Richard A. Carleton

Bio: Richard A. Carleton is an academic researcher from Brown University. The author has contributed to research in topics: Population & Health promotion. The author has an hindex of 35, co-authored 116 publications receiving 9231 citations. Previous affiliations of Richard A. Carleton include American Heart Association & Memorial Hospital of South Bend.

Incidence of Death During Jogging in Rhode Island From 1975 Through 1980

Abstract: In the six years from 1975 through 1980, a total of 12 men died during jogging in the state of Rhode Island. The cause of death in 11 was coronary heart disease (CHD). One man died of an acute gastrointestinal hemorrhage. The prevalence of jogging in the Rhode Island population was determined using a random-digit telephone survey. Among men aged 30 through 64 years, 7.4%±2.6% (mean±SE e ) reported jogging at least twice a week. The incidence of death during jogging for men of this age group was one death per year for every 7,620 joggers, or approximately one death per 396,000 man-hours of jogging. This rate is seven times the estimated death rate from CHD during more sedentary activities in Rhode Island and suggests that exercise contributes to sudden death in susceptible persons. The occurrence of only one death per 7,620 joggers per year demonstrates that the risk of exercise is small and suggests that the routine exercise testing of healthy subjects before exercise training is not justified. ( JAMA 1982;247:2535-2538)

Using the stages of change model to increase the adoption of physical activity among community participants

Abstract: Purpose. This study examined the use of the stages of change model to design an exercise intervention for community volunteers. Design. The “Imagine Action” campaign was a community-wide event incorporating the involvement of local worksites and community agencies. Community members registering for the campaign were enrolled in a six-week intervention program designed to encourage participation in physical activity. Subjects. Six hundred and ten adults aged 18 to 82 years old enrolled in the program. Seventy-seven percent of the participants were female and the average age was 41.8 years (SD=13.8). Setting. The campaign was conducted in a city with a population of approximately 72,000 and was promoted throughout community worksites, area schools, organizations, and local media channels. Measures. One question designed to assess current stage of exercise adoption was included on the campaign registration form as were questions about subject name, address, telephone number, birthdate, and gender. I...

Self-reported physical activity compared with maximal oxygen uptake

Abstract: Maximal oxygen uptake has been used as a measure of physical fitness. This measure increases by approximately 25% when sedentary individuals become more physically active. Oxygen uptake measurement in the laboratory or estimation in fieldwork is complex and costly with finite risk. For the present study, 36 men and 32 women completed the Paffenbarger Physical Activity Index Questionnaire, including a sweat-inducing physical activity frequency question, and had measurement of oxygen uptake during pedal ergometry. Using maximal oxygen uptake as the measure of fitness, the authors found that the Paffenbarger Physical Activity Index, although more detailed, may be less valid than the simpler sweat induction frequency question for estimating fitness. The correlations observed between the sweat question and oxygen uptake were 0.54 for males, 0.26 for females, and 0.46 for the total group. The correlations between the Physical Activity Index and oxygen uptake were 0.26 for males, 0.08 for females, and 0.29 for the total group. The regression relationship (oxygen uptake = 1.92 X (sweat days) + 23.76; standard error of estimate = 8.63 ml/kg/min) is significant for sweat versus oxygen uptake. While the confidence interval limits the practical ability to predict individual values, low cost, absence of risk, and population validity suggest that fitness can be assessed rapidly and simply for epidemiologic studies with a simple "sweat" question.

Prevalence and trends in obesity among US adults, 1999-2008.

Abstract: Results In 2007-2008, the age-adjusted prevalence of obesity was 33.8% (95% confidence interval [CI], 31.6%-36.0%) overall, 32.2% (95% CI, 29.5%-35.0%) among men, and 35.5% (95% CI, 33.2%-37.7%) among women. The corresponding prevalence estimates for overweight and obesity combined (BMI 25) were 68.0% (95% CI, 66.3%-69.8%), 72.3% (95% CI, 70.4%-74.1%), and 64.1% (95% CI, 61.3%66.9%). Obesity prevalence varied by age group and by racial and ethnic group for both men and women. Over the 10-year period, obesity showed no significant trend among women (adjusted odds ratio [AOR] for 2007-2008 vs 1999-2000, 1.12 [95% CI, 0.89-1.32]). For men, there was a significant linear trend (AOR for 2007-2008 vs 1999-2000, 1.32 [95% CI, 1.12-1.58]); however, the 3 most recent data points did not differ significantly from each other.

Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.

