Low Levels Of Cardiorespiratory Fitness Research Articles

Physiological Fitness in People with Advanced Multiple Sclerosis

IntroductionPhysiological fitness, encompassing cardiorespiratory fitness (CRF) and body composition, are important markers of overall health, functional capacity, and quality of life in general and clinical populations. Characterizing fitness is important for the development of tailored interventions and strategies to optimize well-being across the spectrum of disability in multiple sclerosis (MS). While existing research has explored fitness in people with mild-to-moderate disability, there is a scarcity of data in people with advanced MS (Expanded Disability Severity Scale, EDSS≥7.0). ObjectiveTo characterize CRF and body composition and their associations with fatigue, quality of life, and function in individuals with advanced MS. MethodsParticipants (n=18, mean age=60.7 years-old, median EDSS=7.5) underwent a cardiopulmonary exercise test and dual-energy X-ray absorptiometry scanning. Main outcomes included peak volume of oxygen uptake (V̇O2peak) and whole and regional body fat, lean mass, bone mineral content, and bone density. Symptoms of fatigue (Modified Fatigue Impact Scale, MFIS), quality of life (29-item MS Impact Scale, MSIS-29), and daily function (Late-Life Function and Disability Instrument, LLFDI) were collected. ResultsParticipants exhibited notably low CRF levels (V̇O2peak=9.8 mL/min/kg) and poor body composition (lower lean mass, bone mineral content and density) compared to previous studies in the general population and in individuals with MS with lower disability. V̇O2peak was most consistently associated with function in daily life (LLFDI scores, rs≥0.637, p≤0.004). ConclusionThese findings reinforce the potential importance of physiological fitness to preserve function in people with advanced MS.

Swim, Strength, or Combined Programs: Effect on Health-Related Physical Fitness in Adolescents With Down Syndrome.

The adolescent population with Down syndrome (DS) appears to show higher levels of body fat and lower levels of cardiorespiratory fitness or muscle strength than their peers without disabilities. There is a need to create physical activity programs to improve these data. The aim of this research was to determine the effects of a 16-week swimming program, strength program, and combined program (swimming and strength training) on body composition and health-related physical fitness on adolescents with DS and to assess whether there are differences in the results of the different training programs. Forty-five adolescents (17 female and 28 male; average age 15.5 [1.53] years) with DS were recruited and randomized to three groups (swim [n = 15], strength [n = 15], and combined [n = 15]). Results showed that the swim group had significant improvements in all health-related physical fitness variables and there was an improvement in some body-composition variables (p < .05). The strength and combined groups obtained minor improvements in the variables analyzed. In summary, a 16-week swim program consisting of three sessions of 60min is able to improve levels of body composition and health-related physical fitness in adolescents with DS. The swim training program seems to be more effective in improving body composition and health-related physical fitness than the strength or combined program. These findings could be useful in different special-education centers due to the predisposition shown by the population with DS to this sportmodality.

Association Between Cardiorespiratory Fitness and Trend of Age-Related Rise in Arterial Stiffness in Individuals With and Without Hypertension or Diabetes

Abstract BACKGROUND This study aimed to investigate whether higher cardiorespiratory fitness (CRF) can modify the trend of age-related rise in arterial stiffness in individuals with and without hypertension (HTN) or diabetes. METHODS The study included 4,935 participants who underwent maximal cardiopulmonary exercise testing with respiratory gas analysis in a health screening program. CRF was directly measured using peak oxygen uptake during the cardiopulmonary exercise test, while arterial stiffness was evaluated using brachial–ankle pulse wave velocity (baPWV). RESULTS Participants with high CRF levels had significantly lower baPWV compared with those with low CRF levels, regardless of HTN or diabetes status (P &amp;lt; 0.05). The trend of baPWV increased with age, but the rate of age-related increase in baPWV was lower in individuals with moderate-to-high CRF levels compared with those with low CRF levels, regardless of HTN or diabetes status. Joint association analysis indicated that the trend of age-related increase in baPWV was the lowest in fit individuals without HTN or diabetes compared with unfit individuals with HTN or diabetes (P &amp;lt; 0.01). However, the trend of age-related increase in baPWV was not attenuated in fit with HTN or diabetes compared with unfit with HTN or diabetes. CONCLUSIONS These findings suggest that higher CRF levels may mitigate the trend of age-related rise in arterial stiffness in individuals with and without HTN or diabetes. However, this attenuating trend appears more pronounced in individuals without HTN or diabetes.

