The most important sentence.
"For push-ups, the firefighter was instructed to begin push-ups in time with a metronome set at 80 beats per minute. Clinic staff counted the number of push-ups completed until the participant reached 80, missed 3 or more beats of the metronome, or stopped owing to exhaustion or other symptoms (dizziness, lightheadedness, chest pain, or shortness of breath)."
This was a combined strength/cardiovascular test. You had to book it. Only the firefighters that
This is literally a push-up sprint.
For comparison the US Army requires 42 pushups over 2 minutes (120 seconds) with any amount of pauses (to meet minimum standards) and maxes out at 71 push ups in 2 minutes.
The people I knew who were maxing out their PT tests weren't hitting anywhere near this pace and I suspect only a handful of them could.
Or maybe I'm just making excuses for not being able to do this.
Just as pullups and chin-ups are different things, perhaps these shallow pushups should have a different name to distinguish them from "to the floor" pushups.
It really does sound like something you would need to train pretty specifically for to complete when the reality is that just being fit is the metric for lower risk of heart disease
But in reality if you are in the "high chances of heart attack" group, the training might be the thing that kills you, which is why being able to do the push-ups is a good indicator of having low chances of heart attack...
This type of studies is just useless
In other words, push-ups are probably a better measure of cardiovascular fitness than the treadmill test, but only for the tiny percentage of the population who isn't limited by strength.
For a person who is 5ft10in, the BMI comparison in pounds would be 187lbs avg for the highest group vs 231 lbs, 211 lbs avg for the two lowest groups.
Look at the details from Table 1 in the Study (go to https://jamanetwork.com/journals/jamanetworkopen/fullarticle..., on the right hand side, click on 'Figures and Tables', then click on the 'View Large' link for Table 1):
BMI = Body Mass Index, BP = blood pressure, SD = Standard Deviation
Mean Avg Values for the two lowest groups of pushups (0-10, 11-20):
Age: 48.4 (SD=10.1), 45.1 (SD=8.6)
BMI: 33.1 (SD=5.8) , 30.3 (SD=4.9)
BP: 136.9/89.4 , 129.96/86.5
Smokers (Prev & Current): 54.7%, 58.8%
Age: 35.1 (SD=7.1)
BMI: 26.8 (SD=2.9)
Smokers (Prev & Current): 30.9%
BMI: 25-29.9: - overweight, >= 30: obese
BP: high blood pressure = 1st number >= 130 or 2nd number >= 80
I mean the ability to complete 40 push ups could be a result of exercising in general.
To hit this top group that gives you less than 33 seconds to hit 41. You're not gonna hit those numbers just by exercising in general.
They take the few people that had some form of heart disease (37 out of 1104 over ten years) and noted that none of them except one could do 40 pushups. By some magic, this is translated into a 96% reduction in chance of a heart attack.
If that's really the reasoning, could I not just pick any metric (i.e. words typed per minute over 120, or IQ over 130) which is likely to eliminate almost all of the participants and conclude that it is reducing risk of heart disease?
Am I missing something? Is this kind of reasoning not complete bogus?
It is true that, with the small number of events, the precise "96% reduction" number shouldn't be taken too seriously- the study notes that the 95% confidence interval is 99% to 64%; essentially, there's a one-in-twenty chance that it's a 99% reduction, or likewise that it's only a 64% reduction. Science never grants absolute uncertainties- but sadly, that part never makes it into the news story.
I used to be able to do 40+ push ups, but at no where near the pace that the researchers required.
"metronome set at 80 beats per minute ... until the participant reached 80, missed 3 or more beats of the metronome, or stopped"
I don't know if there are any national standards. But I'm under the impression that at most places there is some baseline cardio component to the fitness test, but that the upper body strength standards are much more demanding.