After adjustment for race, body mass index (BMI), and hormone replacement status, a graded reduction in the Framingham risk score was observed across low (5.8%), moderate (4.0%), and high (3.6%) fitness levels (P for trend = 0.009). Women in both the moderate and high fitness categories had a lower (P < 0.01) risk score compared with their low fit counterparts. Significant differences in risk were not seen among low (3.9%), moderate (4.9%), and high (4.4%) physical activity groups. The lack of association between the risk score by physical activity may have been due to the homogeneity of activity levels among participants. Our findings reinforce existing data that show enhanced levels of fitness are associated with lower risk for CHD.

Objectives: Individuals may engage in more than one risk behaviour at any given time. The extent to which risk behaviours cluster among African American adults has been largely unexplored. This study examined the prevalence and clustering of three risk behaviours among African American church members: smoking; low moderate-to-vigorous intensity leisure time physical activity (leisure MVPA); and low fruit and vegetable consumption. Design: Cross-sectional study. Setting: African Methodist Episcopal churches in South Carolina. Method: Participants self-reported leisure MVPA, fruit and vegetable consumption and smoking. The prevalence of single and multiple risk behaviours was computed. To examine whether risk behaviours clustered, a series of hierarchical log-linear models (SAS CATMOD) were fitted to the observed counts. Results: Of the 1123 participants, 7.0% smoked, 56.0% engaged in <150 minutes/week of leisure MVPA and 76.8% consumed <5 servings/day of fruit and vegetables; 11.8% of the sample had no risk behaviours, 39.5% had one, 45.7% had two and 2.9% had all three. The most common risk behaviour cluster was low leisure MVPA and low fruit and vegetable consumption (42.1%). Results from the log-linear models showed dependence among low fruit and vegetable consumption and low leisure MVPA, independent of smoking status. Conclusions: Church members who engaged in low levels of leisure MVPA were more likely to have low fruit and vegetable consumption, regardless of smoking status. These findings suggest that these two behaviours should not be considered in isolation from one another when developing behaviour change interventions; interventions targeting both behaviours may be more effective.

This paper first discusses how population exposures to environmental pollutants are estimated from environmental monitoring data and the problems that are encountered in estimating risk from pollutants on the basis of ecologic studies. We then present a technique of estimating individualized exposures to an atmospheric pollutant, sulfur dioxide ( SO 2 ) , through atmospheric transport modeling for a case ± control study. The transport model uses the quantities of SO 2 released from 30 geographically identified industrial facilities and meteorological data ( wind speed and direction ) to predict the downwind ground -level concentrations of SO 2 at geographically identified residences, receptors, of 797 study subjects. A distribution of facility SO 2 emissions, uncertainties in effective stack height, and model uncertainty are incorporated to examine the uncertainty in the predicted versus ambient monitoring SO 2 levels, and to generate an exposure uncertainty distribution for both the cases and controls. The transport model's accuracy is evaluated by comparing recorded ambient measurements of SO 2 with the model's predicted SO 2 estimates at geographically identified ambient monitoring stations.

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