Cardiorespiratory Fitness Levels Research Articles

The mediation role of physical fitness in association between muscle-strengthening physical activities and its component with blood pressure among young adults: considering gender and abnormal blood pressure as moderators, moderate-vigorous physical activity, sleep behavior, sedentary behavior, mental wellbeing and BMI as covariates.

Global burden of hypertension among young people continues to increase. There have been many studies examining the effect of aerobic and muscle-strengthening physical activity on blood pressure, many of them didn't consider interdependence between them. Conflicting results of health-related fitness, particularly handgrip strength, as intermediate outcomes of muscle-strengthening physical activity on blood pressure also emerged. This research will carry out a mediation-moderation analysis to find out the relationship between muscle strengthening physical activity and blood pressure among young adults by considering health-related fitness and 24-hour movement behavior. A cross-sectional study among 221 Indonesian young adults attending a physical activity intervention collected participant's muscle-strengthening physical activity, and 24 h movement behavior, including aerobic physical activity, sedentary and sleep behavior, and mental well-being using validated questionnaires. Mediation and moderation analyses were conducted using Process Macro model 10 on SPSS 25 to investigate the association of muscle-strengthening physical activity on blood pressure, with gender and blood pressure as moderator, mediators consist of handgrip strength, muscle mass percentage and cardiorespiratory fitness. A subgroup analysis was conducted based on participant's cardiorespiratory fitness level. Volume of muscle-strengthening physical activities in a week have a direct association with systolic blood pressure among prehypertensive male with an effect of 0,00989359 (95% CI 0,0046488 to 0,00336478). Considering its volume as mediator, the frequency of muscle-strengthening physical activity contributed to a significant direct effect on diastolic blood pressure in both genders, but the duration of MSPA has a significant direct effect on systolic blood pressure in male subjects. There is no component of physical fitness that provides a significant mediating effect. After a subgroup analysis, the relationship between MSPA Volume and blood pressure is not significant for individuals with a high level of cardiorespiratory fitness. This study shows that increased participation in muscle strengthening physical activity, especially in subject with low cardiorespiratory fitness, could increase blood pressure in prehypertensive young adult male population without mediation by physical fitness. Further research is needed to investigate other mechanisms that influence this relationship.

RELATIONSHIP BETWEEN ANTHROPOMETRY AND CARDIORESPIRATORY FITNESS AMONG UiTM FOOTBALL PLAYERS

Cardiorespiratory fitness (CRF) is one of the important components among football players. Physiological characteristics of individuals such as anthropometry may influence the level of CRF. Therefore, this study aims to determine the relationship between anthropometry and CRF among UiTM Football Players. A causal- comparative research design, consisting of 24 male participants representing Universiti Teknologi MARA Football Club (UiTM FC) were recruited. Anthropometry was measured via body weight and body height and CRF was measured using a bleep test and the result of the test was calculated to estimate maximum volume of oxygen (VO2 max). Pearson correlation was used to determine the relationship between anthropometry and CRF. Mean score for anthropometry was 65.17 ± 5.90 for body weight (kg) and 171.18 ± 4.66 for body height (cm). Mean score for CRF was 47.20 ± 4.34 (ml/kg/min). Results show a very weak relationship between body weight and CRF (r = 0.027). Meanwhile, there was a positive and weak relationship between body height and CRF (r = 0.265). In conclusion, evidence from this study showed no association between anthropometry and cardiorespiratory fitness. However, possibly a good anthropometry characteristic possibly gives the advantage of having good cardiorespiratory fitness. Ideal body weight and height is a potential physiological characteristic in determinants of cardiorespiratory fitness. Anthropometric does have a role as part of holistic monitoring of talented players in future development. Viewing the limitations of this study, further studies involving larger sample size are needed to find actual association with this hypothesis.

O.4.2-4 The influence of organized sport participation on health-related fitness development during adolescence

