Search

Introduction: Physical activity among children and adolescents remains insufficient, despite the substantial efforts made by researchers and policymakers. Identifying and furthering our understanding of potential modifiable determinants of physical activity behaviour (PAB) and sedentary behaviour (SB) is crucial for the development of interventions that promote a shift from SB to PAB. The current protocol details the process through which a series of systematic literature reviews and meta-analyses (MAs) will be conducted to produce a best-evidence statement (BESt) and inform policymakers. The overall aim is to identify modifiable determinants that are associated with changes in PAB and SB in children and adolescents (aged 5-19 years) and to quantify their effect on, or association with, PAB/SB., Methods and Analysis: A search will be performed in MEDLINE, SportDiscus, Web of Science, PsychINFO and Cochrane Central Register of Controlled Trials. Randomised controlled trials (RCTs) and controlled trials (CTs) that investigate the effect of interventions on PAB/SB and longitudinal studies that investigate the associations between modifiable determinants and PAB/SB at multiple time points will be sought. Risk of bias assessments will be performed using adapted versions of Cochrane's RoB V.2.0 and ROBINS-I tools for RCTs and CTs, respectively, and an adapted version of the National Institute of Health's tool for longitudinal studies. Data will be synthesised narratively and, where possible, MAs will be performed using frequentist and Bayesian statistics. Modifiable determinants will be discussed considering the settings in which they were investigated and the PAB/SB measurement methods used., Ethics and Dissemination: No ethical approval is needed as no primary data will be collected. The findings will be disseminated in peer-reviewed publications and academic conferences where possible. The BESt will also be shared with policy makers within the DE-PASS consortium in the first instance., Systematic Review Registration: CRD42021282874., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Physical activity, alcohol use and smoking might affect cardiovascular disease through modifying autonomic nervous system (ANS) activity. We investigated: 1) whether there are consistent relationships between lifestyle factors and cardiac ANS activity over time, and 2) whether 2-year changes in lifestyle factors relate to 2-year changes in cardiac activity. Baseline (n=2618) and 2-year follow-up (n=2010) data of the Netherlands Study of Depression and Anxiety was combined. Baseline data was collected in the Netherlands from 2004-2007. Lifestyle factors were habitual physical activity, frequency of sport activities, alcohol use, and smoking. Indicators of cardiac activity were heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) (100min of registration). The results showed that high physical activity (-1.8beats/min compared to low activity), high frequency of sport activities ('couple of times/week': -2.5beats/min compared to 'almost never') and mild/moderate alcohol use (-1.2beats/min compared to non-drinking) were related to low HR. Heavy smoking was related to high HR (>30cigarettes/day: +5.1beats/min compared to non-smoking). High frequency of sport activities was associated with high RSA ('couple of times/week':+1.7ms compared to 'almost never') and moderate smoking with longer PEP (11-20cigarettes/day: +2.8ms compared to non-smoking). Associations were consistent across waves. Furthermore, 2-year change in frequency of sport activities and number of smoked cigarettes/day was accompanied by 2-year change in HR (β=-0.076 and β=0.101, respectively) and RSA (β=0.046 and β=-0.040, respectively). Our findings support consistent effects of lifestyle on HR and parasympathetic activity in the expected direction. Cardiac autonomic dysregulation may be partly mediating the relationship between lifestyle and subsequent cardiovascular health., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: The prognostic power of heart rate recovery (HRR) after exercise has been well established but the exact origin of individual differences in HRR remains unclear. This study aims to estimate the heritability of HRR and vagal rebound after maximal exercise in adolescents. Furthermore, the role of voluntary regular exercise behavior (EB) in HRR and vagal rebound is tested., Methods: 491 healthy adolescent twins and their siblings were recruited for maximal exercise testing, followed by a standardized cooldown with measurement of the electrocardiogram and respiratory frequency. Immediate and long-term HRR (HRR60 and HRR180) and vagal rebound (heart rate variability in the respiratory frequency range) were assessed 1 and 3 min after exercise. Multivariate twin modeling was used to estimate heritability of all measured variables and to compute the genetic contribution to their covariance., Results: Heritability of HRR60, HRR180 and immediate and long-term vagal rebound is 60 % (95 % CI: 48-67), 65 % (95 % CI: 54-73), 23 % (95 % CI: 11-35) and 3 % (95 % CI: 0-11), respectively. We find evidence for two separate genetic factors with one factor influencing overall cardiac vagal control, including resting heart rate and respiratory sinus arrhythmia, and a specific factor for cardiac vagal exercise recovery. EB was only modestly associated with resting heart rate (r = -0.27) and HRR (rHRR60 = 0.10; rHRR180 = 0.19) with very high genetic contribution to these associations (88-91 %)., Conclusions: Individual differences in HRR and immediate vagal rebound can to a large extent be explained by genetic factors. These innate cardiac vagal exercise recovery factors partly reflect the effects of heritable differences in EB., Competing Interests: Compliance with ethical standards Sources of funding Funding was obtained from the VU-AMS fund. This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases under Grant number RO1DK092127. Conflict of interest The authors report no conflict of interest.

