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Watts EL, Gonzales TI, Strain T, Saint-Maurice PF, Bishop DT, Chanock SJ, Johansson M, Keku TO, Le Marchand L, Moreno V, Newcomb PA, Newton CC, Pai RK, Purdue MP, Ulrich CM, Smith-Byrne K, Van Guelpen B, Day FR, Wijndaele K, Wareham NJ, Matthews CE, Moore SC, Brage S. Observational and genetic associations between cardiorespiratory fitness and cancer: a UK Biobank and international consortia study. Br J Cancer 2024; 130:114-124. [PMID: 38057395 PMCID: PMC10781786 DOI: 10.1038/s41416-023-02489-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 10/20/2023] [Accepted: 10/31/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The association of fitness with cancer risk is not clear. METHODS We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of lung, colorectal, endometrial, breast, and prostate cancer in a subset of UK Biobank participants who completed a submaximal fitness test in 2009-12 (N = 72,572). We also investigated relationships using two-sample Mendelian randomisation (MR), odds ratios (ORs) were estimated using the inverse-variance weighted method. RESULTS After a median of 11 years of follow-up, 4290 cancers of interest were diagnosed. A 3.5 ml O2⋅min-1⋅kg-1 total-body mass increase in fitness (equivalent to 1 metabolic equivalent of task (MET), approximately 0.5 standard deviation (SD)) was associated with lower risks of endometrial (HR = 0.81, 95% CI: 0.73-0.89), colorectal (0.94, 0.90-0.99), and breast cancer (0.96, 0.92-0.99). In MR analyses, a 0.5 SD increase in genetically predicted O2⋅min-1⋅kg-1 fat-free mass was associated with a lower risk of breast cancer (OR = 0.92, 95% CI: 0.86-0.98). After adjusting for adiposity, both the observational and genetic associations were attenuated. DISCUSSION Higher fitness levels may reduce risks of endometrial, colorectal, and breast cancer, though relationships with adiposity are complex and may mediate these relationships. Increasing fitness, including via changes in body composition, may be an effective strategy for cancer prevention.
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Affiliation(s)
- Eleanor L Watts
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Tomas I Gonzales
- MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Tessa Strain
- MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Pedro F Saint-Maurice
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - D Timothy Bishop
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Mattias Johansson
- Genomics Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Temitope O Keku
- Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC, USA
| | | | - Victor Moreno
- Oncology Data Analytics Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Clinical Sciences, Faculty of Medicine and University of Barcelona Institute for Complex Systems (UBICS), University of Barcelona, Barcelona, Spain
- ONCOBEL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Christina C Newton
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Rish K Pai
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Mark P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Cornelia M Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Karl Smith-Byrne
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Bethany Van Guelpen
- Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Felix R Day
- MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Nicholas J Wareham
- MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Soren Brage
- MRC Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
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Cirone D, Berbrier DE, Gibbs JC, Usselman CW. Health-related physical fitness in women with polycystic ovary syndrome versus controls: a systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:17-36. [PMID: 36920532 DOI: 10.1007/s00404-023-07004-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is a common endocrinopathy associated with cardiometabolic dysfunction. PURPOSE (1) To compare HRPF indices, including cardiorespiratory fitness (CRF), muscle strength, and muscle endurance, between women with and without PCOS (i.e., controls). (2) To explore the impact of moderating factors, i.e., insulin sensitivity, androgen levels, physical activity levels, and body mass index, on these indices. METHODS Articles comparing HRPF between PCOS and control groups were identified until February 27th, 2022. Random-effects meta-analyses were conducted and moderating factors were explored with subgroup and meta-regression analyses. RESULTS Twenty studies were included. Compared to controls, CRF was lower in women with PCOS (n = 15, - 0.70 [- 1.35, - 0.05], P = 0.03, I2 = 95%). Meta-regression analyses demonstrated that fasting insulin (P = 0.004) and homeostatic model assessment of insulin resistance (P = 0.006) were negatively associated with CRF, while sex-hormone binding globulin levels (P = 0.003) were positively associated. Absolute muscle strength was not different between PCOS and controls (n = 7, 0.17 [- 0.10, 0.45], P = 0.22, I2 = 37%). One study evaluated muscle endurance and reported lower core endurance in PCOS subjects compared to controls. CONCLUSION These data suggest that PCOS may be associated with impaired CRF. It remains unclear whether muscle strength and endurance differ between women with PCOS and controls. As this data set was limited by a small sample size, potential for bias, and inconsistent findings, additional studies accounting for the heterogeneous presentation of PCOS as well as improved matching between PCOS and controls for characteristics known to affect HRPF would help elucidate the impact of PCOS on indices of HRPF. PROSPERO REGISTRATION NUMBER CRD42020196380.
