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State of Fitness: Overview of the Clinical Consequences of Low Cardiorespiratory Fitness

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Diabetes and Exercise

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

The United States is unfit for optimal health with its low level of cardiorespiratory fitness (CRF). Low CRF clinically translates to markedly higher rates of type 2 diabetes (T2D). While the percentages of obesity (13%) and type 2 diabetes (T2D) (1.6%) were too large in 1960, they have both increased manyfold in the past half century to 36% and 7%, respectively, in 2013 in the United States. Historically, type 2 diabetes (T2D) was rare in youth. In contrast, T2D was an adult disease, appearing after 30 years of age. Around 1990, T2D accounted for less than 3% of adolescent diabetes. Ten years later, it accounted for 45% of youth cases. Physical inactivity decreases CRF, and decreases in CRF increase mortality in T2D. This chapter considers (a) CRF’s association with morbidity and mortality, (b) factors determining CRF, and (c) clinical implications associated with low CRF. Also discussed are associations of low CRF with (a) glucose metabolism, (b) metabolic syndrome, (c) increased prevalence with cardiovascular diseases, and (d) increases in multiple risk factors for increased mortality. The relationship of changes in CRF on changes in the relative risk of death is presented. CRF’s inverse relationships are given with various pathological mechanisms (insulin resistance, hyperlipidemia, body composition, obesity, and inflammation). CRF is not fixed at an inheritable level but can be modulated up (by increased physical activity) or down (by physical inactivity, such as sedentary lifestyle). However, genes fix a decline in CRF beginning as early as adolescence.

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References

  1. Long-Term Trends in Diagnosed Diabetes. Centers for disease control and prevention. Accessed 10 Dec 2015.

    Google Scholar 

  2. Nadeau K, Dabelea D. Epidemiology of type 2 diabetes in children and adolescents. Endocr Res. 2008;33(1–2):35–58. PubMed PMID: 19156573. Epub 2009/01/22. eng

    Article  PubMed  Google Scholar 

  3. Pinhas-Hamiel O, Zeitler P. The global spread of type 2 diabetes mellitus in children and adolescents. J Pediatr. 2005;146(5):693–700. PubMed PMID: 15870677. Epub 2005/05/05. eng

    Article  PubMed  Google Scholar 

  4. Zhuo X, Zhang P, Barker L, Albright A, Thompson TJ, Gregg E. The lifetime cost of diabetes and its implications for diabetes prevention. Diabetes Care. 2014;37(9):2557–64. PubMed PMID: 25147254. Epub 2014/08/26. eng

    Article  PubMed  Google Scholar 

  5. Booth FW, Chakravarthy MV, Gordon SE, Spangenburg EE. Waging war on physical inactivity: using modern molecular ammunition against an ancient enemy. J Appl Physiol. 2002;93(1):3–30. (Bethesda, Md : 1985) PubMed PMID: 12070181. Epub 2002/06/19. eng

    Article  PubMed  Google Scholar 

  6. Wei M, Gibbons LW, Kampert JB, Nichaman MZ, Blair SN. Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes. Ann Intern Med. 2000;132(8):605–11. PubMed PMID: 10766678. Epub 2000/04/15. eng

    Article  CAS  PubMed  Google Scholar 

  7. Juraschek SP, Blaha MJ, Blumenthal RS, Brawner C, Qureshi W, Keteyian SJ, et al. Cardiorespiratory fitness and incident diabetes: the FIT (Henry ford exercIse testing) project. Diabetes Care. 2015;38(6):1075–81. PubMed PMID: 25765356. Epub 2015/03/15. eng

    Article  PubMed  Google Scholar 

  8. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346(11):793–801. PubMed PMID: 11893790. Epub 2002/03/15. eng

    Article  PubMed  Google Scholar 

  9. Blair SN, Kohl HW 3rd, Paffenbarger RS Jr, Clark DG, Cooper KH, Gibbons LW. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA. 1989;262(17):2395–401. PubMed PMID: 2795824. Epub 1989/11/03. eng

    Article  CAS  PubMed  Google Scholar 

  10. Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ: Can Med Assoc J J de l’Assoc Med Can. 2006;174(6):801–9. PubMed PMID: 16534088. Pubmed Central PMCID: PMC1402378. Epub 2006/03/15. eng