Objective: Despite the latest discovery of obesity-associated genes, the rapid rise in global obesity suggests a major role for environmental factors. This study investigated the influence of environmental factors on physical activity and dietary intake independent of genetic effects., Methods: Sixteen female monozygotic twins aged 48.8 ± 9.8 years (range 37-70) with a mean BMI discordance of 3.96 ± 2.1 kg/m(2) (range 0.7-8.2) were studied. Physical activity was determined using 7-day accelerometry and dietary intake using 3-day 24-h recalls., Results: Heavier cotwins were generally less physically active (mean activity counts × 1,000 per day ± SD; 505.5 ± 155.1 vs. 579.6 ± 185.4, P = 0.047) and tended to spend 6.1 min/day less in moderate to vigorous physical activity than leaner cotwins (P = 0.09). Energy intake did not significantly differ within pairs. Total fat intake (en%; P = 0.03), specifically monounsaturated fat (P < 0.01) and polyunsaturated fat (P = 0.08), was higher in the heavier cotwins., Conclusions: After eliminating genetic effects, higher BMI is associated with lower overall and moderate to vigorous physical activity and higher intake of total fat, although the direction of causality cannot be determined. Future identification of the environmental factors responsible for these findings might contribute to developing new strategies in managing obesity., (© 2016 The Obesity Society.)

Regular exercise has often been suggested to have beneficial effects on cognition, but empirical findings are mixed because of heterogeneity in sample composition (age and sex); the cognitive domain being investigated; the definition and reliability of exercise behavior measures; and study design (e.g., observational versus experimental). Our aim was to scrutinize the domain specificity of exercise effects on cognition, while controlling for the other sources of heterogeneity. In a population based sample consisting of 472 males and 668 females (aged 10-86 years old) we administered the Computerized Neurocognitive Battery (CNB), which provided accuracy and speed measures of abstraction and mental flexibility, attention, working memory, memory (verbal, face, and spatial), language and nonverbal reasoning, spatial ability, emotion identification, emotion- and age differentiation, sensorimotor speed, and motor speed. Using univariate and multivariate regression models, CNB scores were associated with participants' average energy expenditure per week (weekly METhours), which were derived from a questionnaire on voluntary regular leisure time exercise behavior. Univariate models yielded generally positive associations between weekly METhours and cognitive accuracy and speed, but multivariate modeling demonstrated that direct relations were small and centered around zero. The largest and only significant effect size (β = 0.11, p < 0.001) was on the continuous performance test, which measures attention. Our results suggest that in the base population, any chronic effects of voluntary regular leisure time exercise on cognition are limited. Only a relation between exercise and attention inspires confidence., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Body mass index (BMI) discordant monozygotic (MZ) twins allow an examination of the causes and consequences of adiposity in a genetically controlled design. Few studies have examined longitudinal BMI discordance in MZ pairs., Objectives: The aim of this work was to study the development over time of BMI discordance in adolescent and adult MZ twin pairs and to examine lifestyle, metabolic, inflammatory and gene expression differences associated with concurrent and long-term BMI discordance in MZ pairs., Subjects/methods: BMI data from 2775 MZ twin pairs, collected in eight longitudinal surveys and a biobank project between 1991 and 2011, were analyzed to characterize longitudinal discordance. Lifestyle characteristics were compared within discordant pairs (ΔBMI⩾3 kg m(-2)) and biomarkers (lipids, glucose, insulin, C-reactive protein, fibrinogen, interleukin (IL)-6, tumor necrosis factor-α and soluble IL-6 receptor and liver enzymes aspartate aminotransferase, alanine aminotransferase and gamma glutamyl transferase) and gene expression were compared in peripheral blood from discordant pairs who participated in the Netherlands Twin Register biobank project., Results: The prevalence of discordance ranged from 3.2% in 1991 (mean age=17, s.d.=2.4) to 17.4% (N=202 pairs) in 2009 (mean age=35, s.d.=15) and was 16.5% (N=174) among pairs participating in the biobank project (mean age=35, s.d.=12). Of the 699 MZ pairs with BMI data from 3 to 5 time points, 17 pairs (2.4%) were long-term discordant (at all available time points; mean follow-up range=6.4 years). Concurrently discordant pairs showed significant differences in self-ratings of which twin eats most (P=2.3 × 10(-13)) but not in leisure time exercise activity (P=0.28) and smoking (P>0.05). Ten out of the 14 biomarkers showed significantly more unfavorable levels in the heavier of twin of the discordant pairs (P-values <0.001); most of these biomarker differences were largest in longitudinally discordant pairs. No significant gene expression differences were identified, although high ranking genes were enriched for Gene Ontology terms highlighting metabolic gene regulation and inflammation pathways., Conclusions: BMI discordance is uncommon in adolescent identical pairs but increases with higher pair-mean of BMI at older ages, although long-term BMI discordance is rare. In discordant pairs, the heavier twin had a more unfavorable blood biomarker profile than the genetically matched leaner twin, in support of causal effects of obesity.

