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Currently 23.5 million working-age adults 20 years or older have had a diagnosis of both coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM), with estimates that an additional 9% of the total US population will have a diagnosis of this chronic disease combination by the year 2025. Current annual health care costs for this working-age population including medical costs, functional disability, work loss, and premature mortality currently exceed $620 billion. Prior research efforts have shown that 25% to 32% of patients requiring a coronary revascularization procedure have both CAD and T2DM. The primary intervention prescribed for these patients to regain functional ability after revascularization is enrollment in a standard outpatient cardiac rehabilitation (CR) program. These standard programs, ranging in duration from 6 to 12 weeks, have been shown to improve the physical function of CAD patients by up to 15%, but patients diagnosed with both chronic conditions of CAD and T2DM (T2DM+CAD) attending these same programs exhibit only an 8% improvement. Moreover, T2DM+CAD patients experience much lower rates of rehabilitation program appointment adherence as well as greater program attrition (T2DM+CAD: 45%-62% vs CAD: 92%). Current medical literature regarding the relationship between CAD, T2DM, and cardiac rehabilitation will be examined to identify specific factors that could influence the functional outcomes achieved by the T2DM+CAD population when enrolled in a standard CR program and help increase understanding of why the adherence and attrition differences exist.

Background: Physical activity (PA) tends to decrease from adolescence to young adulthood, and factors that have been proposed to contribute to this decrease are life transitions. The focus of this study is to examine life transitions, such as marriage and parenthood, and the impact they may have on the physical activity levels of young adults., Methods: This 2-year prospective analysis assessed physical activity (hrs/wk) and sociodemographics in young adults (n = 638, 48% male, 15% nonwhite, 24 ± 1.1 years old) via questionnaire. PA data were normalized through log transformations and examined using ANCOVAs, controlling for appropriate covariates., Results: ANCOVA results showed that becoming married did not significantly change PA compared with individuals who stayed single [F(1,338) = 0.38, P = .54, d = 0.06]. Conversely, PA was significantly lower [F(1,517) = 6.7, P = .01, d = 0.41] after having a child, compared with individuals who stayed childless., Conclusions: These results suggest that marriage does not impact PA in young adults, but having a child significantly decreases PA in parents, and may offer an optimal period of intervention.

Purpose: The purpose of this investigation was to determine the individual and combined effects of aerobic fitness and body weight on physiological responses, perceived exertion, and speed variables during self-selected steady-state treadmill (TM) walking in 60 healthy college-age women., Methods: The women were placed into one of four categories based on body mass index (BMI) and fitness level, assessed by a graded TM test. Subjects walked continuously on a TM at a self-selected pace for 15 min at a 2.5% grade. The dependent variables were oxygen uptake (VO(2)), HR, percentage of maximal oxygen uptake (VO(2max)), percentage of HRmax (%HRmax), RPE for the overall body, TM belt speed, and total energy expenditure (EE)., Results: There were no significant interactions or body weight main effects for any of the dependent variables. However, lower-fitness subjects walked at a TM speed that resulted in a higher (P < 0.0005) VO(2max) (52.4 vs 39.56) than the higher-fitness subjects., Conclusion: These findings suggest that fitness, and not body weight, influences preferred exercise intensity as measured by VO(2max) during TM walking in college-age women. The self-selected walking speed did not result in an intensity, as determined by VO(2max), that is consistent with the enhancement of cardiorespiratory fitness for higher-fitness women regardless of body weight.

Purpose: To evaluate the accuracy of air displacement plethysmography (ADP) by using the BOD POD in comparison with hydrostatic weighing (HW) in a collegiate wrestling population in hydrated and acutely dehydrated states., Methods: Body composition was determined by ADP, HW, and three-site skinfolds (SK) in 66 NCAA Division I collegiate wrestlers before and after acute dehydration (2.6% reduction in body mass). For all methods, body density (D(b)) was converted to percent body fat (%BF) by using the Brozek equation for Euro-Americans and the Schutte equation for African-Americans., Results: There were no significant differences between ADP and HW for D(b), %BF, and fat-free mass (FFM) in either the hydrated or dehydrated states. The standard errors of the estimate for %BF estimated from ADP with HW as the reference method were 2.12% (hydrated) and 2.16% (dehydrated); prediction errors were 2.35% (hydrated) and 2.49% (dehydrated). Bland-Altman plots of D(b) and %BF showed no systematic bias, and 64 out 66 subjects fell within the 95% limits of agreement (mean difference +/- 2 SD) for both variables. For SK, %BF was significantly higher than HW in both the hydrated and dehydrated state. All methods (ADP, HW, and SK) showed a significant decrease in FFM from the hydrated to the dehydrated state., Conclusions: This study demonstrates that the BOD POD air displacement method provides similar estimates of D (b), %BF, and FFM when compared with HW in a heterogeneous collegiate wrestling population during hydrated and acutely dehydrated states. Pretest guidelines to ensure normal hydration status before body composition assessment using any method must be followed to minimize measurement error in %BF.

The aim of this study was to predict indoor rowing performance in 12 competitive female rowers (age 21.3 +/- 3.6 years, height 1.68 +/- 0.54 m, body mass 67.1 +/- 11.7 kg; mean +/- s) using a 30 s rowing sprint, maximal oxygen uptake and the blood lactate response to submaximal rowing. Blood lactate and oxygen uptake (VO2) were measured during a discontinuous graded exercise test on a Concept II rowing ergometer incremented by 25 W for each 2 min stage; the highest VO2 measured during the test was recorded as VO2max (mean = 3.18 +/- 0.35 l.min-1). Peak power (380 +/- 63.2 W) and mean power (368 +/- 60.0 W) were determined using a modified Wingate test protocol on the Concept II rowing ergometer. Rowing performance was based on the results of the 2000 m indoor rowing championship in 1997 (466.8 +/- 12.3 s). Laboratory testing was performed within 3 weeks of the rowing championship. Submitting mean power (Power), the highest and lowest five consecutive sprint power outputs (Maximal and Minimal), percent fatigue in the sprint test (Fatigue), VO2max (l.min-1), VO2max (ml.kg-1.min-1), VO2 at the lactate threshold, power at the lactate threshold (W), maximal lactate concentration, lactate threshold (percent VO2max) and VEmax (l.min-1) to a stepwise multiple regression analysis produced the following model to predict 2000 m rowing performance: Time2000 = -0.163 (Power) -14.213.(VO2max l.min-1) +0.738.(Fatigue) 7.259 (R2 = 0.96, standard error = 2.89). These results indicate that, in the women studied, 75.7% of the variation in 2000 m indoor rowing performance time was predicted by peak power in a rowing Wingate test, while VO2max and fatigue during the Wingate test explained an additional 12.1% and 8.2% of the variance, respectively.