Cardiorespiratory Fitness in Young Adulthood and the Development of Cardiovascular Disease Risk Factors

Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 12/2003; 290(23):3092-100. DOI: 10.1001/jama.290.23.3092
Source: PubMed


Low cardiorespiratory fitness is an established risk factor for cardiovascular and total mortality; however, mechanisms responsible for these associations are uncertain.
To test whether low fitness, estimated by short duration on a maximal treadmill test, predicted the development of cardiovascular disease risk factors and whether improving fitness (increase in treadmill test duration between examinations) was associated with risk reduction.
Population-based longitudinal cohort study of men and women 18 to 30 years of age in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants who completed the treadmill examination according to the Balke protocol at baseline were followed up from 1985-1986 to 2000-2001. A subset of participants (n = 2478) repeated the exercise test in 1992-1993.
Incident type 2 diabetes, hypertension, the metabolic syndrome (defined according to National Cholesterol Education Program Adult Treatment Panel III), and hypercholesterolemia (low-density lipoprotein cholesterol > or =160 mg/dL [4.14 mmol/L]).
During the 15-year study period, the rates of incident diabetes, hypertension, the metabolic syndrome, and hypercholesterolemia were 2.8, 13.0, 10.2, and 11.7 per 1000 person-years, respectively. After adjustment for age, race, sex, smoking, and family history of diabetes, hypertension, or premature myocardial infarction, participants with low fitness (<20th percentile) were 3- to 6-fold more likely to develop diabetes, hypertension, and the metabolic syndrome than participants with high fitness (> or =60th percentile), all P<.001. Adjusting for baseline body mass index diminished the strength of these associations to 2-fold (all P<.001). In contrast, the association between low fitness and hypercholesterolemia was modest (hazard ratio [HR], 1.4; 95% confidence interval [CI], 1.1-1.7; P =.02) and attenuated to marginal significance after body mass index adjustment (P =.13). Improved fitness over 7 years was associated with a reduced risk of developing diabetes (HR, 0.4; 95% CI, 0.2-1.0; P =.04) and the metabolic syndrome (HR, 0.5; 95% CI, 0.3-0.7; P<.001), but the strength and significance of these associations was reduced after accounting for changes in weight.
Poor fitness in young adults is associated with the development of cardiovascular disease risk factors. These associations involve obesity and may be modified by improving fitness.

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    • "In a few studies, researchers have reported associations between cardiorespiratory fitness (hereafter as " fitness " ), an objective measure of habitual physical activity, and type 2 diabetes [18e20]. The 15-year longitudinal results of the Coronary Artery Risk Development in Young Adults (CARDIA) study showed that a person's fitness measured with a maximal treadmill test was inversely associated with his or her developing type 2 diabetes and metabolic syndrome [18]. The investigators reported that risk of developing type 2 diabetes was double for low-fitness compared with high-fitness young adult men and women (i.e., those who have attained low/high levels of physical fitness). "

    Full-text · Dataset · Dec 2015
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    • "Cardiovascular disease (CVD) remains the leading cause of death worldwide [1]. Several biological risk factors, such as male gender, family history of heart disease, high blood pressure (BP), dyslipidemia, obesity, glucose abnormalities, insulin resistance, and lifestyle risk factors, such as smoking, poor diet, lack of physical activity, low cardiorespiratory fitness, excessive alcohol use, and stress, are associated with the development and progression of CVD [2] [3]. Notably, these lifestyle risk factors strongly influence the established biological CVD risk factors and also affect novel pathways of risk such as inflammation [4]. "
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    ABSTRACT: The effects of light intensity physical activity (LIPA) on cardiovascular disease (CVD) risk factors remain to be established. This review summarizes the effects of LIPA on CVD risk factors and CVD-related markers in adults. A systematic search of four electronic databases (PubMed, Academic Search Complete, SPORTDiscus, and CINAHL) examining LIPA and CVD risk factors (body composition, blood pressure, glucose, insulin, glycosylated hemoglobin, and lipid profile) and CVD-related markers (maximal oxygen uptake, heart rate, C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and tumor necrosis factor receptors 1 and 2) published between 1970 and 2015 was performed on 15 March 2015. A total of 33 intervention studies examining the effect of LIPA on CVD risk factors and markers were included in this review. Results indicated that LIPA did not improve CVD risk factors and CVD-related markers in healthy individuals. LIPA was found to improve systolic and diastolic blood pressure in physically inactive populations with a medical condition. Reviewed studies show little support for the role of LIPA to reduce CVD risk factors. Many of the included studies were of low to fair study quality and used low doses of LIPA. Further studies are needed to establish the value of LIPA in reducing CVD risk.
    Full-text · Article · Sep 2015 · BioMed Research International
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    • "While fitness level was not associated with any difference in standard clinical blood markers (ex. lipids, cholesterol, etc.) insulin was significantly higher in the LF group (Table 1: males and females combined). Additionally it has been observed that higher baseline fitness levels are associated with a lower incidence of future cardiovascular disease and prediabetes/diabetes202122. Future studies should examine the role of %BF over time as it may be an influencing factor. "

    Preview · Article · May 2015
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