Cardiorespiratory Fitness Assessment for Exercise Research in Mild Cognitive Impairment Due to Alzheimer's Disease.

To analyze cardiorespiratory fitness (CRF) levels using the gold-standard, laboratory-based cardiopulmonary exercise test (CPET) in community-dwelling older adults (N = 145) with amnestic mild cognitive impairment (aMCI), specifically CPET feasibility, CRF prediction, and CRF status in comparison to published sedentary, cognitively normal, age- and sex-adjusted normative data. Peak oxygen consumption (VO2Peak [mL/kg/min]) was assessed by CPET, which was categorized as submaximal, near-maximal, or maximal tests. VO2Max predicted was compared to VO2Max measured to assess its utility. Data were analyzed with t tests. Participants' mean age was 73.77 years (SD = 5.74 years), with 51.7% males, 91.7% Caucasian, 68.3% married, and 16.9 years (SD = 2.88 years) of education. Mean VO2Peak measured was 17.07 (SD = 4.92) for the total sample (18.29 [SD = 4.64] for males, 15.78 [SD = 4.91] for females). Sixteen (11.03%) CPETs were submaximal, 53 (36.55%) were near-maximal, and 76 (52.41%) were maximal. Mean VO2Max predicted was 28.59 (SD = 21.94) for the total sample (29.36 [SD = 22.3] for males, 27.76 [SD = 21.68] for females) and was significantly higher than VO2Max measured (p < 0.0001). Among participants with maximal CPETs, VO2Peak measured was significantly lower than sedentary normative data (p < 0.0001). CPET was feasible for older adults with aMCI. VO2Max predicted overly inflates CRF estimates. Low levels of CRF in older adults with aMCI suggest aerobic exercise as an important intervention. [Journal of Gerontological Nursing, 50(9), 31-36.].

The combined effect of cardiorespiratory and muscular fitness on the incidence of metabolic syndrome before midlife.

Cardiorespiratory fitness (CRF) could reduce the risk of metabolic syndrome (MetS) while the association between muscular endurance capacity (MEC) and incident MetS has rarely been investigated in young adults. A total of 2890 military men and women, aged 18-39years, free of baseline MetS in Taiwan, were followed for incident MetS from baseline (2014) until the end of 2020. All subjects received annual health examinations for assessment of MetS. Physical fitness was assessed by CRF (estimated maximal oxygen uptake, VO2 max [mL/kg/min], in a 3000-m run) and MEC (numbers of 2-min push-ups). MetS was defined according to the International Diabetes Federation (IDF) criteria. Multiple Cox regression analysis was conducted with adjustments for baseline age, sex, substance use status and physical activity to determine the associations of CRF and MEC with incidences of new-onset MetS and related features, for example, central obesity, hypertension, dyslipidaemia and prediabetes or diabetes. To examine the combined effects of CRF and MEC status on incidence of MetS, high and low levels of CRF and MEC were separately defined by over and under the sex-specific median in each exercise test. During a median follow-up of 5.8years, there were 673 (23.3%) new-onset MetS. Higher CRF was associated with a lower incidence of MetS (hazard ratio [HR] and 95% confidence interval: 0.905 [0.877-0.933]), and its components separately, except hypertension. No association was observed between MEC and incident MetS, and its components separately, except hypertension. When evaluating the combined effects of MEC and CRF status on the incidence of MetS, it was observed that compared with the low CRF/low MEC, the high CRF/high MEC (HR: 0.553 [0.439-0.697]) and the high CRF/low MEC (HR: 0.730 [0.580-0.918]) had a lower incidence of new-onset MetS (P value for the intergroup difference=0.04). There was no significant result for the low CRF/high MEC. This study highlights that although the protective effects of MEC to reduce the incidence of MetS and most of its related features were mainly driven by CRF in young adults, there was an addictive effect of greater MEC on CRF to prevent the development of new-onset MetS before midlife.