    Article  Google Scholar 

  11. Koch LG, Britton SL, Wisloff U. A rat model system to study complex disease risks, fitness, aging, and longevity. Trends Cardiovasc Med. 2012;22(2):29–34. PubMed PMID: 22867966. Pubmed Central PMCID: PMC3440495. Epub 2012/08/08. eng

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009;301(19):2024–35. PubMed PMID: 19454641. Epub 2009/05/21. eng

    Article  CAS  PubMed  Google Scholar 

  13. Ekelund LG, Haskell WL, Johnson JL, Whaley FS, Criqui MH, Sheps DS. Physical fitness as a predictor of cardiovascular mortality in asymptomatic North American men. The lipid research clinics mortality follow-up study. N Engl J Med. 1988;319(21):1379–84. PubMed PMID: 3185648. Epub 1988/11/24. eng

    Article  CAS  PubMed  Google Scholar 

  14. Gupta S, Rohatgi A, Ayers CR, Willis BL, Haskell WL, Khera A, et al. Cardiorespiratory fitness and classification of risk of cardiovascular disease mortality. Circulation. 2011;123(13):1377–83. PubMed PMID: 21422392. Pubmed Central PMCID: PMC3926656. Epub 2011/03/23. eng

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lee DC, Artero EG, Sui X, Blair SN. Mortality trends in the general population: the importance of cardiorespiratory fitness. J Psychopharmacol (Oxford England). 2010;24(4 Suppl):27–35. PubMed PMID: 20923918. Pubmed Central PMCID: PMC2951585. Epub 2010/10/15. eng

    Article  CAS  Google Scholar 

  16. Lavie CJ, Cahalin LP, Chase P, Myers J, Bensimhon D, Peberdy MA, et al. Impact of cardiorespiratory fitness on the obesity paradox in patients with heart failure. Mayo Clin Proc. 2013;88(3):251–8. PubMed PMID: 23489451. Epub 2013/03/16. eng

    Article  PubMed  Google Scholar 

  17. Uretsky S, Supariwala A, Gurram S, Bonda SL, Thota N, Bezwada P, et al. The interaction of exercise ability and body mass index upon long-term outcomes among patients undergoing stress-rest perfusion single-photon emission computed tomography imaging. Am Heart J. 2013;166(1):127–33. PubMed PMID: 23816031. Epub 2013/07/03. eng

    Article  PubMed  Google Scholar 

  18. Noonan V, Dean E. Submaximal exercise testing: clinical application and interpretation. Phys Ther. 2000;80(8):782–807. PubMed PMID: 10911416. Epub 2000/07/27. eng

    CAS  PubMed  Google Scholar 

  19. Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, et al. ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of cardiology/American heart association task force on practice guidelines (committee to update the 1997 exercise testing guidelines). J Am Coll Cardiol. 2002;40(8):1531–40. PubMed PMID: 12392846. Epub 2002/10/24. eng

    Article  PubMed  Google Scholar 

  20. Gulati M, Black HR, Shaw LJ, Arnsdorf MF, Merz CN, Lauer MS, et al. The prognostic value of a nomogram for exercise capacity in women. N Engl J Med. 2005;353(5):468–75. PubMed PMID: 16079370. Epub 2005/08/05. eng

    Article  CAS  PubMed  Google Scholar 

  21. Bouchard C, An P, Rice T, Skinner JS, Wilmore JH, Gagnon J, et al. Familial aggregation of VO(2max) response to exercise training: results from the HERITAGE family study. J Appl Physiol (Bethesda Md: 1985). 1999;87(3):1003–8. PubMed PMID: 10484570. Epub 1999/09/14. eng

    CAS  Google Scholar 

  22. Bouchard C, Rankinen T. Individual differences in response to regular physical activity. Med Sci Sports Exerc. 2001;33(6 Suppl):S446–51. discussion S52-3. PubMed PMID: 11427769. Epub 2001/06/28. eng

    Article  CAS  PubMed  Google Scholar 

  23. Rankinen T, Roth SM, Bray MS, Loos R, Perusse L, Wolfarth B, et al. Advances in exercise, fitness, and performance genomics. Med Sci Sports Exerc. 2010;42(5):835–46. PubMed PMID: 20400881. Epub 2010/04/20. eng

    Article  PubMed  Google Scholar 

  24. Wisloff U, Najjar SM, Ellingsen O, Haram PM, Swoap S, Al-Share Q, et al. Cardiovascular risk factors emerge after artificial selection for low aerobic capacity. Science (New York, NY). 2005;307(5708):418–20. PubMed PMID: 15662013. Epub 2005/01/22. eng

