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1 Department of Kinesiology and Applied Physiology, University of Colorado, Boulder 80309; and 2 Divisions of Cardiology and Geriatric Medicine, Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado 80262
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ABSTRACT |
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 TOP
 ABSTRACT
 INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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We tested the hypothesis that the age-related decline in
maximal aerobic capacity, as measured by maximal oxygen uptake
(
O2 max), is greater in Hispanic than
in Caucasian women. We studied 146 healthy sedentary women aged
20-75 yr: 53 Hispanic (primarily of Mexican descent) and 93 Caucasian (non-Hispanic white). The groups did not differ in mean age,
body mass, percent body fat, estimated physical activity-related energy
expenditure, or education-based socioeconomic status (SES). During
maximal exercise, respiratory exchange ratio, rating of perceived
exertion, and percent predicted maximal heart rate were similar across
age and ethnicity, suggesting equivalent maximum voluntary efforts in
all subjects. O2 max (ml · kg
1 · min1) was
inversely related to age (P < 0.01) in Caucasian
(r =
0.68) and Hispanic (r = 0.61) women.
The absolute rate of decline in O2 max
with age was the same in the two groups (0.31 ml · kg1 · min1 · yr1).
The relative rate of decline (% from age 25 yr) also was similar in
the Caucasian (9.0%) and Hispanic (9.2%) women. When subjects of
all ages were pooled, mean levels of
O2 max were similar in the two groups
(~28 ml · kg1 · min1).
These results, the first to our knowledge in Hispanics, indicate that
mean levels of O2 max, as well as the
rate of decline in O2 max with age, are
similar in healthy sedentary Hispanic and Caucasian women of similar
SES. Thus it does not appear that Hispanic ethnicity per se modulates
maximal aerobic capacity in this population.
aging; maximal oxygen uptake; Mexican-American
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INTRODUCTION |
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TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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MAXIMAL AEROBIC
CAPACITY, as assessed by maximal oxygen uptake
(O2 max), declines with advancing age
in healthy men and women (2, 6, 9, 12, 30). This decline
contributes to a reduction in physical functional capacity, resulting
in older individuals working closer to maximal effort when performing a particular submaximal task (3). Eventually, reductions in
physical functional capacity with age lead to increased disability,
loss of independence, and reduced quality of life (18,
34). Moreover, maximal aerobic capacity is an independent risk
factor for all-cause and cardiovascular disease mortality (4,
5), the prevalence of which increases markedly with age
(1, 10).
Hispanics are the fastest growing segment of the US population and by the year 2020 will constitute our largest minority group (32). As a consequence, the greatest percent growth in older adults in the future will be in the Hispanic population. Recent evidence suggests that age-related reductions in physical functional capacity and increases in functional disability, as measured by physical performance tasks, may be greater in Hispanics than Caucasians (7, 15, 16, 26, 28), particularly in women (13). It also is noteworthy that after 60 yr of age, Hispanic women are at a greater risk of premature mortality compared with non-Hispanic white women (19). Whether the age-associated declines in maximal aerobic capacity are greater in Hispanic women and, therefore, could contribute to their greater functional disability and premature mortality with age is unknown.
Accordingly, the primary experimental objective of the present investigation was to test this working hypothesis. To determine whether any group differences observed in the decline in maximal aerobic capacity with age could be attributed to Hispanic ethnicity per se, subjects of similar socioeconomic status (SES) were studied because SES is independently and positively related to functional capacity and disease risk (28, 36).
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METHODS |
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TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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Subjects. We studied 146 healthy sedentary women aged 20-75 yr: 53 Hispanic and 93 Caucasian. The Hispanic women studied constituted all of the healthy available subjects of sufficiently high SES in the region who could be recruited. Subjects were recruited from churches, community centers, newspaper advertisements, and posted flyers primarily from the greater Boulder County, Colorado area. Ethnicity was determined by asking subjects to which ethnic group they belonged. Those who stated "Caucasian, white, or non-Hispanic white" were considered Caucasian and those who chose "Mexican/Mexican-American, Central American, or South American" were considered Hispanic as described by Winkleby et al. (35). Hispanic women also volunteered that they or their parents or grandparents were born in Mexico, Central, or South America. Ninety percent of the Hispanic subjects were of Mexican descent.
All subjects were healthy as assessed by medical history. Subjects 50 yr of age and older were further evaluated for clinical evidence of cardiopulmonary disease with a physical examination and electrocardiograms during rest and maximal exercise. Subjects were nonsmokers and were not using any regular medications that could influence maximal aerobic capacity. The nature, purpose, and risks of the study were explained to each subject in English or Spanish, as needed, before written informed consent was obtained. The experimental protocol was approved by the Human Research Committee at the University of Colorado at Boulder.Measurements.