The Interplay of Type 2 Diabetes Status, Cardiorespiratory Fitness Level, and Sudden Cardiac Death: A Prospective Cohort Study

BackgroundTo evaluate the individual and joint effects of type 2 diabetes (T2D) status and cardiorespiratory fitness (CRF) level with sudden cardiac death (SCD) risk. MethodsPrevalent T2D was defined based on guideline recommendations, and CRF level was assessed using a respiratory gas-exchange analyzer during exercise testing at baseline, in 2308 men aged 42-61 years. T2D status was classified as either “Yes” or “No,” and CRF level was classified as low, medium, or high. Cox regression analysis was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for SCD. ResultsA total of 264 SCDs occurred during a median follow-up of 28.1 years. Comparing Yes vs No history of T2D, the multivariable-adjusted HR (95% CI) for SCD was 1.79 (1.19-2.72). Comparing low vs high CRF levels, the corresponding adjusted HR (95% CI) for SCD was 1.77 (1.21-2.58). The HRs persisted when T2D status was further adjusted for CRF level, and vice versa. Compared with No-T2D & medium-high CRF level, men with No-T2D & low CRF and those with Yes-T2D & low CRF had an increased SCD risk: (HR = 1.87, 95% CI, 1.38-2.55) and (HR = 3.34, 95% CI, 2.00-5.57), respectively. No significant association occurred between men with Yes-T2D & medium-high CRF and SCD risk (HR = 1.46, 95% CI, 0.46-4.65). Modest evidence indicated the presence of additive and multiplicative interactions between T2D status and CRF level, in relation to SCD. ConclusionsAn interplay exists between T2D status, CRF level, and SCD risk in middle-aged and older men. Higher CRF levels may mitigate the increased SCD risk observed in men with T2D.

Temporal trends and distributional changes in cardiorespiratory fitness among Chinese children and adolescents from 1985 to 2019.

The aim of this study was to analyze the temporal trends in cardiorespiratory fitness (CRF) and body mass index (BMI) among children and adolescents from 1985 to 2019. A total of 1 840 212 children and adolescents aged 7-18 years (921 223 boys) were tested for CRF from 1985 to 2019. CRF was tested by 50-m × 8 shuttle run for boys and girls aged 7-12 years, 1000-m run for boys aged 13-18 years, and 800-m run for girls aged 13-18 years. Trends in BMI from 2000 to 2019 were also investigated. Cardiorespiratory fitness decreased during the entire 34 years among children and adolescents in all sex and age categories, and the most rapid decline occurred from 1995 to 2005. Some positive trends in CRF were observed among adolescents aged 13-15 years from 2005 to 2019 and among girls aged 16-18 years from 2014 to 2019. The variation in the CRF distribution was not uniform, with Z-scores for participants with high CRF levels changing little or increasing (CRF stabilized or improved) and Z-scores for participants with low CRF levels continuing to decrease (CRF decreased). BMI increased over time for boys and girls in all age categories, with an acceleration of the increase for adolescents in recent years. This study revealed that the overall CRF levels of Chinese children and adolescents decreased over three decades but stabilized or improved in recent years. BMI continued to increase. Our findings are important for the focus on future domestic physical fitness and public health.

CARDIORESPIRATORY FITNESS, HIGH BODY FAT PERCENTAGE AND THE RISK OF CORONARY CALCIFICATION IN MIDDLE–AGED MEN

Objective: Low levels of cardiorespiratory fitness (CRF) have been showed to increase the risk of cardiovascular disease(CVD). We tested the hypothesis that central obesity is associated with coronary artery calcification (CAC), but that fitness attenuates this association. Design and method: We analyzed men who participated in a health screening program. We measured CAC using multidetector computed tomography (MDCT) with a calculation of Agatston coronary artery calcium score. CAC score over 400 were defined as the prevalence of moderate to severe subclinical atherosclerosis. Central obesity was defined as body mass index (BMI) over 25kg/m2 and body fat percentage (BFP) over 30% in men. Fitness was directly measured by peak oxygen uptake (VO2peak) and divided into unfit (low tertile) and fit (middle and upper tertile) categories based on age-specific VO2peak percentiles. Results: Compared with normal weight men, central obese men was associated with a higher prevalence of CAC after adjusting for age, SBP, lipid profile, logCRP, s-glucose, heart rate, diabetes, and hypertension. The fit men was associated with lower odds ratios for having CAC. However, the fit with central obesity had odds ratios for CAC that were similar to those of the fit with normal weight. Conclusions: Our findings demonstrate that BMI and BFP are associated with increased risk of moderate to severe CAC score, but that high fitness appears to attenuate the risk in men.