    Article  CAS  Google Scholar 

  25. Fleg JL, Morrell CH, Bos AG, Brant LJ, Talbot LA, Wright JG, et al. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation. 2005;112(5):674–82. PubMed PMID: 16043637. Epub 2005/07/27. eng

    Article  PubMed  Google Scholar 

  26. Jackson AS, Sui X, Hebert JR, Church TS, Blair SN. Role of lifestyle and aging on the longitudinal change in cardiorespiratory fitness. Arch Intern Med. 2009;169(19):1781–7. PubMed PMID: 19858436. Pubmed Central PMCID: PMC3379873. Epub 2009/10/28. eng

    Article  PubMed  PubMed Central  Google Scholar 

  27. American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30(6):975–91. PubMed PMID: 9624661. Epub 1998/06/13. eng

    Google Scholar 

  28. Church TS, Earnest CP, Skinner JS, Blair SN. Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. JAMA. 2007;297(19):2081–91. PubMed PMID: 17507344. Epub 2007/05/18. eng

    Article  CAS  PubMed  Google Scholar 

  29. Duscha BD, Slentz CA, Johnson JL, Houmard JA, Bensimhon DR, Knetzger KJ, et al. Effects of exercise training amount and intensity on peak oxygen consumption in middle-age men and women at risk for cardiovascular disease. Chest. 2005;128(4):2788–93. PubMed PMID: 16236956. Epub 2005/10/21. eng

    Article  PubMed  Google Scholar 

  30. McGavock JM, Hastings JL, Snell PG, McGuire DK, Pacini EL, Levine BD, et al. A forty-year follow-up of the Dallas bed rest and training study: the effect of age on the cardiovascular response to exercise in men. J Gerontol A Biol Sci Med Sci. 2009;64(2):293–9. PubMed PMID: 19196908. Pubmed Central PMCID: PMC2655009. Epub 2009/02/07. eng

    Article  PubMed  Google Scholar 

  31. McGuire DK, Levine BD, Williamson JW, Snell PG, Blomqvist CG, Saltin B, et al. A 30-year follow-up of the Dallas bedrest and training study: I. Effect of age on the cardiovascular response to exercise. Circulation. 2001;104(12):1350–7. PubMed PMID: 11560849. Epub 2001/09/19. eng

    Article  CAS  PubMed  Google Scholar 

  32. McGuire DK, Levine BD, Williamson JW, Snell PG, Blomqvist CG, Saltin B, et al. A 30-year follow-up of the Dallas bedrest and training study: II. Effect of age on cardiovascular adaptation to exercise training. Circulation. 2001;104(12):1358–66. PubMed PMID: 11560850. Epub 2001/09/19. eng

    Article  CAS  PubMed  Google Scholar 

  33. Saltin B, Blomqvist G, Mitchell JH, Johnson RL Jr, Wildenthal K, Chapman CB. Response to exercise after bed rest and after training. Circulation. 1968;38(5 Suppl):VII1–78. PubMed PMID: 5696236. Epub 1968/11/01. eng

    CAS  PubMed  Google Scholar 

  34. Heath GW, Hagberg JM, Ehsani AA, Holloszy JO. A physiological comparison of young and older endurance athletes. J Appl Physiol Respir Environ Exerc Physiol. 1981;51(3):634–40. PubMed PMID: 7327965. Epub 1981/09/01. eng

    CAS  PubMed  Google Scholar 

  35. U.S. Department of Health and Human Services. Physical activity and health: a report of the surgeon general. http://www.cdc.gov/nccdphp/sgr/pdf/sgrfull.pdf. 1996 (Jan 3).

  36. Colberg SR, Albright AL, Blissmer BJ, Braun B, Chasan-Taber L, Fernhall B, et al. Exercise and type 2 diabetes: American college of sports medicine and the American diabetes association: joint position statement. Exercise and type 2 diabetes. Med Sci Sports Exerc. 2010;42(12):2282–303. PubMed PMID: 21084931. Epub 2010/11/19. eng

    Article  PubMed  Google Scholar 

  37. Lee DC, Sui X, Church TS, Lee IM, Blair SN. Associations of cardiorespiratory fitness and obesity with risks of impaired fasting glucose and type 2 diabetes in men. Diabetes Care. 2009;32(2):257–62. PubMed PMID: 18984778. Pubmed Central PMCID: PMC2628690. Epub 2008/11/06. eng

