Association Of Cardiorespiratory Fitness Research Articles

Associations of Cardiorespiratory Fitness and Muscular Endurance Fitness With Pulmonary Function in Physically Active Young Adults

RationaleWhile the beneficial effects of physical fitness on general health are well-documented, the specific relationship between different types of physical fitness, particularly cardiorespiratory fitness (CRF) and muscular endurance fitness (MEF), and lung function in physically active young adults remains less explored. ObjectiveThis study investigated the relationship between CRF and MEF, and their correlation with lung function in physically active young adults. MethodsThis cross-sectional study involved a cohort of 1227 physically active young adults without lung diseases. Lung function was assessed using FEV1, FVC, and FEV1/FVC measurements. The 3000-m run was used to assess CRF, and the 2-min push-up and sit-up tests were used to assess MEF. Multivariable linear regression analysis was used to evaluate the relationships between these fitness measures and lung function, adjusting for potential covariates. ResultsEnhanced CRF was associated with superior FEV1 and FVC after adjusting for covariates (β=−.078, p=.015 for FEV1; β=−.086, p=.009 for FVC). Push-ups were positively associated with FEV1 (β=.102, p=.014), but not with FVC. In contrast, sit-ups showed no significant correlation with lung function in the fully adjusted model. ConclusionThe study demonstrated a clear association between improved physical fitness and better lung function in physically active young adults, with various exercises showing distinct associations with lung metrics. Notably, push-ups were particularly associated with higher FEV1. A future prospective study is necessary to determine whether routine exercises, such as push-ups, might lead to greater lung function.

The association of cardiorespiratory fitness with spirometric small airway obstruction.

Spirometric small airway obstruction is associated with impaired ventilatory response to exercise independently of FEV1/FVC ratio https://bit.ly/3pre4sk.

Associations of cardiorespiratory fitness, body composition, and blood pressure with arterial stiffness in adolescent, young adult, and middle-aged women.

Few studies have investigated whether higher cardiorespiratory fitness (CRF) or favourable body composition are related to lower arterial stiffness in women. We therefore investigated the associations of CRF, body fat percentage (BF%), fat free mass index (FFMI), and mean arterial pressure (MAP) with arterial stiffness in 146 women aged 16-58years. CRF was assessed by a maximal exercise test with respiratory gas analysis either on a cycle ergometer or a treadmill. Aortic pulse wave velocity (PWVao), augmentation index (AIx%), and MAP were assessed by a non-invasive oscillometric device and BF% and FFMI by a bioelectrical impedance or DXA device. CRF was inversely associated with PWVao (β = - 0.004, 95% CI - 0.005 to - 0.002) and AIx% (β = - 0.075, 95% CI - 0.102 to - 0.048) and these associations remained similar after adjustment for BF% or MAP, but not after the adjustment for age. FFMI was inversely associated with PWVao (β = - 0.010, 95% CI - 0.019 to - 0.002) and MAP directly associated with PWVao (β = 0.005, 95% CI 0.003 to 0.006) and AIx% (β = 0.092, 95% CI 0.069 to 0.116) and the associations with PWVao also remained after further adjustments for BF% and age. In conclusion, a higher FFMI and a lower MAP were independently associated with lower arterial stiffness.

Associations of cardiorespiratory fitness, screen time and mental health among Chinese school children

To assess the independent and joint associations between cardiorespiratory fitness (CRF), screen time and mental health among Chinese school-aged children, a cross-sectional study was conducted in 3 primary schools in Wuhan city, China. Children self-reported ST, and their height, weight and CRF were measured. Mental health (anxiety, depressive symptom, and self-esteem) was assessed by self-administered questionnaires. A total of 805 children aged 9.1 ± 0.6 years participated in this study. High ST was associated with significantly increased risk for anxiety and low self-esteem, while high CRF was associated with a decreased risk of low self-esteem. In the joint model, children with low ST and high CRF showed the lowest risk for anxiety (OR: 0.42, 95%CI: 0.20-0.89) and low self-esteem (OR:0.44, 95%CI: 0.24-0.82). High ST and low CRF were negatively associated with mental health in Chinese schoolchildren. Health care and interventions on limiting ST and improving CRF level are warranted to promote the mental health in this population.