Studies on the determinants of physical activity have traditionally focused on social factors and environmental barriers, but recent research has shown the additional importance of biological factors, including genetic variation. Here we review the major tenets of this research to arrive at three major conclusions: First, individual differences in physical activity traits are significantly influenced by genetic factors, but genetic contribution varies strongly over age, with heritability of leisure time exercise behavior ranging from 27% to 84% and heritability of sedentary behaviors ranging from 9% to 48%. Second, candidate gene approaches based on animal or human QTLs or on biological relevance (e.g., dopaminergic or cannabinoid activity in the brain, or exercise performance influencing muscle physiology) have not yet yielded the necessary evidence to specify the genetic mechanisms underlying the heritability of physical activity traits. Third, there is significant genetic modulation of the beneficial effects of daily physical activity patterns on strength and endurance improvements and on health-related parameters like body mass index. Further increases in our understanding of the genetic determinants of sedentary and exercise behaviors as well as the genetic modulation of their effects on fitness and health will be key to meaningful future intervention on these behaviors.

Social cognitive models of health behavior propose that individual differences in leisure time exercise behavior are influenced by the attitudes towards exercise. At the same time, large scale twin-family studies show a significant influence of genetic factors on regular exercise behavior. This twin-sibling study aimed to unite these findings by demonstrating that exercise attitudes can be heritable themselves. Secondly, the genetic and environmental cross-trait correlations and the monozygotic (MZ) twin intrapair differences model were used to test whether the association between exercise attitudes and exercise behavior can be causal. Survey data were obtained from 5,095 twins and siblings (18-50 years). A genetic contribution was found for exercise behavior (50 % in males, 43 % in females) and for the six exercise attitude components derived from principal component analysis: perceived benefits (21, 27 %), lack of skills, support and/or resources (45, 48 %), time constraints (25, 30 %), lack of energy (34, 44 %), lack of enjoyment (47, 44 %), and embarrassment (42, 49 %). These components were predictive of leisure time exercise behavior (R(2) = 28 %). Bivariate modeling further showed that all the genetic (0.36 < |rA| < 0.80) and all but two unique environmental (0.00 < |rE| < 0.27) correlations between exercise attitudes and exercise behavior were significantly different from zero, which is a necessary condition for the existence of a causal effect driving the association. The correlations between the MZ twins' difference scores were in line with this finding. It is concluded that exercise attitudes and exercise behavior are heritable, that attitudes and behavior are partly correlated through pleiotropic genetic effects, but that the data are compatible with a causal association between exercise attitudes and behavior.