Abstract Purpose Organized sport participation plays particularly big role in promoting adolescents’ physical activity and health-related fitness. However, it remains to be understood how current, past, or complete non-participation in organized sports affect adolescents’ individual trajectories of cardiorespiratory and muscular fitness and whether adolescents benefit from their past participation in organized sports in terms of fitness. Thus, the aim of this research was to study the development of cardiorespiratory and muscular fitness during adolescence in those 1) who continued or started organized sport participation, 2) who dropped out, and 3) who never participated or dropped out before adolescence. Methods In this five-year longitudinal study, which was carried out between 2017-2021, self-reported sport participation data were collected annually, and cardiorespiratory and muscular fitness measurements were collected every other year from 963 participants (Mage = 11.25 ± 0.31). Multi-group parallel latent growth curve model was used to examine initial levels and slopes (rate of change) of cardiorespiratory and muscular fitness simultaneously in each of three sport participation group: 1) continuous, 2) dropout, and 3) non-part. Results Continuous group had significantly higher initial levels of cardiorespiratory and muscular fitness compared to other two groups. Moreover, both continuous and non-part groups had positive slopes of cardiorespiratory and muscular fitness. Although dropout group had significantly higher initial levels of cardiorespiratory and muscular fitness compared to non-part group, the slopes were smaller or not significant. Thus, at the last time point, there were no longer significant differences between these two groups in levels of cardiorespiratory and muscular fitness. Conclusions Continued participation in organized sports promotes adolescents’ health-related fitness. However, as adolescents dropout these health-related fitness improvements seem to be lost. Therefore, it is necessary to consider what could be done so that adolescents who dropout or never participated in organized sports would have equal opportunities to promote their health-related fitness. One reason for dropout is that organized sports tend to get more competitive, time-consuming, and expensive in adolescence. Thus, solution could be low-cost and low-threshold recreational or school-related physical activities that could improve or maintain health-related fitness during adolescence. Funding Source Finnish Ministry of Education and Culture

Effects of cardiorespiratory fitness and body mass index on cardiometabolic risk factors in schoolchildren

IntroductionHigh levels of physical fitness established during childhood and adolescence have been associated with positive effects on cardiometabolic risk factors (CMRF), which persist into adulthood. Conversely, a sedentary lifestyle, overweight, and obesity during this period are considered public health problems. These conditions tend to worsen in adulthood, increasing the incidence of chronic diseases, deteriorating CMRF, and consequently leading to higher comorbidity and mortality rates.ObjectiveTo investigate the effect of cardiorespiratory fitness (CRF) and body mass index (BMI) on CMRF in children and adolescents.MethodsThe sample consisted of 49 schoolchildren of both sexes aged 10–17 years. Anthropometric assessments, CRF test, muscle strength test, and blood pressure (BP) measurement were conducted. Participants were allocated into groups based on BMI (eutrophic, overweight, obese), and CRF levels (low-fit, normal-fit, and high-fit).ResultsObese individuals had lower CRF values compared to the eutrophic and overweight groups. The cardiometabolic risk profile (CMRP) was significantly higher in the obese group compared to the eutrophic group but showed no significant difference compared to the overweight group. The hight-fit group had lower CMRP values compared to the low-fit group.ConclusionsHigher BMI and CRF values had negative and positive effects on CMRF and CMRP in schoolchildren, respectively. Overweight or obese schoolchildren with low levels of CRF constitute an unfavourable cardiometabolic risk profile.

Cardiorespiratory fitness in Chilean cancer patients: A comparative Analysis

Physical activity and cardiorespiratory fitness (CRF) are protective factors in cancer development. However, the CRF in the Chilean population diagnosed with cancer is unknown. This study aimed to evaluate the association that the CRF had between people with and without a cancer diagnosis and, secondarily, to compare the trend of the CRF according to years of cancer diagnosis in the Chilean population. Data from 5,483 people from the 2016-2017 National Health Survey between 15 and 98 years old were analyzed. Cancer diagnosis (all available) was determined with standardized questions, and CRF was calculated with an abbreviated method (demographics, anthropometry, lifestyles). Linear regression analysis adjusted for confounding variables was performed with the complex sample analysis module of the STATA v.16 program (95% CI, p < 0.05). People with some cancer diagnosis versus those without cancer had a lower FCR level (ft: -1.23 [95% CI: -1.52; -0.94]). When comparing CRF levels according to cancer type, similar results were observed for colorectal, breast, and uterine cancer (p < 0.001) but not for thyroid cancer (p = 0.253). There was lower CRF from the first year of diagnosis of all types of cancer to over ten years, although not significant (p = 0.109). Those diagnosed with cancer presented lower CRF compared to those not diagnosed. In addition, in people with cancer, the CRF decreased with increasing years since the first diagnosis. It would be essential to evaluate and increase CRF in cancer patients.

