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Purpose. To evaluate the relation of physical activity and cardiorespiratory fitness to morbidity, mortality, and functional limitations in older persons. Data Sources. We reviewed published reports related to the review's purpose. Sources were identified from recent major reports and position statements from scientific and public health organizations, our files, and reference lists of published papers. Study Inclusion and Exclusion Criteria. We included prospective epidemiological studies and clinical trials published in the peer-reviewed literature that included data from age groups of people 60 years and older. We evaluated study methods and included studies that used valid measures of exposures, clearly specified outcomes, and controlled for confounders. Data Extraction Methods. We extracted by detailed review data on sample characteristics, outcomes, and rates and relative risks. Data Synthesis. Extracted data were included in tables, figures, or the text and were synthesized by nonquantitative methods. Major Conclusions. Active and fit individuals were at much lower risk for morbidity, mortality, and loss of function when compared with sedentary and unfit persons. Data from the studies generally conformed to a steep inverse dose-response gradient across activity or fitness categories. Results were consistent, temporally appropriate, strong, and graded, and therefore support a causal hypothesis that a fit and active way of life improves health and function in older individuals.

Providing medical care for the treatment and prevention of injuries and health problems for competitive or recreational athletes is the most widely recognized role of sports medicine. However, the field is much broader and includes clinical practice and research in many areas related to physical activity in the prevention and treatment of chronic disease. Sports medicine and exercise science involve not only physicians and other licensed health care practitioners but also physiologists, social scientists, epidemiologists, kinesiologists, and other public health and medical professionals. There is overwhelming scientific evidence that a physically active lifestyle is important for optimal health. A key role of sports medicine is to focus the attention of a wide variety of health professionals, educators, and policy makers on developing and implementing strategies to help more individuals enjoy the many health-promoting benefits of regular physical activity.

The worldwide rise in body weight has reached epidemic proportions and this has serious public health consequences. Despite the universal recognition of this problem, its causes are still debated: some attribute it to excess caloric intake; others blame a lack of physical activity (PA); some implicate specific changes to micro- and macro-nutrients. During the past century, government health agencies have developed guidance on healthy eating. These, along with advances in agriculture and food manufacturing, have largely eliminated nutrient deficiencies and helped reduce the consumption of fat. Over the past 60 years, however, technological advances and shifts in the types of occupations prominent in industrialised as well as developing countries have resulted in well-documented decreases in energy expenditure. Energy intake must be balanced with energy expenditure in order to prevent weight gain, and there is increasing evidence that this balance must be at a relatively high level of energy flux. A programme that was started in São Paulo in 1996 known as 'Agita' has sought to motivate populations to engage in small amounts of physical exercise daily to tackle growing obesity levels. This multi-agency initiative is one example of how to successfully increase exercise within a community and scale both within (e.g. all states in Brazil) and across many nations. Reducing caloric intake in whole populations is challenging especially at relatively low levels of energy expenditure, and evidence suggests that there is a critical energy flux threshold for regulating intake to achieve energy balance. Increasing PA, however, may be more achievable than reducing intake. Activity raises caloric expenditure and can offset excess intake. The implementation of programmes to achieve greater PA is therefore vital if the worldwide rise in body weight is to be halted, while we also need to implement programmes to help people eat smarter.

Background. Recruitment, retention, and success in a worksite health promotion program was examined among various demographic groups of employees (n = 11,830) of the Dallas, Texas Independent School District. Methods. Enrolled employees (n =3,873) were given a health screen consisting of health habit assessment, measurement of clinical variables, physical fitness testing, and a medical examination. Results. Thirty-three percent of employees were successfully recruited into the program. Recruitment rates were virtually identical for men and women (32 % and 33%, respectively), but varied across ethnic, age, and education groups. Blacks, younger employees, and noncollege graduates were less likely to be recruited. Sixtynine percent of the employees were retained in the program, as defined by participation in the second screen, and women were more likely to be retained than men (71 % versus 64%, respectively). Retention rates throughout the 10-week program were higher for whites and Hispanics, and were virtually identical for each age group and education level. Overall, participants in the program showed an improvement in physical fitness and general well-being, lost weight, and smoked less. These changes were relatively consistent across the various demographic groups. Discussion. Data suggest demographic characteristics are related to recruitment and retention in a health promotion program.

Background. The ideal screening tool for worksite health screening programs has not yet been identified, and the effectiveness of screening programs in predicting future chronic disease risk factors status is not well understood. This study compared two commonly used screening tools, health-related questionnaires and measurement of physiological parameters, in terms of their ability to predict future chronic disease risk factor status in an employee population. Methods. Data were collected over a 10-year period from Liberty Corporation employees (N = 723). Baseline evaluation included the administration of questionnaires and measurement of physiological data. Follow-up evaluation measured physiological data only. Regression analyses identified the statistically significant predictors of future risk factor status using 1) baseline questionnaire data; 2) baseline physiological data; and 3) both questionnaire and physiological data as predictor variables. Results. Although both screening methods were able to predict future risk factor status, R2 values were higher in models including baseline physiological measures than models including questionnaire data only. Adding questionnaire data to physiological data provided little or no additional predictive ability. Discussion. These results suggest that physiological data, particularly baseline measures of a risk factor, are more predictive of future risk factor status than questionnaire data.