    Article  PubMed  PubMed Central  Google Scholar 

  38. Sui X, Jackson AS, Church TS, Lee DC, O’Connor DP, Liu J, et al. Effects of cardiorespiratory fitness on aging: glucose trajectory in a cohort of healthy men. Ann Epidemiol. 2012;22(9):617–22. PubMed PMID: 22763087. Pubmed Central PMCID: PMC3723333. Epub 2012/07/06. eng

    Article  PubMed  PubMed Central  Google Scholar 

  39. Krogh-Madsen R, Thyfault JP, Broholm C, Mortensen OH, Olsen RH, Mounier R, et al. A 2-wk reduction of ambulatory activity attenuates peripheral insulin sensitivity. J Appl Physiol (Bethesda, Md: 1985). 2010;108(5):1034–40. PubMed PMID: 20044474. Epub 2010/01/02. eng

    Article  CAS  Google Scholar 

  40. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med: J Br Diabet Assoc. 1998;15(7):539–53. PubMed PMID: 9686693. Epub 1998/08/01. eng

    Article  CAS  Google Scholar 

  41. Singh S, Dhingra S, Ramdath DD, Vasdev S, Gill V, Singal PK. Risk factors preceding type 2 diabetes and cardiomyopathy. J Cardiovasc Transl Res. 2010;3(5):580–96. PubMed PMID: 20593256. Epub 2010/07/02. eng

    Article  PubMed  Google Scholar 

  42. Carnethon MR, Gidding SS, Nehgme R, Sidney S, Jacobs DR Jr, Liu K. Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease risk factors. JAMA. 2003;290(23):3092–100. PubMed PMID: 14679272. Epub 2003/12/18. eng

    Article  CAS  PubMed  Google Scholar 

  43. Sui X, Hooker SP, Lee IM, Church TS, Colabianchi N, Lee CD, et al. A prospective study of cardiorespiratory fitness and risk of type 2 diabetes in women. Diabetes Care. 2008;31(3):550–5. PubMed PMID: 18070999. Pubmed Central PMCID: PMC3410433. Epub 2007/12/12. eng

    Article  PubMed  Google Scholar 

  44. Laaksonen DE, Lakka HM, Salonen JT, Niskanen LK, Rauramaa R, Lakka TA. Low levels of leisure-time physical activity and cardiorespiratory fitness predict development of the metabolic syndrome. Diabetes Care. 2002;25(9):1612–8. PubMed PMID: 12196436. Epub 2002/08/28. eng

    Article  PubMed  Google Scholar 

  45. Lessard SJ, Rivas DA, Stephenson EJ, Yaspelkis BB 3rd, Koch LG, Britton SL, et al. Exercise training reverses impaired skeletal muscle metabolism induced by artificial selection for low aerobic capacity. Am J Phys Regul Integr Comp Phys. 2011;300(1):R175–82. PubMed PMID: 21048074. Pubmed Central PMCID: PMC3023282. Epub 2010/11/05. eng

    CAS  Google Scholar 

  46. Rivas DA, Lessard SJ, Saito M, Friedhuber AM, Koch LG, Britton SL, et al. Low intrinsic running capacity is associated with reduced skeletal muscle substrate oxidation and lower mitochondrial content in white skeletal muscle. Am J Phys Regul Integr Comp Phys. 2011;300(4):R835–43. PubMed PMID: 21270346. Pubmed Central PMCID: PMC3075075. Epub 2011/01/29. eng

    CAS  Google Scholar 

  47. Mitchell JM, Anderson KH. Mental health and the labor force participation of older workers. Inq: J Med Care Organ Provision Financing. 1989;26(2):262–71. PubMed PMID: 2526094. Epub 1989/01/01. eng

    CAS  Google Scholar 

  48. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358(6):580–91. PubMed PMID: 18256393. Epub 2008/02/08. eng

    Article  CAS  PubMed  Google Scholar 

  49. Bouchard C, Blair SN, Katzmarzyk PT. Less sitting, more physical activity, or higher fitness? Mayo Clin Proc. 2015;90(11):1533–40. PubMed PMID: 26422244. Epub 2015/10/01. eng