Introduction: The aim of this study was to investigate the relative influence of genetic and environmental factors on children's leisure time exercise behavior through the classic twin design., Methods: Data were taken from The Netherlands Twin Register. The twins were 7 (n = 3966 subjects), 10 (n = 3562), and 12-yr-olds (n = 8687), with longitudinal data for 27% of the sample. Parents were asked to indicate the children's regular participation in leisure time exercise activities, including frequency and duration. Resemblance between monozygotic and dizygotic twins for weekly MET-hours spent on exercise activities was analyzed as a function of their genetic relatedness., Results: Average weekly MET-hours increased with age for both boys (age 7 yr: 14.0 (SD = 11.8); age 10 yr: 22.6 (SD = 18.7); age 12 yr: 28.4 (SD = 24.9)) and girls (age 7 yr: 9.7 (SD = 9.5); age 10 yr: 15.3 (SD = 15.1); age 12 yr: 19.3 (SD = 19.8)). Around 13% of boys and girls across all age groups did not participate in any regular leisure time exercise activities. Tracking of exercise behavior from age 7 to 12 yr was modest (0.168 < r < 0.534). For boys, genetic effects accounted for 24% (confidence interval, 18%-30%) of the variance at age 7 yr, 66% (53%-81%) at age 10 yr, and 38% (32%-46%) at age 12 yr. For girls, this was 22% (15%-30%), 16% (9%-24%), and 36% (30%-43%), respectively. Environmental influences shared by children from the same family explained 71%, 25%, and 50% of the variance in boys (age 7, 10, and 12 yr) and 67%, 72%, and 53% in girls. The shared environment influencing exercise behavior was partially different between boys and girls., Conclusion: Our results stress the important role of shared environment for exercise behavior in young children.

Objective: To examine whether ceiling effects at long inter beat intervals (IBIs)cause an underestimation of cardiac vagal control in regular exercisers by time and frequency-domain measures of respiratory sinus arrhythmia (RSA)., Methods: 24-hour ECG and respiration recordings were performed in 26 regularly exercising subjects, actively engaged in aerobic training for the past year, and enrolled in supervised training in the six weeks pre-study, and in 26 age- and sex-matched non-exercisers. Sleep and waking levels of cardiac vagal control were estimated by RSA obtained through the peak-valley method, by the standard deviation of the IBIs, the root mean square of successive IBIs, and the high frequency IBI spectral power., Results: In 11 of the exercisers the IBI-RSA relationship was characterized by a quadratic relationship. This reflected a ceiling effect at very long IBI values attained by regular exercisers, particularly during the nighttime recording. Irrespective of this ceiling effect, RSA as well as other heart rate variability (HRV) measures was still significantly larger in the exercisers with a quadratic IBI-RSA relationship than in non-exercisers or exercisers with a linear IBI-RSA relationship., Conclusions: We conclude that a subgroup of regular exercisers is characterized by a low heart rate paired to high levels of cardiac vagal control. In these exercisers, vagal control is underestimated from HRV measures in ambulatory recordings. Inspection of the IBI-RSA relationship should be routinely added when HRV measures are used to index cardiac vagal control., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Individual differences in adolescent exercise behavior are to a large extent explained by shared environmental factors. The aim of this study was to explore to what extent this shared environment represents effects of cultural transmission of parents to their offspring, generation specific environmental effects or assortative mating. Survey data on leisure-time exercise behavior were available from 3,525 adolescent twins and their siblings (13-18 years) and 3,138 parents from 1,736 families registered at the Netherlands Twin Registry. Data were also available from 5,471 adult twins, their siblings and spouses similar in age to the parents. Exercise participation (No/Yes, using a cut-off criterion of 4 metabolic equivalents and 60 min weekly) was based on questions on type, frequency and duration of exercise. A model to analyze dichotomous data from twins, siblings and parents including differences in variance decomposition across sex and generation was developed. Data from adult twins and their spouses were used to investigate the causes of assortative mating (correlation between spouses = 0.41, due to phenotypic assortment). The heritability of exercise in the adult generation was estimated at 42%. The shared environment for exercise behavior in adolescents mainly represents generation specific shared environmental influences that seem somewhat more important in explaining familial clustering in girls than in boys (52 versus 41%). A small effect of vertical cultural transmission was found for boys only (3%). The remaining familial clustering for exercise behavior was explained by additive genetic factors (42% in boys and 36% in girls). Future studies on adolescent exercise behavior should focus on identification of the generation specific environmental factors.