336 Cardiopulmonary Fitness and CR-POSSUM in One-Year Outcomes of Colorectal Patients

Abstract Aim Colorectal surgery can be a high-risk surgery. Risk stratification takes the form of calculation tools, like ColoRectal Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (CR-POSSUM), and measurement of cardiopulmonary fitness using exercise test(CPET). Literature search on Pubmed and Science Direct did not show any studies have reviewed correlation between both tests and postoperative outcomes of patients undergoing colorectal surgery. Hence, we aim to assess correlation of CR-POSSUM and CPET using postoperative morbidity as primary outcome. Method All patients with stage I-IV CRC who underwent CPET testing between January 2013-June 2021 were collected and followed-up for 30days. Major postoperative complications were classified using Clavien-Dindo Classification≥Grade 3. Anaerobic threshold (AT) and VO2Max were used as markers of cardiopulmonary fitness on CPET. Results In total, 160 individuals with both CR-POSSUM and CPET were included,64% were male,115 underwent surgery. Median age was 77.2(±8.0). Mean CR-POSSUM operative severity, physiology score and predicted mortality were 7.5(7-9), 11.7(6-18) and 7.0(0.7-28.4) respectively. Mean AT was 9.9(±2.27) kg/ml/min and VO2Max was 74.4(±15.2)%. These variables did not show normal distribution(p-&amp;lt;0.05). AT was correlated with VO2Max(p = 0.03), but not CR-POSSUM. VO2Max was correlated with CR-POSSUM physiology score(p = 0.002) and CR-POSSUM predicted mortality(p = 0.003). Fifteen (13%) patients experienced major post-operative complications. There was no correlation between presence of severe complications and AT, VO2Max or CR-POSSUM(p&amp;gt;0.05). Conclusions Some CPET variables correlates with CR-POSSUM physiology score and predicted mortality. Low level of cardiorespiratory fitness did not predict major postoperative complication.

326 Cardiopulmonary Exercise Test as Predictor of Postoperative Ileus in Elective Colorectal Surgery – a Prospective Cohort Study

Abstract Aim Postoperative ileus (POI) is a complication where there is abnormal pattern of slow or absent gastrointestinal motility after surgery. Elderly, frail, and comorbid patients often undergo cardiopulmonary exercise test (CPET) to determine their risks and suitability for major surgery. A literature review on Pubmed and Web of Science reveal no studies have been published on whether CPET variables can act as a predictor of POI. Hence, we aim to investigate whether there is a correlation between CPEX and post-operative ileus or major complications after colorectal surgery. Method All patients with stage I-IV Colorectal cancer who underwent CPET test between January 2013-June 2021 before elective major colorectal surgery were enrolled. Anaerobic threshold (AT) was used as a marker of cardiopulmonary fitness on CPET. POI was defined in any patient with NGT inserted postoperatively. Major complications were classified using Clavien-Dindo Classification≥Grade 3. Fisher’s exact test was used for categorical variables and independent sample t-test for continuous variables. Results In total, 115 patients were included - 64% were males and median age was 78(51-95) years old. Mean Anaerobic threshold was 10.4(6.4-15.6) mg/kg/min. Thirty-three(29%) and fifteen(13%) patients experienced POI and major complications respectively. There were no significant differences in mean AT for those who had POI versus without (10.9 vs 10.2, p = 0.13) and those with major complications versus without (10.7 vs 10.4, p = 0.62). Conclusions The overall incidence of POI was relatively high. Our study did not confirm level of cardiorespiratory fitness as a predictor of postoperative ileus or major complications.

CORRELATION BETWEEN THE CARDIORESPIRATORY FITNESS LEVEL AND HABITUAL PHYSICAL ACTIVITY IN BRAZILIAN AIR FORCE RECRUITS

Cardiorespiratory fitness is the ability to maintain moderate or high-intensity efforts for long periods of time and is highly related to physical activity habits and fitness levels. Analyzing habitual physical activity in military personnel and its relationship with cardiorespiratory fitness is consequently fundamental. Thus, the objective of this study was to verify the correlation between the cardiorespiratory fitness level and habitual physical activity in Brazilian Air Force recruits. The sample consisted of 86 recruits in the final phase of the soldier training course. Data was collected using the 12-minute cardiorespiratory fitness test and the Baecke questionnaire validated for the Portuguese language to assess the practice of habitual physical activity. Descriptive statistics were used for sample characterization and exploratory analysis. The distribution of data normality was analyzed using the Shapiro-Wilk test, followed by Pearson’s correlation test and the Mann-Whitney U test to compare the groups with lower and higher cardiorespiratory fitness. The significance level of p ≤ 0.05 was adopted. According to the results, 63.9% of the sample had satisfactory cardiorespiratory fitness levels (good and excellent). No significant correlations were observed between cardiorespiratory fitness and habitual physical activity indices, except for the physical exercise/sports index (p= 0.05). It was found that only the Body Mass Index showed a difference (p= 0.017, Effect Size= 0.637) between the cardiorespiratory fitness groups. It is concluded that most military recruits have adequate cardiorespiratory fitness levels, but these are not influenced by the habitual practice of physical activity.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0036/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

As we were and as we Should Be, Combined Exercise Training in Adults with Schizophrenia: CORTEX-SP Study Part I.