O2 max was determined during continuous
incremental treadmill exercise using on-line computer-assisted,
open-circuit spirometry as described in detail previously (11,
29, 30). Expired air volume was measured with a turbine (model
VMM-2, Interface Associates, Laguna Niguel, CA) previously calibrated
against a 7-liter syringe (Hans Rudolph, Kansas City, MO). Gas
fractions were analyzed with a mass spectrometer (model MGA-1100,
Perkin-Elmer, Pomona, CA). Before each trial, the mass spectrometer was
calibrated with standard gases of known concentrations. After a 6- to
10-min warm-up period, each subject walked at a comfortable speed that corresponded to ~70% of age-predicted maximal heart rate. Heart rate
was monitored via a five-lead electrocardiogram. Treadmill grade was
increased 2.5% every 2 min until volitional exhaustion. At the end of
each stage, subjects were asked to rate perceived effort using the Borg
scale (6-20). Each treadmill test lasted between 8 and 12 min. Maximal heart rate was defined as the highest value
recorded during exercise. To ensure that subjects gave a maximal
voluntary effort, at least three of the following criteria were met:
1) voluntary exhaustion (unable to continue walking); 2) a respiratory exchange ratio of at least 1.10;
3) achievement of age-predicted maximal heart rate; and
4) rating of perceived exertion 
18 units
(20). No subjects had to be retested for failing to meet
these criteria.
O2 max expressed per kilogram FFM
obtained from skinfold measurements and those from DXA were similar
with regard to depicting both age-related rates of decline and mean
ethnic group differences. Given this internal validation of the
skinfold-derived values in the present study sample, and the fact that
these values allowed us to use a much larger and, therefore,
representative Caucasian control population from which to determine any
ethnicity-related differences, these values were used rather than the
DXA-derived values.
Education was used as a measure of SES rather than income, occupation,
or a combination of the three because education is more closely
associated with risk factors for chronic disease than income or
occupation (24, 25, 36). Education was determined as the
highest number of completed school years.
Habitual physical activity was determined from estimates of daily
energy expenditure using the Stanford Physical Activity Questionnaire
(27) as employed previously by our laboratory (21,
33).
Data analysis and statistics.
The decline in O2 max across subject
age within a group was expressed in both absolute units (i.e., l/min,
normalized for kg of body mass, and normalized for kg of FFM) and as
the relative change. The latter was defined as the mean percent change in O2 max per decade of age starting
with the initial decade of age through the last decade of age in the
group, as described previously by our laboratory (12, 30).
Multivariate analysis of variance was used to determine differences in
the dependent variables among age groups and between ethnic groups. Analysis of group differences in O2 max
expressed per unit kilogram of body mass or FFM using the ratio method
(ANOVA) and using analysis of covariance in which body mass and FFM
served as covariates (23, 31) provided similar results;
thus only the more traditional ratio-based values are presented below.
Simple regression analyses and partial correlation coefficients were used to determine the relations among the dependent variables. Multiple-regression analyses were used to identify independent determinants for the age-related declines in
O2 max. The slopes and intercepts of
regression lines between groups were compared using analysis of
covariance. Data are expressed as means ± SE. The level of
statistical significance was set at P < 0.05 for all analyses.
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RESULTS |
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TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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Subject characteristics: relation to age.
Selected subject characteristics are shown in Table
1. In the Caucasian women, no significant
relations were observed between age and height, SES, FFM, or physical
activity-related energy expenditure; however, body mass and percent
body fat increased (P < 0.01) with advancing age. In
the Hispanic women, only percent body fat was positively related to age
(P < 0.05).
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Maximal exercise responses: relation to age.
Mean values per decade of age obtained during maximal exercise are
presented in Table 2. In both groups,
heart rate as a percentage of age-predicted maximum, peak respiratory
exchange ratio, and rating of perceived exertion at
O2 max were not different across age,
indicating similar maximal voluntary efforts.
O2 max declined with advancing decades
of age in both groups regardless of manner of expression
(P < 0.01). Maximal heart rate also declined with age
(P < 0.01).
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Rate of decline in O2 max with age.
Figure 1 shows the individual subject
data for O2 max across age in the two
groups. O2 max
(ml · kg1 · min1) was
inversely related to age in both the Caucasian (r = 0.68) and the Hispanic (r = 0.61) women
(P < 0.001); the mean absolute rates of decline were
similar in the two groups (0.31
ml · kg1 · min1 · yr1)
(Fig. 2A). The relative (%) rates of decline in
O2 max from mean levels at age ~25 yr
also were similar in the Caucasian (9.0%/decade) and Hispanic
(9.2%/decade) women (Fig.