Introduction: The objective of this study was to identify genetic variants that are associated with adult leisure time exercise behavior using genome-wide association (GWA) in two independent samples., Methods: Exercise behavior was measured in 1644 unrelated Dutch and 978 unrelated American adults of European ancestry with detailed questions about type, frequency, and duration of exercise. Individuals were classified into regular exercisers or nonexercisers using a threshold of 4 MET·h (metabolic equivalents-hours per week). GWA analyses of ∼1.6 million observed and imputed Single Nucleotide Polymorphism (SNP) were conducted in both samples independently using logistic regression in SNPTEST, including sex, age, and body mass index as covariates. A meta-analysis of the results was performed using the weighted inverse variance method in METAL., Results: Thirty-seven novel SNPs in the PAPSS2 gene and in two intergenic regions on chromosomes 2q33.1 and 18p11.32 were associated with exercise participation (pooled P values <1.0 × 10(-5)). Previously reported associations (ACE, CASR, CYP19A1, DRD2, LEPR, and MC4R genes) or linkage findings (2p22.3, 4q28, 4q31.21 7p13, 9q31, 11p15, 13q22, 15q13, 18q12.2, 18q21.1, 19p13.3, and 20q12) were not replicated, although suggestive evidence was found for association to rs12405556 in the LEPR gene (pooled P value 9.7 × 10(-4); American sample, P value 9.8 × 10(-5)) and for association to rs8036270 in the GABRG3 gene (pooled P value 4.6 × 10(-5)) in the linkage region 15q12-13., Conclusions: The heritability of leisure time exercise behavior is likely to be accounted for by many genetic variants with small effect size. These can be detected by GWA as was shown here for the PAPSS2 gene, but larger samples with genome-wide genotypes and high-quality exercise data are needed for further progress.

Context: In the population at large, regular exercise is associated with reduced anxious and depressive symptoms. Results of experimental studies in clinical populations suggest a causal effect of exercise on anxiety and depression, but it is unclear whether such a causal effect also drives the population association. We cannot exclude the major contribution of a third underlying factor influencing exercise behavior and symptoms of anxiety and depression., Objective: To test causal effects of exercise on anxious and depressive symptoms in a population-based sample., Design: Population-based longitudinal study (1991-2002) in a genetically informative sample of twin families., Setting: Causal effects of exercise were tested by bivariate genetic modeling of the association between exercise and symptoms of anxiety and depression, correlation of intrapair differences in these traits among genetically identical twins, and longitudinal modeling of changes in exercise behavior and anxious and depressive symptoms., Participants: A total of 5952 twins from the Netherlands Twin Register, 1357 additional siblings, and 1249 parents. All participants were aged 18 to 50 years., Main Outcome Measurements: Survey data about leisure-time exercise (metabolic equivalent task hours per week based on type, frequency, and duration of exercise) and 4 scales of anxious and depressive symptoms (depression, anxiety, somatic anxiety, and neuroticism, plus a composite score)., Results: Cross-sectional and longitudinal associations were small and were best explained by common genetic factors with opposite effects on exercise behavior and symptoms of anxiety and depression. In genetically identical twin pairs, the twin who exercised more did not display fewer anxious and depressive symptoms than the co-twin who exercised less. Longitudinal analyses showed that increases in exercise participation did not predict decreases in anxious and depressive symptoms., Conclusion: Regular exercise is associated with reduced anxious and depressive symptoms in the population at large, but the association is not because of causal effects of exercise.