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Affiliation(s)
- Domenica Cirone
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Canada
| | - Danielle E Berbrier
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Canada
| | - Jenna C Gibbs
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Charlotte W Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Canada.
- McGill Research Centre for Physical Activity and Health, McGill University, Montreal, Canada.
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Trovato B, Roggio F, Petrigna L, Musumeci G. Modified Isoinertial-Based Ruffier Test in Healthy Individuals: A Feasibility Study. J Funct Morphol Kinesiol 2023; 8:jfmk8020036. [PMID: 37092368 PMCID: PMC10123694 DOI: 10.3390/jfmk8020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 04/25/2023] Open
Abstract
Cardiorespiratory fitness is an essential indicator in sports science and sports medicine that can be assessed with several tests. The Ruffier test is a submaximal test valid to estimate maximum oxygen uptake; it consists of 30 squats in 45 s, which may be challenging for inexperienced individuals. This study aims to verify the feasibility of a modified inertial-based version of the Ruffier test to assess cardiorespiratory fitness with 10 squats in 15 s. Both classic and isoinertial Ruffier tests were administered to thirty-five healthy young adults (20 men and 15 women), age 22.06 ± 2.13 years, BMI 23.87 ± 2.74. The two one-sided test confirmed the comparability of the isoinertial Ruffier test with its classic version within equivalence bounds of ±3.726. Furthermore, gender, age, body weight, the difference between peak heart rate after isoinertial squatting and resting heart rate, and the isoinertial Ruffier index are the coefficients of our best VO2max prediction model with an adjusted R2 of 0.937, sensitivity of 0.89, and specificity of 0.81. The study evidenced the feasibility of the isoinertial Ruffier test to measure cardiorespiratory fitness through a quick, safe, and short squat test easy to perform in fitness centers and primary care clinics.
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Affiliation(s)
- Bruno Trovato
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
| | - Federico Roggio
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
| | - Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
- Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
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Relationships between Obesity, Exercise Preferences, and Related Social Cognitive Theory Variables among Breast Cancer Survivors. Nutrients 2023; 15:nu15051286. [PMID: 36904284 PMCID: PMC10005113 DOI: 10.3390/nu15051286] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
Breast cancer survivors with obesity have an increased risk of cancer recurrence, second malignancy, and comorbidities. Though physical activity (PA) interventions are needed, investigation of the relationships between obesity and factors influencing PA program aspects among cancer survivors remain understudied. Thus, we conducted a cross-sectional study examining associations amongst baseline body mass index (BMI), PA program preferences, PA, cardiorespiratory fitness, and related social cognitive theory variables (self-efficacy, exercise barriers interference, social support, positive and negative outcome expectations) from a randomized controlled PA trial with 320 post-treatment breast cancer survivors. BMI was significantly correlated with exercise barriers interference (r = 0.131, p = 0.019). Higher BMI was significantly associated with preference to exercise at a facility (p = 0.038), lower cardiorespiratory fitness (p < 0.001), lower walking self-efficacy (p < 0.001), and higher negative outcome expectations (p = 0.024), independent of covariates (comorbidity score, Western Ontario and McMaster Universities osteoarthritis index score, income, race, education). Those with class I/II obesity reported a higher negative outcome expectations score compared with class III. Location, walking self-efficacy, barriers, negative outcome expectations, and fitness should be considered when designing future PA programs among breast cancer survivors with obesity.