Given the health benefits and the role of exercise as an anti-inflammatory adjuvant program, this study aimed to determine the effectiveness of a combined exercise program on cardiorespiratory fitness (CRF), body composition, and biochemical levels in adults with schizophrenia (SZ) characterized at baseline as metabolically unhealthy overweight with low CRF. Participants diagnosed with SZ (n = 112, 41.3 ± 10.4 yr, 28.7% women) were randomly assigned into a Treatment-As-Usual (TAU) control group (n = 53) or a supervised exercise group (n = 59, 3 days/week). Each combined exercise session consisted of both a low-volume high-intensity interval training (less than 10 min of high-intensity time per session) and a resistance circuit-training program. All variables were assessed pre-and post-intervention (20 weeks). For the assessment of CRF, a peak cardiopulmonary exercise test on a cycle ergometer was used. Following the intervention, participants from the exercise group (n = 51) showed increases in CRF (P < 0.001) through peak oxygen uptake (L·min-1; Δ = 17.6%; mL·kg.1·min-1, Δ = 19.6%) and the metabolic equivalent of task (Δ = 19%), with no significant changes (P > 0.05) in body composition and biochemical variables. However, the TAU group (n = 38) did not show any significant change in the study variables (P > 0.05). Between-group significant differences (P ≤ 0.05) were observed in CRF, first ventilatory threshold, and heart rate peak after the intervention period favoring the exercise group. This study demonstrated that a supervised combined exercise program in people with SZ helps to maintain body composition values and improve CRF levels. This could lead to an important clinical change in the characterization from metabolically unhealthy overweight to a metabolically healthy overweight population. Hence, exercise should be considered a co-adjuvant program in the treatment of the SZ population.

Association of physical activity and fitness with executive function among preschoolers

It is well-documented in the literature that high levels of regular physical activity (PA), low levels of sedentary behavior (SB), and high levels of cardiorespiratory fitness (CRF) are associated with superior cognitive functioning, especially with regard to older populations. However, concerning other age groups (e.g., preschoolers) the available evidence documenting such a positive relationship is relatively scarce. Thus, this study aimed to investigate the association of time spent in different PA intensity zones and CRF with executive functions (EFs) in preschool-age children. To this end, preschoolers (n = 127) aged 3 to 6 years were recruited from 9 kindergarten classes in 2 districts of Shenzhen, China. The amount and the intensity of PA were assessed via accelerometry, and the CRF level was quantified by the 20-meter shuttle run test. EFs including inhibitory control and working memory were assessed using the one-on-one iPad-based Early Year Toolbox. Results suggested that children who had a higher CRF level (“impulse control” scores: β = 0.34, p < .001; “Go” accuracy: β = 0.31, p < .001; “No-Go” accuracy: β =0.28, < .001) and spentmore time in moderate-to-vigorous physical activity (MVPA) (“impulse control” scores: β = 0.50, p < .001; No-Go” accuracy: β = 0.52, p < .001) had higher scores on inhibitory control tasks, and those who had a higher CRF level had higher scores on a working memory task (β = 0.24, p < .05). The findings are discussed in light of the positive roles of MVPA and CRF for promoting EFs, but also consider the disproportionate association of PA and CRF with working memory relative to inhibition.

Cardiorespiratory fitness and development of childhood cardiovascular risk: The EXAMIN YOUTH follow-up study.

Background: Obesity- and hypertension-related cardiovascular (CV) risk has been shown to originate in childhood. Higher body mass index (BMI) and blood pressure (BP) have been associated with increased large artery stiffness and a lower microvascular arteriolar-to-venular diameter ratio (AVR) in children. This study aimed to investigate the association of cardiorespiratory fitness (CRF) with development of BMI, BP and vascular health during childhood. Methods: In our prospective cohort study, 1,171 children aged 6-8years were screened for CRF, BMI, BP, retinal vessel diameters and pulse wave velocity using standardized protocols. Endurance capacity was assessed by 20m shuttle run test. After 4years, all parameters were assessed in 664 children using the same protocols. Results: Children with a higher CRF at baseline developed a significantly lower BMI (β [95% CI] -0.09 [-0.11 to -0.06] kg/m2, p < 0.001), a lower systolic BP (β [95% CI] -0.09 [-0.15 to -0.03]mmHg, p = 0.004) and a higher AVR (β [95% CI] 0.0004 [0.00004 to 0.0007] units, p = 0.027) after 4years. The indirect association of CRF with development of retinal arteriolar diameters was mediated by changes in BMI. Conclusion: Our results identify CRF as a key modulator for the risk trajectories of BMI, BP and microvascular health in children. Obesity-related CV risk has been shown to track into adulthood, and achieving higher CRF levels in children may help counteract the development of CV risk and disease not only in pediatric populations, but may also help reduce the burden of CVD in adulthood. Registration: http://www.clinicaltrials.gov/ (NCT02853747).