2B). There also were no
differences in either the absolute or the relative rates of decline
between the two groups when O2 max was expressed in liters per minute or per unit FFM (ml · kg
FFM1 · min1) (data not shown). In
addition, there were no differences between the groups in either the
slope or the intercept for all regression models of the rate of decline
in maximal aerobic capacity with age.
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Rate of decline in maximal heart rate with age.
Both groups demonstrated an inverse relation between maximal heart rate
and age (Caucasian, r = 0.66; Hispanic, r =
0.75; both P < 0.01; Fig.
3). The slopes of the age-related
declines in maximal heart rate were not different
(P = 0.90) in the Caucasian (0.62
beats · min1 · yr1) and
Hispanic (0.75
beats · min1 · yr1) women.
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Subject characteristics: relation to ethnicity. Mean values for age, SES, body mass, body fat percent, and estimated energy expenditure were not different between groups. The Hispanic women were shorter and had a slightly smaller FFM (P < 0.05) (Table 1).
Maximal exercise responses: relation to ethnicity.
Mean values are presented in Table 2. Heart rate as a percentage of
age-predicted maximum, peak respiratory exchange ratio, and rating of
perceived exertion at O2 max were not
different in the two groups, indicating similar maximal voluntary
efforts (Table 2). Mean values for
O2 max (Fig.
4) were similar in the pooled groups of
Hispanic and Caucasian women regardless of manner of expression.
Absolute levels of maximal heart rate also were similar in the two
groups.
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Correlates of the age-related decline in
O2 max.
Table 3 shows the significant independent
predictor variables of the age-related reductions in
O2 max normalized for body mass in the
two groups as determined by multiple-regression analysis. Variables of
physiological interest entered into the multiple regression model
included age, body mass, FFM, estimated physical activity, and maximal
heart rate. Age and FFM were the significant independent predictors in
the Caucasian group (both P < 0.01). FFM was the only
significant independent predictor in the Hispanic group
(P = 0.01).
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DISCUSSION |
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TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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There are at least three new and, we believe, significant findings from the present investigation. First, among healthy sedentary women aged 20-75 yr of similar SES, Hispanic (primarily of Mexican descent) ethnicity per se is not obviously associated with greater age-related declines in maximal aerobic capacity when compared with Caucasians. Second, mean levels of maximal aerobic capacity are not lower in healthy sedentary Hispanic compared with Caucasian women. Third, the age-related declines in maximal heart rate are not different in Hispanic and Caucasian women. To our knowledge, the present results represent the first data on maximal aerobic capacity and its associated physiological correlates in Hispanics.
Our working hypothesis of augmented declines in maximal aerobic
capacity with age in Hispanic women was based on three previous sets
of, albeit indirect, observations. The first was that Hispanic adults
in general, and Hispanic women in particular, have been reported to
experience greater reductions in physical functional capacity with age
than their Caucasian peers (7, 13, 15, 16, 26, 28).
Because maximal aerobic capacity is known to be an important
determinant of physical functional capacity (3), it
follows that Hispanic adults may undergo greater reductions in
O2 max with age than Caucasians.
The second observation is that, within Mexican-American women,
leisure-time physical activity levels decline with advancing age and
that older Mexican-American women have the lowest levels of
leisure-time physical activity among any majority or minority group
(8). Jackson et al. (23) have shown that
declines in leisure-time physical activity levels are strongly
associated with age-related reductions in maximal aerobic capacity
among healthy women. Third, Hispanic women demonstrate a greater
prevalence of overweight and obesity compared with Caucasian women
(14, 17, 35). Because greater increases in body mass and
fatness with age are linked to greater age-related declines in
O2 max among healthy women (23,
31), the high prevalence of obesity reported previously in
Hispanic women would, in itself, act to lower maximal aerobic capacity.
In contrast to our hypothesis, the results of the present
cross-sectional study indicate that both the absolute and relative rates of decline in maximal aerobic capacity were similar in our healthy Hispanic and Caucasian women. These findings were independent of the expression of O2 max used for
comparison. Both the absolute (0.31
ml · kg1 · min1 · yr1)
and relative (~9% decrease per decade from mean levels at age 25 yr)
rates of decline were similar to the values reported by our laboratory
in earlier meta-analysis and laboratory-based investigations of
O2 max and age in healthy women
(12, 30), and to the results of others (6).