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Ho CC, Lee PF, Xu S, Hung CT, Su YJ, Lin CF, Wu MC, Chen YT. Associations between cigarette smoking status and health-related physical fitness performance in male Taiwanese adults. Front Public Health 2022; 10:880572. [PMID: 36062134 PMCID: PMC9433563 DOI: 10.3389/fpubh.2022.880572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/28/2022] [Indexed: 01/21/2023] Open
Abstract
Background The highest proportion of smoking behavior occurs in male adults in Taiwan. However, to our knowledge, no study has investigated the relationship between smoking behavior and health-related physical fitness according to education level, health status, betel nut-chewing status and obesity in male adults aged 18 years or older in Taiwan. Aims This study aimed to determine the associations between cigarette smoking and health-related physical fitness performance in male Taiwanese adults. Methods This was a cross-sectional study conducted on 27,908 male adults (aged 23-64 years) who participated in Taiwan's National Physical Fitness Survey 2014-2015. Data from a standardized structured questionnaire, anthropometric variables, and health-related physical fitness measurements were analyzed. Individuals were categorized as never smoking cigarettes, former smoker, and current smoker. Multiple linear regression analysis was performed to evaluate the association between cigarette smoking and health-related physical fitness performance. Results Never smoking group exhibited a lower (p < 0.05) proportion of abdominal obesity, higher (p < 0.05) proportion of perceived good health status, and greater (p < 0.05) performance in 1-min sit-up and sit-and-reach tests when compared with current smoking and former smoking group. Former smoking group had the highest (p < 0.05) performance in 3-min step test among all groups. Current smoker was significantly negatively (p < 0.05) associated with 3-min step, 1-min sit-up and sit-and-reach tests. Notably, former smoker was significantly positively (p < 0.05) associated with 3-min step and 1-min sit-up tests, but still negatively (p < 0.05) associated with sit-and-reach performance. Conclusion Current smoker was associated with an increased the risk of abdominal obesity, reduced the perceived health status and health-related physical fitness performance. Quitting smoking had beneficial effect on the perceived good health status, cardiorespiratory and muscular fitness in male Taiwanese adults, but not on flexibility performance. Further research on the ameliorate mechanism underlying this phenomenon is warranted.
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Affiliation(s)
- Chien-Chang Ho
- Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan,Research and Development Center for Physical Education, Health, and Information Technology, College of Education, Fu Jen Catholic University, New Taipei City, Taiwan,Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan
| | - Po-Fu Lee
- Department of Leisure Industry and Health Promotion, National Ilan University, Yilan County, Taiwan
| | - Shu Xu
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, United States
| | - Chang-Tsen Hung
- Department of Health and Leisure Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Yan-Jhu Su
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, United States
| | - Chi-Fang Lin
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei City, Taiwan
| | - Min-Chen Wu
- Office of Physical Education, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Yun-Tsung Chen
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei City, Taiwan,*Correspondence: Yun-Tsung Chen
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Davis ME, Blake C, Perrotta C, Cunningham C, O'Donoghue G. Impact of training modes on fitness and body composition in women with obesity: A systematic review and meta-analysis. Obesity (Silver Spring) 2022; 30:300-319. [PMID: 35088563 DOI: 10.1002/oby.23305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aimed to assess the effectiveness of different exercise modalities and determine the optimal exercise prescription for improving cardiorespiratory fitness, body composition, and metabolic health of women with obesity. METHODS A systematic review of randomized controlled trials (RCTs) published between January 1988 and October 2020 was conducted. The RCTs were screened using the following inclusion criteria: 1) participants: women aged 18 to 65 years with BMI > 30 kg/m2 and without comorbidities; 2) intervention: exercise; 3) comparison: non-intervention control; and 4) outcomes measures: cardiorespiratory fitness (maximal oxygen consumption), body composition (i.e., body weight, percentage body fat), and/or metabolic measures (i.e., blood pressure, cholesterol). RESULTS A total of 20 RCTs with a total of 2,062 participants were included. Although the results showed that any form of exercise was more effective than control, improvements in fitness and body composition were modest. Aerobic exercise (vigorous and moderate intensity) appeared most promising for improving fitness and body weight, whereas low-load resistance training resulted in the largest improvements in body fatness. CONCLUSIONS In women living with obesity, aerobic exercise was consistently effective in improving fitness and body composition. Although both resistance training and combined exercise interventions appear promising, more research is needed to evaluate their efficacy and determine an optimal exercise prescription for this population.