Time course efficiency of MICE and HIIE on inhibitory control and HRV in adolescents with obesity and different cardiorespiratory fitness.

Adolescent obesity is associated with impaired inhibitory control. Acute exercise can improve executive function. However, due to the influence of exercise intensity, cognitive test timing, and cardiorespiratory fitness (CF) level, the most effective exercise program remains controversial. The current study investigated the time-course effects of moderate-intensity continuous exercise (MICE) and high-intensity interval exercise (HIIE) on inhibitory control (Stroop) and task-related heart rate variability (HRV) in adolescents with different CF. A mixed experimental design of 2 CF levels (high CF, HCF; low CF, LCF) × 3 exercise methods (MICE, HIIE, CON) × 3 test timing (pre, post-0, post-20) was adopted. Heart rate variability (HRV) and Stroop task tests were conducted before exercise (pre), immediately after exercise (post-0), and 20 min after exercise (post-20). Individuals with HCF exhibited a positive decrease in Stroop response time immediately and 20 min after MICE and HIIE, compared to pretest response times (RT). Conversely, individuals with LCF showed a slight increase in Stroop task (RT) only immediately after HIIE. All individuals had a slight increase in ACC after MICE and HIIE compared to before exercise. In addition, compared with the control group, the time-domain index (the square root of the mean squared differences of successive NN intervals, RMSSD) of HRV was significantly decreased, the frequency-domain index (the absolute power of the Low-Frequency band/the absolute power of the High-Frequency band ratio, LF/HF) was significantly increased after MICE and HIIE, and the effect of HIIE on RMSSD and LF/HF was significantly greater than that of MICE. The current study found that the acute effects of MICE and HIIE on inhibitory control in obese adolescents were influenced by the interaction of cognitive test timing and cardiorespiratory fitness. Individuals with high cardiorespiratory fitness performed better on the Stroop task than individuals with low cardiorespiratory fitness. The inhibitory control of HIIE in high-cardiorespiratory obese adolescents produced positive effects similar to those in MICE but more lasting, suggesting that HIIE is more beneficial for high-cardiorespiratory obese adolescents. MICE promoted inhibitory control in obese adolescents with low cardiorespiratory fitness, but HIIE impaired inhibitory control in obese adolescents with low cardiorespiratory fitness immediately after exercise, suggesting that low cardiopulmonary fitness obese adolescents may be suitable for MICE rather than HIIE exercise intervention. The shift from balanced HRV to sympathetic dominance after acute exercise reflects increased arousal levels and may be one of the underlying mechanisms by which acute exercise brings benefits to executive function.

Runners with better cardiorespiratory fitness had higher prefrontal cortex activity during both single and exercise-executive function dual tasks: an fNIRS study.

Objective: This study investigated the relationship between executive function and prefrontal cortex oxygenation during exercise in young adults with different Cardiorespiratory fitness (CRF) levels. Methods: A total of 28 amateur runners (n = 14) and sedentary college students (n = 14) were recruited. The maximum oxygen uptake estimated for the sub-maximal intensity run (4.97 miles/h) was used to indicate the different CRF levels. After 1week, participants must complete the Stroop and 2-Back tasks in silence while performing moderate-intensity exercise. Using 19-channel functional near-infrared spectroscopic (fNIRS) to examine changes in prefrontal cortex oxyhemoglobin. Results: There was no significant difference in the correctness of the Stroop and 2-Back tasks between the two groups during exercise, but the amateur runner group showed an acceleration in reaction time. fNIRS results showed that during the exercise 2-Back task, the left dorsolateral prefrontal cortex oxyhemoglobin was higher in the amateur runner group than in the sedentary group. Conclusion: Executive function during exercise was similarly improved in participants with better fitness, suggesting that CRF provides an excellent metabolic reserve and directed allocation for cognitive tasks during exercise.

