Choline plays a central role in many physiological pathways, including neurotransmitter synthesis (acetylcholine), cell-membrane signaling (phospholipids), lipid transport (lipoproteins), and methyl-group metabolism (homocysteine reduction). Endurance exercise might stress several of these pathways, increasing the demand for choline as a metabolic substrate. This review examines the current literature linking endurance exercise and choline demand in the human body. Also reviewed are the mechanisms by which exercise might affect blood choline levels, and the links between methyl metabolism and the availability of free choline are highlighted. Finally, the ability of oral choline supplements to augment endurance performance is assessed. Most individuals consume adequate amounts of choline, although there is evidence that current recommendations might be insufficient for some adult men. Only strenuous and prolonged physical activity appears sufficient to significantly decrease circulating choline stores. Moreover, oral choline supplementation might only increase endurance performance in activities that reduce circulating choline levels below normal.

Field tests are a practical method to assess aerobic fitness, but they demonstrate greater error variability than laboratory tests. The principal goals of this study were to identify potential sources of systematic error in 2 commonly used field tests (Cooper's 12-minute run [12MR] and the multistage shuttle run [MSR]) and estimate the reliability of the 2 tests from these data. In addition, criterion-related validity evidence for field tests was evaluated via Bland-Altman plots. To assess trends across test protocol and test trials, 60 subjects (mean age = 21.8 ± 3.6 years) completed 6 test trials, including 3 trials of each field test. Of these 60 individuals, 21 volunteers completed an incremental treadmill run and expired gas analysis (TR) that was used to establish criterion-related validity evidence for the 2 field tests. G-study analysis of the field test data returned a high reliability coefficient (ϕ = 0.96), with the largest amount of systematic error variance (4.3%) attributable to an interaction between subjects and test occasions. The MSR predicted Vo2max scores lower than those measured in the laboratory setting (p < 0.01), whereas 12MR and TR scores were not different (p > 0.05). However, Bland-Altman plots showed the 12MR to underestimate Vo2max scores at lower Vo2max values and overestimate Vo2max scores at higher values, a trend not observed in the MSR data. These data suggest high overall reliability for Vo2max field tests in young, healthy individuals. Nevertheless, test administrators must use caution when attempting to use field test data to predict criterion Vo2max scores. The MSR appears to be a more useful tool than the 12MR because of a consistent mean bias across fitness levels.

Firefighting requires high fitness to perform job tasks and minimize risk of job-related cardiac death. To reduce this risk, the International Association of Firefighters has recommended firefighters possess a VO2max ≥ 42 ml·kg-1·min-1. This recommendation is not universally applied because existing screening tests require costly equipment and do not accommodate firefighters unable to run. The purpose of this study was to develop a walking test to predict VO2max in firefighters using a standard treadmill. Thirty-eight male firefighters wore a vest weighing 20% of their body weight and performed a walking VO2max test on a standard treadmill. Walking speed was dependent on leg length and ranged from 3.6 to 4.3 mph. The test began with a 3-minute warm-up, after which the speed was increased to test speed. Every minute thereafter, the grade increased 1% until participants reached exhaustion. For cross-validation, 13 firefighters also performed a running VO2max test. The average test time was 16.95 ± 2.57 minutes (including warm-up) and ranged between 8 and 22 minutes. Average VO2max was 48.4 ± 6.5 ml·kg-1·min-1. Stepwise linear regression included time as the only significant independent variable explaining 76% of the variance in VO2max (p < 0.001). The standard error of the estimate was 3.2 ml·kg-1·min-1. The equation derived is: VO2max (ml·kg·min-1) = 11.373 + time (minute) × 2.184. On average, VO2max values measured while walking were 4.62 ± 5.86 ml·kg-1·min-1, lower than running values. This test has good potential for predicting VO2max among structural firefighters, and minimal equipment needs make it feasible for fire departments to administer.

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