Associations of Cardiorespiratory Fitness With Estimated Remnant Cholesterol and Non–High-Density Lipoprotein Cholesterol in Healthy Men

Remnant cholesterol (RC) and non-high-density lipoprotein cholesterol (non-HDL-C) may contribute to the residual risk for atherosclerotic cardiovascular disease. High cardiorespiratory fitness (CRF) is associated with favorable traditional lipid profiles, but its relation with RC and non-HDL-C remains unclear. We analyzed cross-sectional data on 4,613 healthy men (mean age 49years). CRF was measured using peak oxygen uptake during incremental exercise testing and categorized into quartiles. RC was estimated as total cholesterol minus HDL-C and low-density lipoprotein cholesterol, and elevated RC was defined as ≥38mg/100ml (90 percentile). Non-HDL-C was calculated as total cholesterol minus HDL-C, and high non-HLD-C was defined as ≥190mg/100ml. CRF was inversely associated with RC (β -0.31, 95% confidence interval [CI] -0.39 to -0.24) and non-HDL-C (β -0.34, 95% CI -0.57 to -0.11) after adjustment for several risk factors. Each metabolic equivalent increment in CRF was associated with lower odds of having elevated RC (odds ratio [OR] 0.85, 95% CI 0.77 to 0.93) and non-HDL-C (OR 0.93, 95% CI 0.85 to 1.00) in multivariable analysis. Compared with the bottom quartile, the top quartile of CRF had significantly lower odds of elevated RC (OR 0.63, 95% CI 0.45 to 0.88) and non-HDL-C (OR 0.68, 95% CI 0.51 to 0.91). In conclusion, higher CRF was independently associated with lower levels of RC and non-HDL-C and lower odds of the prevalence of elevated RC and non-HDL-C in healthy men.

Sex-specific associations of cardiorespiratory fitness and galectin-3 in the general population.

Low cardiorespiratory fitness (CRF) is associated with greater mortality and morbidity. Galectin-3 (Gal-3) is a prognostic biomarker for fibrosis and heart failure. Gal-3 is also associated with a greater risk for cardiovascular mortality. Whether CRF is related with Gal-3 is unclear. The objective of this study was to assess the sex-specific associations of CRF and Gal-3 levels in the general population. Gal-3 concentrations were determined using a sandwich enzyme immunoassay in the population-based Study of Health in Pomerania (SHIP-TREND-0). Sex-stratified linear regression models adjusted for age, current smoking status, and renal function were used. Individuals with left ventricular ejection fraction (LVEF) <40%, previous myocardial infarction, atrial fibrillation, chronic lung disease, severe renal disease (estimated glomerular filtration rate <30mL/min/mm2 ), a history of cancer, and extreme values for Gal-3 (<1st percentile; >99th percentile) were excluded. A total of n=1515 participants with a median age of 49 (IQR: 39-60years, 48% males) were included. In men, a 1L/min greater VO2 peak was significantly related to 0.50ng/mL (95% CI -0.8068 to -0.1938, P<0.01) less Gal-3. In males, a 1mL/min/kg higher VO2 peak adjusted for body weight was associated with -0.0286ng/mL (95% CI -0.0052 to -0.0005, P=0.02) less Gal-3. When VO2 peak was adjusted for lean mass 1mL/kg/min more was correlated with a -0.0022ng/mL (95% CI -0.0043 to -0.0007, P=0.04) less Gal-3. In women, VO2 peak (β -0.2046 95% CI -0.6541 to 0.2449, P=0.37) and VO2 peak adjusted for lean mass (β -0.0019 95% CI -0.0421 to -0.0050, P=0.12) were not related with Gal-3, whereas a 1mL/min/kg higher VO2 peak adjusted for body weight was significantly associated with a -0.0064ng/mL lower Gal-3 (95% CI -0.0092 to -0.0035, P<0.01). There were no differences between pre-menopausal and post-menopausal women. VO2 peak was associated with Gal-3 only in men, but VO2 peak adjusted for body weight in women and men. Our results suggest that the adverse consequences of low CRF may be mediated by Gal-3. Further research is needed to understand the sex-specific association between CRF and Gal-3 and whether they are clinically relevant.