This study was aimed at identifying the genomic loci linked to exercise participation in males and females. Cross-sectional exercise data of twins and siblings (18-50 years) were used from the Netherlands Twin Registry. The sample consisted of 1432 genotyped sibling pairs from 622 families (1120 sibling pairs were genotyped on all chromosomes). Exercise participation (no/yes, based on a cutoff criterion of four metabolic equivalents and 60 min weekly) was assessed by survey. Genotyping was based on 361 markers and an average marker density of 10.6 cM. Identical by descent status was estimated for a 1 cM grid. A variance components-based sex-limited linkage scan was carried out for exercise participation. The heritability of exercise participation in males was 68.5% and in females 46.3%. The genetic overlap was estimated at 0.32, indicating that partly different genes affect exercise in the two sexes. Suggestive linkage was found in all subjects on chromosome 19p13.3 (LOD=2.18). Although sex differences in linkage effect were not significant, mainly females contributed to the suggestive linkage. The 19p13.3-13.2 region harbors a number of genes related to muscle performance and muscle blood flow, which might affect exercise behavior through exercise ability. Most likely, a large number of genes with each small effects affect exercise participation in males and females. Large collaborative samples are needed to detect these effects.

Objective: We investigated the association between leisure time exercise participation and well-being (i.e., life satisfaction and happiness) and examined the causality underlying this association., Method: The association between exercise participation and well-being was assessed in around 8000 subjects, (age range 18-65 years) from The Netherlands Twin Registry (NTR). Causality was tested with the co-twin control method in 162 monozygotic (MZ) twin pairs, 174 dizygotic (DZ) twin and sibling pairs, and 2842 unrelated individuals., Results: Exercisers were more satisfied with their life and happier than non-exercisers at all ages. The odds ratio for life satisfaction given exercise participation was significantly higher than unity in unrelated pairs, and a trend was visible in DZ pairs. In MZ pairs, the odds ratio was close to unity. The pattern of odds ratios for happiness given exercise participation was similar., Conclusion: Exercise participation is associated with higher levels of life satisfaction and happiness. This association is non-causal and appears to be mediated by genetic factors that influence both exercise behavior and well-being.

The purpose of this study is to investigate whether there is an association between exercise participation and self-rated health and whether this association can be explained by common genes and/or common environmental influences. In a sample of 5,140 Dutch adult twins and their non-twin siblings from 2,831 families, exercise participation (sedentaries, light or moderate, vigorous exercisers) and self-rated health were assessed by survey. To investigate the etiology of the association, bivariate genetic models using structural equation modeling were applied to the data. The correlation between exercise participation and self-rated health is significant but modest (r = 0.20). Exercise participation and self-rated health are both heritable (around 50% of the variance of both phenotypes is explained by genetic factors). The genetic factors influencing exercise participation and self-rated health partially overlap (r = 0.36) and this overlap fully explains their phenotypic correlation. We conclude that the association between exercise and self-rated health can be explained by genes predisposing to both exercise participation and self-rated health. These genes may directly influence both phenotypes (pleiotropy). Alternatively, genes that affect exercise or self-rated health may indirectly influence the other phenotype through a causal relationship. We propose that identification of the genes that cause differences in exercise behavior will help resolve the issue of causality.

Background: A sedentary lifestyle remains a major threat to health in contemporary societies. To get more insight in the relative contribution of genetic and environmental influences on individual differences in exercise participation, twin samples from seven countries participating in the GenomEUtwin project were used., Methodology: Self-reported data on leisure time exercise behavior from Australia, Denmark, Finland, Norway, The Netherlands, Sweden and United Kingdom were used to create a comparable index of exercise participation in each country (60 minutes weekly at a minimum intensity of four metabolic equivalents)., Principal Findings: Modest geographical variation in exercise participation was revealed in 85,198 subjects, aged 19-40 years. Modeling of monozygotic and dizygotic twin resemblance showed that genetic effects play an important role in explaining individual differences in exercise participation in each country. Shared environmental effects played no role except for Norwegian males. Heritability of exercise participation in males and females was similar and ranged from 48% to 71% (excluding Norwegian males)., Conclusions: Genetic variation is important in individual exercise behavior and may involve genes influencing the acute mood effects of exercise, high exercise ability, high weight loss ability, and personality. This collaborative study suggests that attempts to find genes influencing exercise participation can pool exercise data across multiple countries and different instruments.