Cardiorespiratory fitness in women after severe pre-eclampsia

ABSTRACT Aims To objectively study cardiorespiratory fitness (CRF) and physical activity (PA) and to evaluate limiting factors of exercise intolerance associated with poor CRF after severe pre-eclampsia. Methods In this single-centre, cross-sectional study, CRF was measured as peak oxygen uptake (VO2peak) during a cardiopulmonary exercise test (CPET) on a treadmill in women 7 years after severe pre-eclampsia. Ninety-six patients and 65 controls were eligible to participate. Cardiac output (CO) was measured by impedance cardiography. PA was measured using accelerometers. Results In 62 patients and 35 controls (mean age 40 ± 3 years), the VO2peak (in mL·kg–1·min–1) values were 31.4 ± 7.2 and 39.1 ± 5.4, respectively (p<0.01). In the patients, the COpeak was (9.6 L·min-1), 16% lower compared to controls (p<0.01). Twelve patients (19%) had a cardiac limitation to CPET. Twenty-three (37%) patients and one (3%) control were classed as unfit, with no cardiopulmonary limitations. The patients demonstrated 25% lower PA level (in counts per minute; p<0.01) and 14% more time being sedentary (p<0.01), compared with the controls. Twenty-one patients (34%) compared with four (17%) controls did not meet the World Health Organization’s recommendations for PA (p=0.02). Body mass index and PA level accounted for 65% of the variability in VO2peak. Conclusion Significantly lower CRF and PA levels were found in patients on long-term follow-up after severe pre-eclampsia. CPET identified cardiovascular limitations in one third of patients. One third appeared unfit, with adiposity and lower PA levels. These findings highlight the need for clinical follow-up and exercise interventions after severe pre-eclampsia.

Omega-3 index, cardiorespiratory fitness, and cognitive function in mid-age and older adults

Higher levels of omega-3 fatty acids in red blood cell membranes (omega-3 index or O3I) and cardiorespiratory fitness (CRF) are each associated with reduced cognitive impairment, but little research has examined the relationship between O3I and cognitive function while accounting for CRF. We analyzed cross-sectional data from 5,464 healthy men and women aged 55–85 years who had preventive medical examinations between 2009 and 2023. Primary exposures included O3I (<4.0%, 4.0–7.9%, or ≥ 8.0%) and age- and sex-based CRF quintile (1 = low, 2–3 = moderate, 4–5 = high). Cognitive impairment was defined as a Montreal Cognitive Assessment score of ≤ 25. We used Poisson regression to estimate relative risks (RR) of cognitive impairment, controlling for covariates. O3I < 4% was associated with increased cognitive impairment relative to ≥ 8.0% (RR, 1.21; 95% CI, 1.01–1.44) in a partially adjusted model. This association did not remain statistically significant in the fully adjusted model which included CRF. Low versus high CRF was associated with cognitive impairment (RR, 1.28; 95% CI, 1.07–1.53), independent of O3I and clinical biomarkers. The interaction between CRF and O3I was not significant (P = 0.8). In joint association analysis, risk of cognitive impairment was elevated with lower omega-3 index or CRF or both. Additional research is needed to fully understand the association between O3I and cognitive function at varying CRF levels.

Effects of the Trp64Arg Polymorphism in the ADRB3 Gene on Body Composition, Cardiorespiratory Fitness, and Physical Activity in Healthy Adults.

The ADRB3 gene plays a role in energy expenditure by participating in lipolysis, which affects body composition and performance. The ADRB3 rs4994 polymorphism has been studied in groups of athletes, overweight individuals, and obese and diabetic patients, but it has not been studied in young and healthy adults so far. In the present study, we examined the association of ADRB3 rs4994 polymorphism with body composition, somatotype, cardiorespiratory fitness and physical activity in young, healthy adults (N = 304). All subjects had anthropometric measurements, and somatotypes were assessed using the Heath-Carter method. In addition, cardiorespiratory fitness and physical activity levels were assessed. Genotyping for the ADRB3 gene was performed using a PCR-RFLP method. In the male group, body components were associated with the Trp64Trp genotype (waist circumference (p = 0.035), hip circumference (p = 0.029), BF (%) (p = 0.008), and BF (kg) (p = 0.010), BMI (p = 0.005), WHtR (p = 0.021), and BAI (p = 0.006)). In addition, we observed that the Trp64Trp genotype was associated with somatotype components (p = 0.013). In contrast, the Arg allele was associated with the ectomorphic components (0.006). We also observed a positive impact of the Trp64Trp genotype with maximal oxygen uptake (p= 0.023) and oxygen pulse (p = 0.024). We observed a negative relationship of the Trp64Trp genotype in the female group with reported moderate-intensity exercise (p = 0.036). In conclusion, we found an association of the Trp64 allele with anthropometric traits, somatotype and parameters describing physical performance in the male group. In the female subpopulation, we only found an effect of the polymorphism Trp64Arg on the level of physical activity for moderate-intensity exercise.

Association between cardiorespiratory fitness level and insulin resistance in adolescents with various obesity categories.