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Affiliation(s)
- Mary E Davis
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland
| | - Carla Perrotta
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland
| | - Caitriona Cunningham
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland
| | - Gráinne O'Donoghue
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland
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Self-Administered Six-Minute Walk Test Using a Free Smartphone App in Asymptomatic Adults: Reliability and Reproducibility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031118. [PMID: 35162141 PMCID: PMC8834251 DOI: 10.3390/ijerph19031118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/21/2021] [Accepted: 12/08/2021] [Indexed: 12/03/2022]
Abstract
Background: The 6-min walk test (6MWT) is a simple, inexpensive, reliable, and reproducible test that provides a reasonable estimate of the cardiorespiratory fitness (CRF). We aimed to assess the reliability and reproducibility of a self-administered 6MWT in asymptomatic adults using a free smartphone app. Methods: In the 1st phase, 93 participants underwent a supervised 6MWT (6MWTsup) in a 30 m indoor corridor, using a triaxial accelerometer and their smartphones to compare the total step counts and to develop a 6-min walk distance (6MWD) prediction equation. In the 2nd phase, 25 participants performed the 6MWTsup and two self-administered 6MWTs outdoors (6MWTsa1 and 6MWTsa2, at least 48 h apart) using a free smartphone app. Results: The agreement between accelerometer- and app-based total step counts was limited (mean difference, −58.7 steps (−8.7%): 95% confidence interval, −326.5 (−46.8%) to 209.1 (29.3%)). The best algorithm for predicting the 6MWTsupm included: 795.456 + (0.815 heightm app-steps) − (1.620 ageyears) − (3.005 weightkg) − (1.155 app-steps), R2 = 0.609). The intraclass correlation coefficient between 6MWTsa2 and 6MWTsa1 was excellent (0.91: 0.81–0.96). The coefficient of variation was 6.4%. The agreement between the two self-administered tests was narrow (−1.9 (0.2%) meters: −57.4 (−9.5%) to 61.3 (9.9%)). Conclusions: The self-administered 6MWT has excellent reliability and reproducibility in asymptomatic adults, being a valuable tool for assessing CRF in community-based interventions.
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The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: A cohort study. PLoS One 2021; 16:e0250508. [PMID: 33951071 PMCID: PMC8099071 DOI: 10.1371/journal.pone.0250508] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 04/07/2021] [Indexed: 12/15/2022] Open
Abstract
Background It has been suggested that cardiorespiratory fitness (CRF) may be used to identify those at greatest risk for severe COVID-19 illness. However, no study to date has examined the association between CRF and COVID-19. The objectives of this study were to determine whether CRF is independently associated with testing positive with or dying from COVID-19. Methods This is a prospective cohort study of 2,690 adults from the UK Biobank Study that were followed from March 16th, 2020 to July 26th, 2020. Participants who were tested for COVID-19 and had undergone CRF assessment were examined. CRF was estimated (eCRF) and categorized as low (<20th percentile), moderate (20th to 80th percentile) and high (≥80th percentile) within sex and ten-year age groups (e.g. 50–60 years). Participants were classified as having COVID-19 if they tested positive (primarily PCR tests) at an in-patient or out-patient setting as of July 26, 2020. Participants were classified as having died from COVID-19 if the primary or underlying cause of death was listed ICD-10 codes U071 or U072 by June 30th, 2020. Adjusted risk ratios (aRR) and 95% confidence intervals (CI) were estimated and a forward model building approach used to identify covariates. Findings There was no significant association between eCRF and testing positive for COVID-19. Conversely, individuals with moderate (aRR = 0.43, 95% CI: 0.25, 0.75) and high fitness (aRR = 0.37, 95% CI: 0.16, 0.85) had a significantly lower risk of dying from COVID-19 than those with low fitness. Conclusions While eCRF was not significantly associated with testing positive for COVID-19, we observed a significant dose-response between having higher eCRF and a decreased risk of dying from COVID-19. This suggests that prior gains in CRF could be protective against dying from COVID-19 should someone develop the virus.
