Associations Between Cardiorespiratory Fitness And Diverticulitis In Older Adults

Abstract

PURPOSE: To examine the independent and joint associations of cardiorespiratory fitness (CRF) and body mass index (BMI) with the prevalence of diverticulitis in older adults, a topic on which there is limited data. METHODS: This cross-sectional study included 476 older adults (61% women; mean age 71 years old) with no history of myocardial infarction, stroke, cancer, inflammatory bowel disease, or type 2 diabetes. CRF was assessed by time (minutes) to complete a 400-meter walk test. BMI was calculated using measured weight (kg) divided by height (meter) squared. Participants were categorized into sex-specific tertiles (thirds) of CRF. The cases of diverticulitis were identified by physician diagnosis from a standardized medical history questionnaire. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of the prevalence of diverticulitis by tertiles of CRF. CRF and BMI were further dichotomized into either “unfit” (the lowest one-third of CRF), “fit” (the upper two-thirds of CRF), “overweight/obese” (BMI ≥ 25.0 kg/m2), or “normal-weight” (BMI < 25.0 kg/m2) to investigate the joint association of CRF and BMI with diverticulitis. RESULTS: Among the 476 participants, 35 (7.4%) were identified as having diverticulitis. Compared with the lower CRF, the ORs (95% CIs) of diverticulitis were 0.52 (0.22-1.22) and 0.33 (0.12-0.94) in the middle and upper CRF, respectively, after adjusting for possible confounders. However, the association was no longer significant after further adjustment for BMI. Compared with the normal-weight group, the ORs (95% CIs) of diverticulitis were 2.86 (1.05-7.79) and 2.98 (0.95-9.35) in the overweight and obese groups, respectively, after adjusting for possible confounders, including CRF. In the joint association analysis, compared with the “unfit and overweight/obese group, the ORs (95% CIs) were 0.16 (0.04-0.61) in the “fit and normal-weight” group. CONCLUSIONS: Higher CRF and lower BMI appear to be associated with a lower prevalence of diverticulitis in older adults. The lowest prevalence of diverticulitis was found in the normal-weight and fit older adults. Prospective studies are warranted.