Effects of a co-designed exercise and sport intervention on cardiorespiratory fitness and metabolic syndrome components among individuals living in a refugee camp in Greece: A randomized controlled trial

BackgroundThe metabolic syndrome epidemic, including in forcibly displaced individuals, requires cost-effective prevention and treatment strategies. Yet, the health needs of forcibly displaced individuals often remain underserved. Our study evaluated the effect of a co-designed exercise and sport intervention on cardiorespiratory fitness and metabolic syndrome components among individuals in a refugee camp in Greece and examined the indirect effect through cardiorespiratory fitness on metabolic syndrome components. MethodsWe conducted a randomized controlled trial involving an intervention and a wait-list control group with n = 142 (52.8 % women) forcibly displaced Southwest Asians and Sub-Saharan Africans. The intervention group participated for 10 weeks in exercise and sport activities. Outcomes were cardiorespiratory fitness and single metabolic syndrome components. Effects were analyzed with structural equation modeling. ResultsIn total, 62.7 % of participants presented with low cardiorespiratory fitness levels (<40th percentile), and 24.6 % met the criteria for metabolic syndrome. In the intervention group, 73.5 % attended the exercise and sport sessions at least once a week. There was evidence for a direct intervention effect on cardiorespiratory fitness, ßdirect = 0.12, p = 0.022, but not for any of the metabolic syndrome components (p ≥ 0.192). Cardiorespiratory fitness significantly facilitated the intervention's indirect effect on abdominal obesity, ßindirect = −0.03, p = 0.012, high diastolic blood pressure, ßindirect = −0.04, p = 0.011, and elevated triglycerides, ßindirect = −0.03, p = 0.025. ConclusionImplementing exercise and sport activities in a refugee camp in Greece effectively reaches a wider target population and improves cardiorespiratory fitness among forcibly displaced individuals. The intervention contributes to a decrease in abdominal obesity, high diastolic blood pressure and elevated triglycerides indirectly via improved cardiorespiratory fitness.

The association between the dietary inflammatory index and cardiorespiratory fitness in United States young adults: a cross-sectional study from the National Health and Nutrition Examination Study, 1999-2004.

Cardiorespiratory fitness (CRF) is a vital indicator of overall health and cardiovascular efficiency. Systemic inflammation significantly impacts CRF, and reducing systemic inflammation may serve as an effective strategy to improve CRF. Diet plays a crucial role in systemic inflammation, but daily dietary intake typically involves multiple elements rather than a single nutrient. The Dietary Inflammatory Index (DII) provides an overall assessment of dietary inflammation on the basis of the anti-inflammatory and pro-inflammatory effects of the nutrients consumed. However, the relationship between DII and CRF is not yet well understood. To examine the association between the DII and CRF. This study analyzed 3,087 participants from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2002. The study subjects were divided into three distinct groups by DII tertile: T1 (n = 1,027), T2 (n = 1,029), and T3 (n = 1,031). The associations between DII levels and CRF were examined via logistic regression analysis and restricted cubic splines (RCSs). Elevated DII scores were significantly linked to low CRF levels. Compared with those in the lowest tertile, participants in the highest DII tertile exhibited a greater prevalence of low CRF (T1: 10.85%, T2: 16.32%, T3: 19.31%). In the model with full adjustments, elevated scores on the DII were consistently linked with a heightened likelihood of low CRF (OR: 1.17, 95% CI: 1.07-1.28; P < 0.001). Compared with those in the T1 group, participants with higher DIIs had an increased risk of lower CRF (T2: OR: 1.42, 95% CI: 1.01-2.01, P = 0.046; T3: OR: 1.71, 95% CI: 1.22-2.40, P = 0.003). Additionally, a significant interaction (P = 0.045) between sex and the DII for low CRF was observed within the population. A higher DII score is linked to an elevated risk of low CRF. Moreover, sex can impact CRF, with women being more prone to low CRF.

Sleep duration and cardiorespiratory fitness in adolescents: Longitudinal analysis from the LabMed study.

