Pontus Henriksson, PhD; Hanna Henriksson, PhD; Per Tynelius, MSc; Daniel Berglind, PhD; Marie Löf, PhD; I-Min Lee, MBBS, ScD; Eric J. Shiroma, ScD; Francisco B. Ortega, PhD
Grant Support: This study was supported by a grant from the Karolinska Institutet to Dr. Ortega (2018-02043). Dr. Pontus Henriksson was supported by grants from the Henning and Johan Throne-Holst Foundation and the Strategic Research Area Health Care Science, Karolinska Institutet/Umeå University. Dr. Hanna Henriksson was supported by grants from the Swedish Society of Medicine and the County Council of Östergötland, Sweden. Dr. Shiroma was supported by the intramural research program at the National Institute on Aging. Dr. Ortega was supported by a visiting grant from the Henning and Johan Throne-Holst Foundation and by grants from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement no. 667302; the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence, Unit of Excellence on Exercise and Health; the SAMID III network, RETICS, funded by the PN I+D+I 2017–2021 (Spain), ISCIII Sub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (ref. RD16/0022); and the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI).
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1861.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Proctor & Gamble, Pfizer, and Johnson & Johnson.
Reproducible Research Statement:Study protocol, statistical code, and data set: Not available.
Corresponding Author: Pontus Henriksson, PhD, Department of Biosciences and Nutrition, Karolinska Institutet, SE-14183 Huddinge, Sweden; e-mail, pontus.henriksson@ki.se.
Current Author Addresses: Dr. Pontus Henriksson and Dr. Löf: Department of Biosciences and Nutrition, Karolinska Institutet, SE-14183 Huddinge, Sweden.
Dr. Hanna Henriksson: Department of Medicine and Health, Linköping University, SE-58183 Linköping, Sweden.
Mr. Tynelius and Dr. Berglind: Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, SE-11365 Stockholm, Sweden.
Dr. Lee: Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue East, Boston, MA 02215.
Dr. Shiroma: Laboratory of Epidemiology and Population Science, National Institute on Aging, 7201 Wisconsin Avenue, Room 2N300, Bethesda, MD 20814.
Dr. Ortega: Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Ctra. Alfacar s/n, Granada 18071, Spain.
Author Contributions: Conception and design: P. Henriksson, P. Tynelius, D. Berglind, M. Löf, F.B. Ortega.
Analysis and interpretation of the data: P. Henriksson, H. Henriksson, M. Löf, I.M. Lee, E.J. Shiroma, F.B. Ortega.
Drafting of the article: P. Henriksson, H. Henriksson, M. Löf, E.J. Shiroma.
Critical revision of the article for important intellectual content: P. Henriksson, H. Henriksson, P. Tynelius, D. Berglind, M. Löf, I.M. Lee, E.J. Shiroma, F.B. Ortega.
Final approval of the article: P. Henriksson, H. Henriksson, P. Tynelius, D. Berglind, M. Löf, I.M. Lee, E.J. Shiroma, F.B. Ortega.
Statistical expertise: P. Tynelius, E.J. Shiroma, F.B. Ortega.
Obtaining of funding: D. Berglind, F.B. Ortega.
Administrative, technical, or logistic support: F.B. Ortega.
Collection and assembly of data: P. Tynelius, D. Berglind.
Low physical fitness, obesity, and the combination of the two in adolescence may be related to risk for disability in adulthood, but this has rarely been studied.
To examine individual and combined associations of cardiorespiratory fitness and obesity in male adolescents with later receipt of a disability pension due to all and specific causes.
Population-based cohort study.
Sweden.
1 079 128 Swedish adolescents aged 16 to 19 years who were conscripted into the military between 1972 and 1994.
Cardiorespiratory fitness and body mass index (BMI) were measured at conscription and were related to information on later receipt of a disability pension obtained from the Social Insurance Agency.
Over a median follow-up of 28.3 years, 54 304 men were granted a disability pension. Low cardiorespiratory fitness was strongly associated with later receipt of a disability pension due to all causes (hazard ratio, 3.74 [95% CI, 3.55 to 3.95] for lowest vs. highest fitness decile) and specific causes (psychiatric, musculoskeletal, injuries, nervous system, circulatory, and tumors). Obesity was associated with greater risk for receipt of a disability pension due to all and specific causes, with the greatest risks observed for class II and III obesity. Compared with being unfit, being moderately or highly fit was associated with attenuated risk for receipt of a disability pension across BMI categories.
The cohort did not include women, had data on smoking and alcohol intake only in a subsample, and lacked repeated measures of exposures and covariates.
Low cardiorespiratory fitness, obesity, and the combination of the two were strongly associated with later chronic disability due to a wide range of diseases and causes. Although additional well-designed studies are required, these findings support the importance of high cardiorespiratory fitness and healthy body weight during adolescence to prevent later chronic disease.
Karolinska Institutet.
Henriksson P, Henriksson H, Tynelius P, Berglind D, Löf M, Lee I, et al. Fitness and Body Mass Index During Adolescence and Disability Later in Life: A Cohort Study. Ann Intern Med. ;170:230–239. doi: 10.7326/M18-1861
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© 2019
Published: Ann Intern Med. 2019;170(4):230-239.
DOI: 10.7326/M18-1861
Published at www.annals.org on 12 February 2019
Obesity, Tobacco, Alcohol, and Other Substance Abuse.
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