TY - JOUR
T1 - Fitness change effects on midlife metabolic outcomes
AU - Chow, Lisa
AU - Eberly, Lynn E.
AU - Austin, Erin
AU - Carnethon, Mercedes
AU - Bouchard, Claude
AU - Sternfeld, Barbara
AU - Zhu, Na
AU - Sidney, Steve
AU - Schreiner, Pamela
N1 - Publisher Copyright:
© 2014 by the American College of Sports Medicine.
PY - 2015/5/21
Y1 - 2015/5/21
N2 - Purpose: Fitness decline, high body mass index (BMI), and insulin resistance (IR) are associated with worsening cardiometabolic risk factors prospectively; modification of the fitness change effect by BMI and IR remains unknown. Methods: Participants from the Coronary Artery Risk Development in Young Adults study without diabetes at year 0 (Y0) (n = 2048, 43.4% men; mean age, 25 yr) had fitness quantified by treadmill at Y0 and Y20. Y0 BMI was normal (nBMI G25 kg.m2) or high (hBMI Q25 kg.m2). Y0 IR status was insulin sensitive (IS) (homeostatic model assessment IR G1.84 (75th percentile)) or insulin resistant (IR) (homeostatic model assessment IR Q1.84). Four groups were established: nBMI/IS, hBMI/IS, nBMI/IR, and hBMI/IR. Y0 fitness was low (G33rd percentile for sex) or average high (Q33rd percentile for sex). Fitness change (treadmill time: Y20-Y0) was maintained (increase or decline e20th percentile for sex) or decreased (decline 920th percentile for sex). The outcomes were incident diabetes and percentage change over 25 yr in weight, waist girth, blood pressure, and lipid profile. Analysis was by multiple linear regression and proportional hazards regression with adjustment for individual characteristics. Results: Maintained fitness after 20 yr was associated with greater increase in HDL cholesterol and less increase in weight, waist girth, blood pressure, and triglycerides than decreased fitness, similarly for the groups defined by BMI and IR. Maintained fitness reduced the rate of incident diabetes in IS but not IR participants. Conclusions: Maintained fitness after 20 yr was associated with more favorable middle-age cardiometabolic risk factors than decreased fitness; this benefit might be blunted by baseline IR.
AB - Purpose: Fitness decline, high body mass index (BMI), and insulin resistance (IR) are associated with worsening cardiometabolic risk factors prospectively; modification of the fitness change effect by BMI and IR remains unknown. Methods: Participants from the Coronary Artery Risk Development in Young Adults study without diabetes at year 0 (Y0) (n = 2048, 43.4% men; mean age, 25 yr) had fitness quantified by treadmill at Y0 and Y20. Y0 BMI was normal (nBMI G25 kg.m2) or high (hBMI Q25 kg.m2). Y0 IR status was insulin sensitive (IS) (homeostatic model assessment IR G1.84 (75th percentile)) or insulin resistant (IR) (homeostatic model assessment IR Q1.84). Four groups were established: nBMI/IS, hBMI/IS, nBMI/IR, and hBMI/IR. Y0 fitness was low (G33rd percentile for sex) or average high (Q33rd percentile for sex). Fitness change (treadmill time: Y20-Y0) was maintained (increase or decline e20th percentile for sex) or decreased (decline 920th percentile for sex). The outcomes were incident diabetes and percentage change over 25 yr in weight, waist girth, blood pressure, and lipid profile. Analysis was by multiple linear regression and proportional hazards regression with adjustment for individual characteristics. Results: Maintained fitness after 20 yr was associated with greater increase in HDL cholesterol and less increase in weight, waist girth, blood pressure, and triglycerides than decreased fitness, similarly for the groups defined by BMI and IR. Maintained fitness reduced the rate of incident diabetes in IS but not IR participants. Conclusions: Maintained fitness after 20 yr was associated with more favorable middle-age cardiometabolic risk factors than decreased fitness; this benefit might be blunted by baseline IR.
KW - Body Mass Index
KW - Cardiometabolic Risk Factors
KW - Cardiorespiratory Fitness
KW - Insulin Resistance
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U2 - 10.1249/MSS.0000000000000481
DO - 10.1249/MSS.0000000000000481
M3 - Article
C2 - 25160846
AN - SCOPUS:84928111922
SN - 0195-9131
VL - 47
SP - 967
EP - 973
JO - Medicine and science in sports and exercise
JF - Medicine and science in sports and exercise
IS - 5
ER -