    Article  PubMed  Google Scholar 

  50. Berry JD, Willis B, Gupta S, Barlow CE, Lakoski SG, Khera A, et al. Lifetime risks for cardiovascular disease mortality by cardiorespiratory fitness levels measured at ages 45, 55, and 65 years in men. The Cooper Center longitudinal study. J Am Coll Cardiol. 2011;57(15):1604–10. PubMed PMID: 21474041. Pubmed Central PMCID: PMC3608397. Epub 2011/04/09. eng

    Article  PubMed  PubMed Central  Google Scholar 

  51. Wang CY, Haskell WL, Farrell SW, Lamonte MJ, Blair SN, Curtin LR, et al. Cardiorespiratory fitness levels among US adults 20-49 years of age: findings from the 1999 to 2004 national health and nutrition examination survey. Am J Epidemiol. 2010;171(4):426–35. PubMed PMID: 20080809. Epub 2010/01/19. eng

    Google Scholar 

  52. Nayor M, Vasan RS. Preventing heart failure: the role of physical activity. Curr Opin Cardiol. 2015;30(5):543–50. PubMed PMID: 26154074. Pubmed Central PMCID: PMC4615715. Epub 2015/07/15. eng

    Article  PubMed  PubMed Central  Google Scholar 

  53. Russo I, Frangogiannis NG. Diabetes-associated cardiac fibrosis: cellular effectors, molecular mechanisms and therapeutic opportunities. J Mol Cell Cardiol. 2015;90:84–93. PubMed PMID: 26705059. Epub 2015/12/26. Eng

    Article  PubMed  PubMed Central  Google Scholar 

  54. Berry JD, Pandey A, Gao A, Leonard D, Farzaneh-Far R, Ayers C, et al. Physical fitness and risk for heart failure and coronary artery disease. Circ Heart Fail. 2013;6(4):627–34. PubMed PMID: 23677924. Epub 2013/05/17. eng

    Article  PubMed  PubMed Central  Google Scholar 

  55. Khan H, Kunutsor S, Rauramaa R, Savonen K, Kalogeropoulos AP, Georgiopoulou VV, et al. Cardiorespiratory fitness and risk of heart failure: a population-based follow-up study. Eur J Heart Fail. 2014;16(2):180–8. PubMed PMID: 24464981. Epub 2014/01/28. eng

    Article  CAS  PubMed  Google Scholar 

  56. Arauz-Pacheco C, Parrott MA, Raskin P. Treatment of hypertension in adults with diabetes. Diabetes Care. 2003;26(Suppl 1):S80–2. PubMed PMID: 12502624. Epub 2002/12/28. eng

    PubMed  Google Scholar 

  57. Barlow CE, LaMonte MJ, Fitzgerald SJ, Kampert JB, Perrin JL, Blair SN. Cardiorespiratory fitness is an independent predictor of hypertension incidence among initially normotensive healthy women. Am J Epidemiol. 2006;163(2):142–50. PubMed PMID: 16293717. Epub 2005/11/19. eng

    Article  PubMed  Google Scholar 

  58. Rankinen T, Church TS, Rice T, Bouchard C, Blair SN. Cardiorespiratory fitness, BMI, and risk of hypertension: the HYPGENE study. Med Sci Sports Exerc. 2007;39(10):1687–92. PubMed PMID: 17909393. Epub 2007/10/03. eng

    Article  PubMed  Google Scholar 

  59. Stevens J, Cai J, Evenson KR, Thomas R. Fitness and fatness as predictors of mortality from all causes and from cardiovascular disease in men and women in the lipid research clinics study. Am J Epidemiol. 2002;156(9):832–41. PubMed PMID: 12397001. Epub 2002/10/25. eng

    Article  PubMed  Google Scholar 

  60. Wei M, Kampert JB, Barlow CE, Nichaman MZ, Gibbons LW, Paffenbarger RS Jr, et al. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA. 1999;282(16):1547–53. PubMed PMID: 10546694. Epub 1999/11/05. eng

    Article  CAS  PubMed  Google Scholar 

  61. Wong SL, Katzmarzyk P, Nichaman MZ, Church TS, Blair SN, Ross R. Cardiorespiratory fitness is associated with lower abdominal fat independent of body mass index. Med Sci Sports Exerc. 2004;36(2):286–91. PubMed PMID: 14767252. Epub 2004/02/10. eng

    Article  PubMed  Google Scholar 

  62. Gruberg L, Weissman NJ, Waksman R, Fuchs S, Deible R, Pinnow EE, et al. The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention: the obesity paradox? J Am Coll Cardiol. 2002;39(4):578–84. PubMed PMID: 11849854. Epub 2002/02/19. eng