Association of cardiorespiratory fitness with adiposity markers

Cardiorespiratory fitness (CRF) is inversely associated with metabolic diseases and adiposity markers. To assess the association of CRF with body mass index (BMI), waist circumference (WC) and obesity in a representative sample of the Chilean population. Data from 5,958 participants in the Chilean National Health Survey 2016-1027 aged 15 years or above were analyzed. CRF was estimated by an equation that included sociodemographic, anthropometric and health-related data and expressed in metabolic equivalent units (METs). The association between CRF and adiposity was assessed using linear and Poisson regression models and the results were presented as Prevalence Ratio (PR). One MET increment in CRF was associated with a 3.27 kg/m2 (95% confidence intervals (CI): -3.35; -3.2) and 4.56 kg/m2 (95% CI: -4.67; -4.46) lower BMI in men and women, respectively. Waist circumference was 6.7 cm [95% CI: -6.98; -6.42] and 9 cm [95% CI: -9.33; -8.67] lower per 1-MET increment in CRF. With one MET increment, the probability of being obese was 34% (PR = 0.66 [95%CI: 0.63; 0.69]) and 36% (PR = 0.64 [95%CI: 0.61; 0.67]) lower in men and women, respectively. The probability of having a central obesity was 26% (PR = 0.74 [95%CI: 0.71; 0.77]) and 30% (PR = 0.70 [95%CI: 0.68; 0.73]) lower in men and women, respectively. A higher estimated CRF was associated with lower adiposity levels and a lower risk of being obese in both men and women. Public health policies aiming to increase physical activity are needed to increase the CRF of the Chilean population.

Association between cardiorespiratory fitness and risk of all-cause and cause-specific mortality.

The association of cardiorespiratory fitness (CRF) with all-cause and cause-specific mortality remains unclear in Chinese population. This study aimed to evaluate the risk of all-cause, cardiovascular disease (CVD), cancer and other-cause mortality in Chinese adults using estimated CRF (eCRF). We analysed data for 15,566 participants aged ≥20years recruited in The Rural Chinese Cohort Study during 2007 to 2008 and followed for mortality during 2013 to 2014. eCRF was calculated with sex-specific longitudinal non-exercise algorithms. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality risk according to baseline eCRF. During a median of 6.01years of follow-up, 859 deaths occurred, including 359 from CVD, 221 from cancer, and 279 from other causes. Each 1metabolic equivalent increment in eCRF was associated with decreased risk of all-cause mortality (men: HR 0.70, 95% CI [0.66-0.74]; women: 0.59, [0.54-0.64]); CVD mortality (men: 0.70 [0.64-0.77]; women: 0.55, [0.48-0.62]); and other-cause mortality (men: 0.68 [0.62-0.75]; women: 0.57, [0.49-0.66]). The area under receiver operating characteristic curve was significantly higher for eCRF than its modifiable components (waist circumference, body mass index and resting heart rate) in predicting all-cause and cause-specific mortality incidence (all p<.001). eCRF was inversely associated with all-cause, CVD and other-cause mortality.

The independent and joint associations of cardiorespiratory fitness and adiposity with cardiometabolic risk factors and metabolic syndrome in United States college students

Objective To examine the association of CRF and adiposity with cardiometabolic risk factors and metabolic syndrome among emerging adults. Participants: 5681 (60.1% Men; 21 ± 1years) college students from a large university located in the northeast of the United States. Methods: Participants completed an objective health assessment that involved the assessment cardiometabolic risk factors, CRF, and adiposity. Data of 5681 students’ (60.1% Men; 21 ± 1years) who had CRF, adiposity, all risk factors necessary to determine metabolic syndrome evaluated were analyzed using logistic regression analyses. Results: Poor CRF and elevated adiposity were associated with cardiometabolic risk factors and metabolic syndrome regardless of sex, with the association between adiposity and risk factors found to be stronger compared to CRF. Conclusions: Targeted and tailored screening and interventions are urgently needed to reduce adiposity and increase CRF to avoid serious short and long-term negative health outcomes in this population.