We aimed to investigate longitudinal associations between sleep duration and cardiorespiratory fitness, in adolescents. Sleep duration was self-reported and cardiorespiratory fitness was assessed by the 20 m shuttle run test, both at baseline and follow-up (2-year follow-up). Participants were 734 Northern Portuguese adolescents (349 girls), aged 14.6 ± 1.8 years, from the LabMed study. Significant decreases were found between baseline and follow-up for sleep duration, whereas for cardiorespiratory fitness there was an increase. Adolescents with short sleep duration at baseline had lower cardiorespiratory fitness at follow-up, comparing to those meeting the sleep guidelines (odds ratio [OR] = 0.506, 95% confidence interval [CI]: 0.326-0.785; p = .002 for whole week; OR = 0.597, 95% CI: 0.407-0.875; p = .008 for weekdays). Girls who were short sleepers at baseline had lower odds of having a healthy cardiorespiratory fitness at follow-up, comparing to those meeting the sleep guidelines (OR = 0.311, 95% CI: 0.158-0.613; p < .001 for whole week; OR = 0.469, 95% CI: 0.262-0.838; p = .011 for weekdays). No significant associations between sleep duration and cardiorespiratory fitness were found for boys. There was a significant longitudinal association between short sleep duration and lower cardiorespiratory fitness levels, particularly in girls. Future interventions targeting adolescents' sleep duration should acknowledge behavioral differences between genders, as well as different behaviors adopted by boys ang girls, specifically on weekends.

Exercise and aerobic capacity in individuals with spinal cord injury: A systematic review with meta-analysis and meta-regression.

A low level of cardiorespiratory fitness [CRF; defined as peak oxygen uptake ([Formula: see text]O2peak) or peak power output (PPO)] is a widely reported consequence of spinal cord injury (SCI) and a major risk factor associated with chronic disease. However, CRF can be modified by exercise. This systematic review with meta-analysis and meta-regression aimed to assess whether certain SCI characteristics and/or specific exercise considerations are moderators of changes in CRF. Databases (MEDLINE, EMBASE, CENTRAL, and Web of Science) were searched from inception to March 2023. A primary meta-analysis was conducted including randomised controlled trials (RCTs; exercise interventions lasting >2 weeks relative to control groups). A secondary meta-analysis pooled independent exercise interventions >2 weeks from longitudinal pre-post and RCT studies to explore whether subgroup differences in injury characteristics and/or exercise intervention parameters explained CRF changes. Further analyses included cohort, cross-sectional, and observational study designs. Outcome measures of interest were absolute (A[Formula: see text]O2peak) or relative [Formula: see text]O2peak (R[Formula: see text]O2peak), and/or PPO. Bias/quality was assessed via The Cochrane Risk of Bias 2 and the National Institute of Health Quality Assessment Tools. Certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random effects models were used in all meta-analyses and meta-regressions. Of 21,020 identified records, 120 studies comprising 29 RCTs, 67 pre-post studies, 11 cohort, 7 cross-sectional, and 6 observational studies were included. The primary meta-analysis revealed significant improvements in A[Formula: see text]O2peak [0.16 (0.07, 0.25) L/min], R[Formula: see text]O2peak [2.9 (1.8, 3.9) mL/kg/min], and PPO [9 (5, 14) W] with exercise, relative to controls (p < 0.001). Ninety-six studies (117 independent exercise interventions comprising 1,331 adults with SCI) were included in the secondary, pooled meta-analysis which demonstrated significant increases in A[Formula: see text]O2peak [0.22 (0.17, 0.26) L/min], R[Formula: see text]O2peak [2.8 (2.2, 3.3) mL/kg/min], and PPO [11 (9, 13) W] (p < 0.001) following exercise interventions. There were subgroup differences for R[Formula: see text]O2peak based on exercise modality (p = 0.002) and intervention length (p = 0.01), but there were no differences for A[Formula: see text]O2peak. There were subgroup differences (p ≤ 0.018) for PPO based on time since injury, neurological level of injury, exercise modality, and frequency. The meta-regression found that studies with a higher mean age of participants were associated with smaller changes in A[Formula: see text]O2peak and R[Formula: see text]O2peak (p < 0.10). GRADE indicated a moderate level of certainty in the estimated effect for R[Formula: see text]O2peak, but low levels for A[Formula: see text]O2peak and PPO. This review may be limited by the small number of RCTs, which prevented a subgroup analysis within this specific study design. Our primary meta-analysis confirms that performing exercise >2 weeks results in significant improvements to A[Formula: see text]O2peak, R[Formula: see text]O2peak, and PPO in individuals with SCI. The pooled meta-analysis subgroup comparisons identified that exercise interventions lasting up to 12 weeks yield the greatest change in R[Formula: see text]O2peak. Upper-body aerobic exercise and resistance training also appear the most effective at improving R[Formula: see text]O2peak and PPO. Furthermore, acutely injured, individuals with paraplegia, exercising for ≥3 sessions/week will likely experience the greatest change in PPO. Ageing seemingly diminishes the adaptive CRF responses to exercise training in individuals with SCI. PROSPERO: CRD42018104342.