    Article  PubMed  Google Scholar 

  63. Goel K, Thomas RJ, Squires RW, Coutinho T, Trejo-Gutierrez JF, Somers VK, et al. Combined effect of cardiorespiratory fitness and adiposity on mortality in patients with coronary artery disease. Am Heart J. 2011;161(3):590–7. PubMed PMID: 21392616. Epub 2011/03/12. eng

    Article  PubMed  Google Scholar 

  64. McAuley P, Myers J, Abella J, Froelicher V. Body mass, fitness and survival in veteran patients: another obesity paradox? Am J Med. 2007;120(6):518–24. PubMed PMID: 17524754. Epub 2007/05/26. eng

    Article  PubMed  Google Scholar 

  65. McAuley PA, Artero EG, Sui X, Lee DC, Church TS, Lavie CJ, et al. The obesity paradox, cardiorespiratory fitness, and coronary heart disease. Mayo Clin Proc. 2012;87(5):443–51. PubMed PMID: 22503065. Pubmed Central PMCID: PMC3538467. Epub 2012/04/17. eng

    Article  PubMed  PubMed Central  Google Scholar 

  66. McAuley PA, Kokkinos PF, Oliveira RB, Emerson BT, Myers JN. Obesity paradox and cardiorespiratory fitness in 12,417 male veterans aged 40 to 70 years. Mayo Clin Proc. 2010;85(2):115–21. PubMed PMID: 20118386. Pubmed Central PMCID: PMC2813818. Epub 2010/02/02. eng

    Article  PubMed  PubMed Central  Google Scholar 

  67. Sui X, Laditka JN, Hardin JW, Blair SN. Estimated functional capacity predicts mortality in older adults. J Am Geriatr Soc. 2007;55(12):1940–7. PubMed PMID: 17979958. Pubmed Central PMCID: PMC3410432. Epub 2007/11/06. eng

    Article  PubMed  PubMed Central  Google Scholar 

  68. Hamer M, O'Donovan G. Cardiorespiratory fitness and metabolic risk factors in obesity. Curr Opin Lipidol. 2010;21(1):1–7. PubMed PMID: 19770655. Epub 2009/09/23. eng

    Article  CAS  PubMed  Google Scholar 

  69. Leite SA, Monk AM, Upham PA, Bergenstal RM. Low cardiorespiratory fitness in people at risk for type 2 diabetes: early marker for insulin resistance. Diabetol Metab Syndr. 2009;1(1):8. PubMed PMID: 19825145. Pubmed Central PMCID: PMC2762992. Epub 2009/10/15. eng

    Article  PubMed  PubMed Central  Google Scholar 

  70. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24(4):683–9. PubMed PMID: 11315831. Epub 2001/04/24. eng

    Article  CAS  PubMed  Google Scholar 

  71. Arsenault BJ, Lachance D, Lemieux I, Almeras N, Tremblay A, Bouchard C, et al. Visceral adipose tissue accumulation, cardiorespiratory fitness, and features of the metabolic syndrome. Arch Intern Med. 2007;167(14):1518–25. PubMed PMID: 17646606. Epub 2007/07/25. eng

    Article  CAS  PubMed  Google Scholar 

  72. Konig D, Vaisanen SB, Bouchard C, Halle M, Lakka TA, Baumstark MW, et al. Cardiorespiratory fitness modifies the association between dietary fat intake and plasma fatty acids. Eur J Clin Nutr. 2003;57(7):810–5. PubMed PMID: 12821879. Epub 2003/06/25. eng

    Article  CAS  PubMed  Google Scholar 

  73. DiPietro L, Kohl HW 3rd, Barlow CE, Blair SN. Improvements in cardiorespiratory fitness attenuate age-related weight gain in healthy men and women: the aerobics Center longitudinal study. Int J Obes Related Metab Dis: J Int Assoc Stud Obes. 1998;22(1):55–62. PubMed PMID: 9481600. Epub 1998/03/03. eng

    Article  CAS  Google Scholar 

  74. Aronson D, Sheikh-Ahmad M, Avizohar O, Kerner A, Sella R, Bartha P, et al. C-reactive protein is inversely related to physical fitness in middle-aged subjects. Atherosclerosis. 2004;176(1):173–9. PubMed PMID: 15306191. Epub 2004/08/13. eng