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Zeiher J, Manz K, Kuntz B, Perumal N, Keil T, Mensink GBM, Finger JD. Individual and interpersonal correlates of cardiorespiratory fitness in adults - Findings from the German Health Interview and Examination Survey. Sci Rep 2020; 10:445. [PMID: 31949174 PMCID: PMC6965149 DOI: 10.1038/s41598-019-56698-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/17/2019] [Indexed: 12/23/2022] Open
Abstract
Cardiorespiratory fitness (CRF) is an established predictor of adverse health outcomes. The aim of this study is to investigate potential behavioral, interpersonal and socioeconomic correlates of CRF among men and women living in Germany using data from a population-based nationwide cross-sectional study. 1,439 men and 1,486 women aged 18-64 participated in the German Health Interview and Examination Survey (2008-2011) and completed a standardized sub-maximal cycle ergometer test. Maximal oxygen consumption ([Formula: see text]) in ml·min-1·kg-1 was estimated. Mean values of VO2max for various anthropometric, behavioral, interpersonal, and sociodemographic variables were estimated. Linear regression analyses using multiple imputations technique for missing values was performed to analyze the influence of potential correlates on CRF. Women with high alcohol consumption had higher [Formula: see text], (β = 2.20; 95% CI 0.98 to 3.42) than women with low alcohol consumption and women with high occupational status had higher [Formula: see text] (β = 1.83; 95% CI 0.21 to 3.44) in comparison to women with low occupational status. Among men, high fruit intake (β = 1.52; 95% CI 0.63 to 2.40), compared to low or medium fruit intake and performing at least 2.5 hours of total PA per week (β = 2.19; 95% CI 1.11 to 3.28), compared to less than 2.5 hours was associated with higher [Formula: see text]. Among both men and women, lower body mass index, lower waist circumference and higher levels of physical exercise were considerably associated with higher [Formula: see text]. Among women, those in higher age groups showed a considerably lower level of [Formula: see text] compared with those aged 18-24. Furthermore, mean estimated [Formula: see text] was higher among men (36.5; 95% CI 36.0 to 37.0) than among women (30.3; 95% CI 29.8 to 30.7). Despite the cross-sectional nature of the current study, we conclude that several behavioral, anthropometric, and sociodemographic factors are associated with CRF in the general adult population in Germany. These results can provide evidence to tailor prevention measures according to the needs of specific subgroups.
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Affiliation(s)
- Johannes Zeiher
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Kristin Manz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Benjamin Kuntz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Nita Perumal
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Thomas Keil
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute for Health Resort Medicine and Health Promotion, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jonas D Finger
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Nikolakaros G, Vahlberg T, Auranen K, Sillanmäki L, Venetoklis T, Sourander A. Obesity, Underweight, and Smoking Are Associated with Worse Cardiorespiratory Fitness in Finnish Healthy Young Men: A Population-Based Study. Front Public Health 2017; 5:206. [PMID: 28868273 PMCID: PMC5563318 DOI: 10.3389/fpubh.2017.00206] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 07/26/2017] [Indexed: 02/05/2023] Open
Abstract
Background Obesity and smoking are strongly associated with worse cardiorespiratory fitness (CRF). Most previous studies that have examined the association of body composition with CRF have neither assessed non-linearity nor separately examined the effects of underweight. Thus, very little is known on how underweight affects CRF. Possible joint effects of obesity and smoking on CRF have not been adequately explored. Aims We examined the association between body mass index (BMI) and smoking with CRF in 1,629 Finnish army conscripts. We focused on non-linear effects of BMI in order to assess the importance of underweight. We also examined whether the cooccurrence of obesity and smoking potentiates their deleterious effects on CRF. Methods We used the Cooper’s 12-minute run test (12MR) to measure CRF. The 12MR score was analyzed as continuous (linear, polynomial, and restricted cubic spline regression) and categorical. In categorical analyses, we used binary logistic regression with the 12MR score in two groups (low = lowest quintile vs. intermediate/high = quintiles 2–5) and multinomial logistic regression with the 12MR score in three groups (low = lowest quintile, intermediate = quintiles 2 and 3, and high = quintiles 4 and 5). Results Non-linearity in the spline model was statistically significant (p < 0.001). In addition, the non-linear models had a clearly better fit than the linear one in terms of Akaike Information Criterion and R-squared values. There was a statistically significant interaction between smoking and BMI (p < 0.01). In the categorical analysis, overweight/obese regular smokers were at a particularly high risk of not achieving high CRF. Conclusion In healthy young men, not only overweight/obesity but also underweight may be associated with worse CRF. This provides a potential mechanism for the previously reported association between underweight and increased mortality. The cooccurrence of overweight/obesity and regular smoking may have a deleterious effect on CRF.
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Affiliation(s)
- Georgios Nikolakaros
- General Psychiatry Outpatient Clinic, Psychiatric Care Division, Satakunta Hospital District, Pori, Finland
| | - Tero Vahlberg
- General Psychiatry Outpatient Clinic, Psychiatric Care Division, Satakunta Hospital District, Pori, Finland
| | - Kari Auranen
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Lauri Sillanmäki
- Research Center for Child Psychiatry, University of Turku, Turku, Finland
| | - Takis Venetoklis
- Department of Social Policy, University of Turku, Turku, Finland
| | - Andre Sourander
- Research Center for Child Psychiatry, University of Turku, Turku, Finland
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