Objectives: To examine whether regular exercise is associated with anxiety, depression and personality in a large population-based sample as a function of gender and age., Methods: The sample consisted of adolescent and adult twins and their families (N=19,288) who participated in the study on lifestyle and health from The Netherlands Twin Registry (1991-2002). Exercise participation, anxiety, depression and personality were assessed with self-report questionnaires., Results: The overall prevalence of exercise participation (with a minimum of 60 min weekly at 4 METs (Metabolic Energy Expenditure Index)) in our sample was 51.4%. Exercise participation strongly declined with age from about 70% in young adolescents to 30% in older adults. Among adolescents, males exercised more, whereas, among older adults, females exercised more. Exercisers were on average less anxious (-0.18 SD), depressed (-0.29 SD) and neurotic (-0.14 SD), more extraverted (+0.32 SD) and were higher in dimensions of sensation seeking (from+0.25 SD to+0.47 SD) than non-exercisers. These differences were modest in size, but very consistent across gender and age., Conclusions: This study corroborates and extends previous findings: regular exercise is cross-sectionally associated with lower neuroticism, anxiety and depression and higher extraversion and sensation seeking in the population.

Purpose: A twin design was used to assess the relative contribution of genetic and environmental influences on the variation in sports participation of Dutch male and female twins between the ages of 13 and 20 yr., Methods: Survey data from 2628 complete twin pairs were available (443 male and 652 female monozygotic twin pairs, 377 male and 434 female dizygotic twin pairs, and 722 opposite-sex twin pairs). Subjects were classified as participating in sports if they engaged in competitive or noncompetitive leisure-time sports activities with a minimal intensity of 4 METs for at least 60 min.wk., Results: An overall main effect of age and sex was found on the sports participation dichotomy. Younger twins participated more in sports than older twins, and for each age group males participated more often than females. Genetic analyses of twin resemblance showed a shift in the factors contributing to sports participation from adolescence to adulthood. Between the ages of 13 and 16 yr, environmental factors shared by children from the same family largely account for individual differences in sports participation (78-84%), whereas genes are of no importance. At the age of 17-18 yr, genetic influences start to appear (36%), and the role of common environment decreases (47%). After the age of 18 yr, genes largely explain individual differences in sports participation (85%), and common environmental factors no longer contribute., Conclusions: Environmental factors shared by family members determine sports participation in young adolescence but cease to be of importance in adulthood when individual differences in sports participation are largely due to genetic variation.

Objective: This study tested whether functional somatic symptoms are associated with exaggerated increases in self-reported anxiety and somatic complaints in response to stress and CO(2)-enriched air breathing, and whether this association exists in parallel to or in the absence of exaggerated physiological responses., Methods: Out of 499 young somatically healthy undergraduate women, 18 participants high in functional somatic symptoms (HSS group) and 18 participants low in symptoms (LSS) were selected. They were submitted to mental stress, mild physical exercise and relaxation during conditions of normal breathing, breathing compressed normal air, and breathing compressed 5% CO(2)-enriched air. In all conditions, self-reported anxiety and somatic symptoms and respiratory and autonomic responses were assessed., Results: HSS participants reported, as compared to LSS, more tenseness, anxiety, and somatic symptoms at baseline and increased responses to mental stress and during 5% CO(2) breathing, but not in response to exercise. However, no evidence was found for a corresponding exaggerated respiratory or autonomic response., Conclusions: A young, female, and nonclinical population with numerous functional somatic symptoms and high levels of anxiety is characterized by an exaggerated perception of a normal physiological response.

Purpose: A twin design was used to test whether the association between exercise behavior and heart rate and the association between exercise behavior and respiratory sinus arrhythmia (RSA) derive from a common genetic factor., Methods: Data were available from 157 adolescent (aged 13-22) and 208 middle-aged twin pairs (aged 35-62), divided into five sex by zygosity groups (male and female monozygotic twin pairs, and dizygotic twin pairs of same or opposite sex). Exercise behavior was assessed as the average weekly METs spent on sports activities or other vigorous activities in leisure time (sportMETS) in the last 3 months. RSA and heart period (HP) were assessed in the time domain from the combined ECG and respiration signals., Results: Heritability estimates were 16% and 29% for RSA, 64% and 68% for HP, and 79% and 41% for sportMETS in young and middle-aged twins, respectively. A significant association was found between RSA and sportMETS (0.17) in the adolescent twins that derived entirely from a common genetic factor. No association was found between sportMETS and RSA in the older twins. A significant association was found between HP and sportMETS in both adolescent (0.35) and middle-aged (0.18) twins. A large contribution of common genetic factors to these associations was found amounting to 84% and 88% in the young and middle-aged twins, respectively., Conclusions: Although the results of this study do not preclude causal effects of exercise on RSA and heart rate, they show that the association between exercise and these cardiovascular risk factors largely derives from a common genetic factor.