Associations of cardiorespiratory fitness and moderate-to-vigorous physical activity with latent cognitive abilities in older adults

It has been demonstrated that physical activity has a small but positive effect on cognition in old age, which suggests that it may be possible to alter the trajectory of age-related cognitive decline. However, our understanding of which aspects of physical activity that are important for modifying cognition remains incomplete. Adopting an exploratory approach in a sample of 115 healthy older adults (65–75 years), the present cross-sectional study used structural equation modelling to investigate the dissociable associations of physical activity (moderate-to-vigorous activity, derived from 7-day accelerometry) and cardiorespiratory fitness (VO2 max, derived from maximal treadmill ergometer test) with multiple latent cognitive abilities (working memory, episodic memory, spatial and verbal reasoning). The results showed a significant positive association between fitness and working memory, when physical activity was statistically controlled for, and a positive association of similar point magnitude between physical activity and episodic memory, when fitness was statistically controlled for, although the latter association did not reach statistical significance. The results add to the foundation for a more careful investigation of the dissociable associations of moderate-to-vigorous physical activity and fitness with cognition in old age, and encourages future research to test the hypothesis that cardiorespiratory fitness benefits working memory via general cerebrovascular effects on grey matter volume, whilst moderate-to-vigorous physical activity benefits episodic memory via effects on neuroplastic processes.

Association of cardiorespiratory fitness with the risk factors of cardiovascular disease: Evaluation using the Japan step test from the National Institute of Occupational Safety and Health.

ObjectiveCardiorespiratory fitness (CRF) is an important factor for evaluating cardiovascular disease (CVD) risk. We recently developed a novel method (National Institute of Occupational Safety and Health, Japan step test [JST]) for evaluating CRF in workers; its criterion validity has been investigated. However, its association with health risk must be confirmed before its application in the workplace. Therefore, we aimed to determine the association of JST‐evaluated CRF with the prevalence of CVD risk among Japanese workers.MethodsFor CRF evaluation, working adults completed the JST, which comprised a 3‐minute stepping exercise and a 2‐minute recovery period. Data on CVD risk factors and clinical history were collected through medical certification within 1 year from the date of the JST measurements. Participants were divided into three groups for multiple logistic regression analyses based on the JST values (low, moderate, and high). Odds ratios (ORs) for the prevalence of CVD risk were calculated.ResultsWe recruited 885 working adults (46.4% women). The prevalence of CVD risk in the total population was 18.6%. When compared to the reference group (low CRF), the ORs for CVD risk prevalence after adjustments for lifestyle factors (smoking status, alcohol consumption status, and exercise habits) were 0.42 (95% confidence interval [CI], 0.28–0.63) and 0.29 (95% CI, 0.18–0.45) for the moderate and high groups, respectively.ConclusionAn inverse association was noted between the JST‐evaluated CRF and CVD risk prevalence. JST may be helpful for identifying workers at risk for CVD development.

Abstract 11866: Cardiorespiratory Fitness and Mortality in Older Adults Age 60 to 90 Years

Introduction: With an aging population and advances in technology and surgical interventions, physicians are sometimes faced with difficult treatment decisions for older patients. Invasive treatment options may not be beneficial in older adults with limited survival. Chronological age alone does not fully reflect a patient’s prognosis and should not be the only factor used to guide treatment decisions. In this study, we assessed the association of cardiorespiratory fitness with all-cause mortality among adults age 60 to 90 years. Methods: This retrospective cohort study included patients age 60-90 years who underwent symptom-limited exercise treadmill testing at an integrated health system from 2011 to 2019. Patients were categorized into three age groups: 60-70 years, 70-80 years, and 80-90 years. Cardiovascular fitness was categorized into low fitness (&lt;5 METs), moderate fitness (5-10 METs), and high fitness (&gt;10 METs). Median follow-up was 3.5 years. Hazard ratios (HR) associated with exercise capacity were calculated using multivariable Cox regression models. Results: The study cohort included 40520 patients: 27021 (66.7%) age 60-70 years, 11638 (27.6%) age 70-80 years, and 1861 (4.6%) age 80-90 years. After treadmill testing, 3494 (8.6%) were categorized as low fitness, 21863 (54.0%) as moderate fitness, and 15163 (37.4%) as high fitness. Older age, female sex and presence of cardiovascular risk factors including hypertension, diabetes, and chronic kidney disease were associated with having low fitness. Low fitness and higher chronological age were independently associated with lower survival. Using the age 60-70 years group with high fitness as reference, the age 80-90 group with high fitness had better survival than their younger counterparts with low fitness (age 80-90 high fitness: HR 2.9, 95% CI 1.2-7.2; age 60-70 low fitness HR 4.3, 95% CI 3.1-5.9; age 70-80 low fitness HR 6.8, 95% CI 5.2-8.9). Conclusions: High cardiorespiratory fitness is a strong predictor of survival. When assessing a patient’s prognosis for long-term survival, chronological age alone should not be the only factor considered. Evaluation of cardiorespiratory fitness using treadmill testing may be useful for tailoring prognostic information.