In addition, mean levels of O2 max in
the pooled ethnic groups were almost identical. Thus, taken together,
these results fail to indicate any obvious association between Hispanic
ethnicity per se and maximal aerobic capacity among healthy adult women.
This lack of association likely is due, at least in part, to the
absence of differences in the physiological and behavioral factors
described above that are known to influence
O2 max in healthy women. For example,
estimated habitual physical activity did not decline with age in either
group, nor were mean levels different in the Hispanic compared with the
Caucasian women. The absence of any significant differences in
estimated physical activity levels with age or ethnicity in the present
study most likely was due to the fact that the women were all of
similarly high SES. SES is directly related to leisure-time activity
levels (25).
There are several experimental considerations that should be mentioned.
First, we used a cross-sectional, rather than a longitudinal, study
design. It has been suggested that these two approaches may provide
different results when used to determine age-related declines in
O2 max (6). However, as
our laboratory has found previously (12, 30),
investigations in which both study designs were employed in the same
study sample(s) have demonstrated similar mean rates of decline with
age using these different approaches. Second, our subject samples
consisted only of healthy women. If women with clinically
documented disease (e.g., severe obesity, the prevalence of which is
higher in Hispanic women) had been included, our results may have been
different. Third, although our overall subject number (n) of
~150 women represents a relatively large study sample for a
laboratory-based physiological investigation, it nevertheless is a
small subject sample from an epidemiological perspective, particularly
considering the limited number of Hispanic subjects in general
(n = 53) and in certain age intervals. In this regard,
it should be noted that we were limited by the availability of Hispanic
women of sufficiently high SES to compare with the regional Caucasian
population of women (controls). Thus the reader should be aware of the
possibility of type II errors, particularly in the context of
age-related changes in our Hispanic women. Fourth, the Hispanic women
studied here were primarily (~90%) of Mexican-American descent. As
such, our findings cannot be generalized to Hispanic women of other
descent. Fifth, as mentioned previously, SES is directly related to
measures of functional capacity and disability (28).
Therefore, although the exact relation between SES and maximal aerobic
capacity has not been determined, it is possible (even likely) that our
results would have been different had we not studied Hispanic and
Caucasian women of similar SES.
The present findings have important implications for gerontology and geriatric medicine. Age-associated reductions in physical functional capacity result in increased disability, dependence on family and others for care, and costs of health services, as well as reduced quality of life. Current projections indicate marked increases in the number of US adults >65 yr of age in the near future, greatly exacerbating these present problems. Physical functional capacity has been reported to be reduced and functional disability increased in older Hispanic adults, particularly women (13). Because Hispanics are our fastest growing minority population (32), it is important to determine the physiological factors contributing to age-related disability in this group. The present findings indicate that Hispanic ethnicity per se (i.e., cultural and/or genetic predisposition) is not obviously associated with greater declines in maximal aerobic capacity with age or with mean levels. Thus this factor does not appear to contribute directly to ethnicity-related differences in physical functional capacity.
In conclusion, these results, the first to our knowledge in Hispanics, do not support the hypothesis that the rate of decline in maximal aerobic capacity with age is greater in healthy sedentary Hispanic women than in Caucasian women of similar SES. Thus it does not appear that Hispanic ethnicity per se modulates maximal aerobic capacity, an important determinant of physical functional capacity, in this population.
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ACKNOWLEDGEMENTS |
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This study was supported by National Institute on Aging (NIA) Awards R03 AG-16387, RO1 AG-06537, and AG-13038 and by Division of Research Resources Research Grant 5 01 RR-00051. Y. G. Casas was supported by NIA Research Supplement for Underrepresented Minority Graduate Research Assistants AG-13038. C. A. DeSouza was supported initially by Research Supplements to Minority Individuals in Postdoctoral Training HL-39966 and AG-13038 and later by Mentored Research Scientist Award HL-03840.
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FOOTNOTES |
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Address for reprint requests and other correspondence: D. R. Seals, Dept. of Kinesiology and Applied Physiology, Campus Box 354, Univ. of Colorado Boulder, CO 80309 (E-mail: seals{at}spot.colorado.edu).
The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
Received 27 December 1999; accepted in final form 23 April 2001.
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TOP
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METHODS
RESULTS
DISCUSSION
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P. E. Gates, C. L. Gentile, D. R. Seals, and D. D. Christou Adiposity Contributes to Differences in Left Ventricular Structure and Diastolic Function with Age in Healthy Men J. Clin. Endocrinol. Metab., October 1, 2003; 88(10): 4884 - 4890. [Abstract] [Full Text] [PDF]
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