An association between cardiorespiratory fitness (CRF) and insulin resistance in obese adolescents, especially in those with various obesity categories, has not been systematically studied. There is a lack of knowledge about the effects of CRF on insulin resistance in severely obese adolescents, despite their continuous rise. To investigate the association between CRF and insulin resistance in obese adolescents, with special emphasis on severely obese adolescents. We performed a prospective, cross-sectional study that included 200 pubertal adolescents, 10 years to 18 years of age, who were referred to a tertiary care center due to obesity. According to body mass index (BMI), adolescents were classified as mildly obese (BMI 100% to 120% of the 95th percentile for age and sex) or severely obese (BMI ≥ 120% of the 95th percentile for age and sex or ≥ 35 kg/m2, whichever was lower). Participant body composition was assessed by bioelectrical impedance analysis. A homeostatic model assessment of insulin resistance (HOMA-IR) was calculated. Maximal oxygen uptake (VO2max) was determined from submaximal treadmill exercise test. CRF was expressed as VO2max scaled by total body weight (TBW) (mL/min/kg TBW) or by fat free mass (FFM) (mL/min/kg FFM), and then categorized as poor, intermediate, or good, according to VO2max terciles. Data were analyzed by statistical software package SPSS (IBM SPSS Statistics for Windows, Version 24.0). P < 0.05 was considered statistically significant. A weak negative correlation between CRF and HOMA-IR was found [Spearman's rank correlation coefficient (rs) = -0.28, P < 0.01 for CRFTBW; (rs) = -0.21, P < 0.01 for CRFFFM]. One-way analysis of variance (ANOVA) revealed a significant main effect of CRF on HOMA-IR [F(2200) = 6.840, P = 0.001 for CRFTBW; F(2200) = 3.883, P = 0.022 for CRFFFM]. Subsequent analyses showed that obese adolescents with poor CRF had higher HOMA-IR than obese adolescents with good CRF (P = 0.001 for CRFTBW; P = 0.018 for CRFFFM). Two-way ANOVA with Bonferroni correction confirmed significant effect of interaction of CRF level and obesity category on HOMA-IR [F(2200) = 3.292, P = 0.039 for CRFTBW]. Severely obese adolescents had higher HOMA-IR than those who were mildly obese, with either good or poor CRF. However, HOMA-IR did not differ between severely obese adolescents with good and mildly obese adolescents with poor CRF. CRF is an important determinant of insulin resistance in obese adolescents, regardless of obesity category. Therefore, CRF assessment should be a part of diagnostic procedure, and its improvement should be a therapeutic goal.

Effects of a 4-week Multicomponent Exercise (Vivifrail) on Predicted Maximum Oxygen Consumption and Fatigue Levels in the Elderly with Frailty Syndrome: A Randomized Controlled Trial

Introduction: Frailty syndrome (FS) impairs cardiorespiratory fitness, physical capacity, and disability in the elderly population. Vivifrail, a multicomponent exercise, has shown significant benefits for FS management, but research in the Asian population is still limited. This study aims to see how 4-week Vivifrail program affects predicted maximum oxygen consumption (VO2max) and fatigue levels in the elderly with FS. Methods: This randomized controlled trial included 47 participants with FS living in a nursing home in Surabaya, Indonesia. The participants were randomly assigned to either the Vivifrail group (VG) and the control group (CG). The VG followed the 5 days a week Vivifrail program combined with 15 min daily group-based conventional exercise for 4 weeks. The CG was only given the conventional exercise. Six-minute walking test and the Indonesian version of the Fatigue Severity Scale (FSS-I) were measured to assess VO2max dan and fatigue levels before and after the 4-week intervention. Results: After 4 weeks of intervention, a significant increase in VO2max and decrease in FSS-I were found in the VG (P = 0.021 and P = 0.002, respectively), whereas no significant changes in VO2max or FSS-I were found in the CG (P = 0.170 and P = 0.052). However, there was no statistically significant difference in VO2max between groups (P = 0.716), but the decline of FSS-I between groups was statistically significant (P = 0.001). Conclusions: The addition of Vivifrail exercise for 4 weeks can improve cardiorespiratory fitness and decrease fatigue levels. This supports the routine use of Vivifrail for Indonesian elderly with FS who live in nursing homes.