The association of cardiorespiratory fitness and the risk of hypertension: a systematic review and dose-response meta-analysis.

Established evidence has indicated a negative correlation between cardiorespiratory fitness (CRF) and hypertension risk. In this study, we performed a meta-analysis to investigate the categorical and dose-response relationship between CRF and hypertension risk and the effects of CRF changes on hypertension risk reduction. The PubMed, Web of Science, and Embase databases were searched for relevant studies. The summarized relative risk (RR) and 95% confidence interval (95% CI) were estimated using the DerSimonian and Laird random effect model, and the dose-response relationship between CRF and hypertension risk was characterized using generalized least-squares regression and restricted cubic splines. Nine cohorts describing 110,638 incident hypertension events among 1,618,067 participants were included in this study. Compared with the lowest category of CRF, the RR of hypertension was 0.63 (95% CI: 0.56-0.70) for the highest CRF category and 0.85 (95% CI: 0.80-0.91) for the moderate category of CRF. For a 1-metabolic equivalent increment in CRF, the pooled RR of hypertension was 0.92 (95% CI: 0.90-0.94) in the total population. The RR of hypertension was 0.71 (95% CI: 0.64-0.79) for participants with CRF increased compared with those whose CRF was decreased over time. In conclusion, our meta-analysis supports the widely held notion of a negative dose-dependent relationship between CRF and hypertension risk.

Association of Cardiorespiratory Fitness with Achievement Motivation in Physical Education in Adolescents.

Cardiorespiratory fitness is an important health marker in adolescents. Thus, examining the relation between cardiorespiratory fitness and motivation should be important to increase health-related behaviors. This study aimed to describe adolescents’ cardiorespiratory fitness and motivation by gender and to analyze the association between two cardiorespiratory fitness tests (original and with music) and motivation. A total of 341 adolescents (14.2 ± 1.5 years, 52.2% girls) participated in this study. Cardiorespiratory fitness was assessed using the 20 m shuttle run and its adaptation with music. Motivation was assessed though the “Achievement Motivation towards Physical Education” questionnaire. Boys presented with higher cardiorespiratory fitness and motivation (all, p < 0.05). Yet, when classifying fit and unfit groups, a higher percentage of girls were considered fit compared to boys (85.8% vs. 74.5%). A higher level of cardiorespiratory fitness (stages) and VO2max were associated with a higher level of motivation (self-perceived competence and compared competence) and lower anxiety (all p < 0.05). These associations with motivation were stronger when the music was present in the test. In this sense, including music in activities focused on cardiorespiratory fitness could increase the cardiorespiratory fitness performance and motivation, especially in girls. It should be important to increase adolescents’ cardiorespiratory fitness levels in order to increase motivation in physical education lessons and to include more motivational activities in order to achieve higher performance.

Associations of cardiorespiratory fitness and obesity parameters with blood pressure: fitness and fatness in youth Latin-American ethnic minority