    Article  CAS  PubMed  Google Scholar 

  75. Church TS, Barlow CE, Earnest CP, Kampert JB, Priest EL, Blair SN. Associations between cardiorespiratory fitness and C-reactive protein in men. Arterioscler Thromb Vasc Biol. 2002;22(11):1869–76. PubMed PMID: 12426218. Epub 2002/11/12. eng

    Article  CAS  PubMed  Google Scholar 

  76. Williams MJ, Milne BJ, Hancox RJ, Poulton R. C-reactive protein and cardiorespiratory fitness in young adults. Eur J Cardiovasc Prev Rehabil: Off J Eur Soc Cardiol Work Group Epidemiol Prev Card Rehabil Exerc Physiol. 2005;12(3):216–20. PubMed PMID: 15942418. Epub 2005/06/09. eng

    Article  Google Scholar 

  77. Pialoux V, Brown AD, Leigh R, Friedenreich CM, Poulin MJ. Effect of cardiorespiratory fitness on vascular regulation and oxidative stress in postmenopausal women. Hypertension. 2009;54(5):1014–20. PubMed PMID: 19786647. Epub 2009/09/30. eng

    Article  CAS  PubMed  Google Scholar 

  78. Mora S, Cook N, Buring JE, Ridker PM, Lee IM. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation. 2007;116(19):2110–8. PubMed PMID: 17967770. Pubmed Central PMCID: PMC2117381. Epub 2007/10/31. eng

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Joyner MJ, Green DJ. Exercise protects the cardiovascular system: effects beyond traditional risk factors. J Physiol. 2009;587(Pt 23):5551–8. PubMed PMID: 19736305. Pubmed Central PMCID: PMC2805367. Epub 2009/09/09. eng

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Ogden CL, Yanovski SZ, Carroll MD, Flegal KM. The epidemiology of obesity. Gastroenterology. 2007;132(6):2087–102. PubMed PMID: 17498505. Epub 2007/05/15. eng

    Article  PubMed  Google Scholar 

  81. Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF. Lifetime risk for diabetes mellitus in the United States. JAMA. 2003;290(14):1884–90. PubMed PMID: 14532317. Epub 2003/10/09. eng

    Article  CAS  PubMed  Google Scholar 

  82. Kokkinos P, Myers J. Exercise and physical activity: clinical outcomes and applications. Circulation. 2010;122(16):1637–48. PubMed PMID: 20956238. Epub 2010/10/20. eng

    Article  PubMed  Google Scholar 

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Acknowledgments

GNR was funded by AHA 16PRE2715005 and the University of Missouri Life Center. Professor John O. Holloszy initiated many of the concepts described in the review during his training of FWB.

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Authors and Affiliations

  1. Department of Biomedical Sciences, University of Missouri, 1600 East Rollins St, Columbia, MO, 65211, USA

    Gregory N. Ruegsegger PhD

  2. Biomedical Sciences, University of Missouri, 1600 East Rollins St, Columbia, MO, 65211, USA

    Frank W. Booth PhD

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  1. Gregory N. Ruegsegger PhD
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  2. Frank W. Booth PhD
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Correspondence to Gregory N. Ruegsegger PhD .

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Editors and Affiliations

  1. Department of Medicine, Division of Endocrinology Metabolism and Diabetes and Center for Women’s Health Research, University of Colorado, Aurora, Colorado, USA

    Jane E. B. Reusch, MD

  2. Department of Medicine, Division of General Internal Medicine and Center for Women’s Health Research, University of Colorado School of Medicine, Aurora, Colorado, USA

    Judith G. Regensteiner, PhD, MA, BA

  3. Clinical and Research Exercise Physiology, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

    Kerry J. Stewart, Ed.D., FAHA, MAACVPR, FACSM

  4. Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

    Aristidis Veves, MD, DSc

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Ruegsegger, G.N., Booth, F.W. (2018). State of Fitness: Overview of the Clinical Consequences of Low Cardiorespiratory Fitness. In: Reusch, MD, J., Regensteiner, PhD, MA, BA, J., Stewart, Ed.D., FAHA, MAACVPR, FACSM , K., Veves, MD, DSc, A. (eds) Diabetes and Exercise. Contemporary Diabetes. Humana Press, Cham. https://doi.org/10.1007/978-3-319-61013-9_1

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  • DOI: https://doi.org/10.1007/978-3-319-61013-9_1

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