Poor fitness and obesity in adolescence linked to later chronic disease

Adolescents who have poor cardiorespiratory fitness or are obese have an increased risk of developing cardiovascular disease later in life, serious enough to qualify them for disability pension due to a chronically reduced work capacity. The findings also suggest that a small improvement in fitness is associated with a lower risk.

Fat man jogging, catching up with thin men. Low angle view of runners running in park. Blurred feet motion group of runners, Fitness and healthy lifestyle, outdoor sports activity. Copy space. Photo credit Lina Moiseienko “In the study, we see that both obesity and poor fitness are two strong risk factors for subsequently receiving disability pension due to cardiovascular disease. The measurements were carried out in late adolescence, and it’s interesting to see that even at that age it’s possible to identify individuals who have a higher risk of being affected later in life”, says Pontus Henriksson, senior lecturer in the Department of Health, Medicine and Caring Sciences (HMV) at Linköping University.Pontus Henriksson. Photo credit Emma Busk Winquist

The study, which has been published in the European Heart Journal, is one of the first in which scientists have investigated the associations between obesity and physical fitness in adolescence with later disability pension. Disability pension is granted to working aged individuals who are likely to never work full-time again because of a chronic disease or injury.

In a previous study in early 2019, the scientists had shown an association between poor fitness, obesity and receiving disability pension due to several diseases. Previous work has shown that poor fitness and low muscular strength are associated with an increased risk of cardiovascular disease. For this reason, the researchers decided to look in more detail at the future risk for some particular cardiovascular diseases such as myocardial infarction, heart failure and the effects of conditions in brain blood vessels, such as strokes.

Possible to improve

The research team studied more than 1 million young Swedish men conscripted for military service in the period 1972-1994. At that time, conscription was compulsory and virtually all young men in Sweden participated. At the conscription, cardiorespiratory fitness, muscular strength and body mass index (BMI) of the conscripts were measured, together with other parameters. The subjects have been followed for an average of 28 years. Poor cardiorespiratory fitness and obesity were found to be strong risk factors for later chronic cardiovascular disease, while muscular strength was not. The researchers believe that the results show the possibilities to promote good future health.Hanna Henriksson. Photo credit Emma Busk Winquist

“Especially cardiorespiratory fitness is modifiable for most individuals. You don’t have to be an elite athlete, and even a small improvement in fitness can have a positive effect. With respect to obesity, it’s extremely important to prevent overweight, because it is difficult to treat obesity when it has become established”, says Hanna Henriksson, postdoc researcher at HMV and principal author of the article.

Men who were obese but with good cardiorespiratory fitness had a lower risk of future chronic cardiovascular disease than those who were obese but had poor fitness, which suggests that good fitness is important for health also for those who are overweight.

The study has examined only men, and it is therefore not possible to generalise the results to women. Other studies, however, have shown that fitness and body weight are also significant for the health of women.

The study has received financial support from, among other sources, the Swedish Society of Medicine, Region Östergötland and Karolinska Institutet.

The current study:
Cardiorespiratory fitness, muscular strength, and obesity in adolescence and later chronic disability due to cardiovascular disease: a cohort study of 1 million men”, Hanna Henriksson, Pontus Henriksson, Per Tynelius, Mattias Ekstedt, Daniel Berglind, Idoia Labayen, Jonatan R. Ruiz, Carl J. Lavie and Francisco B. Ortega, (2019), European Heart Journal, published online 9 November 2019, doi:10.1093/eurheartj/ehz774

The previous study:
Fitness and Body Mass Index During Adolescence and Disability Later in Life”, Pontus Henriksson, Hanna Henriksson, Per Tynelius, Daniel Berglind, Marie Löf, I-Min Lee, Eric J. Shiroma and Francisco B. Ortega, (2019), Annals of Internal Medicine, published 12 February 2019, doi: 10.7326/M18-1861

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