study Tasks	184
	Notes	185
	Further Reading	185
PART III	AGEING, THERAPEUTIC EXERCISE AND PUBLIC HEALTH	187
11	Exercise and Ageing	189
	Introduction	189
	Decline in Functional Capacities with Ageing	190
	Exercise Training and Functional Capacity in Older Individuals	194
	Exercise, Ageing and Independent Living	199
	Intervention Trials of Physical Activity in the Elderly	200
	Summary	202
	Study Tasks	203
	Further Reading	203
12	Therapeutic Exercise	204
	Introduction	204
	Cardiac Disease	205
	Claudication	210
	Hypertension	210
	Type 2 Diabetes	211
	Obesity	215
	Respiratory Diseases	218
	Mental Illness	221
	Other Conditions	221
	Summary	222
	Study Tasks	223
	Notes	223
	Further Reading	224
13	Hazards of Exercise	225
	Introduction	225
	Musculo-Skeletal Injuries	226
	Triggering of Heart Attack, Sudden Cardiac Death	229
	Menstrual Dysfunction: Causes, Consequences and Correlates	231
	Upper Respiratory Tract Infection and Impaired Immune Function	236
	Prevention	238
	Summary	239
	Study Tasks	239
	Further Reading	240
14	Physical Activity, Fitness and Public Health	241
	Introduction	241
	Recommendations for Physical Activity	243
	Changing Physical Activity Behaviours	249
	Benefits versus Risks	250
	Walking as the Basis of Public Health Strategy	251
	A ‘Best Buy in Public Health’?	253
	Summary	254
	Study Tasks	255
	Notes	256
	Further Reading	256
	Glossary	257
	Bibliography	264
	Index	285