This study tested various sources of changes in respiratory sinus arrhythmia (RSA). Twenty-two healthy participants participated in three experimental conditions (mental stress, relaxation, and mild physical exercise) that each consisted of three breathing parts (normal breathing, breathing compressed room air, and breathing compressed 5% CO2-enriched air). Independent contributions to changes in RSA were found for changes in tonic vagal modulation of heart rate, central respiratory drive (i.e., PaCO2), respiratory depth, and respiratory frequency. The relative contributions to changes in RSA differed for mental stress and physical exercise. It is concluded that uncorrected RSA will suffice to index within-subject changes in tonic vagal modulation of heart rate in most situations. However, if the central respiratory drive is expected to change, RSA should ideally be corrected for changes in PaCO2, respiratory depth, and respiratory frequency.

In 21 nurses (34.4+/-3.9 yr), VO2max physical activity, body composition and lifestyle parameters were measured to determine which of these characteristics are related to metabolic and hemostatic risk for cardiovascular disease. Physical activity was assessed with the 7-day recall interview. VO2max was measured in a progressive and continuous treadmill test to volitional fatigue. Fasting insulin, total cholesterol, HDL-C, triglycerides, fibrinogen, tPA-act, tPA-ag, and PAI-1-ag were determined from fasting blood samples. Contrary to our expectation, there was no association of physical activity with any of these risk indicators. High VO2max was associated with lower levels of insulin and fibrinogen. Regression analyses indicated that metabolic and hemostatic risk indicators, as measured in healthy premenopausal nurses, were mainly predicted by waist circumference and oral contraceptive use.

This study assessed the association of aerobic fitness with psychological make-up and physiological stress-reactivity in a group of untrained men, as well as the effects of 4 and 8 months of exercise training on these parameters. Psychological assessment included questionnaires on personality (Neuroticism, Type A, Hostility), coping styles (Anger In, Anger Out), negative affect (Depression, Anxiety), and self-esteem. Stress reactivity was measured as the cardiovascular and urinary catecholamine response to two competitive reaction time tasks and the cold pressor test. No cross sectional relationships were found between aerobic fitness, defined as the maximal oxygen consumption during an exhaustive exercise test, and any of the psychological variables. In addition, psychological make-up did not change as a consequence of exercise training. In further contrast to our hypothesis, aerobic fitness was associated with high, rather than low, cardiovascular reactivity. Longitudinal effects of training were limited to a reduction in the overall levels of heart rate and diastolic blood pressure. This suggests that regular exercise does not increase the resistance to stress-related disease by influencing psychological make-up or acute psychophysiologic reactivity.

Plasminogen activator inhibitor (PAI) activity, an important regulator within the fibrinolytic system, has been shown to be a risk indicator for venous and arterial thrombosis. The present study aimed to test the effects of exercise training on PAI activity, and to link possible changes in PAI activity to changes in cardiovascular fitness, body composition, and the lipid profile. Four groups of previously sedentary subjects were studied thrice in an 8-month period. A long-term training group (N = 11) trained during the entire 8-month period. A detraining group (N = 14) trained for 4 months and then reverted to sedentary habits. A postponed training group (N = 16) trained only during the second 4-month period, and a no-training control group (N = 9) remained untrained throughout the entire 8-month period. PAI activity always decreased in response to training, but the training effects were small and spontaneous seasonal shifts in PAI activity of the control groups clouded their interpretation. Furthermore, detraining failed to influence PAI activity and training-induced changes in PAI activity were not related to simultaneous changes in maximal oxygen consumption, diastolic blood pressure, triglycerides, or percentage body fat, and inconsistently related to the training-induced changes in LDL-cholesterol and HDL-cholesterol. The occurrence of simultaneous changes in body fat, blood pressure, and the lipid profile underscores the potential of regular exercise to protect against cardiovascular disease. Whether these beneficial effects are accompanied by changes in the fibrinolytic system remains to be proven.