Influence of cardiorespiratory fitness and body composition on resting and post-exercise indices of vascular health in young adults

Poor cardiorespiratory fitness may mediate vascular impairments at rest and following an acute bout of exercise in young healthy individuals. This study aimed to compare flow mediated dilation (FMD) and vascular augmentation index (AIx75) between young adults with low, moderate, and high levels of cardiorespiratory fitness before and after an acute bout of aerobic exercise. Forty-three participants (22 men; 21 women) between 18 and 29 years of age completed the study. Participants were classified into low, moderate, and high health-related cardiorespiratory fitness groups according to age- and sex-based relative maximal oxygen consumption (V˙O2 max) percentile rankings. FMD was performed using Doppler ultrasound and AIx75 was performed using pulse wave analysis at baseline and 60-min after a 30-min bout of treadmill running at 70% V˙O2 max. A significant interaction (p ​= ​0.047; ηp2 ​= ​0.142) was observed, with the moderate fitness group exhibiting a higher FMD post-exercise compared with baseline ([6.7% ​± ​3.1%] vs. [8.5% ​± ​2.8%], p ​= ​0.028; d ​= ​0.598). We found a significant main effect of group for AIx75 (p ​= ​0.023; ηp2 ​= ​0.168), with the high fitness group exhibiting lower AIx75 compared to low fitness group ([−10% ​± ​10%] vs. [2% ​± ​10%], respectively, p ​= ​0.019; g ​= ​1.07). This was eliminated after covarying for body fat percentage (p ​= ​0.489). Our findings suggest that resting FMD and AIx75 responses are not significantly influenced by cardiorespiratory fitness, but FMD recovery responses to exercise may be enhanced in individuals with moderate cardiorespiratory fitness levels.

Exercise for chronic kidney disease: effects on vascular and cardiopulmonary function.

Patients with chronic kidney disease (CKD) have an exacerbated prevalence of cardiovascular disease (CVD). Vascular dysfunction, characterized by impaired endothelial function and arterial stiffness, and markedly low cardiorespiratory fitness levels are hallmark manifestations of the disease that contribute to the CVD burden. Despite advancements in blood pressure and lipid lowering pharmacological therapies, CVD remains markedly prevalent across the spectrum of CKD. This highlights a stagnation in effective clinical strategies to improve cardiovascular health and reinforces the critical need for adjuvant lifestyle strategies such as physical activity and exercise training to be incorporated into routine clinical care. This narrative review provides an overview of the known effects of exercise on vascular and cardiopulmonary function across the spectrum of CKD. The physiological mechanisms of vascular dysfunction that serve as exercise-specific therapeutic targets are highlighted and future perspectives are discussed.

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.

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.

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.

Interplay Between Fitness, Systolic Blood Pressure and Sudden Cardiac Death (from a Cohort Study)

Modifiable risk factors, such as blood pressure and cardiorespiratory fitness (CRF) play a role in the genesis of sudden cardiac death (SCD). However, data on their joint contributions to SCD risk are scarce. We aimed to evaluate the interplay between systolic blood pressure (SBP), CRF, and SCD risk in a cohort of men. Resting SBP was measured using a random-zero sphygmomanometer and CRF was assessed using a respiratory gas exchange analyzer during clinical exercise testing at baseline in 2,291 men aged 42 to 61years. SBP was classified as normal and high (<140 and ≥140mm Hg, respectively) and CRF as low, medium, and high. Cox regression analysis was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for SCD. A total of 262 SCDs occurred during a median follow-up of 28.2years. Comparing high versus normal SBP, the multivariable-adjusted HR (95% CI) for SCD was 1.35 (1.03 to 1.76). Comparing low versus high CRF levels, the corresponding adjusted HR (95% CI) for SCD was 1.81 (1.23 to 2.65). The HRs remained similar when SBP was further adjusted for CRF and CRF was further adjusted for SBP. Men with high SBP and low CRF compared with normal SBP and medium-high CRF, had an increased risk of SCD (HR 2.67, 95% CI 1.76 to 4.05), with no significant evidence of an association between men with high SBP and medium-high CRF and SCD risk (HR 1.38, 95% CI 0.84 to 2.26). There was modest evidence of an additive interaction between SBP and CRF in relation to SCD. In conclusion, there exists an interplay between SBP, CRF, and SCD risk in middle-aged and older men. Medium to high CRF levels may mitigate the increased risk of SCD in subjects with high SBP.

