Abstract
Objective:
The objective of this study was to examine whether childhood cardiorespiratory fitness attenuates or modifies the long-term cardiometabolic risks associated with childhood obesity.
Design and Methods:
The study consisted of a 20-year follow-up of 1792 adults who participated in the 1985 Australian Schools Health and Fitness Survey when they were 7–15 years of age. Baseline measures included a 1.6-km run to assess cardiorespiratory fitness and waist circumference to assess abdominal adiposity. At follow-up, participants attended study clinics where indicators of Metabolic Syndrome (MetS) (waist circumference, blood pressure, fasting blood glucose and lipids) were measured and cardiorespiratory fitness was reassessed using a submaximal graded exercise test.
Results:
Both high waist circumference and low cardiorespiratory fitness in childhood were significant independent predictors of MetS in early adulthood. The mutually adjusted relative risk of adult MetS was 3.00 (95% confidence interval: 1.85–4.89) for children in the highest (vs lowest) third of waist circumference and 0.64 (95% confidence interval: 0.43–0.96) for children with high (vs low) cardiorespiratory fitness. No significant interaction between waist circumference and fitness was observed, with higher levels of childhood fitness associated with lower risks of adult MetS among those with either low or high childhood waist circumference values. Participants who had both high waist circumference and low cardiorespiratory fitness in childhood were 8.5 times more likely to have MetS in adulthood than those who had low waist circumference and high cardiorespiratory fitness in childhood. Regardless of childhood obesity status, participants with low childhood fitness who increased their relative fitness by adulthood had a substantially lower prevalence of MetS than those who remained low fit.
Conclusions:
Childhood waist circumference and cardiorespiratory fitness are both strongly associated with cardiometabolic health in later life. Higher levels of cardiorespiratory fitness substantially reduce the risk of adult MetS, even among those with abdominal obesity in childhood.
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Acknowledgements
The Childhood Determinants of Adult Health study was funded by grants from the Australian National Health and Medical Research Council, the Australian National Heart Foundation, the Tasmanian Community Fund, and Veolia Environmental Services. Financial support was also provided by Sanitarium Health Food Company, ASICS Oceania, and Target Australia. Dr Schmidt was supported by a National Heart Foundation of Australia postdoctoral fellowship. We gratefully acknowledge the contributions of the Childhood Determinants of Adult Health Study’s project manager, Marita Dalton, all other project staff and volunteers, and the study participants.
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Schmidt, M., Magnussen, C., Rees, E. et al. Childhood fitness reduces the long-term cardiometabolic risks associated with childhood obesity. Int J Obes 40, 1134–1140 (2016). https://doi.org/10.1038/ijo.2016.61
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DOI: https://doi.org/10.1038/ijo.2016.61
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