Abstract: "Physical activity," "exercise," and "physical fitness" are terms that describe different concepts. However, they are often confused with one another, and the terms are sometimes used interchangeably. This paper proposes definitions to distinguish them. Physical activity is defined as any bodily movement produced by skeletal muscles that results in energy expenditure. The energy expenditure can be measured in kilocalories. Physical activity in daily life can be categorized into occupational, sports, conditioning, household, or other activities. Exercise is a subset of physical activity that is planned, structured, and repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness. Physical fitness is a set of attributes that are either health- or skill-related. The degree to which people have these attributes can be measured with specific tests. These definitions are offered as an interpretational framework for comparing studies that relate physical activity, exercise, and physical fitness to health.

Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise

Abstract: The purpose of this Position Stand is to provide guidance to professionals who counsel and prescribe individualized exercise to apparently healthy adults of all ages. These recommendations also may apply to adults with certain chronic diseases or disabilities, when appropriately evaluated and advised by a health professional. This document supersedes the 1998 American College of Sports Medicine (ACSM) Position Stand, "The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults." The scientific evidence demonstrating the beneficial effects of exercise is indisputable, and the benefits of exercise far outweigh the risks in most adults. A program of regular exercise that includes cardiorespiratory, resistance, flexibility, and neuromotor exercise training beyond activities of daily living to improve and maintain physical fitness and health is essential for most adults. The ACSM recommends that most adults engage in moderate-intensity cardiorespiratory exercise training for ≥30 min·d on ≥5 d·wk for a total of ≥150 min·wk, vigorous-intensity cardiorespiratory exercise training for ≥20 min·d on ≥3 d·wk (≥75 min·wk), or a combination of moderate- and vigorous-intensity exercise to achieve a total energy expenditure of ≥500-1000 MET·min·wk. On 2-3 d·wk, adults should also perform resistance exercises for each of the major muscle groups, and neuromotor exercise involving balance, agility, and coordination. Crucial to maintaining joint range of movement, completing a series of flexibility exercises for each the major muscle-tendon groups (a total of 60 s per exercise) on ≥2 d·wk is recommended. The exercise program should be modified according to an individual's habitual physical activity, physical function, health status, exercise responses, and stated goals. Adults who are unable or unwilling to meet the exercise targets outlined here still can benefit from engaging in amounts of exercise less than recommended. In addition to exercising regularly, there are health benefits in concurrently reducing total time engaged in sedentary pursuits and also by interspersing frequent, short bouts of standing and physical activity between periods of sedentary activity, even in physically active adults. Behaviorally based exercise interventions, the use of behavior change strategies, supervision by an experienced fitness instructor, and exercise that is pleasant and enjoyable can improve adoption and adherence to prescribed exercise programs. Educating adults about and screening for signs and symptoms of CHD and gradual progression of exercise intensity and volume may reduce the risks of exercise. Consultations with a medical professional and diagnostic exercise testing for CHD are useful when clinically indicated but are not recommended for universal screening to enhance the safety of exercise.

An Ecological Perspective on Health Promotion Programs

Abstract: During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health promotion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease. This article proposes an ecological model for health promotion which focuses attention on both individual and social environmental factors as targets for health promotion interventions. It addresses the importance of interventions directed at changing interpersonal, organizational, community, and public policy, factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individuals in the population is essential for implementing environmental changes.

Prevalence of Obesity and Trends in the Distribution of Body Mass Index Among US Adults, 1999-2010

Abstract: Results In 2009-2010 the age-adjusted mean BMI was 28.7 (95% CI, 28.3-29.1) for men and also 28.7 (95% CI, 28.4-29.0) for women. Median BMI was 27.8 (interquartile range [IQR], 24.7-31.7) for men and 27.3 (IQR, 23.3-32.7) for women. The age-adjusted prevalence of obesity was 35.5% (95% CI, 31.9%-39.2%) among adult men and 35.8% (95% CI, 34.0%-37.7%) among adult women. Over the 12-year period from 1999 through 2010, obesity showed no significant increase among women overall (age- and race-adjusted annual change in odds ratio [AOR], 1.01; 95% CI, 1.00-1.03; P=.07), but increases were statistically significant for non-Hispanic black women (P=.04) and Mexican American women (P=.046). For men, there was a significant linear trend (AOR, 1.04; 95% CI, 1.02-1.06; P.001) over the 12-year period. For both men and women, the most recent 2 years (2009-2010) did not differ significantly (P=.08 for men and P=.24 for women) from the previous 6 years (20032008). Trends in BMI were similar to obesity trends.