ABSTRACT Background: In spite of wide international evidence about cardiorespiratory fitness (CRF) and adiposity in association with cardiovascular disease, there is poor evidence about this relationship in schoolchildren of ethnic minorities. Aim: To examine the relationship between CRF and body composition on blood pressure (BP) in a sample of ethnic minority schoolchildren from three Latin-American countries. Material and methods: A descriptive cross sectional study of total n = 3866, mean age 12.5 (2.7) y [girls n = 1997, mean age 12.8 (2.8) y; boys n = 1869, mean age 12.2 (2.7) y] schoolchildren from three Latin-American countries (Colombia, Brazil, Chile). Main outcomes were CRF, body mass index (BMI), waist circumference, body fat percentage (%BF), and BP (systolic SB, diastolic BP, and mean arterial pressure (MAP). Results: In both sex, and after adjusting for covariates (age and ethnicity group), negative CRF by O2peak levels were associated with a higher body fatness parameters (BMI, WC, WHtR and %BF p<0.001), and blood pressure measures (systolic BP, diastolic BP, and MAP; p<0.001). A lower CRF (by O2peak) was associated with a higher BP in girls (systolic SB −0.15; −5.10 (0.30), diastolic BP −0.14; −4.43 (0.23), and MAP −0.15; −4.93 (0.26) at p<0.001), and boys (systolic SB −0.02; −0.85 (0.32), DB −0.07; −2.23 (0.23), and MAP−0.06; −1.89 (0.25 at p<0.001). There was a significant association between a ‘high-CRF + low-%BF’ with a lower systolic SB diff = − 9.6 [0.7], diastolic BP diff= − 11.0 [0.6]; and MAP level diff = − 10.6 [0.6] all p<0.001). There was a significant association between a ‘high-CRF + low-BMI’ with a lower systolic diff = − 10.3 [1.1], diastolic diff = − 11.2 [1.1], and MAP diff = − 10.9 [1.0] all p<0.001. Conclusion: A lower CRF is associated with a higher body fatness parameters, and higher BP levels in Latin-American ethnic schoolchildren. Abbreviators: %BF: Percentage of Body fat; BIA: Bioelectric impedance analysis; BMI: Body mass index; BP: Blood pressure; CRF: Cardiorespiratory fitness; CVD: Cardiovascular disease; LDL-cholesterol: SD: Standard deviation; WC: Waist circumference; WHtR: Waist-height to ratio; O2max: Maximal oxygen consumption; O2peak: Peak of oxygen consumption

Physical fitness and white matter microstructure in children with overweight or obesity: the ActiveBrains project

Recent studies investigated the association of cardiorespiratory fitness with white matter microstructure in children, yet little work has explored to what extent other components of physical fitness (i.e., muscular or motor fitness) are associated with white matter microstructure. Indeed, this association has not been previously explored in children with overweight/obesity who present a different white matter development. Therefore, we aimed to examine associations between physical fitness components and white matter microstructure in children with overweight/obesity. In total, 104 (10.04 ± 1.15 years old; 43 girls) children were included in this cross-sectional study. Physical fitness was assessed using the ALPHA-fitness test battery. Fractional anisotropy (FA) and mean diffusivity were derived from diffusion tensor imaging (DTI). No association was found between physical fitness and global DTI metrics (all P > 0.082). Within individual tracts, all associations became non-significant when analyses were adjusted for multiple comparisons. Using the voxel-wise approach, we identified a small cluster in the left lateral frontal lobe where children with greater upper-body muscular fitness showed higher FA (PFWE-corrected = 0.042). Although our results cannot conclude physical fitness is related to white matter microstructure in children with overweight/obesity; those findings indicate that the association of muscular fitness with white matter microstructure might be more focal on frontal areas of the brain, as opposed to global differences.

Cardiorespiratory fitness and survival following cancer diagnosis.

Data on the association of cardiorespiratory fitness with survival of cancer patients are limited. This study aimed to evaluate the association between midlife cardiorespiratory fitness and survival after a subsequent cancer diagnosis. We evaluated 19,134 asymptomatic self-referred adults who were screened in preventive healthcare settings. All subjects were free of cardiovascular disease and cancer at baseline and completed a maximal exercise stress test. Fitness was categorised into age-specific and sex-specific quintiles according to the treadmill time and dichotomised to low (quintiles 1-2) and high fitness groups. The mean age was 50 ± 8 years and 72% were men. During a median follow-up of 13 years (interquartile range 7-16) 517 (3%) died. Overall, 1455 (7.6%) subjects developed cancer with a median time to cancer diagnosis of 6.4 years (interquartile range 3-10). Death from the time of cancer diagnosis was significantly lower among the high fitness group (Plog rank = 0.03). Time-dependent analysis showed that subjects who developed cancer during follow-up were more likely to die (P < 0.001). The association of cancer with survival was fitness dependent such that in the lower fitness group cancer was associated with a higher risk of death, whereas among the high fitness group the risk of death was lower (hazard ratio 20 vs. 15; Pfor interaction = 0.047). The effect modification persisted after applying a 4-year blanking period between fitness assessment and cancer diagnosis (Pfor interaction = 0.003). Higher midlife cardiorespiratory fitness is associated with better survival among cancer patients. Our findings support fitness assessment in preventive healthcare settings.