Association Between Cardiorespiratory Fitness and Cancer Incidence and Cancer-Specific Mortality of Colon, Lung, and Prostate Cancer Among Swedish Men

Cardiorespiratory fitness (CRF) levels appear to be an important risk factor for cancer incidence and death. To examine CRF and prostate, colon, and lung cancer incidence and mortality in Swedish men, and to assess whether age moderated any associations between CRF and cancer. A prospective cohort study was conducted in a population of men who completed an occupational health profile assessment between October 1982 and December 2019 in Sweden. Data analysis was performed from June 22, 2022, to May 11, 2023. Cardiorespiratory fitness was assessed as maximal oxygen consumption, estimated using a submaximal cycle ergometer test. Data on prostate, colon, and lung cancer incidence and mortality were derived from national registers. Hazard ratios (HRs) and 95% CIs were calculated using Cox proportional hazards regression. Data on 177 709 men (age range, 18-75 years; mean [SD] age, 42 [11] years; mean [SD] body mass index, 26 [3.8]) were analyzed. During a mean (SD) follow-up time of 9.6 (5.5) years, a total of 499 incident cases of colon, 283 of lung, and 1918 of prostate cancer occurred, as well as 152 deaths due to colon cancer, 207 due to lung cancer, and 141 deaths due to prostate cancer. Higher levels of CRF (maximal oxygen consumption as milliliters per minute per kilogram) were associated with a significantly lower risk of colon (HR, 0.98, 95% CI, 0.96-0.98) and lung cancer (HR, 0.98; 95% CI, 0.96-0.99) incidence, and a higher risk of prostate cancer incidence (HR, 1.01; 95% CI, 1.00-1.01). Higher CRF was associated with a lower risk of death due to colon (HR, 0.98; 95% CI, 0.96-1.00), lung (HR, 0.97; 95% CI, 0.95-0.99), and prostate (HR, 0.95; 95% CI, 0.93-0.97) cancer. After stratification into 4 groups and in fully adjusted models, the associations remained for moderate (>35-45 mL/min/kg), 0.72 (0.53-0.96) and high (>45 mL/min/kg), 0.63 (0.41-0.98) levels of CRF, compared with very low (<25 mL/min/kg) CRF for colon cancer incidence. For prostate cancer mortality, associations remained for low (HR, 0.67; 95% CI, 0.45-1.00), moderate (HR, 0.57; 95% CI, 0.34-0.97), and high (HR, 0.29; 95% CI, 0.10-0.86) CRF. For lung cancer mortality, only high CRF (HR, 0.41; 95% CI, 0.17-0.99) was significant. Age modified the associations for lung (HR, 0.99; 95% CI, 0.99-0.99) and prostate (HR, 1.00; 95% CI, 1.00-1.00; P < .001) cancer incidence, and for death due to lung cancer (HR, 0.99; 95% CI, 0.99-0.99; P = .04). In this cohort of Swedish men, moderate and high CRF were associated with a lower risk of colon cancer. Low, moderate, and high CRF were associated with lower risk of death due to prostate cancer, while only high CRF was associated with lower risk of death due to lung cancer. If evidence for causality is established, interventions to improve CRF in individuals with low CRF should be prioritized.

Progression to Insulin Therapy in Patients With Type 2 Diabetes According to Cardiorespiratory Fitness, Body Mass Index, and Statin Therapy

ObjectiveTo evaluate the association between statin therapy, cardiorespiratory fitness (CRF), body mass index (BMI), and progression to insulin therapy in type 2 diabetes mellitus (T2DM). MethodsParticipants were patients with T2DM (mean age, 62.7±8.4 years; men, 178,992; women, 8360) not treated with insulin, with no evidence of uncontrolled cardiovascular disease, who completed an exercise treadmill test between October 1, 1999, and September 3, 2020. Of these, 158,578 were treated with statins and 28,774 were not. We established 5 age-specific CRF categories according to peak metabolic equivalents of task achieved during an exercise treadmill test. ResultsDuring a median follow-up period of 9.0 years, 51,182 patients progressed to insulin therapy with an average annual incidence rate of 28.4 events/1000 person-years. The adjusted progression rate was 27% higher in statin-treated patients (hazard ratio [HR], 1.27; 95% CI, 1.24 to 1.31), related directly to BMI and inversely related to CRF. A progressively higher rate was noted in statin-treated vs non–statin-treated patients within all BMI categories, ranging from 23% for normal weight to 90% for those with BMI of 35 kg/m2 and higher. The statin-CRF interaction revealed 43% higher rate in the least-fit statin-treated patients (HR, 1.43; 95% CI, 1.35 to 1.51) and a progressive decline with increased CRF to 30% lower risk in highly fit statin-treated patients (HR, 0.70; 95% CI, 0.66 to 0.75). ConclusionIn patients with T2DM, the statin-related progression to insulin therapy was associated with relatively low CRF and high BMI levels. The progression rate was mitigated by increased CRF regardless of BMI. Clinicians should foster regular exercise for patients with T2DM to enhance CRF and to lessen the rate of progression to insulin therapy.