Cardiorespiratory Fitness Levels in Coronavirus Disease Survivors

Introduction: Covid-19 survivors often complain of fatigue, cough, shortness of breath, fever, dermatitis, headache and so on. This decrease then has an impact on changes in cardiorespiratory fitness. Objective: Determine the level of cardiorespiratory fitness in Covid-19 survivors. Method: This study used a cross sectional design. The population of this study is Covid-19 survivors in Makassar City. Sampling using purposive sampling technique with a sample of 385 people. Data collection was carried out by taking primary data through measuring cardiorespiratory fitness levels using the Six Minute Walk Test (6MWT). Results: A total of 236 people (61.3%) Covid-19 survivors had a low level of cardiorespiratory fitness with an average distance value of 507.6 meters. Conclusion: Respondents who come from the adolescent age group, have a normal BMI, high activity, asymptomatic and mild symptoms, and a phase of chronic Covid-19 infection tend to have a good level of cardiorespiratory fitness. While most respondents from the elderly age group, have obese and obese BMI, work as medical personnel with low physical activity, accompanied by comorbidities and the acute Covid-19 infection phase have a low level of cardiorespiratory fitness.

Associations between cardiovascular risk factors, disease activity and cardiorespiratory fitness in patients with inflammatory joint disease: a cross-sectional analysis

BackgroundInflammatory joint diseases (IJD) are accompanied by an increased risk of cardiovascular disease (CVD). Cardiorespiratory fitness (CRF) is a modifiable CVD risk factor and low levels of CRF associate with an elevated CVD risk. This study aimed to investigate the associations between CVD risk factors, disease activity and CRF in patients with IJD and to explore differences between patients with normal versus low levels of CRF.MethodsCRF was measured as peak oxygen uptake (VO2peak) with a cardiopulmonary exercise test. Participants were also evaluated for: Body composition, blood pressure, blood lipids, inflammatory markers and disease activity. Patient-reported use of cigarettes/snuff, medication, disease duration, pain, fatigue, CVD history, habitual physical activity and exercise beliefs and self-efficacy were collected by questionnaire. Cross-sectional associations between CVD risk factors, disease-related factors and CRF were analyzed by multiple linear regression. CRF was categorized to normal CRF (VO2peak ≥ 80%) or low CRF (VO2peak < 80%) according to age- and gender-stratified reference data. Differences in demographic, CVD and disease-related factors between patients with normal versus low CRF were explored.ResultsIn 60 Norwegian patients with IJD [34 females, age 59 years (IQR: 52–63)], mean VO2peak was 30.2 (± 6.9) mL/kg/min, corresponding to 83% (± 18) of normative reference values. Age (coefficient: − 0.18 years, p = 0.01) and fat mass (coefficient: − 0.67 %, p < 0.001) were inversely associated with CRF, while physical activity index (coefficient: 0.13 points, p = 0.05) was positively associated with CRF (R2 = 0.66). There were no significant associations between CRF, classical CVD risk factors and disease-related variables. Compared to patients with low CRF (n = 30), patients with normal CRF (n = 30) had higher peak oxygen uptake (+ 9.4 mL/kg/min, p < 0.001), high-density lipoprotein cholesterol (+ 0.5 mmol L−1, p < 0.001), and exercise self-efficacy (+ 6.9, p < 0.01) as well as lower fat mass (− 8.7%, p < 0.001), resting heart rate (− 8.0 beats/min, p < 0.01) and triglycerides (− 0.5 mmol L−1, p < 0.01).ConclusionsIn this sample of IJD-patients, age, fatmass and physical activity level were associated with CRF. CRF was lower than reference values and patients with normal CRF presented with a more favorable health profile. There is a continued need for exercise interventions to improve CRF in patients with IJD.Trial registration: NCT04922840.