Association of Cardiorespiratory Fitness and Hemodynamic Responses to Submaximal Exercise Testing With the Incidence of Chronic Kidney Disease: The Framingham Heart Study

ObjectiveTo relate cardiorespiratory fitness (CRF) and hemodynamic responses to exercise to the incidence of chronic kidney disease (CKD). MethodsWe evaluated 2715 Framingham Offspring Study participants followed up (mean, 24.8 years) after their second examination (1979-1983) until the end of their ninth examination (2011-2014). Participants (mean age, 43 years; 1397 women [51.5%]) without prevalent CKD or cardiovascular disease at baseline were included. We examined the associations of CRF and hemodynamic response to exercise with incident CKD using multivariable Cox proportional hazards regression with discrete intervals. ResultsCompared with low CRF (first tertile), participants with moderate (second tertile) or high (third tertile) CRF had a lower risk of CKD (hazard ratios [95% CIs]: 0.74 [0.61-0.91] and 0.73 [0.59-0.91], respectively). Participants with chronotropic incompetence (hazard ratio, 1.38 [95% CI, 1.06 to 1.79]), higher exercise systolic blood pressure (hazard ratio per SD, 1.20 [95% CI, 1.07 to 1.34]), and impaired heart rate recovery (hazard ratio, 1.51 [95% CI, 1.08 to 2.10]) had a higher risk of CKD compared with those with chronotropic competence, lower exercise systolic blood pressure, and normal heart rate recovery, respectively. These associations remained robust when the exercise variables were mutually adjusted for. The third tertile of a standardized exercise test score comprising the statistically significant variables was associated with a higher risk of CKD compared with the first tertile (hazard ratio, 1.85; 95% CI, 1.45 to 2.36). ConclusionHigher CRF and favorable hemodynamic responses to submaximal exercise in young adulthood may be markers of lower risk of CKD in later life.

Association of cardiorespiratory fitness, physical activity level, and sedentary behavior with overweight in adolescents

Abstract Physical activity and sedentary behavior promote opposite effects on overweight and obesity, in adolescents; however little is known of their combined impact on these outcomes. We aimed to investigate if there were any associations between overweight, and physical activity level, cardiorespiratory fitness, and sedentary behavior, both as isolated variables and in combination. Data of 1,015students from two public and four private schools from the metropolitan area of Rio de Janeiro, Brazil were analyzed. Overweight was classified according to body mass index, whereas physical activity level was assessed by the International Physical Activity Questionnaire (IPAQ), cardiorespiratory fitness by a 9-minute test (T9), and sedentary behavior by a self-completed questionnaire, considering the time spent watching television as the main indicator. Associations were examined by binary logistic regression analysis. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were used to measure the magnitude of the associations. IBM SPSS Statistics version 20 was used for all statistical analyses. Adolescents with poor cardiorespiratory fitness (OR=3.71; 95%CI=1.30-10.6) and a high degree of sedentary behavior (OR=1.73; 95%CI=1.24-2.42) had a bigger chance of being overweight. However the combination of these two categories in the same individual was not statistically associated with overweight. The study indicates that both sedentary behavior and poor performance on cardiorespiratory fitness test are significantly independent associated with overweight in adolescents.

Re: The Association of Cardiorespiratory Fitness, Body Mass Index, and Age with Testosterone Levels at Screening of Healthy Men Undergoing Preventive Medical Examinations: The Cooper Center Longitudinal Study.

Re: The Association of Cardiorespiratory Fitness, Body Mass Index, and Age with Testosterone Levels at Screening of Healthy Men Undergoing Preventive Medical Examinations: The Cooper Center Longitudinal Study.